Depression in Children and Adolescents
What is depression?
Depression is the most common mental disorder, not only for adults, but for children and teenagers as well. The DSM-IV classifies depression as a mood disorder. It states that an individual has suffered a “major depressive episode” if certain symptoms persist for at least two weeks, including a loss of enjoyment in previously pleasurable activities, a sad or irritable mood, a significant change in weight or appetite, problems sleeping or concentrating, and feelings of worthlessness. These symptoms of depression fall into four categories: mood, cognitive, behavioral, and physical. Depression affects how individuals feel, think, behave, and how their bodies work. People with depression may experience symptoms in any or all of the categories, depending on personal characteristics and the severity of the depression (Ainsworth 2000).
Victims of depression often describe feelings of emptiness, hopelessness, unreasonable guilt, and profound apathy. Their self-esteem is usually low, and they may feel overwhelmed, restless, and irritable. The changes occurring with depression understandably result in alterations in behavior. Most individuals with moderate-to-severe depression will experience decreased activity levels and appear withdrawn and less talkative, although some severely depressed individuals show agitation and restless behavior, such as pacing the floor. “Depression is more than a mental illness. It is a total body illness (Curtis, p. 132)”.
Major depressive disorder, also know as clinical depression, is the serious and often disabling for of depression that can occur as a single episode or as a series of depressive episodes over a lifetime. A single episode may last as little as two weeks or as long as months to years (Mondimore, 1990). Some people will have only one episode with full recovery. Others recover from the initial episode only to experience another episode months to years later. There may also be clusters of episodes followed by years of remission.
Depression in Children
How do we determine whether children are depressed? All children feel unhappy from time to time. Sadness is a normal, natural response to many life events, from losing a soccer game or moving away from old friends to a death in the family. “Although when that sadness runs too deep, lasts too long, or occurs too often, it may be a sign of clinical depression (Egger, 2002).” For many years, childhood depression went unrecognized. Many mental health professionals believed that children were not emotionally mature enough to experience true depression. It was not until the early 1980s that clinicians and researchers began to realize that childhood depression was a distinct, recognizable disorder. The National Institute of Mental Health (NIMH) estimates that over 1.5 million children and adolescents are seriously depressed (Wingert, 2002).
Since most experts now agree...