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Teen mood swings or depression? Add to ...

We ask the experts to settle common questions we've all wondered about.

Question

How do I know if my child is depressed?

Answer

Clinical depression affects up to 2 per cent of children and 15 to 20 per cent of adolescents - a rate on par with depression in adults.

Consequences can be dire: Depression is implicated in at least 60 per cent of all suicides, and suicide is the second leading cause of death in Canadian children ages 10 to 19, after accidents.

Despite popular beliefs that moodiness is normal in adolescence, most teens do not experience depression. Those who do should be seen by a family doctor, pediatrician or mental-health professional to understand the symptoms and to determine what needs to be done.

Children and adolescents with clinical depression experience many symptoms that impair their functioning with family, in social situations and at school. Some of those symptoms include:

A low, sad or "blue" mood. Some parents state that their child has lost the ability to smile; they wonder where their once-happy child has gone. Many affected young people can still react positively at certain times, especially with peers. This can fool parents into thinking their depressed adolescent is "just a moody teenager."

Irritability is also very common: Young people with depression can be grouchy, argumentative and angry with parents, teachers and friends.

A loss of interest in activities or pursuits. The depressed teen-ager may lose contact with his or her friends and seem inexplicably withdrawn.

Low self-esteem is expressed through self-deprecating talk. Praise is often discounted. Young people, when depressed, can start associating with delinquent peers.

Impaired concentration often results in a decline in school performance.

Indecision can be a significant problem.

Depressed children and teens often become slower in thought, speech or action. Less often, high degrees of physical restlessness can be present.

Low energy levels - where children and teens do not have the vim to participate in their daily life - may cause them to appear lazy or exhausted to adults who know them.

Sleep disturbance is frequent. Often, depressed teens need abnormally high amounts of sleep or get into a pattern of staying up late and sleeping during the day.

Either an increase or a decrease in appetite and weight can occur.

Suicidal thoughts and behaviour can include everything from a fleeting wish to go to sleep and not wake up to deliberate self-harm (e.g. cutting) and suicide plans, notes or attempts. Parents need to treat such concerns very seriously.

Psychotic symptoms can occur in severe depression. These include hallucinations such as hearing voices, or rigidly held irrational beliefs.

If you are concerned, have your child or adolescent assessed by a mental-health professional (preferably with expertise in children and adolescents) or, if such specialized resources are unavailable, by a family doctor or pediatrician.

Get them to the nearest emergency room if there are concerns about violence, psychosis or suicidal behaviour.

You can find more information in the book Helping Your Teenager Beat Depression: A Problem-Solving Approach for Families by Katharina Manassis and Anne Marie Levac or on the Web at:

http://www.narsad.org/dc/childhood_disorders/

depression.html

http://www.webmd.com/depression/features/childhood_

depression?page=1

http://www.camh.net

Dr. John Strauss and Dr. Irfan Mian are staff psychiatrists in the Child, Youth and Family Program at the Centre for Addiction and Mental Health in Toronto.

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