If this mood is unrelieved for more than a week, and especially if it does not seem to come in response to some real disappointment or loss, most likely the parent should seek help. Especially worrisome is a loss of interest in things that used to give pleasure, as when a child seems not to care any longer for favorite toys or activities. Injuries that may seem accidental may have been the result of carelessness. The child may talk about death or thoughts of punishment. Though it's clear now that preadolescent children do suffer from depression, the actual incidence is not known.
Diagnosis is difficult.
Estimates range from a few tenths of a percent to the 15 to 20 percent that is found in adults. One estimate which fits our experience is that 10 percent of all children will suffer a depressive episode before age 12. The idea that a child might think of taking his or her own life is horrifying and repugnant. And while we may be able to entertain the idea in theory, in real life when we run across such a child, perhaps in our own family, our denial kicks in. Therapists, teachers, physicians and others who know the child can get fooled as well, so that though a child or teen may sound seriously depressed to a neutral third party, we're so close to the picture that we don't get the complete message.