When thirteen year old Mark* didn't want to go to school one day his mother Viv* wasn't really worried. But when he didn't want to go the next day and the one after that she felt something was wrong. When she questioned the school she found he wasn't coping so well with his maths and reading and the teachers suggested extra lessons. "It actually turned out that he needed remedial teaching in almost every subject," explains Viv. "What was so sad was that the happy, excited, new learner turned into an unhappy introverted little boy who dreaded going to school."

What eventually brought the decision to a head was when the school asked to see Viv and told her they would like Mark to repeat Grade 8 again. Mark's reaction to this idea was one of total devastation. "I'll never forget the look on his face – if he still had any belief in himself this totally crushed it."

Mark was put on anti-depressants, which together with therapy and a new school saw him turn into a bright, confident boy. The child Viv had always known was there. "I had no idea he was so depressed – it's a word you don't normally associate with a child," explains Viv, tears in her eyes as she recalls the nightmare that was Mark's journey for those years.

Mark is just one of a growing number of such cases in children. And let's face it there's far more today for children to worry about. Apart from the crime they are often surrounded by, there's the constant pressure of knowing they have to do well at school to even think of getting a job today. Then there's HIV/AIDS and the possible loss of someone in their immediate family, not to mention the treat to their own lives. It's not just a case of playing happily in the streets with your mates after school these days …

According to leading child psychiatrist Dr. David Benn, "One of the big problem areas is adolescent depression. But just how do you tell the difference between normal and abnormal adolescent behaviour? And what's more worrying we are definitely seeing an increase in the rate of suicide among adolescents, especially boys. The big problem here is many people don't take kids seriously and by the time they do it's often too late. Telling someone with depression to 'snap out of it' can only worsen the situation. Without treatment the depression simply deepens. During the last fifteen years the suicide rate for children aged 10-14 has doubled.

So what exactly causes depression? This is where it gets difficult. Apart from being triggered by specific events it can simply be a bio-chemical or genetic inheritance. If there are family members with a history of depression then your children are more likely to show signs of the illness. And yes, I use the word illness because that's just what it is. One that can be completely controlled with a mixture of medication and therapy. But perhaps it is above all, the stigma associated with anything that falls under the category 'mental illness' that's the hardest to accept. Maybe people would rather ignore what's in front of them, hoping it will pass as the child grows up. With figures of 2 out of every 100 children having depression and 5 in every 100 teens and growing, it isn't going away by itself.

But surely teens are simply moody individuals to star twith? "There's a difference between the 'blues' and 'depression,'" explains Allesandra Newton, a counsellor with the Family Life Centre in Johannesburg. "But it's difficult to separate the two. When your child or teen doesn't want to get up in the morning that's one thing, but when their eating habits start changing drastically and along with this their school marks drop, that's when you take a closer look. It's not just one symptom, but quite a few that makes you wonder about depression. And the minute you hear "I don't want to be around any more," you take it extremely seriously.

But what about teachers? Surely they can pick up when their learners are depressed? Alessandra shakes her head. "They are overworked and very often can't focus on specific kids. Although schools do notice when there's a sudden drop in marks. Often this is followed by drug and alcohol abuse. Problems for teens are especially intense. When a relationship breaks up it's the same to them as a marriage ending. You have to know your child well enough to know what's going on in their lives," concludes Newton firmly.

So if you notice your child having several of the symptoms and signs listed below, don't leave it. Go to your nearest hospital or GP and seek professional help (free at university hospitals). You can call organizations like the South African Depression and Anxiety Group (SADAG). You don't have to live with depression. And just how do you know for sure? Dr.David Benn sums it up by saying it's a 'loss of joy'…

*Names have been changed to protect identities.

Copyright 2006.Used with permission from the South African Psychiatry Review.