Treatment for Children's Depression has Improved

Fortunately, most children do not suffer from the sometimes-debilitating effects of depression. They face the usual low spots and tough times of growing up, facing life's changes such as moving, parents' divorce, loss of grandparents and loved ones. But, over time, and with family support, they are able to move on and even learn and grow from their experiences.

However, some children are not so lucky. It is estimated that at any point in time, 10 percent to 15 percent of children and adolescents have some symptoms of depression.

Let me state the bad news and the good news right up front. The bad news is that major depression in children is very serious. It can lead to problems in school, alcohol and drug use and even suicide. It's just as serious as depression in adults and can lead to a mood disorder as an adult.

The good news here is that depression is a treatable illness. At no other time have we had the experience and medications at hand to treat depression. We are also living in a culture in which people are more open to talking about and pursuing treatment for mental conditions.

It is common for preteens to be moody as their hormones are changing and as they face new and more demanding challenges. However, depression is more than a sad or bad mood or a temporary response to a particular situation. It is an all-encompassing disorder that affects a child's mental, emotional and physical health. It is not something that they can just will themselves out of.

A child with depression can be sad, angry or irritable, and has been so for more than a few weeks. Depression impacts the ability to function normally; a child will have problems coping with school and getting along with friends and family.

Other signs of depression include:

• Crying often
• Lack of energy
• Loss of interest in prior activities and friendships
• Changes in eating and sleeping habits; both more and less
• Extreme irritability and anger, particularly if seemingly without cause
• Poor self-esteem
• Trouble concentrating
• Lots of head and stomachaches

If your child is talking about hurting himself or running away, call your child's doctor immediately. If you see any of these other signs and they go on for more than a few weeks, it is important to get help right away. A good starting place is your child's pediatrician. He or she can often diagnose and treat depression and may also refer your child to a mental-health specialist.

Your child doesn't necessarily need to see a psychiatrist, but it is important to find someone with experience treating children.

Parents of children with ADHD need to be particularly vigilant about watching for signs of depression. It is very common to see other conditions along with ADHD. Some studies indicate that up to 30 percent of those with ADHD also have depression. Some think ADHD children are more prone to depression because many have trouble regulating their emotions or face ADHD-related problems that undermine their self-esteem. Some types of depression also seem to run in families, suggesting there may be a genetic component. But most often, depression is a combination of genetic, psychological and environmental factors.

Treatment is not just a quick fix with medication; there is a clear role for mental-health counseling or psychotherapy in any depression treatment plan. There is some data that shows that combination treatment -- medication and therapy -- is more effective than medication alone. If you are concerned about putting your child on a medication, get the facts. Talk to your doctor and weigh the medication's side effects against the effects of no medication at all. And be patient, it may take a while to reach the right dosage with the right medication. Regardless of the treatment path, close follow-up is critical.