Depression: Overview

Depression Overview
— Leslie E. Packer, PhD


  • Up to 10% of all children under age 13 experience a major depressive episode or depression.
  • 15 – 20% of teenagers experience a major depressive episode or depression
  • Over 50% of adolescents who have depression turn to drugs.
  • Suicide is the third leading cause of death in the age group 15 – 24.


Children and adolescents with depression may appear sad or blue, but depression may also be manifest as anger or chronic irritability.

Sleep disturbance, loss of interest in previously enjoyed activities, feelings of hopelessness, guilt, appetite changes, lack of energy, and auditory hallucinations (in severe cases) may all be signs of depression. Young children may report a lot of headaches or stomachaches for which there is no obvious reason.


“SAD FACES + GWV”” is an acronym to help you remember the signs and symptoms of depression in terms of what’s affected:

S = sleep changes

A = appetite

D = “down” mood


F = fun (lack of)

A = agitation

C = concentration

E = energy loss

S = suicidal thoughts


G = guilty feelings

W = feels worthless

V = voices (auditory hallucinations)


If there is any significant change in any student’s behavior that lasts more than two weeks, you should contact the child’s parent to inform them of your observations.


Some people just always seem to have the “blahs.” These may be the students that we think of as being depressed over the long term. They may always seen “down in the dumps” even if there’s nothing particularly depressing going on in their lives, and when asked, may tell you that they’ve “always” been this way. Or maybe they always seem “cranky” or slightly irritable. While symptoms in children may appear a bit different than in adults, the key features here are the duration of the depressed mood and the presence of at least two of the following symptoms we associate with the depressed mood:

  • change in appetite/eating habits,
  • change in sleeping habits,
  • low energy or fatigue,
  • poor self-esteem,
  • poor concentration or difficulty making decisions, and
  • feelings of hopelessness

By now, you will probably recognize the above as signs of depression.

But what happens to children with dysthymia? Do the symptoms progress into full-blown depression or do they remit? In some cases, they do evolve into Major Depression.

Some students may have dysthymia but occasionally go into a full-blown major depressive episode. These students are often referred to as having a “double depression.” I refer to them as “being between a rock and a hard place.”


A student who is depressed will have impaired concentration and memory. Even when they know the answers to questions, they may have difficulty retrieving it and may require accommodations on tests because of retrieval problems.

Students who suffer from depression may be irritable or may have explosive outbursts. If the depression continues for any length of time, peer relationships will probably be affected as people lose patience with the depressed peer.

Sleep disorders associated with both depression and Bipolar Disorder will impact the student’s ability to wake up in the morning, get to school on time, and concentrate (particularly in the morning).

Medications used to treat depression may have side effects that can also interfere with school functioning.

Students who are depressed may suffer from psychomotor retardation, meaning that they will move very slowly. Students may be late to class simply because they are moving much more slowly than normal. Do not penalize the student with psychomotor retardation for being late to class. Either allow the student to leave class a few minutes early to get to the next class on time, ignore the lateness, or better yet, praise the student for getting to class at all!

Safety issues may become paramount if the student exhibits any suicidal behaviors or expresses suicidal ideation.