Overlap with Depression
Depression is a mood disorder that can cause your child to feel tired, sad, lonely, bored, hopeless, or unmotivated for an extended period of time. In order for a clinical diagnosis in children, a depressive episode must last longer than two weeks and must interfere with daily functioning and/or be a change that is observable by others. Some researchers view anxiety and depression as two sides of the same coin. This is in part because both conditions involve disruption to the same neurotransmitters in the brain. In addition, symptoms of depression and anxiety overlap and may imitate each other. For example, many people with anxiety experience periods of depressed mood or other depressive symptoms such as guilt and feelings of worthlessness. Conversely, those with depression can experience states of agitation and worry that are very similar to the symptoms of anxiety.
The Irritability Factor
Because children and adolescents aren't always capable of identifying and communicating their feelings and internal experiences to others, they are more likely than adults to show irritability when they are depressed. Irritable children and teens can be very difficult to be around as they never seem content and may be negative or argumentative. Irritability is often contagious, and may snowball into conflict if it is persistent or extreme.
Persistent feelings of worthlessness or excessive and unwarranted guilt can be very intense in both children and adults who are depressed. Guilt is also a strong component of anxiety, particularly if a child is old enough to feel she does not measure up to the expectations of peers, parents, and teachers.
When depression and anxiety are more serious, they can affect your child's ability to sleep and eat regularly. Children suffering from depression can experience loss of appetite, marked weight loss, or failure to make expected weight gains, while children with anxiety may have trouble with their appetite and weight loss. Insomnia involving both the ability to fall and stay asleep can occur in both anxiety and depression, as can a diminished ability to think clearly, concentrate, and make decisions. Children with anxiety are more likely to show agitation, while depressed children are more likely to experience fatigue and lethargy.
People with depression and anxiety are at risk for developing alcohol or drug abuse. The use of chemicals to alleviate emotional distress is referred to as “self-medication.” Teens with anxiety may be especially vulnerable, particularly if they use alcohol or drugs as a “social lubricant.” Talk frankly with your children about your values and expectations regarding chemical use, and be alert for sudden changes in sleep, eating, energy level, and choice of friends, as these can all be indicators of chemical abuse.
Dysthymia is a sub-type of depression, which is experienced much like a “low-grade fever.” That is, it can linger on and cause a person to feel just a bit ill at ease or raw around the edges. Some theorists say that dysthymia may even occur because a person's senses and emotions are overly sensitive and prone to overload.