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Physical Symptoms of Depression in Children

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Updated September 20, 2011

Written or reviewed by a board-certified physician. See About.com's Medical Review Board.

If your child has been diagnosed with a depressive disorder, you may already be familiar with the physical symptoms of depression in children. However, if your child continually complains of vague physical symptoms, which his pediatrician cannot find an underlying medical cause for, you may need to explore the possibility of childhood depression. Research shows that recurrent physical complaints are common in childhood and are often associated with an underlying mental illness rather than a chronic disease.

What Are the Common Physical Symptoms?

The physical symptoms most often associated with childhood depression are:
  • Headache
  • Recurrent abdominal pain
  • Nausea
  • Generalized pain (e.g. neck, lower back)
  • Fatigue that does not lessen with sleep
  • Weight loss or gain
  • Significant appetite increase or decrease
  • Difficulty falling asleep, staying asleep or sleeping too much
Teenage children may experience these symptoms but be more likely to show more of the classic symptoms of depression in adults, as well as evidence of self-medicating with drugs and/or alcohol.

How Often Do These Symptoms Occur?

According to the American Academy of Pediatrics, approximately 3% of children have a depressive disorder, but not all depressed children will experience physical symptoms. One study found that 7 to 25% of children are affected by unexplained recurrent abdominal pain, and that approximately 3% of all pediatrician office visits are due to physical complaints for which no medical illness can be identified.

Additionally, Drs. Andre Tylee and Paul Gandhi -- who published a review studies in the Primary Care Companion to The Journal of Clinical Psychiatry in 2005 -- found that physical ailments are the chief complaint of two-thirds of depression sufferers seen by primary care physicians. They also reported that children are especially prone to experiencing physical symptoms of depression, as compared to adults.

How Does Physical Pain Relate to Depression?

It is unclear why some depression sufferers experience physical symptoms while others do not. However, like other disorders, every child's experience with depression is unique. There is some speculation that childhood depression may manifest itself through physical symptoms because children do not have the cognitive maturity to recognize or regulate their emotions.

According to Dr. John Campo and colleagues, who published a study of children with unexplained recurrent abdominal pain in Pediatrics in 2001, 44.4% of the children they studied also met the criteria for major depression disorder (MDD). They suggested that children who have recurrent abdominal pain might respond to life stress with physical symptoms.

Is My Child Really in Pain?

If you don't have experience with depression, you may be perplexed by a depressed child's complaints of physical pain. Just because it may seem unbelievable doesn't mean that your chlid is not in pain or does not require treatment.

If your child has been diagnosed with depression, his physical symptoms may decrease with prescribed treatment for depression rather than a treatment for each physical complaint.

What Depression Symptoms to Watch For in Your Child

If your child is complaining of any physical symptoms, always talk to your child's pediatrician to rule out an illness first. However, if your child is consistently complaining of physical symptoms that his pediatrician cannot find a medical cause for, consider having your child evaluated for depression. Even if your child has been evaluated for depression before, it is important to have him reevaluated as the rate of childhood depression increases with age.

As your child matures, he will go through changes in appetite, sleeping and growth. However, if you notice sudden or dramatic changes in your child, consult with your child's pediatrician.

There are other symptoms of depression, such as are feelings of excessive guilt; lack of concentration; irritability; isolation from family and friends; avoiding school and social activities; hopelessness; academic decline; excessive crying and thoughts or behaviors of self-harm.

If you notice any of these symptoms talk to your child's pediatrician immediately. Finding a safe and effective treatment for childhood depression is extremely important and gives your child the best chance at recovery.

Why Might My Child's Pediatrician Miss a Depression Diagnosis?

Primary care pediatricians often have very limited time with each patient. And, as stated, these physical symptoms are not always telltale of depression. If your child is experiencing these symptoms, enlist the help of a mental health professional for further evaluation.

Screens for mental health issues always show that a greater proportion of children seen have important issues than are recognized by their general practitioners.

Sources:

Andre Tylee, MD, FRCGP, MRC.Psych, Paul Gandhi, MRC. Psych. "The Importance of Somatic Symptoms in Depression in Primary Care." Primary Care Companion Of The Journal of Clinical Psychiatry, 2005 7(4):167-176.

John V. Campo, Carlo Di Lorenzo, Laurel Chiappetta, et al. "Adult Outcomes of Pediatric Recurrent Abdominal Pain: Do They Just Grow Out of It?" Pediatrics 2001 108.

John V. Campo, MD, Jeff Bridge, PhD, Mary Ehmann, BA, et a. "Recurrent Abdominal Pain, Anxiety, and Depression in Primary Care." PEDIATRICS April 4, 2004 13(4):817-824.

Martin T. Stein, Janet Crow, Myles Abbott and J. Lane Tanner. "Organic or Psychosomatic? Facilitating Inquiry With Children and Parents." Pediatrics , 2004 114:1496-1500.

Paivi Santalahti, MD, Minna Aromaa, MD, Andre Sourander, MD, et al. "Have There Been Changes in Children's Psychosomatic Symptoms? A 10-Year Comparison From Finland." Pediatrics , April 4, 2005 115:e434-e442.

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.

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