Mood Disorders

Mood Disorders

It is distressing for parents to see their child or adolescent sad, withdrawn, or irritable.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.

Key Facts:

  • As many as 3 percent of children and 6 percent of adolescents are currently or recently have been depressed.1
  • More than 70 percent of children and adolescents with depressive disorders or other serious mood disorders do not receive appropriate diagnosis and treatment.2
  • As many as 50 to 75 percent of children with major depression have recurrent episodes, most often within 6 to 12 months of remission.3
  • The incidence of bipolar disorder peaks at age 14 in both males and females and decreases gradually thereafter.4
  • More than 4,200 youth ages 10 to 24 in the United States committed suicide in 2007, making it the third-leading cause of death for this age group.5

References

  1. Williams, S. B., O'Connor, E. A., Eder, M., & Whitlock, E. P. (2009). Screening for Child and Adolescent Depression in Primary Care Settings: A Systematic Evidence Review for the US Preventive Services Task Force. Pediatrics, 123 (4), e716-e735.
  2. Bhatia, S. K., & Bhatia, S. C. (2007). Childhood and adolescent depression. American Family Physician, 75 (1), 73-80.
  3. Emslie, G. J., Kennard, B. D., Mayes, T. L., Nightingale-Teresi, J., Carmody, T., Hughes, C. W., et al. (2008). Fluoxetine versus placebo in preventing relapse of major depression in children and adolescents. American Journal of Psychiatry, 165, 459-467.
  4. Lewinsohn, P., Seeley, J., Buckley, M., & Klein, D. (2002). Bipolar disorder in adolescence and young adulthood. Child and Adolescent Psychiatry Clinics of North America, 11, 461-475.
  5. Centers for Disease Control and Prevention. (2007). Leading Causes of Death Report, 2007. Retrieved May 27, 2010, from Web-based Injury Statistics Query and Reporting System (WISQARS): http://webappa.cdc.gov/cgi-bin/broker.exe