When my nephew was away at college he became very depressed. Frighteningly depressed. It took the whole family by surprise at first because we didn't really see it coming. He had friends, he had just switched his major to something that suited him much better. He had a great apartment and had just gotten a dog. It seemed like everything was going well for him. But then, wisely, he drove to his parent's house one night and told them he needed help. And he did. While he seemed fine over the phone, what the family didn't know was that hours away at school he wasn't seeing any of his friends, he wasn't going to classes, and he was too depressed to even let his dog outside much of the time. After his depression was out in the open we were all able to look back and see the signs that we missed. We thank goodness for the strength he had and for his ability to ask for help. And we've all kicked ourselves a bit for not seeing the red flags that were right in front of us. Had we seen those warning signs, we could have helped him earlier. Today my nephew is doing wonderfully; he's graduated from college and landed an awesome job. Managing his clinical depression is a part of his daily life; he understands his triggers and manages his symptoms well.

Studies show that 2 out of every 100 children and 8 out of every 100 adolescents struggle with depression. While full-blown depression usually starts in adulthood (as it did with my nephew), low-grade depression may start in childhood or teenage years. And it's important to recognize those signs and get help early on.Some of the warning signs include:

• Irritability
• Exhaustion
• Quick changes in habits (appetite, sleep, etc.)
• Anxiety
• Substance abuse
• Poor school performance
• Frequent absences
• Efforts/threats to run away
• Shouting, crying or other frequent outbursts
• Increasing hostility
• Persistent stomach or headaches
  
• Social isolation
• Hypersensitivity to rejection or failure
• Reckless behavior.
  

All children may exhibit any number or combination of the above behaviors at some point. Pre-teens and teens tend to be a bit dramatic by nature, so typical ups and downs in mood shouldn't be blown out of proportion. But big changes in personality and persistent behavioral issues may be a sign of depression. Ask your family doctor or consult a therapist if you're concerned.