A once bubbling, engaging child becomes sullen and with-drawn, or irritable and a bully on the playground. School tardiness or absence becomes frequent, and grades drop. A parent cannot seem to “get through” to a child to discuss what’s wrong, and tension in the family rises.

Depression is a common and serious form of childhood mental disorder. Until as recently as the 1980s, doctors and others rarely considered that children could become depressed. But research has shown that they do, suffering many of the same symptoms that are seen in adults with a major depression, but also some that are unique to their age.  When recognized early and diagnosed accurately, depression is highly responsive to treatment; still, each episode of this recurrent illness tends to increase the likelihood that episodes of illness will recur; and, thus, depression must be treated and managed with an eye toward the long term.

As many as 5 percent, or one in 20, of children and adolescents experience a potentially disabling depression before age 19. This frequency of occurrence, or prevalence, of depression at young ages – and the fact that fewer than half of those who have the illness receive appropriate treatment – helps explain why depression is now the leading cause of disability among adults in the U.S.

Several forms of depression affect children and adults alike.  Major depression is characterized by specific signs and symptoms; suffering at least five of these symptoms for two weeks or more is a highly reliable marker of depression. In dysthymia, symptoms generally are less severe, but the illness is marked by a more chronic and persistent course; rather than shifting episodically into well-defined periods of depression, the child with dysthymia lives in world tinted a joyless gray.

Less frequently seen in children (or adults, in whom the annual prevalence is about 1 percent) is bipolar depression, a phase of manic depressive, or bipolar, disorder, in which periods of depression alternate with periods of unnaturally high levels of energy and grandiosity.

Child & Adolescent FAQ

Does my child have a mental disorder?

The question is difficult, even frightening, for a parent to voice.  Understandably, it is easier to overlook or explain away subtle signs of illness that may occur periodically at worst and are set against the rapid changes of childhood or the turmoil of adolescence.  “It’s just a phase.” “He’ll grow out of it.” “She’s under a lot of stress.” “We need to assure him that we love him.” “No one in our family has a mental illness.”  Yet the concern that sparks a parent’s question may be justified.  One in five American children and adolescents has a mental or behavioral disorder that interferes with their ability to learn in school or to establish healthy relationships with family members and friends. For one in 10 youngsters, a mental disorder will lead to moderate to severe impairment in one or more facets of their life.

What Causes Childhood Depression?

No single cause of depression has been identified. However, we know that depression is an illness with a pronounced biological basis. The genes that we inherit, and which continue to be influenced by experience throughout life, may predispose a person to the illness, but this predisposition, or vulnerability, to depression typically is “triggered” by life events.

Researchers have begun to identify these triggers, called risk factors, for depression.

A child’s risk for becoming depressed may increase with stress or with an experience of devastating loss or trauma. Behavioral problems and mental disorders – for example, conduct, attention-deficit, learning, anxiety, and substance abuse disorders — frequently co-occur with depression and may help explain its onset. A family history of depression or bipolar disorder is a significant risk factor for depression in a child or young adult.

Depression may – and frequently does – occur when no member of a family has knowingly experienced a serious mental disorder.  The underlying biological mechanisms and triggering events for illness in these instances have yet to be clearly understood.

What can be said with surety is that in children no less than in adults, clinical depression is not a character weakness, normal sadness, or a passing phase. It is a real medical illness that can be accurately diagnosed and effectively treated.  Indeed, a child’s response to appropriate treatments is a valuable way of validating the presence of the disorder.