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Depression

What is Depression?

Depression can strike a child at any age. A mood disorder, depression is characterized by a persistent sad or empty feeling, irritability, and a loss of interest in everyday activities. Unlike normal sadness or grieving, most bouts of depression last for weeks, months, or even years. A smaller number of children and adolescent suffer from bipolar disorder-bouts of depression interspersed with periods of elevated (manic) mood (bipolar disorder).

Although depression is usually not considered life-threatening, it can lead to thoughts of and attempts at suicide.

Symptoms

  • Persistent feelings of sadness, apathy, or hopelessness lasting more than two weeks.
  • Diminished interest in most daily activities, particularly pleasurable ones.
  • Decreased appetite and subsequent weight loss; increased appetite and weight gain.
  • Lack of sleep (insomnia), frequent awakening throughout the night, or conversely, an increased need for sleep.
  • Anxiety; diminished ability to think or concentrate.

Diagnosis

Because there are no reliable laboratory tests to diagnose depression, physical examination and psychological evaluation are essential.

  • Expression of either of the first two symptoms of depression (see Symptoms box), in conjunction with other symptoms, for a period of two or more consecutive weeks.
  • A positive family history of depression or a prior depressive episode helps establish the diagnosis.

Treatment

  • Psychotherapy is as effective as drug treatment in mild cases. Psychotherapy may also be used in conjunction with drug therapy.
  • Antidepressant medications, such as selective serotonin reuptake inhibitors (SSRIs), are mainstays of treatment.
  • Exposure to bright light, known as light therapy, may be effective, particularly when depression is related to seasonal changes (seasonal affective disorder).
  • In secondary depression, the underlying cause is addressed, although antidepressant therapy may also be prescribed.

At Hopkins Children's, the Division of Child and Adolescent Psychiatry treats depression.