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.
Learn More:
Doctor Interview
Listen to Robert A. Kowatch, MD, PhD, Director, Pediatric Mood Disorders Center at Cincinnati Children's, explain Major Depressive Disorders. Listen to this segment:
What are the risk factors for major depression?
The following are the most common risk factors for major depression:
family history of mental illness, including depression and suicide (especially if a parent experienced depression as a child or adolescent)
excessive stress
abuse (physical, sexual, or emotional) or neglect
trauma (physical, emotional and/or sexual)
other psychiatric disorders
loss of a parent, caregiver, or other loved one, expecially at an early age, to divorce, death, or abandonment
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
Overview of Depression
Depression is a depressive disorder that involves a child's/adolescent's body, mood, and thoughts. It can affect and disrupt eating, sleeping, or thinking patterns, and is not the same as being unhappy or in a "blue" mood, nor is it a sign of personal weakness or a condition that can be willed or wished away.
Children with a depressive illness cannot merely "pull themselves together" and get better. Treatment is often necessary and many times crucial to recovery.
What are the symptoms of major depression?
The following are the most common symptoms of major depression. However, each child or adolescent may experience symptoms differently. Symptoms may include:
persistent feelings of sadness and/or irritability
feeling hopeless or helpless
having low self-esteem
feeling inadequate
excessive guilt
recurring thoughts of suicide or death
loss of interest in usual activities
loss of pleasure or no longer enjoying pleasurable activities
difficulty with relationships
sleep disturbances (insomnia, hypersomnia)
changes in appetite or weight
change in activity level - either increased or decreased energy
difficulty concentrating, remembering or thinking clearly
a decrease in the ability to make decisions
suicidal thoughts or attempts
frequent physical complaints (headache, stomach ache, fatigue)
running away or threats of running away from home
hypersensitivity to failure or rejection
irritability, hostility, aggression
anger and rage
feeling empty inside
anxiety
For a diagnosis of major depression to be made, an adolescent 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 adolescent's physician for a diagnosis.
How is major depression diagnosed?
Because depression has shown to often co-exist with other psychiatric disorders, such as Bipolar Disorder, substance abuse or anxiety disorders, seeking early evaluation, diagnosis and treatment is crucial to the recovery of your adolescent or child.
A child and adolescent psychiatrist or other mental health professional usually diagnoses major depression following a comprehensive psychiatric evaluation. An evaluation of the adolescent'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 adolescent's physician based on:
your adolescent's age, overall health, and medical history
extent of your adolescent's symptoms
your adolescent's tolerance for specific medications, procedures, 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 adolescent and family. Treatment may include one, or more, of the following:
antidepressant medications (especially when combined with psychotherapy has shown to be very effecting in the treatment of depression in children and teens)
psychotherapy (most often cognitive-behavioral and/or interpersonal therapy) for the adolescent (focused on changing the adolescent's distorted views of themselves and the environment around them; working through difficult relationships; identifying stressors in the adolescent's environment and learning how to avoid them)
family therapy
consultation with the adolescent's school
Parents play a vital supportive role in any treatment process.
For many reasons, many parents of adolescents with depression never seek the appropriate treatment for their adolescent, although, approximately 80 percent of all 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 adolescents is also associated with an increased risk for suicide. Suidice risk rises, particularly among adolescent boys, when the depression is accompanied by other mental health disorders (conduct disorder, substance abuse). It is crucial for parents and care providers of adolescents to take all depressive and suicidal symptoms very seriously and seek treatment immediately. Suicide is a medical emergency. Consult your adolescent's physician for more information.
Contact us
For additional information on this or any Health Topic, please call the Family Resource Center, 513-636-7606, or your pediatrician.
Written 11/00, rev. 5/03, 6/05, 7/07
