Most children cope well with adverse events in their lives, as they are quite resilient and generally have excellent adaptive capabilities. Periods of sadness are to be expected, and normal. Memories of distressing situations usually fade over time, and have little impact on the child’s daily life.

In contrast is the child who feels a sense of sadness almost all of the time, even when there does not seem to be an obvious reason. A continuing low mood may well be a signal that the child is suffering from a true state of depression.

A child who looks sad most of the time, cries often, and frequently talks about sad thoughts and memories is not difficult to diagnose as being depressed. However, children might not have the vocabulary to talk about such feelings and so may express their feelings through behavior. The child might simply seem distracted and have trouble concentrating. He or she might be prone to angry outbursts, have difficulty finding enjoyable activities, have changes in eating habits, exhibit attention-getting behavior, develop sleep disturbances, or suffer unexplained daytime fatigue.

Other possible symptoms of depression in children and adolescents include difficulty with peer relationships, such as an inability to get along with friends; separation anxiety manifested as school avoidance or school phobia; and changes in home relationships and interactions, such as losing interest in family conversations, and a desire to be alone most of the time.

Often, depression in children masquerades as physical illness, such as chronic abdominal pain or headaches. Likewise, a sign of depression might be poor school performance and declining grades.

How much is depression due to heredity and how much to environmental issues? The risk of depression increases if there is a history of mood disorders in close family members. While the predisposition to depression is often inherited, environmental triggers are usually the precipitating cause of the first episode. A genetically vulnerable child , when exposed to family stress, is more likely to develop depression in the face of such things as inconsistent parenting and exposure to negative ways of viewing the world.

Inasmuch as depression is very much intertwined with poor self-esteem, improvements in one will invariably help the other. It is important to break patterns that have been repeated through generations. Enjoy your children, listen attentively, value their uniqueness, and let them be themselves. Transmitting your values in a loving, generous way, and responding to your child’s needs consistently and thoughtfully, is the basis for building self-esteem.

Psychotherapy may be helpful or necessary to encourage the child or adolescent to correct negative thought patterns and use positive coping behaviors instead of giving up or avoiding situations.

For severely depressed children with a distorted view of life, antidepressants such as Zoloft, in a class of medications called SSRI’s (selective serotonin re-uptake inhibitors) can be very effective. These medications appear to relieve a chemical imbalance that creates obsessive thinking about sad thoughts. Despite possible prejudice about using these medications, if a child is suffering, then alleviating that distress is just something that you have to do, without judgment or resistance on your part.

Dealing with a depressed person can be overwhelming. Strive to be understanding, flexible, and tolerant. Seek help. Even the most serious of depressions usually responds to the right treatment.

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