The U.S. Department of Health and Human Services reports that nearly 1 in 5 adolescents have a mental health disorder. For one-third of those, symptoms of depression are present. With over 17% of American students in grades 9-12 reporting considering attempting suicide, it is critical to identify and treat this disorder. However, there are numerous challenges to diagnosing depression in children and teens.
Communication Issues
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The ability of children and teenagers to verbalize the symptoms they are experiencing varies with age, maturity, and family or cultural background. An individual struggling with depression can feel hindered by symptoms and be incapable of expressing their thoughts and feelings. The following issues may also impact a child’s ability to talk about their depression symptoms:
- Anger
- Anxiety
- Disabilities
- Embarrassment
- Language barriers
- Social skills
- Trauma
- Trust issues
Adult Depression Models
Most depression models draw on adult experiences with depressive conditions. Researchers believe that the symptoms in children and teenagers may not align with adult depression due to cognitive functioning, communication skills, coping mechanisms, emotions, and concepts of self that are not as fully developed in young people.
Challenging Symptoms
Symptoms of depression can be ambiguous and confusing, leading to difficulty in diagnosing cases, particularly in children and teenagers.
Symptoms Mirror Other Conditions
Depression symptoms are often difficult to distinguish from other mental health conditions like bipolar disorder, cyclothymic disorder, disruptive mood dysregulation, dysthymia, and premenstrual dysphoric disorder. Other issues such as fatigue, medications, sleep disturbance, or medical conditions like anemia, diabetes, epilepsy, mononucleosis, and thyroid disorders can cause symptoms that mirror depression. Some of these symptoms include:
- Behavior issues in school
- Changes in mood
- Changes in sleep patterns
- Fatigue or energy depletion
- Hopelessness or sadness
- Lack of interest in favorite activities
Symptom Patterns Vary
Different individuals experiencedepression in a variety of patterns. Some children and teenagers report physical pain, but others cite aggression, sadness, numbness, and numerous other symptoms. For some, the onset of depression is slow and subtle, making it difficult to pinpoint. This discrepancy in the manifestation of symptoms causes further difficulties in diagnosing the disorder.
Practitioner Issues
In addition to the challenges of working with children and teenagers and the ambiguity of depression symptoms, numerous issues with the diagnosticians can lead to difficulty in diagnosing cases. Time constraints and other professional factors sometimes impact the amount and quality of training practitioners have in diagnosing adolescents. Bias is another issue, causing diagnosis inequalities along racial lines. A 2022 study showed that Black teenagers were less likely to receive an accurate depression diagnosis than White teens.
Follow-Up
Upon receiving a diagnosis, getting the appropriate treatment is the next challenge for children and teenagers. A whopping 60% of teens diagnosed with mild depression and 25% with more severe depression fail to receive follow-up care.
WPS offers numerous assessments like (CDI 2) Children’s Depression Inventory, Second Edition, to help practitioners navigate the challenges of diagnosing depression in children and teens.