Major depressive disorder, also known as major depression, clinical depression, or MDD, is a serious mood disorder that children can experience.
How Common is MDD?
Approximately 2 to 3% of young children, and 4 to 8% of adolescents will experience MDD.
Boys have a higher rate of MDD in childhood, but this changes during puberty, when girls become twice as likely as boys to be diagnosed with MDD.
Additionally, 5 to 10% of children and adolescents exhibit temporary depressive symptoms, according the American Academy of Child and Adolescent Psychiatry, but do not meet the criteria for MDD.
Symptoms of MDD in Children
The symptoms of MDD last for at least 2 weeks, and significantly interfere with daily functioning and/or impact family and social interactions and relationships.
Symptoms of MDD in children may include:
- Decreased activity or energy level
- Depressed mood
- Loss of interest or pleasure in activities
- Lack of concentration
- Decrease in self-esteem and self-worth
- Feelings of guilt
- Irritability
- Sadness
- Withdrawal from friends and family
- Unexplained physical symptoms
- Becoming easily frustrated
- Mood swings
- Thoughts or actions of self-harm or suicide*
In general, to receive a diagnosis of MDD, a child's depressive symptoms must not be better explained by her substance use, other medical or psychiatric illness(es), or recent loss of a loved one.
Of course, there are exceptions to this rule, and only a trained professional can make an appropriate diagnosis. Any concerning symptoms or behaviors should be brought to the attention of a medical or mental health professional.
The Course of MDD
The duration of a major depressive episode will vary for each child, but may be significantly shortened with appropriate treatment.
Long-term treatment, or continuation treatment, may be needed even once your child is feeling better -- and even then, there is a chance for future recurrence.
Without treatment, there is a higher risk of short- and long-term consequences from MDD, such as poor academic performance, impaired interpersonal relationships, substance abuse, and increased risk of suicide attempt*.
Every child is different, and so is the course of depression. Not all children with depression will have recurrences or negative consequences, but treatment is still recommended.
Risks for Major Depression in Children
It can be difficult to pinpoint a cause of depression in children. However, family history of major depressive disorder is the most predictive risk factor for children, according to the American Academy of Child and Adolescent Psychiatry. Other associated risk factors for MDD may include:
- Low self-esteem
- Previous depressive episodes
- Other psychiatric illnesses, like ADHD
- Being a prolonged victim of bullying
- A limited number of social identities
Whether or not your child has risk factors for MDD, if you think that she has major depressive disorder or is showing depressive symptoms, it is important to have your child evaluated by a professional.
While it can certainly be upsetting to see your child struggling with depression, it is not a reflection of bad parenting. Helping your child to get safe and effective treatment is the best decision for the whole family.
*If your child or someone else you know is having thoughts of suicide, contact the National Suicide Prevention Lifeline at 1-800-273-TALK (1-800-273-8255).
Sources:
Boris Birmaher, MD, David Brent, MD, et al.Practice Parameter for the Assessment and Treatment of Children and Adolescents With Depressive Disorders. Journal of American Academy of Child and Adolescent Psychiatry. 46(11). November 2007. 1503-1526.
Depression and Suicide in Children and Adolescents. Mental Health: A Report of the Surgeon General. Accessed: 02/06/2011. http://www.surgeongeneral.gov/library/mentalhealth/chapter3/sec5.html
S.B. Williams, E.A. O'Connor, Eder, M. Whitlock, E.P. Screening for Child and Adolescent Depression in Primary Care Settings: A Systematic Evidence Review for the US Preventive Services Task Force. Pediatrics April 4, 2009; 123(4):e716-e735.
S.E. Son, J.T. Kirchner. Depression in Children and Adolescents. American Family Physician 2000; 62: 2297-2312.
