Depression in Children - Key Signs & Symptoms in Children

May 21, 2010
Gary Lilienthal

Symptoms and Signs of Severe Depression - Wikimedia Commons

The seat of depression being within the ego, the issue arises as to the special nature of depression in children, whose young egos are still in development.

Depression is a mood disorder, understood from the psychoanalytical viewpoint as resulting from an intra-psychic conflict that stems from the ego's difficulties in integrating aggressive drives that are experienced as being far too dangerous to entertain. These aggressive drives turn against the sufferer, via the strict and demanding parental residues which constitute the superego. The seat of depression being within the ego, the issue arises as to what must be the special nature of depression in children, who are living through specific stages of ego development prior to the formation of an adult ego.

Symptoms and Signs of Severe Depression in Children and Adolescents

Depressed children and adolescents suffer intermittent or chronic bouts of unhappiness, expressed either as emptiness and loneliness, or as guilt. Such children have an irrationally negative self-estimation and hold themselves up to impossible standards. They may attribute their suffering to their own badness, which has the beneficial personal effect of empowering them with a sense of control. Thus, they tend to work hard to be "good".

Typical signs of severe depression in children are:

Sadness
Irritability
Changes in appetite
Changes in weight
Changes in sleep patterns
Tiredness
Loss of interest in activities
Feelings of guilt
Feelings of worthlessness
Difficulty in concentrating
Suicidal thoughts or suicide attempts

The severely depressed adolescent is at risk of substance abuse, early sexual activity, eating disorders and suicide.

Depression in Young Children and Ego Development

There are six early basic organizational levels of emotional experience in young children. Each will be affected in cases of childhood depression according to the state of ego development. The six stages are:

Self-Regulation and Interest in the World: 0-3 months. State of ego development - The child is influenced by the primary care-giver.
Forming Relationships, Attachment, and Engagement: 2-7 months. State of ego development - The infant is capable of pleasure-seeking, protest, withdrawal, rejection, hyper-affectivity, and active avoidance.
Two-Way, Purposeful Communication: 3-10 months. State of ego development – the ego is now capable of differentiating aspects of impersonal experience.
Behavioral Organization, Problem-Solving, and Internalization: A Complex Sense of Self: 9-18 months. State of ego development – a behavioral sense of self.
Representational Capacity: 18-30 months. State of ego development – a capacity of elevate experiences to the formations of representations such as multi-sensory images.
Representational Differentiation, or, Building Logical Bridges between Ideas and Emotional Thinking: 30-48 months. State of ego development – a capacity to elevate representations into those comprising self and other, time and space.

Depression Diagnosis in Children

As depression is, by definition, the outward manifestation of an intra-psychic conflict taking place within the ego, in equilibrium with the super-ego, the symptoms of depression will appear differently in young children, whose egos are still in a nascent state of development. Therefore, to diagnose depression in very young children, look for traces of intra-psychic conflict in the ego as applicable to its current state of development. For example, in a child who is 4 years old, look for evidence of an ability to form representations comprising self and other, time and space. Conversely, any problems in these areas may signify the extent of depression.