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What Are the Signs Your Child Is Depressed?

WebMD Health News

Dec. 13, 2000 -- Does your child get headaches or stomachaches whenever it's time to go to school? Or is she a well-behaved, straight-A student -- who never plays with other kids? Each of these two very different children may suffer from depression, but how would their parents know for sure? A new paper attempts to shed light on this dark subject.

Serious, scientific examinations of childhood depression have been rare until relatively recently, says Jeffrey T. Kirchner, DO, director of the family practice residency program at Lancaster General Hospital in Lancaster, Pa. Kirchner and some colleagues gathered together what literature exists on the subject, and published a review of it in the Nov. 15 issue of the journal American Family Physician.

That review confirms that children and adolescents indeed experience a spectrum of mood disorders, says Kirchner, who also teaches medicine at Temple University in Philadelphia. But even though childhood depression is now acknowledged to be a significant problem, "It's something that's still not talked about much, something that many people -- even physicians -- are not either aware of or tuned into," he tells WebMD.

As with adults, genes may play a part in a child's depression, says Kirchner. However, by school age, children are also vulnerable to life stressors like family conflict, divorce, criticism, school troubles, and confusion about sexual orientation.

"They don't have the same coping mechanisms that an adult or even an adolescent would have to process and deal with the change," Kirchner tells WebMD. The result can be general sadness, anxiety, low self-esteem, excessive guilt, and depression. Sometimes children get involved in drug abuse as a way of dealing with their feelings, he says.

In some children, such feelings are translated into headaches, stomachaches, worry, and irritability, says Kirchner. "It may be a reason kids don't want to go to school."

Poor academic performance can be a signal of depression in some children, says Kirchner, but in others, depressive feelings and low self-esteem may trigger a need to overcompensate. "They work hard to please and be accepted by others, to get the best grades," he says. "But because they are well behaved and doing well in school, no one even suspects they may be depressed."

It's a confusing phenomenon, he admits.

"Parents should look at how their children are interacting outside of school," says Kirchner. "They may be getting all A's, but if there's no interest in outside activities, playing with other children, doing things with siblings, eating, there may be depression."

Ninety percent of children with major depressive disorder will get better by themselves, within a year and a half to two years, he says. But untreated children often are left with poor self-esteem, problems with relationships, and symptoms of depression -- and they often wind up taking increasing risks, leading to smoking, drug abuse, and pregnancy.

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