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Major Depressive Disorder, Pediatric

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Jul.13.2022
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 Major Depressive Disorder, Pediatric

Major Depressive Disorder, Pediatric

Major depressive disorder (MDD) is a mental health condition. It may also be called clinical depression or unipolar depression. MDD causes symptoms of sadness, hopelessness, and loss of interest in things. These symptoms last most of each day, almost every day, for 2 weeks. MDD can also cause physical symptoms. It can interfere with relationships and with school and other everyday activities.

MDD may be mild, moderate, or severe. It may be single-episode MDD, which happens once, or recurrent MDD, which may occur multiple times.

What are the causes?

The exact cause of this condition is not known. MDD is most likely caused by a combination of things, which may include:
  • Your child's personality traits.
  • Your child's learned or conditioned behaviors or thoughts or feelings that reinforce negativity.
  • How your child reacts to stress and strong emotions.
  • Your child's growth and development. This may become a problem if your child has unusual appearance, delayed development, or early development.
  • Going through traumatic experiences in life, including being bullied or going through big changes in life.

What increases the risk?

The following factors may make a child more likely to develop MDD:
  • A family history of depression.
  • Being a girl.
  • Going through puberty.
  • Troubled family relationships.
  • Abnormally low levels of certain brain chemicals.
  • Traumatic or painful events, especially violence, abuse, or the loss of a parent.
  • Long-term (chronic) stress or a lot of stress. This may be caused by:
    • Experiencing discrimination.
    • Living in poverty.
  • Chronic physical illness, other mental health disorders, or substance abuse.

What are the signs or symptoms?

The main symptoms of MDD typically include:
  • Constant depressed or irritable mood.
  • Loss of interest in things and activities that your child normally enjoys.

Other symptoms include:
  • Sleeping or eating too much or too little.
  • Unexplained weight loss or weight gain.
  • Tiredness or low energy.
  • Being agitated, restless, or weak.
  • Feeling worthless or guilty.
  • Trouble thinking clearly or making decisions.
  • Thoughts of suicide, thoughts of harming others, or wishing to be dead.
  • Isolating oneself.
  • Major changes in behavior. This may include:
    • Poor performance in school or having trouble with peers.
    • Acting out of any kind, such as misbehaving or being irritable.

Severe symptoms of this condition may include:
  • Psychotic depression.This may include false beliefs or delusions. This includes seeing, hearing, tasting, smelling, or feeling things that are not real (hallucinations).
  • Chronic depression or persistent depressive disorder. This is low-level depression that lasts at least 2 years.
  • Melancholic depression, or feeling extremely sad and hopeless.
  • Catatonic depression, which includestrouble speaking and trouble moving.

How is this diagnosed?

This condition may be diagnosed based on:
  • Your child's symptoms.
  • Your child's medical and mental health history. You may be asked how long your child has had symptoms of MDD.
  • A physical exam.
  • Blood tests to rule out other conditions.

MDD is confirmed if your child has the following symptoms most of the day, nearly every day, in a 2-week period:
  • Either a depressed mood or loss of interest.
  • At least four other MDD symptoms.

How is this treated?

This condition is usually treated by mental health professionals, such as psychologists, psychiatrists, and clinical social workers. Your child may need more than one type of treatment. Treatment may include:
  • Psychotherapy, also called talk therapy or counseling. Types of psychotherapy include:
    • Cognitive behavioral therapy (CBT). This teaches your child to recognize unhealthy feelings, thoughts, and behaviors, and replace them with positive thoughts and actions.
    • Interpersonal therapy (IPT). This helps your child to improve the way he or she relates to and communicates with others.
    • Family therapy. This treatment includes family members.
  • Medicine to treat anxiety and depression. These medicines help to balance the brain chemicals that affect your child's emotions and behaviors.
  • Lifestyle changes. Your child should:
    • Have the chance to exercise regularly.
    • Have a regular sleeping and waking schedule.
    • Have healthy foods available.

Follow these instructions at home:

Activity

  • Help your child find healthy ways to manage stress, such as:
    • Meditation or deep breathing.
    • Physical activities, such as organized sports, recreational games, or play groups.
    • Spending time in nature.
    • Journaling.
  • Encourage your child to find activities that he or she enjoys.
  • Have your child return to his or her normal activities as told by the health care provider. Ask your health care provider what activities are safe for your child.

General instructions

  • Give over-the-counter and prescription medicines only as told by your child's health care provider.
  • Make sure your child eats a healthy diet and gets plenty of sleep.
  • Consider having your child join a support group. The health care provider may be able to recommend one.
  • Keep all follow-up visits as told by your child's health care provider. This is important.

Where to find more information

Contact a health care provider if:

  • Your child's symptoms get worse.
  • Your child develops new symptoms.

Get help right away if your child:

  • Harms himself or herself.
  • Thinks about harming self or harming others.
  • Hallucinates.

If you ever feel like your child may hurt himself or herself or others, or shares thoughts about taking his or her own life, get help right away. You can go to your nearest emergency department or:
  • Call your local emergency services (911 in the U.S.).
  • Call a suicide crisis helpline, such as the National Suicide Prevention Lifeline at 1-800-273-8255 or 988 in the U.S. This is open 24 hours a day in the U.S.
  • Text the Crisis Text Line at 741741 (in the U.S.).

Summary

  • Major depressive disorder (MDD) is a mental health condition. MDD causes symptoms of sadness, hopelessness, and loss of interest in things. These symptoms last most of the day, almost every day, for 2 weeks.
  • MDD is usually treated by mental health professionals. Treatment may involve psychotherapy, medicines, and lifestyle changes.
  • Help your child find healthy ways to manage stress, and make sure your child eats a healthy diet and gets plenty of sleep.
  • Get help right away if you feel like your child may hurt himself or herself or others, or shares thoughts about taking his or her own life.

This information is not intended to replace advice given to you by your health care provider. Make sure you discuss any questions you have with your health care provider.

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