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Anxiety & Panic Disorders Health Center

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Recognizing Childhood Depression and Anxiety

Parents often mistake depression in children for moodiness.

Childhood Depression continued...

Even so, genuine depression is by no means unknown in preteens.

"As rare as it is, there is a group of school-aged kids -- and even a few preschoolers -- who do experience full-blown depressive episodes," Koplewicz says. "It is one of those times where it is not a parent or an environment that has done this. It is a predisposition, the same way some kids have autism or learning disabilities or a full-blown gift for music at age 5 or 6. It is purely a DNA blip."

Childhood Depression, Childhood Anxiety

Whether a child suffers from true depression or a kind of anxiety, the condition is serious.

Prior to puberty the equivalent of depression in children is anxiety, Koplewicz says. "When kids are anxious they most probably have similar biochemical issues to teenagers. ... So these anxiety disorders are most likely, in prepuberty, the predisposition to depression."

In fact, kids who have anxiety as children are more likely to have teen depression. About half of depressed teens had a childhood anxiety disorder. And 85% of teens who have both anxiety disorders and depression had their anxiety disorder first.

"So anxiety in children is serious, and we tend to minimize it," Koplewicz says. "Anxiety is probably toxic to the brain. We tend to think it is all within the normal range of childhood behavior, and it is not."

Childhood anxiety disorders are persistent symptoms that center on a single theme. They cause children a great deal of distress and disrupt their daily lives. These disorders fall into three categories:

  • Separation anxiety. The most common childhood anxiety disorder is when a child fears there is a threat to his family. There's a deep-seated fear that something bad is going to happen to one of the family members -- or to the child. Being apart from their family is scary to these kids. They may get very real headaches, stomachaches, or diarrhea on school days -- but the pain comes from their brains, not their bowels.
  • Social phobia. These kids are extremely uncomfortable with the social aspects of school. They often become "socially mute." They'll talk with their father or mother or sister, but not with anyone outside the home. Often they refuse to go to school.
  • Generalized anxiety disorder. These kids worry excessively about the future. "They worry about how they will do in college, even though they're in third grade," Koplewicz says. "You ask, 'How did you do in soccer?' 'Two goals,' they'll answer. 'That's good,' you say. 'Yeah, they say, but I'm worried about the spelling test tomorrow.'"

"Hoping it is a phase, hoping the child will grow out of it, is a very big mistake," Koplewicz says. "All these disorders cause distress and dysfunction. It makes people feel hopeless. And hopelessness is what makes people want to hurt themselves. It isn't depression, it is hopelessness."

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