Though the term "depression" can describe a normal human emotion, it also can refer to a mental health illness.  Depressive illness in children and teens is defined when the feelings of depression persist and interfere with a child or adolescent's ability to function.

Depression is common in teens and younger children.  About 5 percent of children and adolescents in the general population suffer from depression at any given point in time.

Children under stress, who experience loss, or who have attentional, learning, conduct or anxiety disorders are at a higher risk for depression.  Teenage girls are at especially high risk, as are minority youth.

Depressed youth often have problems at home.  In many cases, the parents are depressed, as depression tends to run in families.

Over the past 50 years, depression has become more common and is now recognized at increasingly younger ages. As the rate of depression rises, so does the teen suicide rate.

It is important to remember that the behavior of depressed children and teenagers may differ from the behavior of depressed adults.  The characteristics vary, with most children and teens having additional psychiatric disorders, such as behavior disorders or substance abuse problems.

Mental health professionals advise parents to be aware of signs of depression in their children.

If one or more of these signs of depression persist, parents should seek help:

Frequent sadness, tearfulness, crying

Teens may show their pervasive sadness by wearing black clothes, writing poetry with morbid themes, or having a preoccupation with music that has nihilistic themes.  They may cry for no apparent reason.

Hopelessness

Teens may feel that life is not worth living or worth the effort to even maintain their appearance or hygiene.  They may believe that a negative situation will never change and be pessimistic about their future.

Decreased interest in activities; or inability to enjoy previously favorite activities  

Teens may become apathetic and drop out of clubs, sports, and other activities they once enjoyed.  Not much seems fun anymore to the depressed teen.

Persistent boredom; low energy

Lack of motivation and lowered energy level is reflected by missed classes or not going to school.   A drop in grade averages can be equated with loss of concentration and slowed thinking.

Social isolation, poor communication

There is a lack of connection with friends and family. Teens may avoid family gatherings and events. Teens who used to spend a lot of time with friends may now spend most of their time alone and without interests. Teens may not share their feelings with others, believing that they are alone in the world and no one is listening to them or even cares about them. (Read How Can Parents Model Good Listening Skills?)

Low self esteem and guilt

Teens may assume blame for negative events or circumstances.  They may feel like a failure and have negative views about their competence and self-worth.  They feel as if they are not "good enough."

Extreme sensitivity to rejection or failure

Believing that they are unworthy, depressed teens become even more depressed with every supposed rejection or perceived lack of success.  (Visit Peer Influence and Peer Relationships)

Increased irritability, anger, or hostility

Depressed teens are often irritable, taking out most of their anger on their family.  They may attack others by being critical, sarcastic, or abusive.  They may feel they must reject their family before their family rejects them.  (Read Anger in Our Teens and in Ourselves)

Difficulty with relationships

Teens may suddenly have no interest in maintaining friendships. They'll stop calling and visiting their friends.  (Read Peer Influence and Peer Relationships)

Frequent complaints of physical illnesses, such as headaches and stomachaches

Teens may complain about lightheadedness or dizziness, being nauseous, and back pain. Other common complaints include headaches, stomachaches, vomiting, and menstrual problems.

Frequent absences from school or poor performance in school

Children and teens who cause trouble at home or at school may actually be depressed but not know it.  Because the child may not always seem sad, parents and teachers may not realize that the behavior problem is a sign of depression. (Read If an Adolescent Begins To Fail in School, What Can Parents and Teachers Do?)

Poor concentration   

Teens may have trouble concentrating on schoolwork, following a conversation, or even watching television.  (Read ADHD and Depression)

A major change in eating and/or sleeping patterns

Sleep disturbance may show up as all-night television watching, difficulty in getting up for school, or sleeping during the day.  Loss of appetite may become anorexia or bulimia.  Eating too much may result in weight gain and obesity. (Visit Eating Disorders)

Talk of or efforts to run away from home  

Running away is usually a cry for help.  This may be the first time the parents realize that their child has a problem and needs help.  (Visit Runaways and Missing Children)

Thoughts or expressions of suicide or self-destructive behavior

Teens who are depressed may say they want to be dead or may talk about suicide.  Depressed children and teens are at increased risk for committing suicide.  If a child or teen says, "I want to kill myself," or "I'm going to commit suicide," always take the statement seriously and seek evaluation from a child and adolescent psychiatrist or other mental health professional.  People often feel uncomfortable talking about death.  However, asking whether he or she is depressed or thinking about suicide can be helpful.  Rather than "putting thoughts in the child's head," such a question will provide assurance that somebody cares and will give the young person the chance to talk about problems.  (Visit Teen Suicide.)

Alcohol and Drug Abuse

Depressed teens may abuse alcohol or other drugs as a way to feel better. (Visit Alcohol and Teen Drinking and Drugs and Teen Substance Abuse.)

Self-Injury

Teens who have difficulty talking about their feelings may show their emotional tension, physical discomfort, pain and low self-esteem with self-injurious behaviors, such as cutting.  (Visit Self-Injury.)

Early diagnosis and medical treatment are essential for depressed children.

Depression is a real illness that requires professional help, self-help, and support from family and friends.

Comprehensive treatment often includes both individual and family therapy.  Although there are real and frightening concerns about antidepressant medication, most mental health professionals continue to recommend their use.

There are several ways to get referrals of qualified mental health professionals, including the following:

• First, check with your insurance company for any limitations.

• Talk to family members and friends for their recommendations.  If you participate in a parent support group, such as Because I Love You, ask other members for their recommendations.

• Ask your child's primary care physician or your family doctor for a referral.  Tell the doctor what is important to you in choosing a therapist so he or she can make appropriate recommendations.

• Inquire at your church, synagogue, or place of worship.

• Call the professional organizations listed on this page for referrals.

• Network the resources listed on your state's Family Help page.

• Look in the phone book for the listing of a local mental health association or community mental health center and call these sources for referrals.

Ideally, you will end up with more than one therapist to interview.  Call each one and request to ask the therapist some questions, either by phone or in person.  You may want to inquire about his or her licensing, level of training, their expertise, approach to therapy and medication, and participation in insurance plans and fees.  Such a discussion should help you sort through your options and choose someone with whom you believe you and your teen might interact well.