Everyone feels sad sometimes. It is normal to feel sad after you have experienced a loss or a big disappointment. The question is at what point does sadness become depression? Depression is of concern when a person has a period of two weeks or more when they feel down almost every day almost all day. This down feeling can be accompanied by difficulty sleeping and eating. Sometimes the person sleeps or eats too much. Sometimes they have tremendous difficulty falling asleep, staying asleep, or they wake up too early in the morning. Sometimes people who suffer from depression eat too much; sometimes they lose their appetites. Often they feel like they have no energy. They can lose interest in things that previously gave them pleasure. Worst of all, some people who suffer from depression have thoughts of death and suicide.
With children and teenagers children rarely have the classic signs of depression listed above, which can be confusing for parents. More typically children and teens have difficult concentrating, difficulty thinking and remembering, and they can feel angry and irritable rather than sad and down. These problems often lead to academic underachievement, which may lead parents and teachers to become concerned.
An interview with the person is often enough to make a diagnosis. However with some children and teens diagnosis is more difficult. In such situations there are tests that can be used to obtain more information about feelings and symptoms. There are paper and pencil tests like the Children’s Depression Inventory and the Beck Youth Inventories that can be helpful in understanding how a child is feeling. There are also scales for parents to complete about a child that can provide additional information, scales such as the Achenbach Child Behavior Checklist.
Research tells us that the best treatment for depression is Cognitive Behavior Therapy. This is talk therapy based on the idea that we can change the way we feel if we change the way we think. In some cases this kind of therapy needs to be combined with medication. In these situations the family is referred to a child psychiatrist for consultation. I have several psychiatrists I consult with and can provide referrals and collaboration when needed.