Everyone feels periods of sadness throughout their lives and most have also experienced periods of hopelessness as well. However, for some people, these sad and hopeless feelings become so extreme that they cause severe disruptions in their ability to appropriately function on a daily basis. These people may quickly begin to feel as though they have lost control of their emotions and, as a result, find that their personal, social, and educational responsibilities are being negatively affected as a result. Anyone can experience this intense emotional decline, and children and adolescents are without exception. For young people, the effects of depressive disorders will not only have negative effects on their functioning but will likely have a negative impact on their ability to adjust to new stages throughout their development as well.
Depressive disorders will present themselves in a variety of forms and in various stages of severity in each individual. The most common forms of depressive disorders include the following:
Disruptive mood dysregulation disorder is a form of depressive disorder that is unique in that the onset of its symptoms must present before the age of 10, but children under the age of 6 should not be given the diagnosis. Similarly, researchers currently believe that individuals over the age of 18 should not be provided with a diagnosis of disruptive mood dysregulation disorder. The core feature of this particular depressive disorder is that the dominant symptom that causes the disruption in functioning is chronic and severe irritability that leads to the manifestation of frequent temper outbursts and persistent angry moods.
Major depressive disorder is characterized by prolonged periods of depressive symptoms that affect a child or adolescent’s ability to function in most, if not all, aspects of his or her life. These individuals will find that their emotions have overwhelmed their ability to eat, sleep, study, and perform academically. They will likely also begin to lose interest in things that they had once been interested in, or had a passion for, like participating in sports or spending time with friends. Major depressive disorder is further classified by severity by whether the depressive episodes are mild, moderate, or severe.
Dysthymia, now referred to as persistent depressive disorder, exists when a child or adolescent experiences a depressed mood for most of the day, for more days than not, for a period of at least one year. Once children and adolescents have received a diagnosis of persistent depressive disorder, they may still experience major depressive episodes, at which time their symptoms are exacerbated causing them to meet criteria for major depressive disorder.
When children and adolescents are suffering from any form of depression, it is imperative that treatment be received because the symptoms can lead to extremely negative consequences, including participating in self-destructive behaviors, self-harming, experiencing suicidal ideation, or making attempts at suicide. However, with proper intervention and by receiving appropriate treatment, children and adolescents with a depressive disorder can overcome their symptoms and go on to lead happy and productive lives.
According to the National Institute of Mental Health (NIMH), research done on adolescents between the ages of 13 and 18 provided results that stated that approximately 11.2% of people in this age group have experienced some form of depressive disorder throughout their development. In addition, 3.3% of adolescents in this age group suffered from what NIMH refers to as a seriously debilitating depressive disorder. While there are no specific statistics provided regarding the prevalence of depressive disorders in children under the age of 13, researchers have estimated that between 10-15% of children and teens combined suffer from a depressive disorder. According to the American Psychiatric Association, children who experience the chronic irritability typical of disruptive mood dysregulation disorder are at risk for developing other depressive disorders and/or anxiety disorders in adulthood.
Causes and Risk Factors for Depressive Disorders
There is not any one specific cause identified as leading to the onset of depression, but rather it is believed to be a combination of varying factors that work together to play a role in its development. These factors can include:
Genetic: As is true for most mental illnesses, depressive disorders tend to run in families, strongly suggesting that there is a genetic component attributed to the disorder. Children and adolescents who have a first-degree, biological relative, such as a parent or sibling, who suffers from depression are at a much greater risk for developing the condition than those who do not have the same kind of family history. That being said, it should be noted that there are many cases in which people develop depressive disorders despite the absence of a family history of the illness.
Physical: Neuroimaging studies that have been conducted on people suffering from depressive disorders have shown the existence of structural difference in the areas of the brain that are responsible for sleep, appetite, and behavior. In addition, decreased levels of the neurotransmitters serotonin and dopamine have also been attributed to the development of depressive disorders.
Environmental: When children and adolescents are faced with extreme or drastic life changes or stressors, there is the potential that they may feel overwhelmed by the experience and, if they do not have the adequate skills required in order to successfully overcome those challenges, the ultimate result may be the onset of depression.
- Major life changes and stressors
- Poor social support
- Poor or inconsistent parenting
- Family history of depression or other mental illness
- Experiencing or having previously experienced a traumatic events or a series of traumatic events
- Being physically, sexually, verbally, and/or emotionally abused
- Being neglected
- Being bullied
- Low self-esteem
- Low socioeconomic status
- Substance abuse
- Exposure to substance abuse and/or violence
Signs and Symptoms of Depressive Disorders
The signs and symptoms that are displayed as a result of the existence of depression will not only vary from person to person, but they will also vary based on the specific type of depressive disorder that the person is suffering from, as well as the severity of the disorder itself. Symptoms may also be displayed differently in children than they typically are in adults. Examples of various signs and symptoms that may be exhibited by children and adolescents suffering from a depressive disorder may include:
- Refusing to participate in activities that the child once found enjoyable
- Isolating oneself from family and friends
- Angry outbursts / temper tantrums
- Failing to meet academic requirements
- Self-harming behaviors
- Attempting suicide
- Insomnia or hypersomnia
- Fatigue / decreased amount of energy
- Changes in eating patterns
- Noticeable weight gain or weight loss
- Chronic headaches
- Chronic bodily aches and pains that are unexplainable
- Digestive problems
- Inability to concentrate
- Decreased ability to make rational decisions
- Memory problems
- Slowed thinking
- Slowed speaking
- Excessive anxiety
- Overwhelming sadness
- Overwhelming hopelessness
- Low self-worth
- Feeling overly critical of oneself
- Feelings of guilt
- Feeling “empty” inside
- Preoccupation with death, dying, and suicide
Effects of Depressive Disorders
There are a number of different treatment methods that can be implemented that have successfully helped children and adolescents overcome their depressive disorders. However, if left untreated, the long-term consequences of depression can negatively impact a child’s future. Some examples of the long-term effects of untreated depression can include:
- Alcoholism and drug addiction
- Significant relationship problems
- Social isolation
- Increased anxiety, which can go on to cause other psychological disturbances to arise, including things like panic disorders or social phobias
- Inability to maintain a fulfilling career
- Suicidal thoughts and behaviors
Children and teenagers who are suffering from a depressive disorder are at a higher risk for developing other mental disorders, many of which can occur alongside the depression itself. Examples of the most common co-occurring disorders can include:
- Anxiety disorders
- Attention-deficit hyperactivity disorder
- Bipolar disorder
- Conduct disorder
- Eating disorders
- Learning disorders
- Oppositional defiant disorder
- Substance abuse disorders