Depression in Special Circumstances: Children & Adolescents

Childhood is not uniformly a happy time for all. Although major depression is rare in preschoolers and occurs in probably fewer than 3% of school-age children, the likelihood of depression starts to equal that of adults as children reach adolescence. Once in adolescence, one estimate suggests that over one-third of teens are likely to experience anywhere from mild to severe depression. When teens themselves were asked, polls showed over 40% of boys aged 14 to 15, and close to half of the girls, reported depressive symptoms. These figures would tend to make people think that depression is both well recognized and well treated in the teenage population.

Unfortunately, it is often assumed that “adolescent turmoil” is responsible for mood disturbances seen in depressed teens. Indeed, many assume there is nothing particularly unusual about being depressed as a teen. Low self-esteem is also common among teenagers (especially among girls); as a symptom of depression, it doesn’t really stand out either. The best way to tell if a teen is clinically depressed is to try and judge how intense the mood swings are.

Although mood swings in adolescence are normal, the swings tend to intensify in depressed teens and their moods are often volatile. Depressed teens are also more prone to be sad, and there is an increased tendency for them to be either irritable or enraged. Behavioral changes may also be a sign of depression.

For example, school performance is often affected (typically, a child was doing well prior to the depression, at which point, performance declines sharply). Depressed adolescents often skip school, or find every excuse not to finish their assignments. Anti-social behavior may extend to stealing, fighting and bad driving as well, and is particularly noteworthy if a teen has never behaved in such a manner before.

As is true for adults, depressed adolescents may abuse alcohol and other drugs, most commonly, marijuana. Physical complaints are common and may include headaches, stomachaches, lack of appetite and weight loss. As well, depressed teens tend to look pale, tired and lack the energy you’d expect for their age.

Because adolescents are at great risk to take their own life, depression and suicidal ideas – as well as any attempt to end their own life – must be taken seriously. (See also Suicide and Children and Grief)