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In many ways, the symptoms are similar to those of adult depression. In the DSM-IV, the criteria for childhood and adult Major Depression are the same. Children may not have the vocabulary to talk about such feelings and so may express their feelings through behavior. Younger individuals with depression are more likely to show phobias, separation anxiety disorder, somatic complaints and behavior problems . With psychotic depression, children are more likely to report hallucinations. Older adolescents and adults with psychotic depression are more likely to have delusions. (Delusions require more advanced cognitive functioning than simple hallucinations)

One might observe the following external signs in a depressed child or adolescent.

1.Preschool or young elementary age: The child might look serious or vaguely sick. He might be less bouncy or spontaneous. While other children would become tearful or irritable when frustrated, this child may show these states spontaneously. He may say negative things about himself and may be self-destructive.
2.Older elementary school through adolescence: The adolescent may present with academic decline, disruptive behavior, and problems with friends. Sometimes one can also see aggressive behavior, irritability and suicidal talk. The parent may say that the adolescent hates himself and everything else.