MDD: What to Look For

The key sign of depression is a change in mood: unusual sadness and a reduced interest in activities—sports, friends, school—a child had enjoyed. Anticipation of things she normally looks forward to is no longer pleasurable. Some depressed adolescents lose anticipatory pleasure but are able to enjoy what clinicians call “consumatory pleasure” — that is, the idea of pizza no longer interests them, they won’t seek an opportunity to get pizza, but served pizza, they can enjoy eating it. This presentation, known as atypical depression, can fool parents, who may dismiss their daughter’s dogged lack of interest as being oppositional.

Other signs of depression are unexpected, involuntary changes in weight; major shifts in sleep patterns; and sluggishness. A depressed child may express inappropriate guilt or be unusually harsh on herself — I’m ugly, I’m no good, nobody likes me. In the most extreme cases, depressed kids may have thoughts of or make attempts at suicide.