It is distressing for parents to see their child or adolescent sad, withdrawn, or irritable. Yet episodes of sadness and frustration are common during childhood and adolescence. How, then, can a parent or primary care provider determine whether a child or teen is showing signs of a mood disorder?
Depressed mood falls along a continuum. Brief periods of sadness or irritability in response to disappointment or loss are a normal part of growing up and usually resolve quickly in a supportive environment. But some children and adolescents experience intense or long-lasting sadness or irritability that may interfere with self-esteem, friendships, family life, or school performance. These children or teens may be suffering from a depressive disorder. Depressive disorders include dysthymic disorder as well as single and recurring episodes of major depressive disorder.
Another type of mood disorder that can present in childhood or adolescence is bipolar disorder. Although bipolar disorder has been considered uncommon in prepubertal children, evidence suggests that it may not be as rare as previously thought, and that it is often difficult to distinguish from severe forms of attention deficit hyperactivity disorder (ADHD). A child or teen who presents with recurrent depressive symptoms, persistently irritable or agitated/hyperactive behaviors, markedly labile mood, reckless or aggressive behaviors, or psychotic symptoms may be experiencing the initial symptoms of a bipolar disorder.