Understanding Mental Health
What is Depression?
Depression is a serious mental health problem that can affect people of all ages, including children and adolescents. It is generally defined as a persistent experience of a sad or irritable mood as well as anhedonia; a loss of the ability to experience pleasure in nearly all activities that at one time were pleasurable. It includes a range of other symptoms such as changes in appetite, disrupted sleep patterns, increased or diminished activity level, impaired attention and concentration, and markedly decreased feelings of self-worth. Research has shown that children and youth who have depression may show signs that are different from adults.
Major depressive disorder, often called clinical depression, is more than just feeling down or having a bad day. It is different from the normal feelings of grief that usually follow an important loss, such as a death in the family. It is a form of mental illness that affects the entire person. It changes the way the person feels, thinks, and acts and is not a personal weakness or a character flaw.
Children and youth with depression cannot just snap out of it on their own. If left untreated, depression can lead to school failure, conduct disorder and delinquency, anorexia and bulimia, school phobia, panic attacks, substance abuse, or suicide. Depression often initially manifests itself in school, and as such educators play a critical role in its early detection. Once identified, educators are instrumental in referring the student to appropriate resources (e.g., psychologist, social worker, guidance counselor, local CLSC), as well as providing support and classroom adaptations.
Types of Depression
There are different types of depressive disorders,
Major Depressive Disorder also called major depression. The symptoms of major depression are disabling and interfere with everyday activities such as studying, eating, and sleeping. Children and youth may have only one episode of major depression in their lifetimes, but more often, depression comes back repeatedly.
Dysthymic disorder or Dysthymia is mild, chronic depression. Dysthymia is less severe than major depression, but it can still interfere with everyday activities. The symptoms of dysthymia last for a long time, 2 years or more. Children and youth with dysthymia may also experience one or more episodes of major depression during their lifetimes.
Seasonal Affective Disorder (SAD) is another type of depression that usually begins during the winter months, when there is less sunlight and lessens during the spring and summer.
Prevalence and Risk Factors
Depression does not have a single cause. Several factors can lead to depression. Some people carry genes that increase their risk of depression, they may have a predisposition towards depression as it tends to run in families. But not all people with depression have these genes, and not all people with these genes have depression. Environment—one’s surroundings and life experiences—also affects the risk for depression. Any stressful situation may trigger depression in children and youth. Additionally, some children and youth have certain personality characteristics that make them more prone to depression.
Depression in Canadian Children and Youth
Mental health has been identified as a major health issue for students. It is estimated that, at any given time, approximately 15% of children and youth in Canada may experience a mental illness that inhibits healthy development. Fewer than 20% of those children and youth receive treatment.
Research has shown that the majority of mental health disorders affecting adults originate in childhood and adolescence. Each year, over one million people in Canada experience a bout of major depression, putting it on par in prevalence with other chronic, widespread health conditions such as heart disease and diabetes. Estimates of depression in children aged 6 to 14 range from 2.7% to 7.8%, while rates for youth aged 15–18 is 7.6%.
How to Recognize Depression among Children and Youth
The way symptoms are expressed varies with a child’s developmental level. It is important to note that symptoms are usually a change in behavior from previous functioning. Characteristics of depression that usually occur in children and adolescents may include:
Persistent sad and irritable mood
Loss of interest or pleasure in activities once enjoyed
Significant change in appetite and body weight
Difficulty sleeping or oversleeping
Physical signs of agitation or excessive lethargy and loss of energy
Feelings of worthlessness or inappropriate guilt
Difficulty concentrating, unexplained irritability, or excessive crying
Recurrent thoughts of death or suicide
Frequent vague, nonspecific physical complaints (headaches, stomachaches)
Frequent absences from school or unusually poor school performance
School refusal or excessive separation anxiety
Chronic boredom or apathy
Excessive alcohol or drug abuse, increased risk-taking behaviors
Withdrawal, social isolation, and poor communication
Extreme sensitivity to rejection or failure and/or difficulty maintaining relationships
Unusual temper tantrums, defiance, or oppositional behavior
The presence of one or even all of these signs and symptoms does not necessarily mean that a child or youth is suffering from depression. If several of the above characteristics are present, however, it could be a cause for concern and may suggest the need for a professional evaluation. Should educators be concerned about one of their students, it is suggested that they speak with a resource person at their school (i.e., guidance counselor, psychologist, social worker) or seek referral sources through their local CLSC.
For more information on how to recognize depression and what educators can do, click on the following links:
School Adaptations for Students who are Depressed
As depression can have broad negative effects on students' academic work and socialization in school, there are a variety of accommodations and instructional strategies to increase students' engagement and success. The following school strategies can benefit children and adolescents battling depression:
For more school and classroom adaptations and instructional strategies, click on the following links:
For more information on depression and other mood disorders: