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Depression is a complex matter. In recent years, with burgeoning research progress, we are finding out that depression is much more common than many of us thought. At least 15% (and likely more) of women take an antidepressant during their lifetime. Depression is much more common in women than in men, but the reason for this female predominance is unclear.

Besides the fact that woman suffer from depression more often than do men, women often think they can “work through” a depression on their own.  They may misunderstand the low risk associated with medication treatment of depression, or else they believe that because they are intelligent hard-working people a counselor or psychologist will be of no help.  These mistaken beliefs are, unfortunately, common.  Medications for depression may sometimes have annoying side effects, such as agitation, insomnia, or drowsiness, but serious reactions are extremely unusual. Women with a true depression are suffering. Such bothersome, non-life threatening side effects, which may lessen soon anyway, are likely to be much more tolerable than untreated depression for many women. Time and again, studies have shown that either counseling or medication therapy, or optimally both together, are extremely effective in safely relieving depression in both women and men.

Many women would probably seek treatment if they realized what the symptoms of depression are.  Loss of interest in usual activities, social isolation, insomnia, loss of energy or problems concentrating, and either weight loss or weight gain can be symptoms of depression. Many women do not recognize these symptoms as warning signs of an oncoming depression.  A woman needs to report such symptoms to her physician.  Depression may not show itself solely by tearfulness or sadness.

Women with depression have a right to accurate information. They deserve to be warned of the real potential side effects (not word of mouth, gossip, or incomplete newspaper reports) of the medications.  They need to be told that many side effects wear off or lessen with continued treatment. They need to know that there are many classes of antidepressant medication, and many brands within each class of medications, so that if one or more medications fail, others can be prescribed. They need to be persistent in following up with the doctor prescribing the medication, whether it is a primary care physician or a psychiatrist, to report side effects and progress in relieving the depression symptoms. Too many times women go away without planning follow-up visits, or don’t realize what side effects to expect.

Even with all of the barriers to the effective relief of depression in women already mentioned, the biggest one is yet to be mentioned. This is the period of time it takes for the medication to take effect. Medication will take about 1 month to relieve depression.  During that time period, a woman may experience bothersome side effects from the medication while not receiving relief from the depression.  This is often the most difficult challenge for the treating physician and the woman being treated – the fact that full benefit of a given dose or medication brand can take 4 to 6 weeks.  The woman and her physician will need to discuss the expected duration of treatment, which may be longer in women who have had prior episodes of depression. A first episode of depression may require 6 to 12 months of medication, but permanent medication for a first episode is required only in rare circumstances.

Women have so many complex issues to tackle once they begin to experience depression . Because women are still the dominant childcare providers more commonly than men, depressed women may have childcare concerns, issues of out-of-control moodiness, crying, or anger at work. They are often juggling work and childcare more often than men. In addition, women have to think of risks and benefits of treating depression while they are pregnant or nursing. These issues that affect women disproportionately as compared to men need to be addressed by primary care physicians, psychiatrists, and psychologists, and sometimes all 3 health care providers acting as a team.

The good news is that medication and psychotherapy, alone or in combination, are effective in relieving depression. Hopefully, educating the public will result in more women recognizing symptoms of depression, electing to undergo treatment with either counseling, medication, or both, and keeping follow-up appointments to monitor their progress.  Treatment of depression leads to happier and healthier lives.  Women with depression, just like all other women, should want to do what they can to enrich the quality of their daily lives with their families. Treatment of depression can help accomplish this goal.

Recognizing Teen Depression

It is common for adolescents to occasionally feel unhappy. However, when the unhappiness lasts for more than two weeks, and the teen experiences other symptoms typical of depression, then he or she may be suffering from depression.

Estimates on how many adolescents experience depression vary from 3% to 6%. At any given time, from 2% to 10% of school-age children are thought to be suffering from depression.

There are many reasons why teenagers become unhappy. High stress environments can lead to depression. Teens can develop feelings of worthlessness and inadequacy over school performance, social interaction, sexual orientation, or family life. If friends or family, or things that the teen usually enjoys, don’t help to improve his or her sadness or sense of isolation, there’s a good chance that he or she is depressed.

Depression also tends to be more common in adolescents who have a history of depression in their families.

If you believe your teenager is suffering from depression, you should seek help from a qualified healthcare professional.

What are the Symptoms of Teen Depression?

Often, depressed teens will display a striking change in their thinking and behavior, lose their motivation, or become withdrawn. The following are the major signs of depression in adolescents.

  • Sadness, anxiety, or a feeling of hopelessness
  • Loss of interest in food or compulsive overeating that results in rapid weight loss or gain
  • Staying awake at night and sleeping during the day
  • Withdrawal from friends
  • Rebellious behavior, sudden drop in grades, or cutting school
  • Complaints of pains including headaches, stomachaches, low back pain, or fatigue
  • Use of alcohol or drugs and promiscuous sexual activity
  • A preoccupation with death and dying

How is Depression Diagnosed in Adolescents?

There aren’t any specific tests that can be performed to detect depression . Healthcare professionals determine if an adolescent is depressed using psychological tests and detailed clinical interviews with the individual and his or her family members, teachers, and peers. The severity of depression and the risk of suicide are determined based on the assessment of these interviews. Treatment recommendations are also made based on the data collected from the interviews.

Treating Depression

There are a variety of methods used to treat depression. Your mental healthcare provider will determine the best course of treatment for your teen.

The FDA has determined that antidepressant medications increase the risk of suicidal thinking and behavior in children and adolescents with depression and other psychiatric disorders. If you have questions or concerns, discuss them with your health care provider. Learn more

Teen Suicide

Suicide is a serious problem within the teenage population. Adolescent suicide is the second leading cause of death among youth and young adults in the U.S. It is estimated that 500,000 teens attempt suicide every year with 5,000 succeeding. These are epidemic proportions.

Warning signs of suicide include:

  • Threatening to kill one’s self
  • Preparing for death, giving away favorite possessions, writing goodbye letters, or making a will
  • Expressing a hopelessness for the future
  • Giving up on one’s self, talking as if no one else cares

If your teenager displays any of these behaviors, you should seek help from a mental healthcare professional immediately.

Why Do Teens Attempt Suicide?

Suicide is an act of desperation. Depression is often the root cause. It can make problems seem overwhelming and the associated pain unbearable. Family difficulties, the loss of a loved one, or perceived failures at school or in relationships can all lead to negative feelings and depression.

Advice For Parents

Parenting teenagers can be very challenging. Some communication techniques can go a long way toward lowering the stress level of your teenager.

  • When disciplining your child, replace shame and punishment with positive reinforcement for good behavior. Shame and punishment can make an adolescent feel worthless and inadequate.
  • Allow your teenager to make mistakes. Overprotection or making decisions for teens can be perceived as a lack of faith in their abilities. This can make them feel less confident.
  • Give your teen breathing room. Don’t expect them to do exactly as you say all of the time.
  • Do not force your child down a path you wanted to follow. Avoid trying to relive your youth through your child’s activities and experiences.

If you suspect that your child is depressed, take the time to listen to his or her concerns. Even if you don’t think the problem is of real concern, remember that it may feel very real to someone who is growing up. It is important to keep the lines of communication open, even if your child seems to want to withdraw. Try to avoid telling your child what to do; instead, listen closely and you may discover more about the issues causing the problems.

If you feel overwhelmed or unable to reach your child, or if you continue to be concerned, seek help from a qualified healthcare professional.

Depression is a very common condition that is believed by many experts to be the number one cause of disability in the world. In the U.S., 17% of people will experience depression at some point in their lives. An estimated 19 million people in the U.S. are currently suffering from depression. Depression is more common in women then in men, with 25% of women suffering from depression severe enough to warrant treatment at least once during their lifetime.

It’s important to remember that depression is an illness that affects both the body and mind. It is not something that we can just wish away or “snap out of,” nor is it a sign of a weak character. The good news about depression is that almost everyone suffering from this condition can be helped with treatment, so it is important to recognize the signs and symptoms of depression.

According to the U.S. National Institute of Mental Health (NIMH), the main symptoms and signs of depression are the following:

  • persistent sad, anxious, or “empty” mood
  • feelings of hopelessness, pessimism
  • feelings of guilt, worthlessness, helplessness
  • loss of interest or pleasure in hobbies and activities that were once enjoyed, including sex
  • decreased energy, fatigue, being “slowed down”
  • difficulty concentrating, remembering, making decisions
  • insomnia, early-morning awakening, or oversleeping
  • appetite and/or weight loss or overeating and weight gain
  • thoughts of death or suicide; suicide attempts
  • restlessness, irritability
  • persistent physical symptoms that do not respond to treatment, such as headaches, digestive disorders, and chronic pain

If you have been experiencing several of these symptoms to a degree that they have impaired or affected your life, talk to your doctor. He or she can help you find out whether or not you are suffering from depression and direct you to appropriate resources for treatment and recovery.

What is seasonal affective disorder?

Seasonal affective disorder is a type of depression that tends to occur (and recur) as the days grow shorter in the fall and winter. It is believed that affected persons react adversely to the decreasing amounts of light and the colder temperatures as the fall and winter progress. It is important to note that although seasonal affective disorder usually presents in the fall and winter, there are those who suffer from this condition during the summer instead of, or in addition to, during the fall or winter.

Seasonal affective disorder has not been long recognized as a medical condition. The term first appeared in print in 1985. Seasonal affective disorder is also sometimes called winter depression, winter blues, or the hibernation reaction.

The incidence of seasonal affective disorder increases in people who are living farther away from the equator. Seasonal affective disorder is less common where there is snow on the ground. Seasonal affective disorder is more common in women than men. People of all ages can develop seasonal affective disorder.

What are the symptoms of seasonal affective disorder?

Symptoms of seasonal affective disorder include tiredness, fatigue, depression, crying spells, irritability, trouble concentrating, body aches, loss of sex drive, poor sleep, decreased activity level, and overeating, especially of carbohydrates, with associated weight gain. When the condition presents in the summer, the symptoms are more commonly insomnia, poor appetite and weight loss, in addition to irritability, difficulty concentrating, and crying spells. In severe instances, seasonal affective disorder can be associated with thoughts of suicide.

The symptoms of seasonal affective disorder typically tend to begin in the fall each year, lasting until spring. The symptoms are more intense during the darkest months. Therefore, the more common months of symptoms will vary depending on how far away from the equator one lives.

What causes seasonal affective disorder?

Seasonal affective disorder seems to develop from inadequate bright light during the winter months. Researchers have found that bright light changes the chemicals in the brain. Exactly how this occurs and the details of its effects are being studied.

What is the treatment for seasonal affective disorder?

Regular exposure to light that is bright, particularly fluorescent light, significantly improves depression in people with seasonal affective disorder that presents during the fall and winter. The light treatment is used daily in the morning and evening for best results. Temporarily changing locations to a climate that is characterized by bright light (such as the Caribbean) can achieve similar results. Light treatment has also been called phototherapy.

Phototherapy is commercially available in the form of light boxes, which are used for approximately 30 minutes daily. The light required must be of sufficient brightness, approximately 25 times as bright as a normal living room light. Contrary to prior theories, the light does not need to be actual daylight from the sun. It seems that it is quantity, not necessarily quality of light, that matters in the light treatment of seasonal affective disorder. The most common possible side effects associated with phototherapy include irritability, insomnia, headaches, and eyestrain.

Antidepressant medications, particularly those from the serotonin selective reuptake inhibitor family (SSRI) family, have been found effective treatment for seasonal affective disorder that presents during summer as well as that which tends to occur during the fall or winter. Examples of SSRIs include fluoxetine (Prozac), sertraline (Zoloft), paroxetine (Paxil), and citalopram (Celexa). Common side effects for this class of medications include insomnia, nausea, diarrhea, and decreased sex drive or performance. As with any other mood disorder, psychotherapy tends to accentuate the effectiveness of medical treatment and therefore should be included in the approach to addressing this disorder.

What is posttraumatic stress disorder?

Posttraumatic stress disorder (PTSD) is an emotional illness that develops as a result of a terribly frightening, life-threatening, or otherwise highly unsafe experience. PTSD sufferers re-experience the traumatic event or events in some way, tend to avoid places, people, or other things that remind them of the event (avoidance), and are exquisitely sensitive to normal life experiences (hyperarousal). Although this condition has likely existed since human beings have endured trauma, PTSD has only been recognized as a formal diagnosis since 1980. However, it was called by different names as early as the American Civil War, when combat veterans were referred to as suffering from “soldier’s heart.” In World War I, symptoms that were generally consistent with PTSD were referred to as “combat fatigue.” Soldiers who developed such symptoms in World War II were said to be suffering from “gross stress reaction,” and many who fought in Vietnam who had symptoms of what is now called PTSD were assessed as having “post-Vietnam syndrome.” PTSD has also been called “battle fatigue” and “shell shock.” Complex posttraumatic stress disorder (C-PTSD) usually results from prolonged exposure to a traumatic event or series thereof and is characterized by long-lasting problems with many aspects of emotional and social functioning.

Approximately 7%-8% of people in the United States will likely develop PTSD in their lifetime, with the lifetime occurrence (prevalence) in combat veterans and rape victims ranging from 10% to as high as 30%. Somewhat higher rates of this disorder have been found to occur in African Americans, Hispanics, and Native Americans compared to Caucasians in the United States. Some of that difference is thought to be due to higher rates of dissociation soon before and after the traumatic event (peritraumatic); a tendency for individuals from minority ethnic groups to blame themselves, have less social support, and an increased perception of racism for those ethnic groups; as well as differences between how ethnic groups may express distress. Other important facts about PTSD include the estimate of 5 million people who suffer from PTSD at any one time in the United States and the fact that women are twice as likely to develop PTSD as men.

Almost half of individuals who use outpatient mental-health services have been found to suffer from PTSD. As evidenced by the occurrence of stress in many individuals in the United States in the days following the 2001 terrorist attacks, not being physically present at a traumatic event does not guarantee that one cannot suffer from traumatic stress that can lead to the development of PTSD.

PTSD statistics in children and teens reveal that up to more than 40% have endured at least one traumatic event, resulting in the development of PTSD in up to 15% of girls and 6% of boys. On average, 3%-6% of high school students in the United States and as many as 30%-60% of children who have survived specific disasters have PTSD. Up to 100% of children who have seen a parent killed or endured sexual assault or abuse tend to develop PTSD, and more than one-third of youths who are exposed to community violence will suffer from the disorder.

What are the effects of PTSD?

Untreated PTSD can have devastating, far-reaching consequences for sufferers’ functioning and relationships, their families, and for society. Women who were sexually abused at earlier ages are more likely to develop complex PTSD and borderline personality disorder. Babies that are born to mothers that suffer from this illness during pregnancy are more likely to experience a change in at least one chemical in their body that makes it more likely (predisposes) the baby to develop PTSD later in life. Individuals who suffer from this illness are at risk of having more medical problems, as well as trouble reproducing. Emotionally, PTSD sufferers may struggle more to achieve as good an outcome from mental-health treatment as that of people with other emotional problems. In children and teens, PTSD can have significantly negative effects on their social and emotional development, as well as on their ability to learn.

What causes PTSD?

Virtually any event that is life-threatening or that severely compromises the emotional well-being of an individual may cause PTSD. Such events often include either experiencing or witnessing a severe accident or physical injury, receiving a life-threatening medical diagnosis, being the victim of kidnapping or torture, exposure to combat or to a natural disaster, other disaster (for example, plane crash) or terrorist attack, being the victim of rape, mugging, robbery or assault; enduring physical, sexual, emotional or other forms of abuse, as well as involvement in civil conflict.

What are the risk factors and protective factors for PTSD?

Issues that tend to put people at higher risk for developing PTSD include increased duration of a traumatic event, higher severity of the trauma experienced, having an emotional condition prior to the event, or having little social support in the form of family or friends. In addition to those risk factors, children and adolescents, females, and people with learning disabilities or violence in the home have a greater risk of developing PTSD  after a traumatic event.

While disaster-preparedness training is generally seen as a good idea in terms of improving the immediate physical safety and logistical issues involved with a traumatic event, such training may also provide important protective factors against developing PTSD. That is as evidenced by the fact that those with more professional-level training and experience (for example, police, firefighters, mental-health professionals, paramedics, and other medical professionals) tend to develop PTSD less often when coping with disaster than those without the benefit of such training or experience.

Some medications have been found to help prevent the development of PTSD. Some medicines that treat depression, decrease the heart rate, or increase the action of other body chemicals are thought to be effective tools in the prevention of PTSD when given in the days immediately after an individual experiences a traumatic event. Continue Reading »

Why do women get postpartum depression?

Having a baby can be one of the biggest and happiest events in a woman’s life. While life with a new baby can be thrilling and rewarding, it can also be hard and stressful at times. Many physical and emotional changes can happen to a woman when she is pregnant and after she gives birth. These changes can leave new mothers feeling sad, anxious, afraid, or confused. For many women, these feelings (called the baby blues) go away quickly. But when these feelings do not go away or get worse, a woman may have postpartum depression. This is a serious condition that requires quick treatment from a health care provider.

What is postpartum depression? Are the “baby blues” the same thing as postpartum depression?

Postpartum depression (PPD) is a condition that describes a range of physical and emotional changes that many mothers can have after having a baby. PPD can be treated with medication and counseling. Talk with your health care provider right away if you think you have PPD.

There are three types of PPD women can have after giving birth:

  • The baby blues happen in many women in the days right after childbirth. A new mother can have sudden mood swings, such as feeling very happy and then feeling very sad. She may cry for no reason and can feel impatient, irritable, restless, anxious, lonely, and sad. The baby blues may last only a few hours or as long as 1 to 2 weeks after delivery. The baby blues do not always require treatment from a health care provider. Often, joining a support group of new moms or talking with other moms helps.
  • Postpartum depression (PPD) can happen a few days or even months after childbirth. PPD can happen after the birth of any child, not just the first child. A woman can have feelings similar to the baby blues – sadness, despair, anxiety, irritability – but she feels them much more strongly than she would with the baby blues. PPD often keeps a woman from doing the things she needs to do every day. When a woman’s ability to function is affected, this is a sure sign that she needs to see her health care provider right away. If a woman does not get treatment for PPD, symptoms can get worse and last for as long as 1 year. While PPD is a serious condition, it can be treated with medication and counseling.
  • Postpartum psychosis is a very serious mental illness that can affect new mothers. This illness can happen quickly, often within the first 3 months after childbirth. Women can lose touch with reality, often having auditory hallucinations (hearing things that aren’t actually happening, like a person talking) and delusions (seeing things differently from what they are). Visual hallucinations (seeing things that aren’t there) are less common. Other symptoms include insomnia (not being able to sleep), feeling agitated (unsettled) and angry, and strange feelings and behaviors. Women who have postpartum psychosis need treatment right away and almost always need medication. Sometimes women are put into the hospital because they are at risk for hurting themselves or someone else.

What are the signs of postpartum depression?

The signs of postpartum depression include:

  • Feeling restless or irritable.
  • Feeling sad, depressed or crying a lot.
  • Having no energy.
  • Having headaches, chest pains, heart palpitations (the heart being fast and feeling like it is skipping beats), numbness, or hyperventilation (fast and shallow breathing).
  • Not being able to sleep or being very tired, or both.
  • Not being able to eat and weight loss.
  • Overeating and weight gain.
  • Trouble focusing, remembering, or making decisions.
  • Being overly worried about the baby.
  • Not having any interest in the baby.
  • Feeling worthless and guilty.
  • Being afraid of hurting the baby or yourself.
  • No interest or pleasure in activities, including sex.

A woman may feel anxious after childbirth but not have PPD. She may have what is called postpartum anxiety or panic disorder. Signs of this condition include strong anxiety and fear, rapid breathing, fast heart rate, hot or cold flashes, chest pain, and feeling shaky or dizzy. Talk with your health care provider right away if you have any of these signs. Medication and counseling can be used to treat postpartum anxiety.

Who is at risk for getting postpartum depression?

Postpartum depression (PPD) affects women of all ages, economic status, and racial/ethnic backgrounds. Any woman who is pregnant, had a baby within the past few months, miscarried, or recently weaned a child from breastfeeding can develop PPD. The number of children a woman has does not change her chances of getting PPD. New mothers and women with more than one child have equal chances of getting PPD. Research has shown that women who have had problems with depression are more at risk for PPD than women who have not had a history of depression.

Continue Reading »

The holiday season for most people is a fun time of the year filled with parties, celebrations, and social gatherings with family and friends. But for many people, it is a time filled with sadness, self-reflection, loneliness, and anxiety.

What causes the holiday blues?

Sadness is a truly personal feeling. What makes one person feel sad may not affect another person. Typical sources of holiday sadness include

  • stress,
  • fatigue,
  • unrealistic expectations,
  • overcommercialization,
  • financial stress, and
  • the inability to be with one’s family and friends.

Balancing the demands of shopping, parties, family obligations, and house guests may contribute to feelings of being overwhelmed and increased tension. People who do not view themselves as depressed may develop stress responses, such as

  • headaches,
  • excessive drinking,
  • overeating, and
  • insomnia.

Others may experience post-holiday sadness after New Year’s/January 1st. This can result from built-up expectations and disappointments from the previous year, coupled with stress and fatigue.

Tips for coping with holiday stress and depression:

  • Make realistic expectations for the holiday season.
  • Set realistic goals for yourself.
  • Pace yourself. Do not take on more responsibilities than you can handle.
  • Make a list and prioritize the important activities. This can help make holiday tasks more manageable.
  • Be realistic about what you can and cannot do.
  • Do not put all your energy into just one day (for example, Thanksgiving Day, New Year’s Eve). The holiday cheer can be spread from one holiday event to the next.
  • Live “in the moment” and enjoy the present.
  • Look to the future with optimism.
  • Don’t set yourself up for disappointment and sadness by comparing today with the “good old days” of the past.
  • If you are lonely, try volunteering some of your time to help others.
  • Find holiday activities that are free, such as looking at holiday decorations, going window shopping without buying, and watching the winter weather, whether it’s a snowflake or a raindrop.
  • Limit your consumption of alcohol, since excessive drinking will only increase your feelings of depression.
  • Try something new. Celebrate the holidays in a new way.
  • Spend time with supportive and caring people.
  • Reach out and make new friends.
  • Make time to contact a long lost friend or relative and spread some holiday cheer.
  • Make time for yourself!
  • Let others share the responsibilities of holiday tasks.
  • Keep track of your holiday spending. Overspending can lead to depression when the bills arrive after the holidays are over. Extra bills with little budget to pay them can lead to further stress and depression.

Is the environment and reduced daylight a factor in wintertime sadness?

Animals react to the changing season with changes in mood and behavior. People change behaviors, as well, when there is less sunlight. Most people find they eat and sleep slightly more in wintertime and dislike the dark mornings and short days. For some, however, symptoms are severe enough to disrupt their lives and cause considerable distress. These people are suffering from seasonal affective disorder (SAD).

Research studies have that found phototherapy is effective in treating people that suffer from SAD. Phototherapy is a treatment involving a few hours of exposure to intense light. This extra exposure to light while awake seems to correct symptoms of seasonal affective disorder.

How Does Depression in the Elderly Differ from Depression in Younger People?

Depression in later life frequently coexists with other medical illnesses and disabilities. In addition, advancing age is often accompanied by loss of key social support systems due to the death of a spouse or siblings, retirement and/or relocation of residence. Because of their change in circumstances and the fact that they’re expected to slow down, doctors and family may miss the diagnosis of depression in elderly people, delaying effective treatment. As a result, many seniors find themselves having to cope with symptoms that could otherwise be easily treated.

Depression tends to last longer in elderly adults. It also doubles their risk to develop cardiac diseases and increases their risk of death from illness, while reducing their ability to rehabilitate. Studies of nursing home patients with physical illnesses have shown that the presence of depression substantially increased the likelihood of death from those illnesses. Depression also has been associated with increased risk of death following a heart attack. For that reason, making sure that an elderly person you are concerned about is evaluated and treated is important, even if the depression is mild.

Depression in the elderly is more likely to lead to suicide. The risk of suicide is a serious concern among elderly patients with depression. Elderly white men are at greatest risk, with suicide rates in people ages 80 to 84 more than twice that of the general population. The National Institute of Mental Health considers depression in people age 65 and older to be a major public health problem.

Continue Reading »

Can Children Really Suffer From Depression?

Yes. Childhood depression is different from the normal “blues” and everyday emotions that occur as a child develops. Just because a child seems depressed or sad, does not necessarily mean they have depression. But if these symptoms become persistent, disruptive, and interfere with social activities, interests, schoolwork and family life, it may indicate that he or she has the medical illness called depression. Keep in mind that while depression is a serious illness, it is also a treatable one.

How Can I Tell if My Child is Depressed?

The symptoms of depression in children vary. It is often undiagnosed and untreated because they are passed off as normal emotional and psychological changes that occur during growth. Early medical studies focused on “masked” depression, where a child’s depressed mood was evidenced by acting out or angry behavior. While this does occur, particularly in younger children, many children display sadness or low mood similar to adults who are depressed. The primary symptoms of depression revolve around sadness, a feeling of hopelessness, and mood changes.

Signs and symptoms of depression in children include:

  • Irritability or anger
  • Continuous feelings of sadness, hopelessness
  • Social withdrawal
  • Increased sensitivity to rejection
  • Changes in appetite — either increased or decreased
  • Changes in sleep — sleeplessness or excessive sleep
  • Vocal outbursts or crying
  • Difficulty concentrating
  • Fatigue and low energy
  • Physical complaints (such as stomachaches, headaches) that do not respond to treatment
  • Reduced ability to function during events and activities at home or with friends, in school, extracurricular activities, and in other hobbies or interests
  • Feelings of worthlessness or guilt
  • Impaired thinking or concentration
  • Thoughts of death or suicide

Not all children have all of these symptoms. In fact, most will display different symptoms at different times and in different settings. Although some children may continue to function reasonably well in structured environments, most kids with significant depression will suffer a noticeable change in social activities, loss of interest in school and poor academic performance, or a change in appearance. Children may also begin using drugs or alcohol, especially if they are over the age of 12.

Although relatively rare in youths under 12, young children do attempt suicide — and may do so impulsively when they are upset or angry. Girls are more likely to attempt suicide, but boys are more likely to actually kill themselves when they make an attempt. Children with a family history of violence, alcohol abuse, or physical or sexual abuse are at greater risk for suicide, as are those with depressive symptoms.

Which Children Get Depressed?

It is estimated that 2.5% of children in the U.S. suffer from depression. Depression is significantly more common in boys under the age of 10. But by age 16, girls have a greater incidence of depression.

Bipolar disorder is more common in adolescents than in younger children. Bipolar disorder in children can, however, be more severe than in adolescents. It may also co-occur with, or be hidden by, attention deficit hyperactivity disorder (ADHD), obsessive-compulsive disorder (OCD), or conduct disorder (CD). According to the National Institute of Mental Health, 20-40% of adolescents with major depression develop bipolar disorder within five years after having depression.

What Causes Depression in Children?

As in adults, depression in children can be caused by any combination of factors that relate to physical health, life events, family history, environment, genetic vulnerability, and biochemical disturbance. Depression is not a passing mood, nor is it a condition that will go away without proper treatment.

Can Depression in Children Be Prevented?

Children with a family history of depression are at greater risk of experiencing depression themselves. Children who have parents that suffer from depression tend to develop their first episode of depression earlier than children whose parents do not. Children from chaotic or conflicted families, or children and teens who abuse substances like alcohol and drugs, are also at greater risk of depression.

How is the Diagnosis Made?

If the symptoms of depression in your child have lasted for at least two weeks, you should schedule a visit with his or her doctor to make sure there are no physical reasons for the symptoms and to make sure that your child receives proper treatment. A consultation with a mental healthcare professional who specializes in children is also recommended.

A mental health evaluation should include interviews with you (as the parents) and your child, and any additional psychological testing that is necessary. Information from teachers, friends, and classmates can be useful for showing that these symptoms are consistent during your child’s various activities and are a marked change from previous behavior.

There are no specific tests — medical or psychological — that can clearly show depression, but tools such as questionnaires (for both the child and parents) combined with personal information can be very useful.

What Are the Treatment Options?

Treatment options for children with depression are similar to those for adults, including psychotherapy (counseling) and medicine . The role that family and the child’s environment play in the treatment process is different from that of adults. Your child’s doctor may suggest psychotherapy first, and consider antidepressant medicine as an additional option if there is no significant improvement. Currently, there are no good studies documenting the effectiveness of medicine over psychotherapy in children.

However, three studies do show that the antidepressant Prozac is effective in treating depression in children and teens. The drug is officially recognized by the FDA for treatment of children 8-18 with depression.

Treating children with bipolar disorder

Children with bipolar disorder are usually treated with psychotherapy and a combination of medicines, usually an antidepressant and a mood stabilizer. Use of an antidepressant alone can trigger bouts of mania.

The FDA has determined that antidepressant medications increase the risk of suicidal thinking and behavior in children and adolescents with depression and other psychiatric disorders. If you have questions or concerns, discuss them with your health care provider. Learn more Continue Reading »

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