What are Depression and Dysthymia?
There are two types of depression: major depression and dysthymia. The severity of the depression and length of the depression are what differentiate the two.1
Major depression Major depression lasts at least two weeks and can occur more than once throughout a child’s life.
Dysthymia Less severe than major depression, dysthymia is a chronic depression that lasts for more than a year.
Depression is a serious mental illness that can take over your child’s mood and thoughts; it interferes with all aspects of a child’s life, which can result in absences from school, trouble socializing with peers, and in severe cases, thoughts of suicide.2
What are symptoms?
Symptoms that are commonly noticed in children with depression or dysthymia include:1,3,4
- Depressed or irritable mood, restlessness
- Decreased interest in activities; or inability to enjoy previously favorite activities
- Low self-esteem, feeling worthless
- Negative self-talk and unnecessary guilt
- Frequent sadness or crying
- Refusal to go to school, clinging to a parent
- Poor concentration and/or difficulty with decision making
- A major change in eating and/or sleeping patterns
- Mentions wanting to be dead or suicide
- Social withdrawal
- Unexplained general medical complaints (head hurts, stomach hurts)
At times it may be difficult to tell if a child is just going through a temporary “phase” or is suffering from depression. When symptoms last for a short period of time, it may be a passing case of “the blues”; but if they last for more than two weeks and interfere with regular daily activities, family, and school life, your child should be evaluated for a depressive disorder.1 When a child has a depressive disorder, symptoms of depression appear as a distinct shift from your child or teen’s previous functioning.5 Parents usually notice a change in their child’s behavior, or a teacher may mention the child “doesn’t seem to be himself”.6
What causes depression?
Commonly identified risk factors for major depression and dysthymia in children and adolescents include: 5,7
- Parental history of depression or mood disorders
- Parental conflict
- Poor peer relationships
- Negative temperament
- Children under stress, or who experience loss
- Having attentional, learning, conduct or anxiety disorders
At any given point in time 5% of children and adolescents in the general population are suffering from depression.3 Before age 15, more than 7% of children experience an episode of major depression.2 By 15 years of age, girls are twice as likely as boys to have experienced a depressive episode.
What can be done to treat depression?
A pediatrician can rule out medical conditions like diabetes or hypothyroidism that may cause similar symptoms.5 Typical forms of psychotherapy such as psychodynamic, cognitive-behavioral, interpersonal, and family therapy are used in treatment for children with depression.4 Behavioral interventions and instruction in social and interpersonal skills can also be helpful as part of a treatment plan. A pediatrician or psychiatrist may discuss the option of medication as part of a course of treatment. The FDA has approved 2 drugs for use in children diagnosed with a depressive disorder: Prozac for children 8 years and over, and Lexapro for kids 12 years and older.8 Without treatment children with depression risk relapse, the earlier treatment starts, the better the outcome. Improvement may take time, ranging from weeks to months of treatment. Treating any co-occurring conditions, such as an anxiety disorder, is important because they can influence the maintenance and recurrence of depression, and lengthen the duration of the depressive episode.4
Resources:
1 Anxiety and Depression Association of America
2 Boston Children’s Hospital
3 American Academy of Child & Adolescent Psychiatry
4 Medscape: Pediatric Dysthymic Disorder
5 Child Mind Institute
6 National Institute of Mental Health
7 American Family Physician
8 U.S. Food and Drug Administration