Understanding childhood mood disorders
Children younger than age 18 can experience one of two types of mood disorders:
(1) Major Depressive Disorder (MDD)
Approximately 10 percent of youth experience depression in their adolescence. MDD consists of depressive episodes that last two weeks or longer. Symptoms of MDD include feelings of sadness, worthlessness and guilt accompanied by a disinterest in normal activities, appetite change, fatigue, insomnia, suicidal thoughts/actions, and impaired cognitive functioning.
“Depressed children typically withdraw from friends, family members and school,” says David Miklowitz, PhD, director of the UCLA Child & Adolescent Mood Disorders Program. “They may come home after school and go right to sleep. Often, their academic performance declines and their friendships and family relationships suffer.”
(2) Bipolar I/II Disorder
Pediatric bipolar disorder affects an estimated 2 percent of children and adolescents. Children with bipolar disorder experience intense mood changes, swinging between depression and mania. During a manic episode, a child will experience one or more weeks of severe irritability or intense euphoria, along with grandiose beliefs (e.g., “I am smarter than everyone else”). When in a manic state, bipolar children can be excessively social, impulsive and dangerously risky in their behaviors. They often sleep as little as three-to-four hours a night.
There is no biological test or brain scan to diagnose these disorders. A psychiatric diagnostic interview is used to evaluate a child’s moods, energy levels, sleeping patterns, thoughts about himself/herself, family history of psychiatric disorders, and any recent changes in social activity or interests.
“The child may also be going through a life event (e.g., parental divorce or a death in the family) that can set off a depressive or manic episode,” Dr. Miklowitz explains. “High levels of family conflict, any form of abuse, or constant parental criticism can also contribute to the development or worsening of childhood mood disorders.” Some adolescents are also abusing substances, which usually worsens mood symptoms.
How can parents help
- Learn the early signs of depression and bipolar disorder — especially if there’s a family history of these disorders.
- Communicate: Ask your child if there’s anything he/she wants to talk about.
- Keep consistent communication with your spouse/former spouse. Supportive parents can instill resilience in their children.
- If the symptoms cause daily impairment in functioning, or if you fear for your child’s safety, get your child a psychiatric evaluation.
Treatment for mood disorders
Treatment of these disorders depends on how severe and impairing the disorder is, as well as the child’s age. For bipolar disorder, the first treatment response is typically mood stabilizers or antipsychotic medications. Children with major depressive disorder are usually treated with antidepressants, psychotherapy or both.
Get more health tips for parents at www.uclahealth.org/healthtips.