Question: What are the most common signs and symptoms of depression in children/adolescents?
Answer: For a child or adolescent to be diagnosed as depressed, he or she needs to have either sad or irritable mood, or have what we call anhedonia.
Anhedonia means not having fun or having pleasure in activities that used to be fun and enjoyable. The child may have both the sad mood and the anhedonia, and that's quite common as well.
In addition, children who are depressed often have problems sleeping, they may sleep too much, they may sleep too little. They also may have difficulties eating, either eating too much or eating too little. And sometimes depression, when kids eat too little, can look like anorexia nervosa, and we have to figure out whether the child's depressed or has something like anorexia nervosa.
In addition, children often have cognitive symptoms of depression. So that would be problems concentrating, that would be problems like with low self-esteem -- they feel badly about their brains, their looks, their personality, they feel worthless, they often feel hopeless about their future. And sometimes that hopelessness can get so bad, or the helplessness that they feel can get so bad, that they feel suicidal. They may think about suicide, they may actually try to hurt themselves. In extreme cases, they may actually kill themselves.
Sometimes depression in adolescents looks a little differently than depression in children. For example, adolescents who are depressed may have more difficulty, say with alcohol or drug use, and they may try to use these substances to medicate themselves. In addition, the depression can get so bad in adolescents that sometimes they develop what we call psychotic symptoms where their thinking become confused, and they may hear voices, for example, telling them that they're a bad person.
Conversely, children who are depressed sometimes show up with symptoms common in childhood like enuresis or bed-wetting -- that's a common symptom of depression in young people.