Major Depression in Children and Adolescents

EMPOWER Colorado is a nonprofit organization created by parents and families to provide support, education and advocacy for parents and families of children with neurological disorders(brain disorders).

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Major depression is one of the mental, emotional, and behavior disorders that can appear during childhood and adolescence. This type of depression affects a young person's thoughts, feelings, behavior, and body. Major depression in children and adolescents is serious; it is more than "the blues." Depression can lead to school failure, alcohol or other drug use, and even suicide.

Some young children with this disorder may pretend to be sick, be overactive, cling to their parents and refuse to go to school, or worry that their parents may die. Older children and adolescents with depression may sulk, refuse to participate in family and social activities, get into trouble at school, use alcohol or other drugs, or stop paying attention to their appearance. They may also become negative, restless, grouchy, aggressive, or feel that no one understands them. Adolescents with major depression are likely to identify themselves as depressed before their parents suspect a problem. The same may be true for children.

A person with a depressive illness cannot talk themselves into feeling good. They cannot snap themselves out of it. Suffering or not suffering from these illnesses does not have anything to do with a person's willpower. Many times, society assumes a person suffering from depression is just lazy, or lacks motivation to get his or her life together. One might be labeled as simply having a behavior problem. This simply is not true.

Depressive illnesses are not due to personal weakness or a character flaw, but are biological illnesses related to imbalanced or disrupted brain chemistry. The brain is an organ of the body and can get sick just like the heart, liver, or kidneys.

A combination of genetic, psychological, and environmental factors all play a role in how and when a depressive illness may manifest itself. And because these are illnesses, stress doesn't necessarily have to be present, but can trigger or exacerbate a depression. Depression can appear out of nowhere, when everything is going fine, at a time when there would be no reason for a person to feel depressed.

Depressive illnesses are nothing to be ashamed of. We aren't ashamed of having other biological illnesses like heart disease or diabetes. And we aren't ashamed of going to the doctor for treatment of these illnesses. Depression and other depressive illnesses are no different. We would never expect a loved one to treat their high blood pressure on their own. We shouldn't expect them to treat their depression on their own either.

Symptoms of Depression


• Unresponsive when talked to or touched, never smile or cry, or may cry often being difficult to soothe.

• Failure to gain weight (not due to other medical illness).

• Unmotivated in play.

• Restless, oversensitive to noise or touch.

• Problems with eating or sleeping.

• Digestive disorders (constipation/diarrhea).


Persistent unhappiness, negativity, complaining, chronic boredom, no initiative.

• Uncontrollable anger with aggressive or destructive behavior, possibly hitting themselves or others, kicking, or self-biting, head banging. Harming animals.

• Continual disobedience.

• Easily frustrated, frequent crying, low self-esteem, overly sensitive.

• Inability to pay attention, remember, or make decisions, easily distracted, mind goes blank.

• Energy fluctuations from lethargic to frenzied activity, with periods of normalcy.

• Eating or sleeping problems.

• Bedwetting, constipation, diarrhea. Impulsiveness, accident-prone.

• Chronic worry & fear, clingy, panic attacks.

• Extreme self-consciousness.

• Slowed speech & body movements.

• Disorganized speech - hard to follow when telling you a story, etc.

• Physical symptoms such as dizziness, headaches, stomachaches, arms or legs ache, nail-biting, pulling out hair or eyelashes. (ruling out other medical causes)

• Suicidal talk or attempts

In children, depressive illnesses/anxiety may be disguised as, or presented as school phobia or school avoidance, social phobia or social avoidance, excessive separation anxiety, running away, obsessions, compulsions, or everyday rituals, such as having to go to bed at the exact time each night for fear something bad might happen. Chronic illnesses may be present also since depression weakens the immune system.


• Physical symptoms such as dizziness, headaches, stomachaches, neckaches, arms or legs hurt due to muscle tension, digestive disorders. (ruling out other medical causes)

• Persistent unhappiness, negativity, irritability.

• Uncontrollable anger or outbursts of rage.

• Overly self-critical, unwarranted guilt, low self-esteem.

• Inability to concentrate, think straight, remember, or make decisions, possibly resulting in refusal to study in school or an inability (due to depression or attention deficit disorder) to do schoolwork.

• Slowed or hesitant speech or body movements, or restlessness (anxiety).

• Loss of interest in once pleasurable activities.

• Low energy, chronic fatigue, sluggishness.

• Change in appetite, noticeable weight loss or weight gain, abnormal eating patterns.

• Chronic worry, excessive fear.

• Preoccupation with death themes in literature, music, drawings, speaking of death repeatedly, fascination with guns/knives.

• Suicidal thoughts, plans, or attempts.

Depressive illnesses/anxiety may be disguised as, or presented as eating disorders such as anorexia or bulimia, drug/alcohol abuse, sexual promiscuity, risk-taking behavior such as reckless driving, unprotected sex, carelessness when walking across busy streets, or on bridges or cliffs. There may be social isolation, running away, constant disobedience, getting into trouble with the law, physical or sexual assaults against others, obnoxious behavior, failure to care about appearance/hygiene, no sense of self or of values/morals, difficulty cultivating relationships, inability to establish/stick with occupational/educational goals.

If depressive illnesses are left untreated, they can be fatal. 30,000 people kill themselves in the U.S. every year. It is estimated that the actual figure may be 3 times that number due to inaccurate reporting, i.e. suicides recorded as accidental instead. The Journal of the American Medical Association has reported that 95% of all suicides occur at the peak of a depressive episode. Healthy people do not kill themselves. Depressive illnesses can distort a person's thinking, so they don't think clearly or rationally. They may not know they have a treatable illness, or they may think that they can't be helped. Their illness can cause thoughts of hopelessness and helplessness, which may then lead to suicidal thoughts. In order to save lives, it's critical that society recognize the warning signs of these biological diseases that cause suicide. But there is still stigma associated with these illnesses which prevents public education and early treatment for sufferers. The topic of suicide has always been taboo. It is a subject that is so misunderstood by people, thereby allowing myths to be perpetuated. Education is the key to understanding this incredible tragedy that, in many cases, might be prevented.