Overview, Causes, & Risk Factors

Depression is a medical condition that leads to intense feelings of sadness or despair. These feelings don't go away on their own. They are not necessarily related to a particular life event.

What is going on in the body?

Depression is a disorder of the brain. Researchers believe that chemicals called neurotransmitters are involved in depression. Nerve impulses cause the release of neurotransmitters from one nerve cell, or neuron, to the next. This release allows cells to communicate with one another. Too little or too much of these important neurotransmitters may be released and cause or contribute to depression. Some of the neurotransmitters believed to be linked to depression are serotonin, norepinephrine, and dopamine.

What are the causes and risks of the condition?

There are many theories about what causes depression. Depression may be caused by any of these things:

certain illnesses

certain medications, including antibiotics and medicines used to treat acne

changes in brain chemicals

heredity

hormonal changes

lack of sunlight

major stresses

negative thinking patterns

Following are some common risk factors for depression in children:

abuse or neglect

alcohol abuse

chronic illness, such as diabetes

cigarette smoking

divorce of parents

drug abuse and addiction

family history of depression

learning disabilities

low self-esteem

major trauma, such as a natural disaster

other psychiatric disorders, such as attention deficit disorder or adolescent conduct disorder

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Symptoms & Signs

What are the signs and symptoms of the condition?

Some symptoms are common in people of all ages with depression. These symptoms include the following:

appetite problems

decreased energy

difficulty paying attention or making decisions

feeling very sensitive emotionally

feelings of irritability

feelings of sadness, despair, and emptiness

inability to feel pleasure

loss of motivation and withdrawal from others

low self-esteem

pessimism, negativity

sleeping problems

thoughts about suicide and death

Children with depression may have the following additional symptoms:

alcohol abuse

difficulty with friendships or social outings

drug abuse and addiction

fear of death

frequent vague physical ailments, such as headache

poor school performance, tardiness, or absences

problems with authorities

recklessness

sensitivity to failure or rejection

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Diagnosis & Tests

How is the condition diagnosed?

The Children's Depression Inventory, also called CDI 18, may be used to screen a child for depression. A child who screens positively should have a comprehensive evaluation for depression. The evaluation may include a history, physical examination, and laboratory tests.

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Prevention & Expectations

What can be done to prevent the condition?

Depression may not be preventable. Some steps that may be helpful in preventing depression include the following:

avoiding alcohol and illegal drugs

avoiding cigarette smoking

getting prompt treatment for other psychiatric disorders

seeking effective treatment for chronic diseases

talking with a counselor if the child experiences a major trauma

Depression can lead to suicide. It is important to recognize and treat the condition early. Children should be encouraged to talk to someone if they are concerned about depression. There are many people they can talk to including the following:

a clergy member

a family doctor

parents or a trusted family member

a professional at a mental health center

a psychologist

a school counselor

What are the long-term effects of the condition?

Most children recover well from a single episode of depression. However, episodes are likely to recur. Children with depression are at risk for further episodes of depression later in life. They are also at risk for adult personality disorders. Children with depression are more likely to commit suicide than other children.

What are the risks to others?

Depression is not contagious and poses no risk to others.

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Treatment & Monitoring

What are the treatments for the condition?

The two most common ways of treating depression in children are with antidepressant medications and psychotherapy. Often a combination is used. Occasionally a person must be hospitalized for intense treatment or for his or her own safety.

Antidepressant medications are effective in the following ways:

increasing the child's ability to function in daily life

lowering the risk of suicide

making the child feel better

A class of antidepressant medications known as selective serotonin reuptake inhibitors, or SSRIs, can be used in children. Some common SSRIs include fluoxetine and paroxetine.

Psychotherapy can help children:

cope better with having depression

feel less alone

improve relations with family, friends, and coworkers

learn about depression and how it affects them

learn to recognize and avoid situations that can bring on a depressive episode

learn to view the world and others more positively and more realistically

positively address problems that they may be facing

stop episodes of depression early by recognizing warning signs and symptoms

Treatment of depression in a child should involve the family as well as the individual.

What are the side effects of the treatments?

Antidepressants may cause mild and usually temporary side effects in some people. The most common side effects are as follows:

agitation

constipation

dizziness

drowsiness

dry mouth

nausea

What happens after treatment for the condition?

An episode of depression in a child usually responds to treatment with medication and psychotherapy. The child can help prevent relapses by living a healthy lifestyle. Following are some important parts of a healthy lifestyle:

avoiding alcohol, illegal drugs, and smoking

doing regular exercise

eating a balanced diet, following the food guide pyramid

finding a support system for dealing with depression

finding ways to manage stress

getting enough rest

How is the condition monitored?

Once a child has an episode of depression, he or she is at higher risk for further episodes. Any new or worsening symptoms should be reported to the healthcare provider. The provider may recommend regular visits to monitor symptoms. The provider may also order blood tests to monitor the levels of medications.

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