Depression in School-Age Children

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Depression in
School-Age Children

by Robert Needlman, M.D., F.A.A.P.

Depression is a mental illness marked by negative moods (sadness or irritability) and a loss of the ability to enjoy life. In addition to these core symptoms, depression involves negative thoughts, changes in sleep, appetite, energy, and ability to concentrate. When they are depressed, school-age children often are irritable, rather than sad, but in other ways they experience depression just as older children and adults do.

How common is depression?

About 2 to 3 children out of 100 have clinical depression (major depression) at any given time. This makes depression much less common than asthma or allergies, but many times more common than, say, childhood diabetes or cancer. Up until puberty, depression occurs equally in boys and girls; after that, girls are more likely to develop it.

Depression is largely an inherited condition, although a child's past and present experiences and relationships also play an important role. The chances of a child having depression increase if one or both parents have had it. The younger a child is when he begins to show depression, the more severe the problem is likely to be.

What does childhood depression look like?

Any of these symptoms can be signs of depression:

Sadness or crying more than usual, lasting much of the day, several days of the week. (Note: Children who are depressed do not necessarily look sad all of the time.)
Loss of interest: Things that used to be exciting, such as playing sports, baking cookies, or going on outings no longer spark any enthusiasm. If you ask, "Tell me something that's really fun to do," it's hard for a child with depression to answer.
Irritability: Little disappointments spark big anger or distress; the child doesn't seem to be able to shrug off small frustrations.
Pulling back from friends: A child stops going to friends' houses or having friends over. (Note: Many children like to have lots of time to themselves; depression is more of a concern if a child who was sociable changes into a loner.)
Sleep problems: A child starts waking up in the middle of the night or early in the morning, or sleeping much longer than usual. Low energy (can't get out of bed, unusually sleepy during the day, can't get moving) are common in depression.
Changes in appetite, either eating a lot less than usual or (occasionally) a lot more. Other physical complaints (stomachaches, headaches, body aches and pains) often go along with depression as well.
Changes in school performance: A "straight A" student starts getting C's or F's; a child stops participating in class or starts missing lots of school; a child who was well organized starts forgetting things or having a hard time making decisions.
Alcohol or drug use can be early signs of depression.
Negative statements, such as "I'm stupid," "Everything's stupid," "It's all my fault." Feelings of guilt or hopelessness are common in depression.
Suicidal statements: Sometimes, of course, the child who yells, "I wish I were dead!" is really just very angry at that moment. But suicide does happen, even in young children. Any statement about wanting to die deserves to be taken seriously, especially if a child makes these statements often or during a sad mood (rather than when he's angry).

Sorting it out

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Of course, many of the signs of depression listed above can be symptoms of other medical or psychological problems, too. A primary-care physician (pediatrician or family doctor) can check for common medical issues. Some are comfortable making the diagnosis of depression; others will call in a psychologist, psychiatrist, or psychiatric social worker as a consultant. You can help, too, by educating yourself about depression and dealing with your child in a kindly, supportive way.

Depression in School-Age Children

How common is depression?

What does childhood depression look like?

Sorting it out

RELATED LINKS AND INFO

Depression in
School-Age Children