Major Depressive Disorder

Once thought to be an "adult" condition, major depressive disorder is being recognised earlier in life than in previous decades. Also called clinical depression or unipolar depression, children and adolescents are being increasingly diagnosed with this condition, allowing for early intervention and treatment.

Risk Factors

A clear link exists in families, so a family history of mental illness, including depression and suicide attempts is a factor in childhood depression. This is especially true if one or both parents experienced symptoms of depression as children or teens.

Children who have developmental, learning, or behaviour disorders are more prone to depression than their peers, as are kids who have been victims of physical, sexual, or emotional abuse. Traumatic experiences including the loss of a parent or other caregiver due to death, divorce, or abandonment increases the likelihood that a child or teen will become clinically depressed, and the loss of an important romantic relationship can trigger bouts of depression in adolescents.

Kids who have been diagnosed with other psychiatric disorders or chronic illnesses may be prone to depression, with the stress of illness being cited as a common trigger. Finally, kids who smoke cigarettes are considered to be at increased risk of developing a major depressive disorder.

Symptoms

While each child or teen may exhibit symptoms differently, there are a number of common signs that depression may exist. Typically, a number of symptoms must be present and must last for at least a few weeks in order for a diagnosis of major depressive disorder to be reached. Since untreated depression can have tragic results, parents are urged to pay close attention to their children's symptoms and to seek immediate help if they suspect that the child is suffering from any form of depression.

• feelings of sadness or irritability
• loss of interest in usual friends or activities
• feelings of hopelessness or helplessness
• feelings of inadequacy or guilt
• low self-esteem
• sleep difficulties - insomnia or sleeping excessively
• changes in appetite or weight
• angry or hostile tendencies
• frequent complaints of physical discomfort -- headache, stomach ache, fatigue
• difficulty in concentrating or making decisions
• attempts at running away from home
• suicidal thoughts or attempts

Diagnosis

Accurate and timely diagnosis of major depressive disorder is important so that kids and teens can receive the treatment that they need to live happy, productive lives. A child or adolescent psychiatrist is trained to recognise the symptoms of depression and is experienced at formulating treatment plans that are safe and effective, so a consultation with a mental health professional is mandatory. A comprehensive psychiatric examination will help the doctor, parents, and child decide on a course of action best suited to treat the child's individual symptoms.

Treatment

Treatment options vary based on a number of factors, including the age and overall health of the child, extent of symptoms, and the child's ability to tolerate medications or therapeutic techniques. Major depression can be successfully treated with therapy, medication, or a combination of the two. Antidepressant medications have proven to be very effective, especially when used in tandem with ongoing individual and family therapy. Psychotherapy alone can be quite helpful, helping children to change their views of themselves and their environments as well as to develop coping skills to help them to manage the stressors in their lives. Also, the participation and cooperation of parents and other family members can play a great part in helping a depressed child or adolescent to recover, so it is important to look at the condition as a family issue, rather than merely an individual's problem.

The Importance of Treatment

Depression is a highly treatable condition, with improvement often seen in as little as a few weeks. Untreated depression can persist for weeks, months, and even years. What's more, kids who have major depressive disorder are inclined to suffer bouts of depression throughout their lives without appropriate treatment. Finally, depression in adolescents is a major risk factor for suicide, making it crucial that parents do not delay in seeking care if they notice symptoms of depression in their children.