We used to think that children could not get depressed. We used to think that they were emotionally immature or cognitively immature. But, in fact, children and even very young children can get depressed. All children, as they grow up, will feel sad. It's part of growing up. It's part of learning how to regulate one's emotions. But some children will develop a sense of sadness which persists, and it is those children that we need to be worried about. Depression is associated with serious complications-- poor school performance, impaired social relationships, a recurrence of depressive episodes or depressive disorder as they grow up, and in the worst case scenario, the end result may be suicide. So the main symptoms of depression are feeling sad for prolonged periods and with worsening of these feelings, and feeling as if fun has gone out of life. Parents and teachers are often the first to identify the symptoms of depression in young people. Some cases might be obvious. Others, less so. If children are visibly unhappy or uncharacteristically irritable for at least two to four weeks, with these feelings lingering or worsening, they may be depressed. A child suffering from depression may have difficulty concentrating in the classroom, appearing persistently irritable, worried, tearful, moody, or bored. Problems with sleeping, overeating, and under-eating are also common. Any risk-taking behaviours, suicidal thoughts, or evidence of self-harm must be addressed without delay. Many of these symptoms can be found in people suffering from depression at any age, but there are additional symptoms that can be visible more specifically in young people. Young children who complain persistently of aches and pains or other non-specific physical discomfort may be depressed. Teachers and parents might notice changes in peer relationships or social withdrawal. Children may not want to play and visibly lack enjoyment in activities. They may not want to spend time with family and friends and isolate themselves. But equally, they may be clingy and unwilling to separate from them. Depression can cause children to lose interest in their general appearance. Over time, there is a drop in academic performance. Simply moody or unpredictable children should not be diagnosed as being depressed. A child who doesn't want to go to school on a Monday morning is not depressed. In order to fulfil the diagnosis for depression, a child must display a range of symptoms, and those symptoms have to be sufficiently impairing to alter their day-to-day functioning. Teachers and parents should also be aware of the factors which can put children at risk of depression. Among them are bullying and problems with peers or lack of self-confidence and inability to keep up at school. At home, if there is discord within the family or if other members of the family are depressed, children can be at risk. Exposure to drug and alcohol use or adversity, including child abuse, will inevitably put a child's mental health at serious risk. Other life events, such as moving away from home, experiencing bereavement, or suffering other illnesses may bring a degree of instability and render a child more vulnerable to developing depression. The more risk factors present in home and school life, the more likely it is that a child could become depressed. Another form of depression is dysthymia. Dysthymia denotes milder feelings of depression which last for a longer period of time. Children who are dysthymic are often perceived by their peers as being moaners, and the teachers see them as complaining excessively. The danger with dysthymia is that this chronic state can often exacerbate into depression proper. The immediate advice a teacher can give or a parent implement is to ensure that the child has a regular routine, including a sleep routine, a balanced diet, and that they exercise sufficiently. The teacher may need just to watch the child and see what happens over a course of time. Very often, the symptoms are understandable within a context, and there are good reasons why a child may be feeling sad. Parents and teachers must use their judgement. If the symptoms persist, if they worsen, then they should be referred either to the GP or to the SENCO or school nurse. Children do recover, but depression can recur and can become chronic, so continued vigilance is required. Some children are much more vulnerable to stresses and untoward life events than others, particularly in the presence of biological and environmental risk factors. It is difficult to diagnose depression in young children as they may not be able to describe their feelings. Teachers should not be afraid of asking questions, the same questions one would ask an adult. Are you unhappy? What is making you unhappy? Do you cry? Do you feel bad about yourself in any way?