Debbie knew something was wrong. Her 11-year-old son was having difficulty at school. He was often agitated or angry. When he wasn’t, he was tired and withdrawn. She wondered if it might be Attention Deficit and Hyperactivity Disorder, but she also had a nagging suspicion it might be something else. Debbie’s brother had suffered from clinical depression for years. Could her son be depressed?

Children, like adults, can suffer from depression. “Depression is more common than many parents realize,” said Robin Gurwitch, PhD, a child psychologist with the University of Oklahoma’s Department of Pediatrics. “National statistics show depression affects as many as one in every 33 children and one in eight adolescents. Once a child has experienced a major depression, he or she is also more likely to experience depression again within the next five years.

According to Gurwitch, depression can lead to academic underachievement, social isolation, and difficulties in relationships with friends and family. It can also lead to drug or alcohol use and suicide, which is now the third leading cause of death among young people between the ages of 15 and 24.

“This is an extremely important issue and one that is, unfortunately, too often overlooked,” Gurwitch said. “With the beginning of the school year, many children, particularly those entering high school, will feel increased stressors as they navigate the new environment and responsibilities. Although most will be fine, attention to the signs and symptoms of depression should not be minimized.”

Causes of Childhood Depression
It was her brother’s own life-long battle with depression that stirred Debbie’s concerns about her son’s behaviors. Gurwitch said family history may increase a child’s risk of developing clinical depression, but there are other triggers too. Stressful life events like the loss of a parent to death or divorce, physical problems, and chronic illness can also play a role. Children who experience physical or emotional abuse, neglect, or other trauma may also be at risk.

Gurwitch explained that children who are depressed often have other coexisting disorders. That means a child who is depressed may also have attention, learning, or behavior disorders. The American Academy of Child and Adolescent Psychiatry reports that a third of six to twelve-year-olds diagnosed with major depression will also develop bipolar disorders within a few years.

Research has shown clinical depression can contribute to eating disorders, and an eating disorder can also lead to clinical depression.

Warning Signs
Every child has a bad day every now and then. All children feel a little sad from time to time, but clinical depression goes beyond sadness. Dr. Gurwitch explained that depression affects the whole child—his or her feelings, thoughts, and actions.

According to the National Mental Health Association, if your child struggles with any combination of these symptoms for more than two weeks, you should talk with your family doctor or a mental health professional:
• Frequent sadness, tearfulness, crying
• Feelings of hopelessness
• Withdrawal from friends or activities
• Lack of enthusiasm or motivation
• Decreased energy level
• Major changes in eating or sleeping habits
• Increased irritability, agitation, anger, or hostility
• Frequent physical complaints such as headaches or stomachaches
• Indecision or inability to concentrate
• Feelings of worthlessness or excessive guilt
• Extreme sensitivity to rejection or failure
• Pattern of dark imagery in drawings or paintings
• Recurring thoughts or talk of death, suicide, or self-destructive behavior

“In the teen years, substance abuse can also be a warning sign of depression,” warned Gurwitch. “Many teens who are depressed use drugs or alcohol to try to numb or manage their pain. Suicide is also a very real concern. One study by the Centers for Disease Control and Prevention found that more than one in four high school students had thought about suicide. That’s a frightening number and one we can’t ignore.”

What Can You Do?
As with so many health issues, early diagnosis and treatment is essential for children with depression. “If you suspect your child has an ear infection, you wouldn’t hesitate to seek appropriate care and the same holds true for depression,” stressed Gurwitch. “Children who are showing signs that they may be depressed should be referred to and evaluated by a mental health professional who specializes in treating depression in children and teenagers. Depression is an illness. It is not going to just go away. Your child can’t just snap out of it. He or she needs help to get better and there is help available.”

In most instances, a comprehensive treatment plan will be developed for the child who suffers from depression. That plan may include psychotherapy, medication, ongoing evaluations and monitoring. Experts say it is generally best to involve the family and the child or teenager as decisions are made and the plan is developed.

Resources
Contact Crisis Helpline: 848-2273 or 1-800-SUICIDE, www.contactcrisishelpline.org.
If you suspect your child may be depressed or suicidal, Contact Crisis Helpline can put you in touch with important local resources. Its Suicide Awareness Program also utilizes trained facilitators to work with schools and community organizations, educating them about the warning signals of suicide and on how to get help.

OU Children's Physicians Child Study Center: 271-5700. The Child Study Center provides multi-disciplinary evaluation, treatment, consultation, and follow-up of children with developmental, educational, behavioral, and medical needs.

Teenline: 1-800-522 TEEN. Teenline operates each day from noon until midnight, offering support, information, and crisis response to teens and young adults.

Oklahoma Department of Mental Health and Substance Abuse Services, Reach Out program:800-522-9054. Reach-Out is a 24-hour toll free information and referral hotline, providing information and assistance to individuals in crisis. It offers referrals to appropriate treatment or prevention facilities in your area.

National Mental Health Association: www.nmha.org. The National Mental Health Association is a nonprofit organization dedicated to addressing all aspects of mental health and mental illness, through advocacy, education, research, and service.

American Academy of Child and Adolescent Psychiatry:  www.aacap.org. A non-profit organization whose members include more than 6,500 child and adolescent psychiatrists and other interested physicians. It provides information as a public service to aid in the understanding and treatment of developmental, behavioral, and mental disorders in children and adolescents.

Theresa Green is the mother of two children and president of Evergreen Productions, Inc. An award-winning reporter and former news anchor, she has reported on health, education, and parenting issues in Oklahoma City, Seattle, and Detroit.