feels, thinks and acts. If left untreated, depression can lead to school failure, alcohol or other drug use, and even suicide.

What are the symptoms? The symptoms of depression, such as occasionally feeling sad and tearful, are common in young people and are temporary. Depressive illness is different in scale, with the mood disturbance occurring most of the time, during most days and over several weeks. It is often accompanied by other symptoms such as:

- Losing interest and motivation to do things that used to be enjoyable.
- Withdrawing socially and not wanting to see people.
- Difficulty concentrating on schoolwork, leading to falling grades.
- Tiredness, aches and pains.
- Changes in sleeping pattern (difficulty sleeping or sleeping more than usual).
- Changes in appetite and weight (feeling more hungry or less hungry).
- Feeling useless, worthless and unloved.
- Black, pessimistic thoughts about the future.
- Thoughts of death and acts of self-harm.

These symptoms can cause distress, or difficulty coping with schoolwork, or affect relationships with friends and family. Other

people usually notice the young person is not their usual self, although parents are not always aware of how unwell their child is - often adolescents will open up to friends first. After the age of about eight years, the symptom patterns of depression are similar to those of adults and include many or most of the symptoms described above. However, children and adolescents may seem irritable rather than sad, which can be confusing, particularly if the young person withdraws and shuts themselves away. Depressive symptoms can also occur as part of other psychiatric disorders, or in physical illness. Depressed children and adolescents often have other psychiatric problems as well, such as behavior problems or anxiety, which may mask the underlying depression. The young person will need help for these problems in their own right even after the doctor has diagnosed depression. If a parent is also depressed, it is vital that they get the appropriate help and if there are conflicts and rows in the family, then family therapy or counselling may be helpful. Depressed children and adolescents can be withdrawn, irritable or uncooperative, and often have difficulty identifying and expressing their feelings. Some youngsters, particularly boys, deny feeling sad; the only observable complaint will be of irritability, moodiness and boredom. As a result, they may get in fights or other trouble at school, interact less socially and lose friends. They may also 'act out' suicidal feelings, e.g. by cutting themselves, which can be misinterpreted by parents and teachers as manipulative rather than as a communication of distress. All these things can worsen a depressed state.

How common is childhood depression? Depressive illness, or what doctors call major depressive disorder, occurs in 2 to 4 per cent of children, although is rare under the age of eight. It becomes more common after puberty, rising to 4 to 8 per cent of adolescents and in adolescents, depression is more common in girls. The number of children and adolescents being diagnosed with a depressive illness is increasing. This may be because of advances in mental health with the symptoms being recognized earlier, or it could be the illness is actually occurring earlier compared to the previous generation.

Who gets depressed and why? The tendency to develop depressive illness involves a complex mixture of factors, such as inherited (genetic) factors and life experiences. Children and adolescents who get depressed have often had adverse experiences. There is some evidence that an early negative experience, e.g. losing a parent or being abused as a child, raises the risk of depression later on. Recent life events often precipitate an episode of depression. Friendship difficulties and disappointments are common triggers for depression in children and adolescents...>>>>Article Continues>>>>