Depression in Children and Teens - Symptoms

Depression in a child or teen may occur suddenly or develop gradually. Your child may seem more irritable than sad or may feel bored or hopeless. It is common for others to notice that a depressed child's body movements are slow, restless, or agitated. Your child may be self-critical or feel that others are unfairly critical of him or her.

The symptoms of depression are often subtle at first. It can be hard to recognize that symptoms may be connected and that your child might have depression.
Children who are depressed may have the following symptoms:3, 4

* Irritability
* Temper tantrums
* Unexplained aches and pains, such as headaches or stomach pain
* Difficulty thinking and making decisions
* Trouble sleeping, or sleeping too much
* Changes in eating habits that lead to weight gain or loss or not making expected weight gains
* Low self-esteem
* Feelings of guilt and hopelessness
* Constant tiredness or lack of energy
* Social withdrawal, such as lack of interest in friends
* Thinking about death or feeling suicidal

It's important to watch for warning signs of suicide in your child or teen. These signs may change with age. Warning signs of suicide in children and teens may include preoccupation with death or suicide or a recent breakup of a relationship.

Many children who are depressed have symptoms of anxiety, such as worrying too much or fearing separation from a parent. Sometimes these symptoms appear before depression is diagnosed.

Other less common symptoms may occur in severely depressed children, such as hearing voices that aren't there (hallucinations) or having false but firmly held beliefs (delusions). Hallucinations are more common in young children, while delusions are more common in teens.5

Telling the difference between normal moodiness and symptoms of depression can be difficult. Occasional feelings of sadness or irritability are normal. They allow the child to process grief or cope with the challenges of life. For example, grieving (bereavement) is a normal response to loss, such as the death of a family member or even the death a pet, loss of a friendship, or parents' divorce. After a severe loss, a child may remain sad for a longer period of time. But when these emotions do not go away or begin to interfere with the young person's life, the child may develop signs of a mood disorder such as depression or dysthymic disorder (long-term, mild depression), which requires treatment.

Some children who are first diagnosed with depression are later diagnosed with bipolar disorder. 6 Children or teens with bipolar disorder have extreme mood swings between depression and bouts of mania (very high energy, agitation, or irritability). Depression can have symptoms that are similar to those caused by other conditions.

It can be difficult to distinguish bipolar disorder from depression. It is common for children with bipolar disorder to first be diagnosed with only depression and later to be diagnosed with bipolar disorder after a first manic episode. Although depression is part of the condition, bipolar disorder requires different treatment than depression alone. Like depression, bipolar disorder runs in families, so be sure to tell your health professional if your child has a family history of bipolar disorder. (For more information on bipolar disorder, see the topic Bipolar Disorder in Children and Teens.)
WebMD Medical Reference from Healthwise

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