Major Depression can be recognized by the following:
Other signs commonly seen with Major Depression are:
These criteria are the signs and symptoms currently designated by the American Psychiatric Association for this disorder. They are published in the Diagnostic and Statistical Manual of Mental Disorders (fourth edition, 1994), and available in the public domain. Diagnoses for mental health remain dominated by the medical model in this country. A diagnosis is necessary for insurance coverage for services, and for determining a proper treatment plan.
These symptoms present most of the day, for most days, for a period of two weeks result in a likely diagnosis of Major Depression.
This disorder is actually more likely to occur if another family member has this disorder. It occurs in equal incidences in boys and girls before puberty, and is twice as common in girls in adolescence. It is probable that the first severe episode will be handled and not recur (Single Episode). It is also equally likely (50 to 60%) that the condition can occur again in the future (Recurrent). In some cases, it can continue for a long time, with symptoms being stronger at times than at others. In the most severe cases, the child or adolescent can also struggle with symptoms of psychosis (hallucinations). And sometimes (5 to 10%), a person with this severe disorder will progress to having episodes of mania, which means their condition then becomes a BiPolar Disorder.
There is an increased incidence of Attention Deficit Hyperactivity Disorder in children of adults with this disoder.
Most times, counseling can be effective in helping to address symptoms and gain relief of Major Depression. Understanding the condition, working to build coping strategies, and using supportive resources can lead to improvement. Educating the child, adolescent and family about the disorder and how to cope more positively are important. Learning to change negative thinking to positive thoughts and optimism is very powerful. A highly structured therapy for this is called Cognitive or Cognitive-Behavioral Therapy. CBT professionals will identify themselves as such, and are specially trained in the technique. Psychologists and social workers are good resources for counseling, if they have specialized training and experience. Helping schools and teachers deal effectively with kids with this disorder is also a beneficial component of treatment. Informed consent (signed permission) is required before the therapist can communicate with anyone about a child's treatment.
Commonly, children and adolescents may require psychiatric medications to help deal with a Major Depression. At times, a pediatrician may prescribe these, but more often a psychiatrist is the professional to consult. (Be prepared for a long wait to see a child psychiatrist, as there are not enough around and they are highly in demand.) There are many types of anti-depressants available, and having a qualified doctor is best for selecting the proper treatment. Most anti-depressants take effect slowly (10 days to 3 weeks) and may require increased doses until a therapeutic effect is produced. Sometimes, trials of other anti-depressants are necessary until an effective one is found. Sometimes they are prescribed in combination with other medications. Anti-depressants used with children have been associated with an increased report of feelings of suicide in some cases, and parental and professional supervision during the initial weeks of the prescription is necessary. (No deaths have been associated due to their use.)
When symptoms of Major Depression severely interfere with functioning, or when suicide or homocidal impulses are present (danger to self or others) a psychiatric hospitalization may be necessary. These are usually short term for crisis stabilization, to start medications and therapy and then move to outpatient services. However, there are also day treatment programs, and both acute as well as long term residential treatment programs available if needed. Most inpatient hospitalizations are arranged after initial evaluation at any hospital Emergency Room, where criteria for admission and availability of beds are determined. Emergency personnel can also be called in a crisis by calling 9-1-1, when police and ambulance will respond.
Finding a therapist can be challenging. Most child and adolescent therapists are booked solid. Family therapists are even more rare and have special training. Sometimes more than one therapist is involved treating a kid and their family. Follow through is important, especially after the acute (initial) phase of treatment. Many times a parent needs to decide on treatment, as children or adolescents are unable or unwilling.
If you think that your child or adolescent might have Major Depression, or any other mental health issue, you should talk to a professional about what to do and how to get help. Talking to your child's pediatrician is often a good way to get a referral to a competent psychologist, social worker or child psychiatrist. Another great source for referrals is your health insurance company. Many have on-line lists of professionals in their network of providers, or have a phone number on your insurance card to consult for referral sources. If you live in southeast Massachusetts, in Plymouth county, Cranberry Counseling, P.C. in Marshfield would be more than happy to answer your questions and to make an appointment to help diagnose and start a treatment plan for your child or adolescent and your family. See the Cranberry Counseling, P.C. page of this web site for more information, or use the Contact Us form. Psychotherapy can help to reduce problems related to Major Depression.