Major depressive disorder is estimated to occur up to 8.3% of children and adolescents. These children and adolescents are likely to have increased family problems, academic failure, substance abuse, truancy, and suicidal behavior. If untreated children and adolescents are at risk for life long mental health problems.

Who is at risk?

• Children under stress
• Children who have experienced a loss
• Children who have attention or learning problems
• Children with conduct or anxiety disorders are at a higher risk for depression.
• Children who have parents who have a history of depression; Depression also tends to run in families.
• Children who have been abused or neglected
• Children who have experienced an emotional trauma
• Children in families that are going through something stressful

What to look for:

Children with depression may appear sad most days, no longer enjoy activities they previously liked, or they may frequently appear agitated, hyper or irritable. Depressed children may also frequently complain of physical problems such as headaches and stomachaches and often are absent from school frequently or show poor performance in academic subjects. Children who have depression may appear bored or low in energy and frequently have problems concentrating. A major change in eating or sleeping patterns is a frequent sign of depression in children and adolescents. It is important to understand that many children who are depressed will not present as sad and gloomy and are misdiagnosed or completely missed. In younger children it is often the case that they are disruptive and acting-out, but the true cause of the problems is depression. In addition, preschool and young school age children often do not have the vocabulary or understanding of their feelings to express that they are depressed. Instead you may see regressed behavior, disruptive behavior, poor concentration, and low frustration tolerance. Thus, it is important to look for these symptoms in conjunction with any behavior or attention problems.

• Frequent sadness, tearfulness, crying
• Hopelessness
• Decreased interest in activities; or inability to enjoy previously favorite activities
• Persistent boredom; low energy
• Social isolation, poor communication
• Low self esteem and guilt
• Extreme sensitivity to rejection or failure
• Increased irritability, anger, or hostility
• Difficulty with relationships
• Frequent complaints of physical illnesses such as headaches and stomachaches
• Frequent absences from school or poor performance in school
• Poor concentration
• A major change in eating and/or sleeping patterns
• Talk of or efforts to run away from home
• Thoughts or expressions of suicide or self destructive behavior

In teenagers symptoms of depression look more like those seen in adults. However, conduct problems may also be a form of acting-out and reflect and underlying depression. Drug and alcohol use is also very common in depressed teenagers, and used as a way to avoid painful feelings. Adolescents who are depressed are also at great risk for suicide with boys having the highest suicide rate which is 5 times that of girls, although girls lave a higher attempted suicide rate.

Thus, depression in our youth is a serious mental health illness that needs to be addressed and treated.