By Ana Radovic, MD, MSc, Assistant Professor of Pediatrics in the Division of Adolescent and Young Adult Medicine at Children’s Hospital of Pittsburgh
It can be tough to decide whether you think your child has depression or does not. Why is that? Mental health symptoms happen on the inside – they don’t show up like a rash on the skin that everyone can see, even though some studies show how the brain does look different with depression.
When symptoms show up on the inside, the only way you can “see” them, is by the person explaining to you how they feel, or by what you see as their behavior. If they are also having trouble understanding how they feel and are worried about what you will think or that you will get upset if they say anything, they might not share that with you. That is one good reason why if you are the least bit worried, a good idea is to ask your doctor for help figuring it out.
If your doctor tells you that your child may be depressed, what does that really mean?
Maybe some of the “symptoms” they have could be from something else like:
- trouble adjusting to a new situation at school or home
- a bad break-up, a friend who let them down, or not making a sports team or other extracurricular activity
- bullying at school
- a medical problem like anemia (a low blood count), headaches, belly pain
- not getting enough sleep from being overscheduled, overhomeworked, too much online time, or having to wake up too early
- another mental health or physical problem like ADHD, anxiety, or anemia
Don’t some people even have thoughts of harming themselves, but in the end they don’t end up having depression?
It is true that depression can be difficult to diagnose, especially in adolescents and young people, whose moods seem to change every day. Young people have developing brains and because they keep changing, it is hard to know whether some of the symptoms they have are here to stay or not. That’s why health professionals might have to see your child for several visits before they can get a better idea of what is going on.
Some behaviors can be signs of depression symptoms:
- Feeling down most of the day.Maybe your child notices they are just feeling sad, empty, or down in the dumps. They might not even notice – but you might see they are tearful or irritable much of the time.
- Not interested in things they used to like. Things they used to think were fun aren’t fun anymore. They don’t really do them and even if they don’t notice or say they don’t care, you notice the difference.
- Changes in appetite or weight.They’re hungry all the time or they don’t feel like anything tastes good anymore.
- Problems with sleep.They are tired and sleepy all day even when they get enough rest, or the opposite – they can’t fall asleep no matter how hard they try.
- Tiredness or not having energy.
- They feel like everything is their fault.They feel like they’re no good at anything.
- They have a tough time concentrating or making decisions.
- They may have thoughts of suicide.
MOST important is that because of these symptoms, they are having trouble living the life they want to live.
It might mean they are not achieving their goals, getting to school every day, getting to work, doing the fun activities they used to do, or being the kind of friend they want to be.
In the end, you know when your child is not being themselves. It’s normal for teens to want to be independent and make their own decisions – sometimes this could lead to arguments. Being depressed is different – they should still be doing things they enjoy and think are fun. And how well they do in school or other activities shouldn’t be going downhill.
A health professional can help you and your child figure out if your child should get treatment for depression or if something else could be causing the symptoms. For example, having a low blood count can cause sleepiness, fatigue, and a tough time concentrating. Sometimes it can take many visits for you, your child, and your health professional to figure out the best way to help.
The most important thing is if you notice these symptoms in your child, something is wrong, and although it’s easier to say – maybe they will just go away – often they won’t. The good news is the sooner you do something about them, the better. The adolescent and young person brain is amazing – it is kind of like clay – moldable into many different things! Talking to a trusted health professional will be your next best step.
If your child does have depressive symptoms, there are two important reasons why getting treatment is a good idea to consider:
- If your child does have depression that is not treated, the symptoms can get worse. Young people with depression have trouble with their academics. They are also more likely to have health problems like obesity or migraine headaches, be involved with alcohol or drug use, and it can overall keep them from achieving their goals.
- Seeing a therapist can help your child learn new skills which can help them a lot even if they don’t have depression. One of the major treatments that can help with sleep issues and anxiety and problems with pain or headaches is the same type of therapy which is recommended for depression: cognitive behavioral therapy.
For more information about diagnosing depression, see the American Academy of Child Adolescent Psychiatry Facts for Families handout.
If you have questions about depression, schedule an appointment with your primary care physician or visit us in the Division of Adolescent and Young Adult Medicine. To schedule an appointment, call 412-692-6677 or visit www.chp.edu/adolescent.