Depression is a feeling that almost all humans experience at some point in their lives. For some, depression is not just an experience, but a diagnosis. This diagnosis comes from a medical professional, based on the frequency, intensity, and duration of symptoms, and usually requires specialized intervention. A problem with diagnosis of depression, however, is that depression presents differently in children versus adults. This can make access to care difficult. Knowing signs and symptoms of depression in both adults and children can help increase acquisition of services.
Individuals must meet certain criteria to receive a diagnosis of depression. These criteria come from the Diagnostic and Statistical Manual, or DSM. These criteria include depressed mood, lack of interest or pleasure, weight loss or gain, sleeplessness or sleeping too much, slowed movement, tiredness, feelings of worthless or guilt, decreased concentration, and for some, thoughts of death and/or suicidal ideation (O’Connor et al., 2009; Williams, 2009). These criteria must be present for a certain amount of time and cause distress or impairment in order to qualify for a diagnosis. With such a set list of symptoms, why is it sometimes difficult, then, to identify depression? Well, because depression manifests differently in different age groups.
People of all ages can receive diagnoses of depression, from children all the way to older adults. Symptoms of depression, however, may present differently. Young children often do not have the words to describe their mental states, and they express them through complaints of pain in their bodies (Bhatia & Bhatia, 2007). Children may present with anger or irritability, as well as inattention. Differentiating depression from other disorders of childhood, for example attention deficit hyperactivity disorder (ADHD), is therefore important. As adults reach older age, they often have similar presentations: somatic symptoms and loss of interest versus the sadness seen in middle aged adults (Fiske, Wetherell, & Gatz, 2009). In between childhood and adulthood, middle aged adults present with more of the mood changes considered typical of depression (Leah, 2023). Children express more of an external presentation of depression, while middle adults experience more of an internal state. These are all generalizations, however. Each person experiences depression differently. Age just exacerbates the differences.
What is the bottom line when it comes to diagnosis of depression, for children and for adults? Change in behavior. Individuals who are struggling will not feel like themselves or seem like themselves. Whether this is due to depression, or another condition, change in behavior is good cause to see a doctor or other medical professional. Medical professionals are trained to truly differentiate between presentations of symptoms based on age, and between disorders. When in doubt about depression, children (and their caregivers) and adults should always seek professional help to figure it out.
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