Which comes first — depression or low self-esteem? The answer really doesn't matter because they are so closely related that you can't have one without the other. When a child is depressed, he has a negative view of the world and himself. Children and teens compare themselves with their peers in just about every area — school performance, physical appearance, athletic ability, peer relationships. If their self-esteem is low and they see themselves as inferior to their peers, it's easy for depressive symptoms to creep in.

Other issues that can create the double monster of depression and low self-esteem are the loss of a loved one, feelings of helplessness and hopelessness, and fear. A child who fears making mistakes or disappointing his parents can carry this to an extreme. You may know that a kid can't be perfect, but he doesn't always realize this. How he processes his feelings says a lot about whether he will be resilient against developing depression or whether he will fall victim.

If it seems like just about anything can trigger depression, you are right. The key to helping your child is being vigilant, alert, and nurturing. It's a tough job, but it has tremendous rewards!