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Understanding Childhood Depression


Author:

Rama Rao, MD

Community Psychiatry for Adults and Children

Medically Reviewed On: June 14, 2001

When we think of a depressed child, we often envision a morose child who is consistently sad. However, sadness may not be the symptom that defines whether a child is depressed. It is estimated that five percent of all children suffer from serious depression that requires some form of treatment and intervention by physicians and other health care workers. The most important thing that we can do as parents and teachers is to learn to identify the signs and symptoms of this condition, so that proper action can be taken.

Art and play
Children experience and manifest depressive symptoms in a unique set of ways, different from adults. Many children cannot identify their depression with the use of words, so it is vital to recognize other clues. Very young children, for instance, may show depressive signs in their play and drawings with the use of dark colors and sad themes. Depressed children may consistently paint trees without leaves, branches or fruit; they may draw broken down houses, and depict crying moons, suns and animals. They may even paint images of themselves and family members that seem lifeless, sad or morbid. These may be signs that their mood is being greatly affected. Such depressive themes in art and play may indicate the possibility of a primary genetic inheritance of depression, a reaction to family and school stressors, or both.

Behavioral problems
Depressed children may develop new behavioral problems at home and school. They may be persistently irritable and edgy and may not know why. Often their tolerance of conflict and frustration is very low. Attention span is markedly limited, which means that children who are depressed may appear very distracted. The common reaction to this type of behavior is disciplinary action, and often the consideration of depression is overlooked.

School performance
A key clue to depression that should not be ignored is a sudden change in school performance. If a child is falling into the "grade danger zone", or shows significant and sudden change in performance, this may be a clue that the child is depressed. Children who are becoming more seriously depressed often isolate themselves from friends and family in a way that is not characteristic of that child.

Lethargy
Some children sleep for longer than usual periods during the day; they may appear to be slow, lethargic and lack interest in their usual activities.

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