October 9, 2019
Question: What’s wrong with our daughter Maura? She just told us, “Sometimes I just feel like hurting myself.”
Maura, a 13-year-old girl, came into my office because she told her parents, “Sometimes I just feel like hurting myself…I want to jump out the window or suffocate myself with my pillow.” Over the past few months, Maura had become more and more withdrawn and sad. While she used to have friends, she was described by her teacher as “a loner who never smiles and seems very troubled.” Maura had difficulty maintaining her previously stellar grades because she felt unmotivated and had difficulty concentrating. At home, Maura was having trouble sleeping, ate compulsively, and complained of minor ailments such as stomachaches and headaches. Additionally, she wasn’t getting along with her parents and seemed irritable most of the time. Not surprisingly, her parents asked me: What’s wrong with our daughter Maura?
Maura was exhibiting a fairly severe case of Depression, a type of a mood disorder. Mood disorders are one of the most common psychological disabilities in children, affecting about six in 100 children at any particular time. Most children with mood disorders do not display the severity of symptoms that Maura did, but most do seem constantly unhappy, show little enthusiasm for many things, are moody, or think “life’s not just worth living.” For example, Benny was a 12-year-old who had never felt suicidal but was chronically sad and often didn’t feel “up to” hanging out with his friends. His sad mood made it difficult for him to complete his homework since he sometimes felt too tired and lethargic to get things done. Benny was diagnosed with and treated for a mild depression.
Mood disorders fall into two broad categories. On one end of the spectrum are children who experience depression. These children typically suffer from prolonged bouts of sadness (more than 2 weeks at a time) and have often lost interest in activities and friends. However, some children – particularly teens – don’t appear outwardly sad. Instead, they express their depressive symptoms through their irritable mood, so they may seem grouchy, cranky, touchy, or easily upset. In fact, irritability is one of the most common features of depression and is present in nearly four out of five children with depression.
The other category of mood disorders includes children who experience mania. In these cases, they may be grandiose, talkative, hyperactive, and display poor judgment. They may even seem euphoric in that they have an exaggerated sense of well-being. Children who display an ongoing combination of extreme highs and extreme lows may have a condition known as bipolar disorder (which used to be referred to as manic-depressive disorder). Children who have bipolar disorder may have alternating periods of feeling high and low, or they may feel both extremes concurrently.