Depression

Depression differs from normal and temporary sadness, grief, or low energy.  Depression is a serious and debilitating condition of prolonged sadness or irritability accompanied by a diminished interest in previously pleasurable pursuits and activities.  Because frequent fluctuations in mood and temperament accompanied by other significant developmental adjustments are considered normal and are expected during adolescence, parents and other adults often fail to recognize depression in children and teens.  Undiagnosed and untreated depression can seriously diminish and impair a child's quality of life.  Most importantly, prolonged and severe depression can result in serious outcomes including suicidal thoughts, ideas, and behaviors.

Symptoms.  An individual who is struggling with depression may experience a combination of any of the following symptoms over a period of weeks to months:

• Fatigue and energy loss that is often noticeable to others
• Difficulty sustaining mental effort  
• A noticeable and uncharacteristic drop in grades and overall academic performance
• Poor hygiene or lack of interest in appearance
• Change in affect
• Unprovoked irritability and anger with both friends and family
• Conflict in family relationships
• Withdrawal from friendships and social settings and frequent isolation
• Loss of interest in pleasurable pursuits or previous commitments
• Loss of motivation
• Changes in appetite
• Weight gain or loss
• Trouble sleeping or sleeping more than usual
• Inability to concentrate or make decisions
• Frequent and recurring crying spells
• Decline in self-esteem and confidence levels
• Feelings of hopelessness
• Feelings of worthlessness or guilt
• Preoccupation with death or recurrent thoughts of suicide
• Physical symptoms including body aches, headaches, and stomach pain 

Questions to ask.  The majority of children and teens will experience some amount of unexplained sadness or boredom on occasions. The following questions may assist students and parents in identifying circumstances of mild or moderate depression, which is more difficult to discern than symptoms of major depression:

o   Do you feel angry most of the time?

o   Do you feel sad every day?

o   Do you laugh with your friends?

o   Do you feel happy when you are doing things you enjoy, such as a favorite hobby or a sport?

o   Do you feel as though you are easily angered, irritated, or saddened for no apparent reason?

o   Do you stay sad or angry for a long time?

Causes and Risk Factors.  The causes of depression are currently conceptualized as a complex interplay of genetic factors, environmental forces, and neurochemical activity in the brain.  However, several factors have been identified that predispose individuals to depression.  The following items have been identified as risk factors in the development of depression:

• Lack of family or social/peer support
• Personal or family history of depression
• One or both parents with a diagnosis of depression
• Stressful life events including divorce and separation, financial strain, job loss, death, and major illness in the family
• Certain medical conditions such as hypothyroidism

Treatment.  Treatment for depression varies according to the specific needs and symptoms experienced by the individual.  Treatment interventions may include individual or family therapy, group therapy, and/or medication.  Treatment with antidepressant medication is often recommended by mental health and medical professionals.  Antidepressants have been shown to effectively reduce the symptoms of depression especially when utilized as an adjunct treatment to therapy.

*Medications for depression can only be prescribed by a psychiatrist or other medical doctor after an individual has been properly evaluated, and all treatment options have been thoroughly considered.  Psychologists, therapists, social workers, and other mental health professionals frequently refer individuals to consult with psychiatrists in order to be evaluated for treatment with antidepressant medication.  Psychiatrists can provide accurate and up-to-date information about medications including the potential side effects and risks for abuse.