Depressive disorders in children can have far-reaching effects on children's daily functioning and interpersonal relationships. Although ups and downs are a normal part of life, when moods impact functioning, or are frequent or long-lasting, they may be a sign of something more serious.
Major Depression
Major depression occurs in 2 percent of children according to the pharmaceutical giant Merck. While children exhibit many of the same symptoms common in adult depression, including sadness, apathy, social withdrawal, and trouble sleeping and eating, there are a few symptoms unique to children.
Children are often unable to communicate inner feeling or moods, and instead act out at school and at home. Children with major depression disorder may suffer academically in school, or may engage in delinquent acts. Rather than sad, children are more apt to appear irritable and aggressive. In older children, extreme weight loss or anorexia, nightmares, and suicidal thoughts may also be an indication of major depression. Successful treatment of major depression often includes a combination of antidepressants and behavioral therapy.
Early Onset Bipolar Disorder
Also known as manic depression, early onset bipolar disorder is rare in children. This disease is characterized by unusual and often extreme shifts in mood, energy, and functioning from extreme sadness or irritability to a euphoric high. Evidence suggests, according to The National Institute of Mental Health, that when bipolar disease presents during childhood it is likely to be a more severe form than when the disease manifests later in adolescence or adulthood. According to the NIMH, children with anxiety disorders are more likely to develop bipolar disorder, and sometimes early-onset bipolar disorder occurs with attention deficit hyperactivity disorder.
During a manic episode, children with bipolar disorder often have increased energy, overly large egos, and seem to need little sleep for days. They may talk excessively fast and change topics rapidly without interruption. In addition, bipolar children often exhibit extreme ADHD-like symptoms coupled with excessive temper outbursts and mood shifts. A medical evaluation is critical because many of the medications used to treat ADHD may worsen manic symptoms. In addition to mood stabilizers, treatment also includes intense family and individual therapy.
It is important to note that some reputable sources in the medical community, including Anne Duffy of the McGill University Department of Psychiatry who published a paper in the "Canadian Journal of Psychiatry" in July 2007, disagree with the notion that bipolar disorder exists in children. Based on reviews of past studies, Duffy concludes that early-onset bipolar disease is misdiagnosed, and that the disease does not manifest until adolescence.
Dysthymia
Also known as dysthymic disorder, dysthymia is similar to major depressive disorder except that the same symptoms are less severe and more chronic. According to Children's Hospital in Boston, dysthymia occurs in approximately 1 percent of children, and occurs in twice as many girls as boys. Children must have a depressed mood that lasts for at least one year to receive a dysthymia diagnosis.
