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Types of Depression in Children

What are the different types of depression suffered by children

Depression in children is a mood disorder characterized by low mood and it affects children of all ages, at different developmental stages, up to complete puberty. Evidence suggests that approximately 3-5% of children suffer at one point in their childhood from clinical depression and about 10-15% exhibit several depressive symptoms. Until the age of fifteen the depression rates affecting boys and girls are similar. These rates double in the case of girls who are older than fifteen years old. In contrast with depression in adult men and women, whose main symptom is an overwhelming feeling of sadness, depression in childhood is primarily characterized by persistent and increased irritability, constant apathy, self-loathing and self-harming, anti-social and aggressive behaviours.

These symptoms of a depressive disorder typically co-occur with a conduct disorder that manifests itself through a large range of anti-social behaviors which violate the age-appropriate norms and which ultimately may lead to anti-social personality disorder or ASPD. Furthermore, the parents should also be aware of the fact that the comorbidity rate with anxiety disorders ( which include generalized anxiety disorder, panic disorder and phobias) is quite high, depressive disorders in children usually co-existing with anxiety disorders in up to 75%.

There are three major forms of child depression encompassed under the umbrella term “depressive disorders”.

1.dysthymic disorder, also known as chronic depression or dysthymia is a chronic disorder ( persisting for at least 2 years ) characterized by symptoms which are mild in intensity, but which last longer;

2.pediatric bipolar depression, also known as manic-depressive disorder is very rare in children who have not reached puberty yet and it is characterized by episodes of anger and increased irritability (instead of mania which develops only in adults) that alternate with episodes of psychosis (loss of contact with reality);

3.pediatric unipolar depression, also known as major depressive disorder, typically occurs in children as the
atypical depressive disorder subtype, which is the most common form of clinical depression and it affects children of all ages. It is characterized by mood reactivity ( the mood of the child improves with the occurrence of positive events) which alternates with episodes of persistent sadness, apathy, self-destructive behaviour and irritability leading to anger.

The diagnosis of child depression is typically more challenging than the diagnosis of depression in adults. Although the same diagnostic criteria, the DSM-IV criteria apply in both cases, the mood swings which are correlated with normal developmental phases in children ( as triggered by hormonal changes) make more difficult the process of diagnosing correctly depression in childhood. Thus, an accurate diagnosis may be often delayed, postponed or overlooked altogether. Parents play a key role in recognizing potential changes in the mood and behavior of their children. In case parents suspect their child to be suffering from depression, it is advised to seek early on the valuable and expert opinion of a specialized pediatric psychologist or psychiatrist regarding the assessment, correct diagnosis and proper treatment of this mood disorder.

With emotional support from parents and relatives and appropriate clinical treatment which combines psychotherapy with antidepressant medication ( only if necessary), the recovery rate for a depressed child is very high. Recurring depression later in adulthood typically affects 50% of children and it is primarily caused by the delay or postponement in addressing clinically the underlying causes of this affective disorder. According to scientific studies, a recurrence rate of 70% affects children within five years after having been diagnosed with a depressive episode. There is no difference between girls and boys in terms of both the intensity of the symptoms and the recurrence rate. Parents, child welfare or social workers should be aware of the following telltale signs which may signal the onset or chronic presence of child depression. The most severe consequence of untreated child depression is the risk for suicide. Any suicidal attempt should be taken very seriously, because it is a main risk factor for a later potential suicide, in their teen years or early adulthood.

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