Depression in Children: What is Depression?
Depression can strike a child at any age. A mood disorder, depression is characterized by a persistent sad or empty feeling, irritability, and a loss of interest in everyday activities. Unlike normal sadness or grieving, most bouts of depression last for weeks, months, or even years. A smaller number of children and adolescent suffer from bipolar disorder-bouts of depression interspersed with periods of elevated (manic) mood (bipolar disorder).
Although depression is usually not considered life-threatening, it can lead to thoughts of and attempts at suicide.
Persistent feelings of sadness, apathy, or hopelessness lasting more than two weeks.
Diminished interest in most daily activities, particularly pleasurable ones.
Decreased appetite and subsequent weight loss; increased appetite and weight gain.
Lack of sleep (insomnia ), frequent awakening throughout the night, or conversely, an increased need for sleep.
Anxiety; diminished ability to think or concentrate.
Because there are no reliable laboratory tests to diagnose depression, physical examination and psychological evaluation are essential.
Expression of either of the first two symptoms of depression (see Symptoms box), in conjunction with other symptoms, for a period of two or more consecutive weeks.
A positive family history of depression or a prior depressive episode helps establish the diagnosis.
Psychotherapy is as effective as drug treatment in mild cases. Psychotherapy may also be used in conjunction with drug therapy.
Antidepressant medications, such as selective serotonin reuptake inhibitors (SSRIs), are mainstays of treatment.
Exposure to bright light, known as light therapy, may be effective, particularly when depression is related to seasonal changes (seasonal affective disorder).
In secondary depression, the underlying cause is addressed, although antidepressant therapy may also be prescribed.