The Mental Health America (NMHA) launched the first annual servance of National Childhood Depression Awareness Day on May 9, with a press briefing on the prevalence, diagnosis, and treatment of depression in children. The highlight of the event was a series of talks by three teenagers with psychiatric disorders who shared their experiences with the media.

Michael Faenza, president and CEO of the NMHA, detailed the grim statistics of childhood mental illness. "One in 33 children and one in every eight adolescents may suffer from depression," Faenza said, the equivalent of one child in every classroom. The NMHA’s message was that childhood depression is real, is much more common than once assumed, and, most importantly, is highly treatable. Yet only one-third of children with a diagnosable mental disorder receive any treatment, and even fewer receive timely and appropriate treatment.

Faenza was joined by David G. Fassler, M.D., chair of APA’s Council on Children, Adolescents, and Their Families and a clinical associate professor of psychiatry at the University of Vermont. Fassler noted that only recently has the profession begun to really understand the dimensions of childhood depression.

"We used to think," said Fassler, "that kids weren’t emotionally developed enough to experience complex emotions such as depression."

Fassler himself learned from many of his adult patients that their depression started in childhood. Studies have now shown that more than half of all adults with depression relate that their first depressive episode occurred during their childhood. According to the American Academy of Child and Adolescent Psychiatry, 5 percent of all adolescents struggle with depression at any given moment.

Recognition of the signs and symptoms of childhood depression is the most important factor in the battle to diagnose and effectively treat the disease. Depression in children may present with symptoms similar to those in adult depression: sadness, being tearful, decreases in appetite and energy level, and difficulty sleeping. But, according to Fassler, many youngsters with depression have symptoms that are not usually associated with the disorder in adults: irritability, frequent headaches or stomachaches, increased aggression, and falling grades in school.

Fassler said he focuses on three criteria when evaluating a child or adolescent for depression. This evaluation, he stressed, should be done by a physician or mental health specialist who has specific training and experience in the diagnosis and treatment of childhood depression.

The good news, according to both Faenza and Fassler, is that children with depression usually respond very well to treatment. However, Fassler cautioned, "Medication alone is never the right treatment for child or adolescent depression." Treatment should start with individual therapy, sometimes including family therapy, parent education, and working with a patient’s school.

Medications can be very helpful, Fassler said, but the child psychiatry community needs more data to assess such research questions as dosing and side-effect profiles specific to children and identifying which combinations of medications work best in which children.

However, experience from practice has led Fassler to be very optimistic. "With a comprehensive treatment plan," he said, "70 percent to 80 percent of children with depression respond to treatment."

Faenza and Fassler welcomed three teenagers who experienced psychiatric disorders. Leslie Mast, a high school senior, has suffered from depression for years, only recently being diagnosed.

"The most important thing I can tell you today," said Mast, "is parents need to be aware, to watch for signs; parents need to talk to their kids and get into their lives."

Ben Garnett, also in high school, called for more public awareness and understanding to reduce the shame and stigma associated with behavioral, mental, and emotional disorders. Diagnosed at age 7 with depression, Garnett was later diagnosed with obsessive-compulsive disorder (OCD) and then bipolar I disorder.

Anders Novesky, now in the eighth grade, was diagnosed at age 10 with OCD. Noting the courage it takes for a teen to let others know "what you hold inside of you," Novesky said that speaking out was the only way to help other kids with OCD and other psychiatric disorders.

In recognition of efforts to help promote the new campaign, Faenza presented Fassler with the NMHA’s Green Ribbon Award for Excellence in Childhood Depression Education at the press briefing.

Faenza presented the Green Ribbon Founders Award to Susan E. Dubuque for her long struggle to promote awareness.