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Signs of sadness...or depression?

DEAR MAYO CLINIC: I've suffered from depression all my life but wasn't diagnosed until my late 20s. I feel as though my daughter, who is 12, is showing signs of depression, but I'm not sure. What can I do to help her? Is it possible for someone so young to be clinically depressed?

ANSWER: Certainly kids can suffer from depression. If you're concerned about your daughter, a good first step would be to make an appointment with her primary care physician to discuss the situation and have her evaluated. Sometimes, symptoms that appear to be depression may actually be caused by an underlying medical condition. If the problem is depression, effective treatments for children are available.

In the past, many physicians didn't believe children developed depression, because childhood was seen as an idyllic time when kids had nothing to be depressed about. But studies have shown that some children definitely develop depression. Research has found that depression has an inherited genetic component, as well as a behavioral component. Because the genetic portion is there from the beginning of life, it makes sense that, at times, depression can be expressed at a very young age. In addition, children certainly can have events or circumstances in their lives that can lead to feeling depressed.

You can look for some red flags to help determine if your child may be depressed. Children really have three jobs. The first is going to school and learning. The second is spending time with friends, and the third is interacting with family. The onset of significant difficulties in any of these areas could be a sign of depression.

For example, if a child isn't spending time with friends, isn't interested in getting together with friends, or doesn't want to go to school, that may indicate a problem. If a child who used to be excited about friends and school now feels as if nobody likes her or doesn't feel that she has the energy to get out and do things, that could also signal a problem.

Much of the time, the gateway for getting help for mental health problems is a child's pediatrician or family doctor. That physician can assess possible medical causes during an initial appointment. Then, if necessary, the physician may refer a child to a specialist, such as a psychiatrist or a psychologist. Sometimes medical conditions can cause symptoms similar to those of depression -- such as fatigue, low energy, sleep problems and irritability, among others. So it's important to have your child see a doctor if you're concerned.

If your daughter is experiencing depression, getting help for her as soon as possible is important. For children, depression treatment may include psychotherapy either alone or in combination with antidepressant medication.

A key goal of treating depression in children is teaching them strategies that can help manage their symptoms. That way, they'll be more prepared to handle depression if it appears when they're older. If we can help them when they're young, hopefully we can prevent the disorder from spiraling out of control or leading to other negative consequences. For instance, untreated depression may lead to poor school performance, which, in turn, can lead to more significant problems as an adult.

Family involvement is critical. Kids rarely ask to see a therapist. Typically, parents recognize a potential problem and bring a child for evaluation. Parents need to understand what's happening with their child's treatment and be comfortable with it. Because parents are often the most important people in the child's life and are with them the most, I encourage parents to learn strategies that help improve their child's symptoms.

Keep in mind, too, quite a bit of research has shown that a parent's time, warmth and caring are very important for improving all sorts of childhood problems, from depression to anxiety to behavior problems. So, if you see that your child is struggling, for whatever reason, making an effort to spend more time with your child and expressing your care and love can be very beneficial.


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