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.
- 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.
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.
- 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.