Major Depressive Disorder, Pediatric

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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.

    What increases the risk?

    The following factors may make a child more likely to develop MDD:
    • A family history of depression.
    • Being female.
    • Going through puberty.
    • Long-term (chronic) stress, chronic physical illness, other mental health disorders, or substance misuse.
    • Your child's growth and development, especially if your child has delayed development or early development.
    • Trauma, including:
      • Being bullied.
      • Family problems.
      • Violence or abuse.
      • Loss of a parent or close family member.
      • Experiencing discrimination.

    What are the signs or symptoms?

    The main symptoms of MDD typically include:
    • Being depressed or irritable all the time.
    • A 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.
    • Major changes in behavior. This may include:
      • Poor performance in school or having trouble with peers.
      • Acting out, such as misbehaving or being irritable.
      • Spending a lot of time alone.

    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.
    • Thoughts of suicide, thoughts of harming others, or wishing to be dead.

    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 either a depressed mood or loss of interest and at least four other MDD symptoms, most of the day, nearly every day, in a 2-week period.

    How is this treated?

    A child talking with a mental health care provider.

    This condition is usually treated by mental health care providers, 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 they relate to and communicates with others.
      • Family therapy. This treatment includes family members.
    • Medicine to treat anxiety and depression.
    • Lifestyle changes. Your child should:
      • Exercise regularly.
      • Have a regular sleeping and waking schedule. Make sure your child gets plenty of sleep.
      • Eat healthy foods.

    Follow these instructions at home:


    • Help your child find healthy ways to manage stress, such as:
      • Meditation or deep breathing.
      • Exercise. This may include organized sports, recreational games, or play groups.
      • Spending time in nature.
      • Journaling.
    • Encourage your child to find activities they enjoy.
    • Have your child return to normal activities as told by the health care provider. Ask the 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.
    • Consider having your child join a support group. Your child's health care provider may be able to recommend one.
    • Keep all follow-up visits. Your child's health care provider will need to check on your child's mood, behavior, and medicines. Your child's treatment may need to be changed over time.

    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 hurts themselves on purpose (self-harm).
    • Your child thinks about harming themselves or harming others.
    • Your child has hallucinations.

    Get help right away if you feel like your child may hurt themselves or others, or if they have thoughts about taking their own life. Go to your nearest emergency room or:
    • Call 911.
    • Call the National Suicide Prevention Lifeline at 1-800-273-8255 or 988. This is open 24 hours a day.
    • Text the Crisis Text Line at 741741.

    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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