Diagnosing clinical depression in adolescents and children is very difficult. … Teenagers are often moody and distinguishing between moodiness and depression can be challenging even for youngsters to recognise within themselves. Children and teenagers may not always understand why they are feeling down, express their feelings to others or seek help. Older teenagers especially are often too embarrassed and self-conscious to disclose unpleasant feelings to their peers or parents.
Anger and irritability can be common features of depression in children and teenagers. In some, engaging in impulsive or reckless behaviours which accompany feelings of sadness can lead to other problems such as drug and alcohol abuse, dangerous driving and acts of aggression.
As in adults, depression may also develop in children and adolescents at the same time as another condition, or as a complication of a medical illness or medical treatment. Such conditions may include diabetes and other medical illnesses. Depressive disorders can also be associated with certain types of medical interventions and some medications for physical conditions such as acne.
Professional help is necessary for children suffering from severe mood disorders. Without adequate treatment depression can be a recurring problem which eventually leads to increasing levels of psychosocial disability, demoralisation and hopelessness.
Warning signs of a mood disorder in children and teenagers can include a number of emotional and behavioural disturbances.
Emotional problems may include:
- Persistent sadness accompanied by bouts of frequent crying
- Periods of inexplicable anger or irritability
- Feelings of guilt and worthlessness, a sense of needing to be punished
- Hopelessness about the future
- Helplessness in being able to change the way they feel
- Morbid thoughts, thoughts of death, suicide or deliberate self-harm
- Irritability as a key symptom of depression in adolescence
Behavioural problems may include:
- Uncharacteristic behaviours such as stealing and bullying
- Deteriorating academic performance
- Lack of interest in activities
- Pursuit of solitude
- Lack of energy, enthusiasm and motivation
- Restlessness, agitation, disruptive behaviours or over-activity
- Sleeping most of the day, or not being able to go off to sleep or sleeping much less than usual
- Changes in eating patterns
- Engaging in drug or alcohol abuse in older children and teenagers
- Bed-wetting in younger children
However, in children and adolescents depressive disorders are not always treated immediately.
This can occur for a number of reasons including:
- Children and adolescents may not recognise when they are depressed or deny there is a problem
- Parents and carers may not recognise depression in their children
- Presence of other disorders (such as anxiety disorders, conduct disorder, substance abuse, eating disorders and medical conditions) and other problems may mask a depressive disorder
- Families may feel uncomfortable about disclosing that a member is depressed
A diagnosis of depression in young people is made by taking into account the age of the child, presenting symptoms, personality traits, family influences, trauma events and other life stressors. This type of diagnosis should always be made by a qualified mental health professional such as a general practitioner, clinical psychologist or a psychiatrist.