Clinical manifestations according to developmental stage

Depression in childhood and adolescence does not manifest itself in a uniform way. Each stage of development has its own particular signs, which can be difficult to recognize without specific training. The most common manifestations according to age are described below.

Children under 3 years of age: early indicators

Although it may seem surprising, children under the age of three can show signs of depression. At this stage, the indicators are mainly behavioral and somatic. Expressions such as apathy, poor or flat affect, lack of interest in the environment, poor emotional response, and persistent irritability are observed.

In addition, they may show delays in language development, motor skills, and social interaction. A key sign is indifference to separation from the mother, which is not typical at this age. They may also have sleep and eating disorders, as well as more frequent physical illnesses, all without a clear medical cause.

Between 3 and 5 years: emotional and physical symptoms, self-harm

In this age range, children begin to express their distress more clearly. Episodes of crying easily, social withdrawal, difficulty separating from caregivers, and marked irritability become common.

In addition, physical symptoms such as abdominal pain, appetite disturbances, regressions such as enuresis or encopresis, and sleep disorders appear.

Worryingly, in some cases, self-harming behaviors are also observed, even in children as young as four or five, who may make suicidal gestures. These cases require immediate attention.

School age: sadness, isolation, aggression, difficulties at school

During the school years, depressive symptoms can be confused with behavioral problems or poor academic performance.

Children express feelings of persistent unhappiness, isolate themselves from their peers, have difficulty concentrating, and show apathy toward activities they once enjoyed. Frequent somatic complaints (headaches, stomachaches, fatigue) without medical explanation are common.

Some develop school phobias or refuse to attend school. Aggression can be an indirect way of expressing their distress. Negative thoughts about themselves, their environment, or the future may also be observed.

Adolescence: anhedonia, risky behaviors, suicidal thoughts

In adolescence, depressive symptoms are more similar to those observed in adults. Anhedonia (inability to enjoy things), social isolation, sudden changes in appetite and sleep, decreased school performance, and loss of interest in daily activities appear. This is a stage in which risky behaviors such as substance use, promiscuity, criminal acts, or self-harm increase.

Suicidal thoughts may become more apparent and, in many cases, are verbalized or manifested in specific gestures. The risk of suicide attempts is significantly higher at this stage, requiring close monitoring and timely clinical intervention.