What do teenagers cry about

Psychiatry, Psychosomatics & Psychotherapy

Symptoms and clinical picture of children and adolescents with depression

Depression manifests itself differently in some symptoms in children and adolescents than in adults, the clinical picture also differs within the respective age groups:

In small children, physical symptoms such as loss of appetite, sleep disorders or abdominal pain are often in the foreground. After screaming and crying at the beginning of the disease phase, they usually become increasingly passive and disinterested.

In preschoolers, listlessness, mood swings, irritability, and aggressiveness can all be signs of depression.

At school age, affected children often suffer from sadness, feelings of guilt and fear of failure and often withdraw from social contacts. The children can also show an irritable mood.

Typical symptoms that occur in adolescence and adolescence with a depressive illness are difficulty falling asleep and staying asleep, physical complaints such as loss of appetite and weight as well as daily fluctuations in well-being with a "low" in the morning. But changes in behavior such as susceptibility to mood, listlessness, loss of interest, withdrawal, reduced self-confidence or drug consumption can also indicate this.

Depression differs from depression in the duration, frequency, and intensity of symptoms. The following symptoms are common in depressed people of all ages. For a suspicion of depression, several of these symptoms should be observed almost daily for weeks.

  • persistent sadness
  • Feelings of guilt, low self-confidence, feeling of worthlessness
  • low tolerance for frustration, crying or getting angry easily
  • persistent lack of interest, joylessness, lack of energy
  • social retreat, no desire to be with friends
  • Insomnia or sleep too much
  • increased or decreased appetite
  • constant fatigue
  • Difficulty dealing constructively with problems, instead withdrawing
  • Substance abuse, thoughts of suicide
  • Poor concentration and decision-making

Often children and young people cannot get out of a vicious circle of fears and feelings of not being understood without outside help. If you already dare to talk about fears or feelings of self-worth or hopelessness, this should definitely be taken seriously by teachers, parents and colleagues.

If depressive phases alternate with manic phases in children or adolescents, one speaks of a bipolar affective disorder (manic-depressive illness). The manic symptoms include:

  • Strong mood swings compared to young people of the same age with the same cultural background: Either those affected are unusually cheerful and exuberant or very irritable,
  • Exaggerated self-assessment: For example, a young person may believe that he is in contact with God,
  • increased activity and decreased need for sleep (can get by with little or no sleep for several days without feeling tired),
  • Increased talkativeness or urge to speak: The young people speak a lot and very quickly and jump from topic to topic. You won't let yourself be interrupted
  • increased distractibility: attention is constantly jumping from one thing to another,
  • the adolescents behave in a highly self-endangering manner and believe that they are inviolable,
  • it can lead to excessive sexual behavior with risky sexual intercourse

The depressive symptoms include:

  • Persistent sadness; frequent crying; gloomy mood
  • Loss of interest in activities that used to be fun
  • Many physical complaints, such as headache or stomach pain
  • Reduced energy levels, poor concentration, boredom
  • Changes in eating or sleeping behavior, such as increased sleep or increased food intake

Some of these signs are similar to those seen in teenagers with other problems, such as substance abuse, delinquency, hyperactivity, or even schizophrenia. The diagnosis can only be made with observation over a longer period of time. A thorough examination by a child and adolescent psychiatrist, who can also initiate appropriate therapy, is important.

Technical support: Prof. Dr. med. Michael K├Âlch, Berlin (DGKJP)