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Childhood Depression: Signs & Symptoms
What are the signs of depression in children? It is critical that depression is accurately identified and treated in children because their future mental health depends on it. The National Institute of Mental Health (NIMH) reports that childhood depression often persists, recurs and continues into adulthood, especially if untreated, and may indicate other impending severe illnesses.
Children suffering from depression may experience symptoms such as inability to have fun, difficulty concentrating, fatigue, extreme apathy, crying, sleep problems, feelings of worthlessness, weight change, physical complaints, or frequent thoughts of death or suicide (Papalia, 2004). If five or more of these symptoms exist for at least two weeks, a child should be evaluated by a professional for possible depression. According to the National Institute of Mental Health, depressed children may also sulk, pretend to be sick, refuse to go to school, or worry that a parent may die. Uncovering or confirming childhood depression can be a confusing process due to a wide range of common feelings experienced by children.
Childhood depression may also display itself through low-self esteem, poor social skills, or pessimism (APA, 2000). Of course the presence of these signs is to be expected for many children or adolescents and alone does not necessarily signify depression. Professional assistance in verifying the presence of depression is beneficial due to potential signs that seem typical in child development such as irritability, negativity, and feelings of being misunderstood which may exist to an unhealthy degree (NIMH). It is also important to rule out other possible causes of the symptoms that the child is experiencing.
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Gender Differences: Turtles and Dragons
Childhood depression does not always manifest as overt sadness and can go untreated if the child is overlooked or penalized for their symptoms. Four Winds Hospital and Psychiatric Services published, “Turtles and Dragons in the Classroom," which was written by Susan E. Dubuque, M. Ed. This publication describes the two faces that depressed children may wear. Depressed girls often present as “turtles," or withdrawn, quiet, and compliant. These children may be overlooked in the school setting because they are not disruptive. Dubuque (2004) said that a “turtle" may be described by their parents as sensitive and shy while presenting as clingy, dependent, with vague physical symptoms. These attributes are not limited to depressed girls and boys may also present in this manner.
Depressed boys may appear as “dragons" which exhibit aggression and anger. The symptoms that these boys or girls experience may be mistakenly confused with those of attention deficit hyperactivity disorder due to their nature. “Dragons" are hard to get along with so these children may have trouble keeping friends and receive a lot of negative attention from adults, especially at school (Dubuque, 2004). Depression may come across as defiance and will predictably be countered with punitive measures which will prove to be ineffective in altering behavior. These children need support and recognition of their feelings. They will be unable to face overwhelming sadness caused by depression if they feel that their world is condemning.
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American Psychiatric Association (2000). Diagnostic and statistical manual of mental disorders, 4th edition, (DSM-IV-TR). Washington, DC: American Psychiatric Association.
Dubuque, S.E. (2004). Turtles and dragons in the classroom. New York: Four Winds Hospital.
National Institute of Mental Health. Depression. U. S. Department of Health and Human Services. (http://www.nimh.nih.gov)
Papalia, D. E., Olds, S. W., & Feldman, R. D. (2004). A child’s world: Infancy through adolescence. (9th ed.). Boston, MA: McGraw Hill.