It is common for children and adolescents to feel "down," discouraged, sad or angry from time to time. These feelings are often appropriate responses to upsetting events. However, sometimes these feelings do not go away and begin to interfere with the child or adolescent's day to day functioning and enjoyment of usual activities.
While depression has long been recognized as a serious condition for adults, we are now increasingly aware of how depression in children and adolescents can impact their development and functioning. In the Cleveland Clinic's Section of Child and Adolescent Psychiatry, our multidisciplinary team of specialists can provide the relief needed.
Signs of depression
Depression in children and adolescents is characterized by one or more of the following signs or symptoms which do not seem to improve over time:
- Persistent sad, anxious, irritable mood
- Feelings of hopelessness, helplessness or worthlessness
- Constant decrease in energy (fatigue)
- An increase or decrease in sleep or eating routines
- Less enjoyment from usual social activities
- Suicidal thinking or behavior
- Difficulty concentrating
- Physical complaints (such as stomach aches, headaches) that do not respond to treatment
- Reduced ability to function normally during events and activities at home or with friends, in school, extracurricular activities, and in other hobbies or interests
These symptoms can be triggered by traumatic events or unexpected changes such as the loss of a loved one, moving, parents' divorce, the arrival of a new sibling and other events. When the signs of depression last up to two weeks, an evaluation with the child's health care provider is recommended to make sure there is no physical illness. In addition, a consultation with a mental health professional who specializes in treating children may also be recommended.
What causes depression?
Depression is caused by a combination of factors that relate to a person's physical health, life events, heredity, environment, inborn vulnerability and biochemical disturbance. Depression is not a passing mood, nor is it a condition that will go away without proper treatment. Although depression can be triggered by upsetting life events, many children and adolescents are able to manage these situations without suffering any lasting effects. Others, however, are more easily overwhelmed and have trouble coping.
What are the different kinds of depression?
There are many forms of depression that vary in intensity and endurance.
Major depression is marked by the intensity of several depressive symptoms occurring over a two-week period. Major depression interferes with a person’s ability to enjoy once pleasurable activities.
Dysthymia is a milder but longer lasting form of depression characterized by a negative, pessimistic outlook.
Bipolar disorder is a form of depression characterized by mood swings where both “highs” and “lows” are experienced. This is rarely seen in children under 12 and usually emerges in adolescence and early adulthood.
Can depression be helped?
Yes. Depression is a medical disorder that can be successfully treated by a combined treatment approach using medication, psychotherapy and/or family intervention based on the individual needs of the child or adolescent. Often children and adolescents do not initiate the help-seeking process and need the support and direction of their families, teachers and friends.
How we can help
The first step to successful treatment begins with a comprehensive psychiatric evaluation of your child. A psychiatric evaluation includes:
- A review of current problems and concerns
- A thorough review of your child’s development and background
- Past medical and psychiatric history
- Important family background
- A mental status evaluation
Parents and guardians are included in the evaluation process in order to obtain background information and history as well as to participate in the treatment planning. The role of parents and guardians in their child's treatment is essential.
As part of the evaluation, the psychiatrist will discuss an individualized treatment plan for your child. The treatment plan may include:
- Individual therapy for your child
- Family therapy
- Parent education and support
The role of parents and guardians in their child’s treatment is essential.
What are the risks if I don’t get help?
When a person has suicidal thoughts or behavior, there are real life and death concerns – always seek professional help immediately. If the child is destructive of self or others, it is also important to seek help immediately. More frequently, depression can have negative consequences on your child's development and self-esteem. Depression can cause relationship difficulties and poor school performance. When left untreated, depression can become worse and cause untold suffering and possibly lead to more serious health problems.
Obtaining help for your child
Sometimes, a child or adolescent's behavior can be confused with the normal emotional ups and downs of growing up.
Please call 216.444.5997 or 800.223.2273 ext. 45997 to consult with a health care provider about your child's situation. If you're uncertain about whether or not an assessment is appropriate, a health care professional at this number can talk to you about your concerns and help you decide what to do.