Key points to remember
- depression is a serious illness that interferes with everyday life
- it is important to get help if concerned about child depression
- depression can be treated effectively
What is depression?
Lots of children feel sad or upset some of the time, when they think that everything is going wrong with friends, at school, and at home. Depression is different to feeling sad or miserable - it's an illness and its symptoms last for a long time and interfere with a child or young person carrying on with their everyday activities.
How common is it?
Depression is experienced by approximately five percent of children. Both boys and girls can be affected by the illness. Depression is more common in teenagers - affecting approximately nine percent of young men and 18 percent of young women.
Children and young people who are at higher risk for depression are those who are very stressed, have learning or behaviour difficulties, or have experienced a loss.
What causes it?
No one knows the exact cause of depression but a combination of environmental and biological factors are thought to be important. Research has indicated that depression can run in families who may have vulnerable genes. Stressful and negative events can also cause depression, and alcohol and drug use and physical illnesses increase a person's chances of experiencing depression. A person who focuses on negative aspects of life is also more likely to experience depression.
What are the signs and symptoms?
The symptoms of depression are often different for different people.
Common symptoms are:
- feeling miserable, irritable, and unable to cope
- anger and rage, verbal sarcasm and attack
- overreaction to criticism
- low self-confidence
- feelings of helplessness, hopelessness, and guilt
- difficulty experiencing pleasure like they used to
- loss of sexual desire in adolescents
- trouble sleeping, or waking up earlier than usual
- changes in appetite
- frequent complaints of physical illness (such as headaches, stomach aches)
- poor concentration, memory and decision making skills
- being overwhelmed and thinking negatively about the future
- rebellious refusal to work or cooperate
- thoughts of suicide and self-harm
Depression in children and young people is different to adults, and they may be more irritable and rebellious than sad. Children and young people may not be able to express in words how they are feeling because of their age. Also, they may deny that they have a problem or 'put on a happy face' because they are concerned that people will think there is something wrong with them and they do not understand what is going on for them.
It is important not to discount symptoms of depression as 'just being a teenager' and a phase that they will grow out of. This is not the case. Depression is a serious illness that needs to be addressed properly.
The signs and symptoms of depression may be shared with other childhood problems (such as anxiety) and can require professional help to assess properly.
When should I seek help?
If you are concerned that a child or young person is depressed and they have been experiencing symptoms for a long period of time (longer than a few weeks) it is important that you seek help. It is important that an assessment takes place by a professional who knows about depression in children and young people. Physical examinations are also recommended to ensure that there is no underlying illness causing the symptoms.
Going to your family doctor is the recommended first step as they will be able to provide guidance about where to get further help. This may involve a referral to child and adolescent mental health services which can provide specialist assessment and interventions for depression.
What is the treatment?
Medication and psychological therapy are the two researched treatments for depression - these can be used independently or in combination. The severity of the depression and personal preference will often determine what treatment choice is made.
Antidepressant medication influences the chemicals in the brain to improve a person's mood, and can be helpful for moderate to severe depression. Medication is prescribed by a doctor and needs to be taken for a number of weeks for a difference to be experienced. People usually stay on medication for a number of months. Antidepressant medication is not addictive. Doctors will discuss with you how the medication works and any potential side effects, which are usually short-lived and easily manageable.
Psychological therapy is effective in learning ways to overcome depression. Each person's experience is different and the focus of therapy is on thoughts, feelings and behaviours and learning new ways to deal with difficult situations, and to change the way people think about events and situations.
- The Werry Centre for Child and Adolescent Mental Health fact sheets.
- Mental Health Information New Zealand. 2002. Depression in childhood and adolescence. Mental Health Foundation: Wellington.