In children and adolescents the most common mood disorders diagnosed are major depressive disorders like dysthymic disorder and bipolar disorder.

About 11 percent of adolescents have a depressive disorder by age 18, however, often the diagnosis goes undetected by parents or teachers, who may assume a child's changes in behavior are just a "phase" or part of being a "teenager."

Children or teenagers who have depression show signs that are often different from the typical adult symptoms. Children who are depressed may complain of feeling sick, refuse to go to school, cling to a parent and caregiver, or worry excessively. Older children and teens may sulk, get into trouble at school, be negative or crabby, or feel misunderstood.

More pronounced symptoms of major depressive disorder are sadness, loss of interest in activities they once enjoyed, being self-critical, being overly sensitive to criticism, feeling unloved, pessimistic or hopeless about the future; some think life is not worth living and thoughts of suicide may be present.

Depressed children or teens are often irritable, even aggressive, appear indecisive, have problems concentrating, and may lack energy or motivation; they may neglect their appearance or hygiene; their eating and sleep pattern may also be disturbed, with either too much or too little.

Associated anxiety symptoms, such as fears of separation or reluctance to meet people, somatic symptoms (headaches, stomach aches) are also common.

Bipolar disorder is a mood disorder in which episodes of mania alternate with periods of depression; it often begins in adolescence and initial symptoms may be present with a depressive episode.

The clinical problems of mania are very different from depression and are often described as "feeling great" by the teen. Adolescents with mania or hypomania feel energetic, confident and special; they may have trouble sleeping but do not tire; they talk a great deal, often speaking rapidly or loudly.

They may complain that their thoughts are racing. Schoolwork may be done quickly and creatively, but in a disorganized way. Some manic adolescents may have exaggerated or delusional ideas about their capabilities and importance, start numerous projects at once that they don't complete.

They may also engage in reckless or risky behavior, such as fast driving or unsafe, precocious sex. Sexual preoccupations are increased and may be associated with promiscuous behavior.

Both mood disorders carry the additional and high risk of suicide. Teen suicide is the third-leading cause of death for young people ages 15 to 24 and presents as risk factors mental disorders, such as depression.

Suicide is a relatively rare event and it is difficult to predict which person with risk factors will ultimately commit suicide.

However, there are some warnings such as:

• Any talk about dying, disappearing, jumping, shooting or other types of self harm.

• Recent loss through death, divorce, separation, broken relationship, self-confidence, self-esteem, loss of interest in friends, hobbies and activities previously enjoyed.

• Change in personality, such as being sad, withdrawn, irritable, anxious, tired, indecisive and apathetic.

• Change in behavior, such as poor concentration in school, work and routine tasks.

• Change in sleep patterns, such as insomnia, often with early waking or oversleeping, nightmares.

• Change in eating habits, loss of appetite and weight, or overeating.

• Fear of losing control and acting erratically, harming self or others.

• Low self esteem. Feeling worthless, shame, overwhelming guilt, self-hatred.

• No hope for the future. Believing things will never get better, that nothing will ever change.

One in five teens in the U.S. seriously considers suicide annually, 8 percent have attempted suicide, and only one third receive appropriate and ongoing treatment.

Currently, the most effective suicide prevention programs equip mental health professionals and community resources, including schools, to identify who is at risk.

If you know a child or teen who may be depressed, find resources to complete a psychological evaluation to ensure proper and appropriate treatment.

For immediate help, call the crisis response network at (602) 222-9444, they will travel to any site in the Valley for a free suicide or risk assessment.

You can also bring an individual to any hospital for immediate assessment and intervention or call the suicide prevention hotline at 1-800-TALK.

• Astrid Heathcote is a psychologist with a private practice and residence in Ahwatukee. Reach her at (480) 275-2249 or

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