Identifying the Signs of Youth Depression

Mental health intervention and treatment is vital for children

/ Author:  / Reviewed by: Joseph V. Madia, MD

Depression and mental illness in children and adolescents is a rising concern. About five percent of youth under age 18 suffer from depression at any given time, but their numbers are rising. Rates of depression and anxiety among American youth have increased steadily over the last fifty to seventy years, and children are the fastest growing group of depression sufferers.

Five to eight times as many high school and college students today meet the criteria for diagnosis of major depression and/or an anxiety disorder as was true half a century or more ago, says psychology professor Peter Gray of Boston College.

These problems occur in younger children as well. Major depressive disorder occurs in children as young as three years old, and the younger a person is affected by depression, the more likely he or she will suffer from it throughout life. Children who are under stress or have experienced a loss are at higher risk for depression, and depressive disorders as well as other mental illnesses that tend to run in families.

Signs Before Birth

The creation of a hundred billion brain cells and the formation of an incalculable number of connections between them is such a complex task that 86 percent of the 17,000 human genes studied are recruited in the effort. Through this extensive analysis researches have found that the signs of mental and developmental disorders are in the brain before birth.

"The more we learn about the variety in our DNA, our genetic make up, the more we realize how critical the biologic component of the nature / nurture balance really is," says Russell J. Ricci, MD.

Researchers at Yale University identified the genes suspected of causing autism, schizophrenia and other psychiatric illnesses in fetal brains. The researchers examined more than 1,300 tissue samples taken from 57 people at different stages of brain development, from a 40-day-old fetus to an 82-year-old adult.

Tracking thousands of genes involved in development, the extensive genetic analysis looked at 1.9 billion data points to see how these genes were expressed and activated, in a sort of map of brain genetics. A significant amount were shaped before birth, and the genes linked to autism and schizophrenia were found to be activated while in the womb.

“We found a distinct pattern of gene expression and variations prenatally in areas of the brain involving higher cognitive function,” said Nenad Sestan, associate professor of neurobiology, researcher for the Kavli Institute for Neuroscience and senior author of the study. “The complexity of the system shows why the human brain may be so susceptible to psychiatric disorders.”

Hundreds of genetic differences between male and female fetuses were also discovered in the Yale study. Sestan and his team expected to find clear differences in Y chromosomes that are found only in males. However, they also found distinct differences between prenatal males and females in genes that are shared by both sexes, both in how the genes are expressed and in the level of genetic activity.

Tools for Identifying Youth Depression

Childhood depression must be given focus because according to the American Academy of Child Adolescent Psychiatry (AACAP), the behavior of depressed children and teenagers may differ from that of adults. Without knowing these differences, the symptoms of depression or other mental disorders may pass unseen by parents, teachers or other caregivers.

Because many children with mental health problems are never diagnosed or treated, Mayo Clinic and the REACH Institute have released a simple-to-understand toolkit aimed at identifying those kids and getting them the right treatment.

About half of mental health disorders manifest themselves by the time a child has turned 14, and 75 percent manifest by age 24, says Gary Blau, chief of the child, adolescent and family branch of the Substance Abuse and Mental Health Services Administration that unveiled the toolkit. Yet up to 75 percent of youth with mental health disorders such as attention deficit hyperactivity disorder (ADHD), bipolar disorder, anxiety, and eating disorders are usually not identified, and do not receive the care they need.

"A drastic change in behavior, especially in the 18-25 age group, can be the warning sign of major mental illness," says Barbara Long, M.D., Ph.D and author of Keep Your Eye on the Prize!-- a Young Person's Guidebook to Adulthood. She lists some worrisome behavior that indicates a need for mental health help:

1. A previously good student no longer cares about his studies.
2. Saying or doing odd things, such as picking at or burning himself or thinking that others are out to harm him.
3. Indifferent to self-care; becomes disheveled, does not eat or sleep normally.
4. Withdraws completely from usual social supports, such as family, friends, others.

After surveying more than 6,000 parents and children about mental health services in the United States during the past decade, researchers created "Action Signs" to help easily identify symptoms for youth who may be experiencing mental disorders.

The AACAP suggests that parents or other adults seeing the following signs of depression in a child or teen should consult a mental health professional

  • Frequent sadness, tearfulness, crying
  • Decreased interest in activities; or inability to enjoy previously favorite activities
  • Hopelessness
  • Persistent boredom; low energy
  • Social isolation, poor communication
  • Low self esteem and guilt
  • Extreme sensitivity to rejection or failure
  • Increased irritability, anger, or hostility
  • Difficulty with relationships
  • Frequent complaints of physical illnesses such as headaches and stomachaches
  • Frequent absences from school or poor performance in school
  • Poor concentration
  • 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

It's important that children and adolescents who suffer from depression receive treatment because they are at much higher risk of using alcohol or drugs and of committing suicide. More than 70 percent of teens at risk of suicide do not receive any sort of mental health care at all.

Early intervention and treatment of young people with depression and mental disorder is vital for helping them turn into happy, healthy adults.

Review Date: 
November 2, 2011