That is the case less than half the time for our depressed children. Their mood is much different, and they don’t look sad at all. Instead, they are extremely cranky and irritable. The irritability is manifested as anger, rebelliousness, sullenness, aggressive behavior or even by a barrage of disrespectful and cruel comments hurled at you— the parent. That is why I conducted over one hundred interviews of parents with depressed children for my new book, Rescuing Your Teenager From Depression. I wanted to know what kind of detective work these parents did in order to figure out the dark mystery that had seemed to kidnap their once happy and loving child. Sadly, many of them admitted they missed the diagnosis entirely.

Another major symptom our young people manifest is anhedonia. This is medically defined as the inability to show interest in or derive pleasure from things that are ordinarily interesting or pleasurable. The anhedonia may be masked, too. Instead, the parent may hear comments such as, “My friends are dumb,” or “School is boring.” The child may withdraw from activities with flimsy excuses such as, “I don’t have time.”

Now, you might be saying to yourself, “I felt cranky or bored yesterday, and I wasn’t depressed.” You’re right, and the American Psychiatric Association is quick to point out a crucial difference. A clinically depressed mood is sadness, irritability or anhedonia that occurs pretty much every consecutive day for at least two weeks. Furthermore, the mood aberration must significantly interfere with the child’s “jobs”— going to school, getting along with friends and family, and participating in sports or extracurricular activities.

Why don’t depressed young people usually look sad? The answer is that they are still children, and that defines them as emotionally immature. The average child is a concrete thinker until about age 12 and cannot handle abstract notions. Below age 12, they usually cannot manage abstract algebra problems or interpret proverbs such as “A stitch in time saves nine.” How, then, can we expect them to figure out a dark emotional mystery inside them, display their emotions correctly, or even put a name on it all?

Moreover, depression is not only sadness, although sadness is a great part of it. Depression is more accurately defined as the combined feelings of worthlessness and hopelessness. These also may be difficult notions for the young child to understand, and so instead he acts out his discomfort with hostility or aggression.

The parent may see other more subtle signs. For one thing, the depressed child may have found an “antidote” for the depression. One mother whom I interviewed said about her daughter: “She felt so bad about herself on the inside, she wanted to look good on the outside. She subscribed to three or four fashion magazines. She became obsessed with clothes and make-up and planned out all her outfits on a grid for a week.” Other parents said that their child became “obsessed” with sports or entertainment as distractions from the pain. Early in the course of his depression, my own son consumed large quantities of caffeine, to the point of becoming jittery and hyperactive, in order to make himself look and feel “alive.”

The parent may also see attempts at “self-medication.” Tweens and teens use recreational drugs and consume alcoholic beverages for many reasons. One of them, though, may be that the child is trying to put himself out of touch with his emotions. And if these emotions happen to be worthlessness and hopelessness, he is trying to numb the pain of depression. Also, the most recent scientific studies clearly show that excessive food consumption may similarly be a form of self-medication. (There is a reason “comfort food” is called such.) We used to think that the overweight child became secondarily depressed, because children are very concerned with body image. In fact, the converse is often the case. A depressed child may eventually become overweight, even obese, by trying to eat herself out of the problem.

A parent must be the prime detective. Seldom will anyone else alert you to the fact your child seems depressed. Teachers usually don’t. It’s not that school resources usually are insufficient to address this need. Rather, the child considers school his main stage and will often make heroic efforts to avoid looking “weird” or “psycho” at this most important place. When he gets home, the chameleon child changes colors and becomes irritable or sad. Your child’s friends probably won’t alert you either. Even if they could suspect the nature of your child’s problem, children are usually uncomfortable talking to adults about dark emotional issues. Finally, other parents will not be likely to discuss your child’s worrisome behavior, especially when they suspect it could be depression. The reason is that even in this enlightened time depression is a stigmatized disease. Parents do not want to stigmatize your family in the process. And they don’t want to admit that they are eagle-eyed because, perhaps, they had to deal with it in their own family.

It’s better to cry wolf when you suspect depression and take your child to a family physician for a formal depression inventory. Don’t wait until it’s obvious. One mother I interviewed said, “I didn’t want to admit that my daughter was depressed until I heard she jumped off a second story deck at a friend’s house. It took two weeks for her friend’s mother to tell me it was not an accident.”