Major Depression

Major depression, also known as clinical depression, is classified as a type of affective disorder (also called mood disorder) that goes beyond the day's ordinary ups and downs. It is a serious medical condition and important health concern.

Risk factors for major depression

Research indicates that the onset of depression occurs earlier in life today than in past decades. Early-onset depression is concerning because it often persists and recurs in adulthood.

The most common risk factors for major depression are:

• Family history of depression, especially if a parent experienced depression as a child or adolescent

• Excessive stress

• Abuse or neglect

• Physical or emotional trauma

• Cigarette smoking

• Loss of a relationship, for example, moving away, loss of boyfriend or girlfriend

• Other developmental, learning, or conduct disorders

Symptoms of major depression

Although everyone experiences the symptoms of depression differently, these are the most common symptoms:

• Persistent feelings of sadness
• Feeling helpless or hopeless
• Low self-esteem
• Feelings of inadequacy
• Excessive guilt
• Feelings of wanting to die
• Loss of interest in activities once enjoyed
• Relationship difficulty
• Sleep disturbances
• Changes in weight or appetite
• Decreased energy
• Difficulty concentrating
• Inability to make decisions
• Suicidal thoughts or attempts
• Frequent physical complaints, such as fatigue or headaches
• Running away from home
• Irritability, hostility or aggression

For a diagnosis of major depression to be made, a child often needs to exhibit several of the above symptoms during the same two-week period.

Diagnosis and treatment

Because depression has shown to often coexist with other psychiatric disorders, such as substance abuse or anxiety disorders, seeking early diagnosis and treatment is crucial to the recovery of your child.

A child psychiatrist or other mental health professional usually diagnoses major depression following a comprehensive psychiatric evaluation. An evaluation of the child's family, when possible, in addition to information provided by teachers and care providers may also be helpful in making a diagnosis.

Mood disorders, including major depression, can often be effectively treated. Treatment should always be based on a comprehensive evaluation of the child and family. Treatment may include:

• Antidepressants, which have shown to be very effective when combined with psychotherapy.

• Psychotherapy focused on changing the child's distorted views of him- or herself and the surrounding environment, working through difficult relationships and identifying stressors in the child's environment and learning how to avoid them

• Family therapy

• Consultation with the child's school

Parents play a vital supportive role in any treatment process.

For several reasons, many parents of children or adolescents with depression never seek the appropriate treatment for their child, although many people with major depression who seek treatment improve — usually within weeks. Continued treatment may help to prevent reoccurrence of the depressive symptoms.

Without appropriate treatment, symptoms of depression can persist for weeks, months, or years.

In addition to causing interpersonal and psychosocial problems, depression in children and adolescents is also associated with an increased risk for suicide. Further, this risk rises, particularly among adolescent boys, when the depression is accompanied by other mental health disorders.

It is crucial for parents and care providers of children and adolescents to take all depressive and suicidal symptoms very seriously and seek treatment immediately.