According to the Centers for Disease Control and Prevention, 4.3 percent of adolescents between the ages of 12 and 17 experience depression. As reported by Robert Weis in "Introduction to Abnormal Child and Adolescent Psychology," only 1 to 2 percent of children experience depression, while between 3 and 7 percent of adolescents do. The accurate diagnosis of this disorder in children has become increasingly important, as the National Institute of Mental Health reports that depression in childhood is more likely to carry over into adulthood. The mood changes that occur with depression may be difficult to differentiate from normal changes in children and adolescents.
Criteria for Depression in Children
The criteria stated by the "Diagnostic and Statistical Manual of Mental Disorders" for the diagnosis of major depressive disorder require the presence of either depressed mood or loss of interest for the past two weeks along with five other symptoms. These are depressed mood, loss of interest in activities, changes in weight, trouble sleeping, feeling sluggish or restless, lack of energy, trouble concentrating, feeling worthless or guilty, and suicidal thoughts. In children, the criteria for depressed mood may be experienced as irritable mood instead.
Difference from Adults
One difficulty in diagnosing children with depression is that their presentation of symptoms tends to be different than adults. As discussed by Robert Weis in "Introduction to Abnormal Child and Adolescent Psychology," children with depression often seem more irritable than sad. They may complain of stomachaches and headaches and get easily angry or annoyed with others. Changes in weight may be less noticeable in children because they may not have drastic losses, but instead fail to grow at a normal rate for their age. Weis reports that children are more likely to have trouble falling asleep, whereas adults may sleep too much. Children are more likely to be restless and fidgeting, whereas adults are sluggish. Weis notes that lack of energy in children is more evident in their refusal to do chores or other tasks than actually saying they are tired. Difficulty concentrating is often apparent in schoolwork and changes in grades.
Comorbid Problems
As described by Weis, depression in children often co-occurs with other disorders, at times, making it difficult to notice the depressive symptoms. He notes that as many as 50 percent of children with depression also have an anxiety disorder, with the most common being social phobia. Depression may also occur in children with ADHD. Similar symptoms, including difficulty concentrating, difficulties completing schoolwork, and changes in grades, make it difficult to determine what is causing the symptoms. Weis also reports that children with behavior problems like conduct disorder or oppositional defiant disorder may have depression. These symptoms may not be easily detected in light of disruptive and dangerous behaviors. Finally, children and adolescents who abuse drugs and alcohol may experience depression as well, whether as a precursor to their drug use or as a consequence of it. Regardless of its root, these symptoms may be intertwined and difficult to determine the differences.
References
- "Introduction to Abnormal Child and Adolescent Psychology"; Robert Weis; 2008
- "Diagnostic and Statistical Manual of Mental Disorders, 4th edition, text revision"; American Psychiatric Association; 2000
- Centers for Disease Control and Prevention: Depression in the United States Household Population, 2005-2006
- National Institute of Mental Health: How do children and adolescents experience depression?
