Understanding Depression

Depression is a mood disorder that makes people feel sad or low more often, more severely, and/or for longer, than is typical.

There are different kinds of depression, and people can have differing experiences with depression. Depression can be diagnosed in children, teens, and adults.

Some people feel depression symptoms most or all of the time, and other people have periods when they feel well, and periods when they feel depressed. Some people only experience depression at certain times of the year (as in Seasonal Affective Disorder, or SAD), or of the month (as in Premenstrual Dysphoric Disorder.

Symptoms of depression can include:

• losing interest in topics and activities

• having trouble enjoying anything

• being irritable or angry

• clinging to an adult (in children)

• refusing to go to school (in children)

• feeling sad

• frequent crying

• sleep changes: sleeping too much or too little

• eating changes: eating too much or too little

• feeling very tired

• moving, thinking, or talking more slowly

• trouble thinking, paying attention, working, and making decisions

• feeling guilty or worthless

• having trouble motivating to make an effort to do many tasks

• feeling hopeless that things will ever get better

• feeling worthless

• physical symptoms such as stomachache, headache, or backache

• disruptive behavior

• abusing drugs, including alcohol

• avoiding other people

In some cases, depressive disorder can lead a person to think about death and dying, self-harm, and/or suicide. If a person is showing these symptoms, contact a medical provider right away. These are signs that a person needs immediate treatment and support.

If they are at risk of hurting themself, transport them to an emergency room or call 911. Call 988 for 24-hour live crisis counseling.

From time to time, nearly everyone feels sad, lonely, irritated, and remorseful. These are normal and healthy human emotions. Sad feelings may be more common when a person or a loved one has a serious illness such as a heart defect.

However, if you or a loved one are showing signs of depression for more than 2 weeks, or if the signs and symptoms seem extreme, then it is time to get help.

The first step is usually to reach out to a general pediatrician, or primary care physician. Some families may also connect with a psychologist, psychiatrist, developmental-behavior pediatrician, or cardiac neurodevelopmental program. The care team can work with the family to evaluate the symptoms, to make any appropriate diagnoses, and to recommend treatment.

Effective treatment for depression often includes:

• medication (any medicine change should always be approved by a cardiologist)

• psychotherapy with a psychologist, psychiatrist, social worker, or mental health counselor

When people have depression, they often have little hope that things will get better. This feeling of hopelessness is a key symptom of depression, and is not the truth. In some cases, a sense of hopelessness can prevent people from seeking or engaging in effective treatment.

In fact, depression can and does get better. In most cases, appropriate treatments can significantly reduce or even eliminate symptoms of depression.

A "wait and see" attitude can delay treatment, and without treatment, depression can be a progressive disease, getting worse and harder-to-treat over time. When a person has depression, the best approach is to ask for help right away, and to engage with treatment until the condition gets better.

Someone is always available to listen and you are not alone in this struggle.

This content was reviewed by a psychologist at Boston Children's Hospital.

If your child is at immediate risk for self-harm or is a danger to others, immediately call 911 or the Suicide and Crisis Lifeline at 988.

If your child requires an urgent mental health assessment, call or text the Massachusetts Behavioral Health Help Line at 833-773-BHHL (833-773-2445) or visit masshelpline.com for initial guidance. Experienced mental health clinicians are available at this line 24 hours a day, 365 days a year to provide clinical guidance, and direct you to appropriate resources. This may include your local Mobile Crisis Intervention (MCI) team, who could come to your home to perform a psychiatric assessment, if appropriate. This may enable you to avoid waiting in an emergency department. The Behavioral Health Help Line clinicians can also determine the most appropriate type of care for your child, help with referrals, and guide you through the next steps in the process. This service is available for all ages regardless of insurance coverage.

If you are looking for non-urgent mental health or substance use resource referrals for your child, you can also call or text 833-773-BHHL (833-773-2445) or start a chat at masshelpline.com/chat.

Families local to Boston can seek help from the Cardiac Neurodevelopmental Program, the Division of Developmental Medicine, or the Psychiatry Department.