About 11 percent of adolescents have a depressive disorder by age 18 but the risk increases as a child gets older. Episodes of depression in children last 6 to 9 months on average but may last for years. Well over one-half of depressed adolescents have a recurrence within 7 years.

Children who are depressed may complain of feeling sick, refuse to go to school, cling to a parent, or worry excessively that a parent may die. Children are more likely to complain of aches and pains than to say they are depressed. When children are experiencing an episode they may struggle at school, have impaired relationships with their friends and family, internalize their feelings and have an increased risk for suicide. Teens may sulk, get into trouble at school, be negative or grouchy, become angry or aggressive, abuse drugs or alcohol, or feel misunderstood.

Multi-generational studies have revealed a link between depression that runs in families and changes in brain structure and function, which may precede the onset of depression. People at higher risk for depression include those who have ADHD, conduct, learning or anxiety disorders. Symptoms and warning signs of depression are:

  • Extreme stress, trauma, or facing a significant loss
  • Difficulty with relationships and poor communication
  • Increased irritability, anger or hostility
  • Extreme sensitivity to rejection or failure, low self-esteem and guilt
  • Persistent boredom and low energy
  • Decreased interest in activities; or inability to enjoy previously favorite activities
  • Frequent sadness, tearfulness, crying, or hopelessness
  • Frequent complaints of physical illnesses such as headaches and stomachaches
  • Frequent absences, poor performance, or poor concentration in school
  • A major change in eating and/or sleeping patterns
  • Talk of or efforts to run away from home
  • Thoughts or expressions of suicide or self-destructive behavior