Major Depression
What is major depression?Major depression, also known as clinical depression or unipolar
depression, is classified as a type of affective disorder (also called
mood disorder) that goes beyond the day's ordinary ups and downs, and has
become a serious medical condition and important health concern in this
country.
Who is affected by major depression?The National Institute of Mental Health, part of the National
Institutes of Health, reports the following:
- Research indicates that depression onset is occurring earlier in
life today than in past decades.
- Early-onset depression often persists, recurs, and continues into
adulthood. Depression in youth may also predict more severe illness in
adulthood.
- There is an increased incidence of depression in children whose
parents experience depression.
What are the risk factors for major depression?The following are the most common risk factors for major
depression:
- family history of depression (especially if a parent experienced
depression as a child or adolescent)
- excessive stress
- abuse or neglect
- trauma (physical and/or emotional)
- other psychiatric disorders
- loss of a parent, caregiver, or other loved one
- cigarette smoking
- loss of a relationship (i.e., moving away, loss of
boyfriend/girlfriend)
- other chronic illnesses (i.e., diabetes)
- other developmental, learning, or conduct disorders
What are the symptoms of major depression?
The following are the most common symptoms of major depression. However,
each child may experience symptoms differently. Symptoms may include:
- persistent feelings of sadness
- feeling hopeless or helpless
- having low self-esteem
- feeling inadequate
- excessive guilt
- feelings of wanting to die
- loss of interest in usual activities or activities once enjoyed
- difficulty with relationships
- sleep disturbances (i.e., insomnia, hypersomnia)
- changes in appetite or weight
- decreased energy
- difficulty concentrating
- a decrease in the ability to make decisions
- suicidal thoughts or attempts
- frequent physical complaints (i.e., headache, stomach ache, fatigue)
- running away or threats of running away from home
- hypersensitivity to failure or rejection
- irritability, hostility, aggression
For a diagnosis of major depression to be made, a child often needs to
exhibit a "cluster" (several) of the above symptoms during the same
two-week period. The symptoms of major depression may resemble other
problems or psychiatric conditions. Always consult your child's physician
for a diagnosis.
How is major depression diagnosed?
Because depression has shown to often co-exist 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.
Treatment for major depression:
Specific treatment for major depression will be determined by your child's
physician based on:
- your child's age, overall health, and medical history
- extent of your child's symptoms
- your child's tolerance for specific medications or therapies
- expectations for the course of the condition
- your opinion or preference
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 one, or more, of the
following:
- antidepressant medications (especially when combined with
psychotherapy has shown to be very effective in the treatment of
depression in children and teens)
- psychotherapy (most often cognitive-behavioral and/or interpersonal
therapy) for the child (focused on changing the child's distorted views
of themselves and the environment around them; working through difficult
relationships; 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 (i.e., conduct disorder, substance abuse).
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. Suicide is a medical emergency. Consult your
child's physician for more information.
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