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While some people idealize childhood, in reality, children may feel shaken by developmental changes and events over which they have little or no control. Studies show that 2 out of every 100 children and 8 in 100 adolescents have major depression.
  
While a full-blown depression most often starts in adulthood, low-grade depression, or dysthymia may begin during childhood or the teenage years. Although an adult has to have depressive symptoms for at least two years before he or she is diagnosed with dysthymia, in children and teens a diagnosis is made after one year. When dysthymia appears before age 21, major depressive episodes are more likely to emerge later in life.
  
In teens, as in adults, bipolar disorder and depression are clearly connected. As many as 30% of teenagers who experience an episode of major depression develop bipolar disorder in their late teens or early 20s. While rare in early childhood, this disorder occasionally appears in adolescence, especially in cases where a family history of depression exists. Bipolar disorder that emerges during puberty often displays a mixture of high and low symptoms or rapid cycles of highs and lows.

Red Flags for Teenage Depression and Mania

If you are a parent of a teenager, a list of depressive symptoms may make the hairs on the back of your neck rise. Storminess, apparent exhaustion, apathy, irritability, and rapid-fire changes in every realm, including appetite and sleep habits, are common in adolescents. You might find yourself wondering whether a sudden loss of interest in the clarinet signals depression or merely that your teen now thinks that playing in the school band is uncool. Staying up late and sleeping until noon or throwing over one interest in favor of others probably doesn’t signal depression. But constant exhaustion and an unexplained withdrawal from friends and activities a child once enjoyed are reason for concern.
  
Because depression in children and teens often coexists with behavioral problems, anxiety, or substance abuse, experts consider a wide range of potential indicators, such as these:   

· poor performance in school or frequent absences

· efforts or threats to run away from home

· bursts of unexplained irritability, shouting, or crying

· markedly increasing hostility or anger

· abuse of alcohol, drugs, or other dangerous substances

· social isolation or loss of interest in friends

· hypersensitivity to rejection or failure

· reckless behavior.


The Depressed

Child or Teen

Young children may express feelings of depression as vague physical ailments, such as persistent stomachaches, headaches, and tiredness. Although they may truly be sad, depressed children and teens are more likely to appear irritable. Depressed children don’t oversleep or act sluggish as often as depressed adults do, but otherwise, the symptoms of depressive disorders in children, teenagers, and adults are generally similar.  Discuss any of the red flags listed above with your child. If you’re still concerned, speaking with your child’s pediatrician or guidance counselor may help.
  
If a family history of bipolar disorder exists, be especially vigilant about watching for manic symptoms. The signs of manic behavior are similar in adults and children. However, teens who are in a manic episode may also:   

· talk very fast

· be very easily distracted

· get much less sleep than usual, but seem to have the same amount of energy or even more

· have extreme mood changes, for example, shifting between irritability, anger, extreme silliness, or high spirits

· indulge in, think about, or describe hypersexual behavior.

If you notice these symptoms, your child’s pediatrician can help you decide whether to seek professional help.  Dr. Messenger provides a wide range of Interventions in her practice to help your child or teen overcome depression as well as give you, as the parent, suggestions for home.






Notice:  Leave of Absence Closure

Dr. Messenger will be starting  A Leave of Absence as of Friday, Jan. 20, 2017 for an unspecified time.  Assessments and consultation can be scheduled until then.  The website will remain available for educational purposes, until the office is reopened.