Depression Fact Sheet for Physicians
be asked to be involved in psychotherapeutic treatments to help identify major sources of stress for their child or adolescent and to help the family develop better ways of coping with life situations. Parents may be reluctant to agree to drug treatment when it is needed because of the newness of data on medications to treat the disorder in young people and because of sensational and erroneous media coverage linking antidepressants to violent activity or suicide. Physicians can calm these fears by informing parents about the latest studies on the effectiveness and safety of current medications. They can also point to the recommendation of the American Academy of Child and Adolescent Psychiatry that medication can be an effective part of the treatment for depression, especially when it is used as part of a comprehensive treatment plan that includes psychotherapy.(12)
Other Types of Depression In Children and Adolescents
Bipolar Disorder
Although rare in young children, bipolar disorder(27)-also known as manic-depressive illness-can appear in both children and teenagers. Bipolar disorder involves unusual shifts in mood, energy, and functioning. It may begin with either manic or depressive symptoms. It is more likely to affect the children of parents who have the disorder.
Unlike adults, whose symptoms are acute and episodic, young children often experience rapid mood swings and cycle from depression to mania several times within a day. Children with mania are more likely to be irritable and prone to destructive tantrums than to be elated or euphoric. Bipolar disorder accounts for a large proportion of children's psychiatric hospitalizations. Some 20 percent of adolescents with major depression develop bipolar disorder within 5 years of the onset of depression.(13)
Teenagers with bipolar disorder display a combination of extremely manic and depressive moods. Highs may alternate with lows, or, for some youths, the moods may change so quickly that the adolescent feels both extremes at almost the same time.
Symptoms of bipolar disorder often can be difficult to distinguish from other problems of childhood and adolescence. For example, while irritability and aggressiveness can indicate bipolar disorder, they can also be symptoms of depression or conduct disorder. Among teenagers, irritability and aggressiveness could indicate more common adolescent problems such as drug abuse, delinquency, attention deficit hyperactivity disorder (ADHD), or a less frequent disorder, schizophrenia. However, any child who appears to be depressed and exhibits ADHD-like symptoms that are very severe, with excessive temper outbursts and mood changes, should be evaluated to rule
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