It is part of the normal human experience for us to feel sad or down at different times of our lives. However, it is important to distinguish between the “blues” and clinical depression. People with the “blues” present with a temporarily depressed mood, but they usually manage to cope and adjust without requiring treatment. In contrast, clinical depression (also known as major depressive disorder) involves a depressed mood for at least two weeks for most of the day, nearly every day. This stops a person from enjoying things they used to like or from taking part in usual activities such as going out with friends or playing sport. Other characteristics of clinical depression can involve an increased or decreased appetite, sleeping more or less than usual, feeling restless or slowed down, fatigue or loss of energy, feeling worthless or excessively guilty, having difficulty concentrating, and having thoughts of suicide. In clinical depression, these symptoms significantly impair a person’s ability to function. For example, it might be difficult for the person to focus or perform well at school or work, it may impact upon their relationships with family and friends, or they may have trouble getting on with day-to-day activities.
Unfortunately, clinical depression is relatively common in young people. An estimated 7.7% of Australian adolescents aged between 11-17 present with clinical depression.[1] Individuals often present with a mix of depressive and anxiety symptoms.[2] However, it is likely that the true prevalence of mental health disorders in young people is underestimated due to misdiagnosis by health care professionals and/or young people not seeking professional help.[3] Furthermore, there has also been a significant surge in clinical depression and other mental health disorders over the last two years in young people as a result of the Covid-19 pandemic.[4]
A number of factors can increase a young person’s risk of developing clinical depression. These include[5]:
- A history of clinical depression in close family members
- Being female
- Being a more sensitive, emotional or anxious person
- Adverse experiences in childhood, such as lack of care or abuse
- Family poverty
- Learning and other school difficulties
- Adverse events in the person’s life recently, including being a victim of a crime, death or serious illness in the family, having an accident, being bullied or victimised
- Parental separation or divorce
- Social-cultural minorities and social disadvantage (e.g. being part of a sexual minority and gender diverse group, Aboriginal or Torres Strait Islander, refugee, homeless, youth in criminal justice system)
- Lack of a close, confiding relationship
- Having another mental health condition such as an anxiety disorder, psychotic disorder or substance use disorder
- Long-term or serious physical illness
- Premenstrual changes in hormone levels
- Caring full-time for a person with a long-term disability
Clinical depression can also result from:
- The direct effects of some medical conditions (e.g. Vitamin B12 deficiency, hypothyroidism, hepatitis, Glandular Fever, HIV and cancers)
- The side effects of certain medications or drugs (including some acne medications)
- Intoxication from alcohol or drugs
Diagnosis and treatment
If you notice a sudden, persistent change in your child’s mood or behaviour, encourage them to talk about what is on their mind and really listen to what they are saying. Try to ascertain whether their low mood is due to a specific, temporary situation, or due to a more serious, persistent problem. When problems do persist, it is important to seek help from a mental health professional such as a Psychologist to assist with diagnosis and treatment. Getting help and early treatment can reduce the severity of clinical depression, suicide risk and prevent future relapses.
[1] Lawrence, D. et al., (2015). The mental health of children and adolescents: Report on the second Australian Child and Adolescent Survey of Mental Health and Wellbeing. Canberra, Australia.
[2] Melton et al., (2016). Comorbid anxiety and depressive symptoms in children and adolescents: A systematic review, Journal of Psychiatric Practice, 22(2), 84-98.
[3] Radez, J. et al., (2020). Why do children and adolescents (not) seek and access professional help for their mental health problems? A systematic review of quantitative and qualitative studies. European Child & Adolescent Psychiatry, 30(2), 183-211.
[4] Racine, N. et al., (2021). Global prevalence of depressive and anxiety disorders in children and adolescents: A meta-analysis. JAMA Pediatrics, 175(11), 1142-1150.
[5] Kelly, C. et al., (2013). Youth mental health first aid: A manual for adults assisting young people (3rd ed.). Mental Health First Aid: Melbourne, Australia.