An estimated 1 out of 10 children have difficulty escaping the symptoms of depression for long periods of time. The rate of depression is markedly lower (1%) in children ages 1 to 6 years old. The rate is higher in older children ages 9 to 12 years (12%).

During childhood the number of boys and girls affected are almost equal. In adolescence, twice as many girls as boys are diagnosed. (Similar to adult rate) Repeated episodes of depression can take a great toll on a young mind. Well over half of depressed adolescents have a recurrence within seven years. Children with Major Depression have an increased incidence of Bipolar Disorder and recurrent Major Depression.

Depression in children is very similar to depression in adults with a few exceptions. Children may not have the vocabulary to talk about such feelings and so may express their feelings through behavior. Younger individuals with depression are more likely to show phobias, separation anxiety disorder, sleep complaints and behavior problems. Rather than having a depressed mood, children are much more likely to have an irritable mood. Adults often will not enjoy anything when they are depressed, but there are usually some activities children and adolescents will enjoy doing no matter how depressed they get.

To say a child has clinically significant depression (Major Depressive Disorder), they must have five of the 9 symptoms listed below to such a degree that it significantly interferes with their functioning for at least two weeks straight.

1. depressed or irritable mood most of the day, nearly every day
2. markedly diminished interest or pleasure in all, or almost all activities most of the day, nearly every day
3. significant weight loss when not dieting or failure to make appropriate weight gains
4. trouble sleeping or too much sleeping nearly every day
5. restlessness or really slowed down nearly every day which is obvious to others
6. fatigue or loss of energy nearly every day
7. feelings of worthlessness or excessive guilt nearly every day
8. diminished ability to think or concentrate, or indecisiveness, nearly every day
9. recurrent thoughts of death, suicidal thoughts or suicide attempts

Although it is not one of the criteria, some physical symptoms are very, very common in depression. Headaches are one of these. About 10% of children have severe headaches at least once a month. However 40% of girls with depression have severe headaches. The same does not hold true for boys.

Some External Signs of Depression in Children and Adolescents

• Preschool or young elementary age: The child might look serious or vaguely sick. He might be less bouncy or spontaneous. While other children would become tearful or irritable when frustrated, this child may show these states spontaneously. He may say negative things about himself and may be self-destructive.

• Older elementary school through adolescence: The adolescent may present with academic decline, disruptive behavior, and problems with friends. Sometimes one can also see aggressive behavior, irritability and suicidal talk. The parent may say that the adolescent hates himself and everything else.

next: More on the Symptoms of Depression in Children and What Does A Depressed Child Look Like?