children s health issues
Depression and Mood Dysregulation Disorder in Children and Adolescents
Introduction
Depressionincludes a feeling of sadness (or, in children and adolescents, irritability), and/or loss of interest in activities. Inmajor depression, these symptoms last 2 weeks or more and interfere with functioning or cause considerable distress. Symptoms may follow a recent loss or other sad event but are out of proportion to that event and persist beyond an appropriate length of time.Mood dysregulation disorderinvolves persistent irritability and frequent episodes of behavior that is very out of control. Physical disorders, life experiences, and heredity can contribute to depression. Children and adolescents with depression may be sad, disinterested, and sluggish or overactive, aggressive, and irritable. Children with disruptive mood dysregulation disorder have frequent, severe temper outbursts and, between outbursts, are irritable and angry. Doctors base the diagnosis on symptoms as reported by the child, parents, and teachers and do tests to check for other disorders that can be causing the symptoms. For adolescents with depression, a combination of psychotherapy and antidepressants is usually most effective, but for younger children, psychotherapy alone is usually tried first. (See also Depression in adults.) Sadness and unhappiness are common human emotions, particularly in response to troubling situations. For children and adolescents, such situations may include the death of a parent, divorce, a friend moving away, difficulty adjusting to school, and difficulty making friends. However, feelings of sadness are sometimes out of proportion to the event or persist far longer than expected. In such cases, particularly if the feelings cause difficulties in day-to-day functioning, children may have depression. Like adults, some children become depressed even when no unhappy life events occur. Such children are more likely to have family members with mood disorders (a family history). Depression occurs in as many as 2% of children and 5% of adolescents. Depression includes several disorders: Major depressive disorder Disruptive mood dysregulation disorder Persistent depressive disorder (dysthymia) Some children with depression are overactive and irritable rather than sad. 