Have you ever stopped to think about childhood depression? If you are like many people you might think that is an absurd thought.

What could kids possibly have to be depressed about? Bland cereal? Boring video games? Too much homework or long school days? Seriously, kids can't be depressed; they get to play, they don't have to go to work or pay bills, and it is socially acceptable for them to watch cartoons. What could they possibly have to worry about, much less be depressed about?

If it were only that simple.

Childhood depression is real. It can be caused by a number of things. Children under stress, who have experienced loss, or who have attention, learning, or conduct disorders are at a higher risk for depression, according to the American Academy of Child & Adolescent Psychiatry. And adolescent girls are more likely than adolescent boys to develop depression, according to the National Institute of Mental Health. Kids at higher risk can slip into depression from triggers such parental divorce, a step-parent who is hostile towards a step-child, or a parent who ignores their own child.

There is a principle in psychology that what one person finds rewarding another may find aversive. That what one person finds a stressor another may be indifferent to. With this in mind, there is no hard and fast rule for that which can cause childhood depression. Since any number of things can contribute to childhood depression and there is no single cause, childhood depression is hard to detect.

Conventional wisdom says that childhood depression might look like a child "acting-up." As such, acting-up can easily mask a more serious and deep-rooted problem. But that is not the only warning sign. The National Alliance on Mental Illness notes that childhood depression may also look like withdrawal from friends and activities once enjoyed, increased irritability or agitation, poor school performance, changes in eating and sleeping habits (e.g. significant weight loss or insomnia), indecision, lack of concentration or forgetfulness, frequent physical complaints such as headaches and stomachaches, drug and/or alcohol abuse, and even recurring thoughts of death or suicide (expressed or hinted), to name a few.

I am not referring to childhood "blues" and depression in childhood isn't just a "growing up problem." It is the sort of thing that can undermine academic achievement, stunt social growth, or inhibit a child from realizing his or her full potential. These are problems that can and likely will affect a life-course trajectory if not addressed and resolved.

As many as one in every 33 children and one in eight adolescents may have depression, according to the U.S. Center for Mental Health Services. And the NIMH notes that depression can lead to suicide, which is the sixth leading cause of death for five to 15 year olds according to the AACAP.

No child chooses to be depressed and parents typically don't see it coming and sometimes don't recognize it when it is present. But childhood depression is treatable. This is an important social issue. Parents need to know the warning signs of depression and seek professional help for evaluation if they suspect something is wrong. There should be no shame or stigma associated with a parent's concern for the psychological wellbeing of a child. In fact, parents should be ashamed if they don't seek help if they suspect their child may be depressed.

There is an omnipresent concern that children are over-diagnosed with psychological maladies, and rightfully so. What's worse is when children are prescribed medications they don't need. If this is your concern, it need not be; there is nothing wrong with seeking a second and even a third professional opinion. But don't let this concern prevent you from seeking the care your child may need.

The job of being a parent is increasingly hard in our society. If we don't talk about such challenges we risk dismissing their importance, misunderstanding them when they are in front of us, or stigmatizing children for something that is not their fault.

PAUL HEROUX of Attleboro holds a bachelor's degree in psychology, worked with kids for seven years and is a graduate student at the JFK School of Government at Harvard University. He can be reached at Paul_Heroux@hks11.harvard.edu.

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