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Evaluating and Treating Childhood Depression

by Dr. Randi Fredricks, Ph.D., Director of San Jose Counseling and Psychotherapy

Depression is a serious health problem that affects people of all ages, including children and adolescents. It is characterized by the persistent experience of a sad or irritable mood and the loss of interest or pleasure in nearly all activities. These feelings are accompanied by a range of additional symptoms affecting appetite, sleep, activity level, concentration, and feelings of self-worth.

Clinical depression is more than just feeling blue or having a bad day and it's different from the feelings of grief or sorrow that might follow a major loss, such as a death in the family. It's not a personal weakness or a character flaw.

Children and teens with clinical depression cannot simply snap out of it. Depression is a form of mental illness that affects the whole body, impacting the way one feels, thinks and acts. If left untreated, depression can lead to school failure, alcohol or other drug use, and even suicide.

Know The Signs of Childhood Depression

  • Persistent sadness and hopelessness.
  • Withdrawal from friends and activities once enjoyed.
  • Increased irritability or agitation.
  • Missed school or poor school performance.
  • Changes in eating and sleeping habits (e.g. significant weight loss or insomnia).
  • Indecision, lack of concentration or forgetfulness.
  • Feelings of worthlessness or excessive guilt.
  • Frequent physical complaints such as headaches and stomachaches.
  • Lack of enthusiasm or motivation.
  • Low energy and chronic fatigue.
  • Drug and/or alcohol abuse.
  • Recurring thoughts of death or suicide.
The Center for Mental Health Services (CMHS) reported that as many as one in every 33 children and approximately one in eight adolescents may have depression. Fortunately, treatment of major depression is as effective for children as it is for adults.

Risk Factors for Depression in Children

  • According to the American Academy of Child & Adolescent Psychiatry, children with attention disorders who have experienced a loss are at a higher risk for depression.
  • The National Institute of Mental Health (NIMH) reports that adolescent girls are more likely than adolescent boys to develop depression.
  • The NIMH found that younger children who develop depression are likely to have a family history of the disorder.
  • Research from the U.S. Select Committee on Children, Youth & Families found that four out of every five runaway youth suffer from depression.
The Consequences of Depression in Children
  • The CMHS reported that once a young person has experienced an episode of depression, he or she is at risk for developing another episode of depression within the next 5 years.
  • The NIMH found that depression in childhood often predicts more severe depressive illness in adulthood.
  • According to the NIMH, depression in children and adolescents is associated with an increased risk for suicidal behaviors.
What Parents and Other Adults Can Do To Help

If parents or other adults in a young person's life suspect a problem with depression, they should do the following:

  • Know the warning signs of depression and note how long problems have been going on, how often they occur, and how severe they seem.
  • See a mental health professional or the child's doctor for evaluation and diagnosis.
  • Get accurate information from libraries, hotlines and other sources.
  • Ask questions about treatments and services.
  • Talk to other families or find a family network organization.
It is important that a child with depression feels free to ask questions about the mental health care they receive, to discuss their concerns with the provider, ask for more information, and seek help from other sources. The good news is that depression is treatable. Early diagnosis and treatment are essential for children with depression to prevent it from worsening and continuing untreated into adulthood. Children who exhibit symptoms of depression should be referred to and evaluated by a mental health professional who specializes in treating children and adolescents.

The diagnostic evaluation for a child with depression can include psychological testing, laboratory tests and consultation with other specialists. A comprehensive treatment plan typically includes psychotherapy, ongoing evaluation and monitoring. Generally speaking, psychiatric medication is normally only used in the most extreme cases of major depression in children and teens. Optimally, this plan is developed with the family, and whenever possible, the child or adolescent is involved in treatment decisions.

Dr. Randi Fredricks, Ph.D., is an author, researcher, and Licensed Marriage & Family Therapist (#47803) in San Jose, California. She works with teenagers and adults with anxiety, depression, addiction, and eating disorders. To learn more about Dr. Fredricks' work, visit

Disclaimer: Internet Special Education Resources (ISER) provides this information in an effort to help parents find local special education professionals and resources. ISER does not recommend or endorse any particular special education referral source, special educational methodological bias, type of special education professional, or specific special education professional.
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