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We typically think of childhood as a carefree time, but for some
young people it's a period when they may be at risk for major
depression. For adolescents in particular, but also for younger
children, clinical depression can have serious consequences.

John
March, M.D., chief of child and adolescent psychiatry at Duke
University Medical Center, says the problem of childhood depression is
greater than most people realize.

"Although it used to be thought
that depression didn't occur in children or adolescents," says March,
"it turns out that it's actually quite common. About one in 20 kids,
that's 5 percent of kids, will have a major depressive episode."

March
says parents and teachers should learn to recognize the warning signs
of depression in children. This means being alert to changes in a
child's behavior: loss of interest in friends and activities, changes
in sleep patterns, loss of appetite, trouble concentrating or suicidal
thoughts or behaviors.

Parental vigilance is especially important with adolescents who may be depressed, March says.

"Teenagers
may engage in dangerous behavior, such as reckless driving or increased
drinking or harming themselves in some way," he says. "In cases like
this, we should be even more concerned.

"Depression can be a
fatal disease," March adds. "Death by suicide is the third-leading
cause of death among teenagers, and about one-half of those kids have a
major depressive episode as part of their risk factor for either a
suicide attempt or for completed suicide. This makes depression, both
in the amount of suffering it causes and for the fact that it's
associated with significant mortality, a major health problem."

Although
there has been an increase in childhood depression in recent years,
there is good news on the treatment front. March says research during
the past decade has shown that talk therapy and medication, either
separately or in combination, are effective for treating children
suffering from depression.

"Cognitive behavioral psychotherapy
and interpersonal psychotherapy, administered weekly over a period of
about three months, are both effective in about 60 to 70 percent of
kids with major depression," he says. "The serotonin reuptake
inhibitors, medicines like Prozac and Zoloft, are also effective
treatments for major depression."