According to Dr. Jay Hoecker, writing for MayoClinic.com, in years past many doctors did not believe that children could develop problems with depression. Today, there is wide recognition that children suffer from problems with depression. Kenneth Merrell, a psychologist, writes in “Helping Students Overcome Depression and Anxiety” that determining how many children develop problems with depression is difficult. He estimates that about 4 to 6 percent of children may suffer from depression at a significant level.
Children Vs. Adults
Dr. Aaron Beck and Brad Alford, a psychologist, indicate in “Depression: Causes and Treatment” that due to developmental differences children and adults likely experience differences in how some depressive symptoms manifest. While research has yet to identify specific differences, the authors write that they likely exist and the question remains whether they result from the “causes or consequences of depression.”
Depressed Mood
The “Diagnostic and Statistical Manual of Mental Disorders,” or the DSM-IV, published by the American Psychiatric Association, indicates that in order for a child to receive a major depression diagnosis, he or she must experience a depressed mood, all day, almost every day for a period of at least two weeks. Children and adolescents, however, may experience more of an irritable mood versus a depressed one. Many depressed individuals also suffer from anhedonic symptoms, or as Merrell writes, a loss of interest in activities.
Weight
Merrell writes that with depressed adults and adolescents, significant weight loss often occurs; however, with children this may manifest instead in the failure to reach expected weight gains. Problems with weight may arise with a loss of appetite with depression, refusing to eat meals or eating smaller portions than the child typically does.
Energy and Sleep
According to the DSM-IV the depressed child may experience disturbances with sleep. Problems may arise with falling asleep and staying asleep. Conversely, hypersomnia may develop, in which the child will want to sleep excessively. Sometimes stemming from the sleep problems, Merrell writes that the child may appear constantly fatigued or may complain of a lack of energy. Of note, these complaints may still be present even when the child attains a proper amount of sleep. In some cases of depression the child may experience a slowing of motor functioning or conversely, exhibit physical agitation.
Problems Thinking
The DSM-IV indicates that a depressed child may have problems maintaining concentration or thinking in general. In other cases, problems with indecisiveness occur frequently. According to the DSM-IV these problems with thinking, concentration and indecisiveness may be observed by others, particularly with teachers and parents. Merrell writes that depressed children may experience feelings of worthlessness or feelings of excessive guilt.
Somatic Complaints
Merrell writes that one symptom that often characterizes depression in children is the presence of somatic complaints or bodily aches and pains. The child may frequently complain of stomach pains, headaches, among other things.
Functional Problems
All of the symptoms above may normally occur intermittently for many children. According to the DSM-IV, it is when these symptoms cause significant problems in functioning in different environments, such as school, home, family and friends, a diagnosis of depression may be appropriate.
References
- “Depression: Causes and Treatment, 2nd Edition”; Aaron T. Beck, M.D. and Brad A. Alford, Ph.D.; 2009
- “Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision”; American Psychiatric Association; 2000
- “Helping Students Overcome Depression and Anxiety”; Kenneth W. Merrell, Ph.D.; 2001
- MayoClinic.com: What’s the Most Effective Depression Treatment for Children?; Jay L. Hoecker, M.D.
