Childhood depression
Incidence of childhood and adolescent depression has increased multi fold in the past 3 to 4 decades with boys and girls affected almost equally. Children with major depression have an increased incidence of bipolar disorder and recurrent major depression. Children do not have the vocabulary to talk about feelings and express their feelings through behavior. Younger children are more likely to present with phobias, separation anxiety disorder, (psycho) somatic complaints and behaviour problems. Preschool children look serious or vaguely sick. They are less spontaneous. While other children become tearful or irritable when frustrated, depressed children show these states without any stimulus. They may say negative things about themselves and may be self-destructive. The adolescent generally present with academic decline, disruptive behavior, and problems with friends; rarely aggressive behavior, irritability and suicidal talk. Inconsistent parenting, stressful life experiences are associated with childhood depression. It is also associated with a family history of mood disorders or other psychiatric conditions. Treatment must be tailored to the needs and schedule of the child and his family. Generally, with mild to moderate depression, one first tries psychotherapy and then adds an antidepressant if the therapy has not produced enough improvement. If it is a severe depression, or there is serious acting out, one may start medication at the beginning of the treatment or even consider hospitalization.
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