Depression in children and adolescents is underdiagnosed and undertreated. It is fairly common and affects almost 3 percent of children younger than 13 and more than 5 percent of adolescents ages 13 to 18. When depression is not recognized, it can affect a child’s engagement in school, relationships and their emotional development. Thankfully, there are tools to help parents and caregivers recognize depression, and there is help.
Typically, a child will not say they are “sad” or “depressed” when they develop depression; instead, he or she may appear irritable. A 5-year-old child may be described by teachers as “hostile.” It can be a challenge to determine whether this is a result of common developmental growth or a sign of depression. It is more likely to be depression if there are other family members who suffer from depression, the child has a chronic disease, child has changes in sleep (either too much or too little), or he or she starts to negatively refer to him or herself. Sometimes a child will begin to use drugs or overeat as a way to try to feel better.
Adults in a child’s life — including parents, teachers, coaches, religious leaders and caregivers — can help spot the early warning signs of depression. The Children’s Depression Inventory is one questionnaire that parents can use. Health care providers have other questionnaires that can help them confirm a diagnosis.
One serious risk associated with untreated major depression is suicide. Our goal is to help a child or adolescent through the episode of depression and prevent suicide. It is important for the community of caregivers — health care providers, parents, caregivers and teachers — to be aware of the risk of suicide in children and adolescents.
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According to the Centers for Disease Control and Prevention, about one in 100,000 children ages 10 to 14 will commit suicide. This increases to almost seven per 100,000 adolescents ages 15 to 19. There are many resources to help a child through a bout of depression, including a health care provider, hospital emergency department, Centre County Can Help (800-643-5432), the American Foundation for Suicide Prevention (800-273-8255) and the Jana Marie Foundation (janamariefoundation.org).
Depression usually is treated with counseling (or psychotherapy) and may also include medication. Parents sometimes worry about the side effects and risks of taking medicines; they should discuss these concerns with the child’s health care providers. In family medicine, we discuss the risks, benefits and options for treatment. We may consult with psychotherapists and psychiatrists about the right course of treatment.
Not every child or adolescent who is “irritable” or “sad” has depression. There are many other possible causes. Still, it is important to talk with your child if a parent sees signs that he or she is depressed.
The next step may be to share concerns with a physician. The focus needs to be on the child and helping him or her get the right diagnosis and best treatment.
We all want to help our children grow up and live long, healthy lives. When we work together — parents and caregivers, health care providers and mental health workers — we can help reach that goal.