Clinical depression goes beyond sadness. It's more than having a bad day or coping with a major loss such as the death of a parent, grandparent, or even a favorite pet. It's also not a personal weakness or a character flaw. Youth suffering from clinical depression cannot simply "snap out of it."
As many as one in every 33 children and one in eight adolescents may have depression. Two-thirds of children with mental health problems do not get the help they need. Suicide is the third leading cause of death for 15- to 24-year-olds and the sixth leading cause of death for 5- to 15-year-olds.
Depression is a brain disorder (mental illness) that affects the entire body. Depression affects the way one feels, thinks, and acts. Early-onset depression in children can lead to school failure, alcohol or other drug use, and even suicide. Fortunately, it is highly treatable.
There are two main misconceptions about childhood depression. The first actually applies to both adults and children. This misconception is that someone can just get over depression. Clinical depression is more than just feeling "blue." Everyone can feel "down" from time to time. This can be attributed to stress or unhappiness with some aspect of their life. While depression may appear similar to these down moods, it is much more pervasive and can even be life threatening. Clinical depression also is not triggered by a single event in a person's life.
The second misconception is that children do not have any reason to be depressed. Childhood is viewed as a carefree period of life. Adults forget that children are essentially powerless and have no control over their lives. Children also have to deal with peer acceptance, school life, and any pressures or expectations that their parents have. This can be a difficult situation to live with day to day.
In childhood, boys and girls appear to be at equal risk for depressive disorders; but during adolescence, girls are twice as likely as boys to develop depression. Diagnosis of depression in children is not as clear-cut as it is for other ailments. There are no tests that can be given which will positively say that an individual has depression, much less pinpoint the causes. Studies have shown that certain children have risk factors in their lives which could predispose them to depression or "trigger" depression. Some of the recognized risk factors are:
- Cigarette smoking
- A loss of a parent or loved one
- Break-up of a romantic relationship
- Attention, conduct, or learning disorders
- Chronic illnesses, such as diabetes
- Abuse or neglect
- Other trauma, including natural disasters
However, some infants exhibit depressive symptoms at an early age before most of these factors come into play, so an argument can be made for depression being wholly chemical in some children. Researchers also feel that children inherit a predisposition to depression and anxiety, but that environmental triggers are necessary to elicit the first episode of major depression.
Family history and genetics can have a connection to whether a child develops depression. Factors associated with childhood depression include inconsistent parenting, stressful life experiences, and a negative way of viewing the world. Research suggests that parental patterns of irritability and withdrawal lead to low self-esteem in the child, and this poor self-image predisposes the child to depression. Childhood depression is also associated with a family history of mood disorders and with the existence of other psychiatric conditions. If a parent has had childhood or recurrent depression, the child is at an even higher risk of developing depression. When depressed adults are asked about their childhood experiences, they are more likely to report neglect, abuse, rejection, and parental conflict. It is also noteworthy that 30-40% of effectively ill children will have a biologic parent who is also effectively ill (most commonly depression) at the time the young person presents for initial evaluation.
Each child's depression is individual, and causes will be different for each one. The depression could be wholly chemical, wholly due to psychological factors, or a combination of the two. More important than the cause is identifying the illness and treating it.
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It is generally accepted that autism is caused by abnormalities in brain structures or functions. Scientists are studying normal brain development to help them determine how abnormalities occur. The brain develops throughout the entire pregnancy cycle and continues to develop during the first few years after birth. Researchers have identified several different problems that can interfere with normal brain development. But identifying the causes of the problems and determining a cure are difficult tasks.