Many parents come to me asking whether their child is depressed, moody or just going through a developmental stage. I am glad they ask because this means they are really paying attention to their child’s moods and behaviors. At a time when anxiety and depression in kids are on the rise and too many kids commit suicide, parents must be on the lookout for any of these. Here are guidelines to help.
Emotional volatility due to a developmental stage. Children who have not reached the ‘prepubertal years’- the time when hormones are beginning to shift to prepare for real puberty – should not show signs of significant moodiness. If you have a child younger than the prepubertal years displaying frequent anger outburst, constant aggression, prolonged sadness or grades plummeting, this is not normal. See your pediatrician because something is bothering your child that may lead to depression.
When puberty begins, estrogen, progesterone and testosterone rise and fall and each of these affect a child’s emotions. Girls can cry easily for no reason, be irritable with everyone around them or get mad for no reason. I always tell girls that if they are “mad at everyone” then they have the problem, not those around them. Moodiness that comes on suddenly and goes away as fast is a developmental issue. Remember, boys experience the same moodiness with puberty as girls but we forget this. Also – many parents pass off obnoxious teen behavior as normal. If it persists for weeks, it isn’t normal. It’s a sign that something is wrong.
Moodiness. When a child of any age suddenly shifts from being lighthearted and happy to sullen and pouty, this is moodiness. The key with regular moodiness is this: sadness and anger come as quickly as they go. Moodiness can make parents crazy because they can never anticipate what their child will be saying or how he will be behaving. If your child goes down but then comes up and acts happy for a day or two, she’s moody, not depressed.
Depression. Depression can occur in a child of any age. According to the National Institute for Mental Health, 13% of adolescents 12-17 have had a major depressive episode. Girls have higher rates of depression (20% of girls 12-17) than boys. Depression in any age child can be diagnosed by looking for several of the following symptoms that last longer than 2 weeks. The persistence of these symptoms is critical because moodiness can manifest itself in some of these but will come and go.
- Feeling hopeless or pessimistic
- Persistent sadness or feeling of ‘emptiness’
- Feeling guilty, worthless or helpless
- Sleeping too much or too little (that is out of the ordinary)
- Change in eating patterns – too much or too little
- Decreased energy (not due to an increase in activity)
- Aches, pains, headaches or other ailments without a clear cause
- Feeling restless
- Difficulty concentrating
- Thoughts of death or suicide
- Change in grades
- Not enjoying activities previously enjoyed
- Having angry outbursts for no reason at all
Before you run to your doctor or psychiatrist, let me remind you that your child must have displayed several of these symptoms over a period of at least two weeks. It is perfectly normal for kids to have some of these symptoms either one at a time or temporarily.
The most important thing you can do is to study your child. Watch his facial expression, listen to the tone of his voice, watch how much time he spends alone in his room. Has he stopped doing things that he usually liked to do and does he seem down? If you pay close attention, listen to your instincts and feel something is a little off with your child, get help. See her doctor and make an appointment. Go in alone to discuss your concerns.
Then he or she can recommend a course of action. In addition, consult a good psychologist or psychiatrist. The most important thing to do second from getting help is to get an accurate diagnosis of what is going on. Many things look like depression but aren’t: ADHD, anxiety, obsessive-compulsive disorder to name a few. It is critical to know exactly what is wrong with your child before a plan of treatment is arranged.