So Young, So Sad, So Listen: A Parents’ Guide to Depression in Children and Young People, 3rd Edition

Arindam Sarkar, MD

Fam Med. 2021;53(4):313-314.

DOI: 10.22454/FamMed.2021.684119

Book Title: So Young, So Sad, So Listen: A Parents’ Guide to Depression in Children and Young People, 3rd Edition

Authors: Philip Graham, Nick Midgley

Publication Information: Cambridge, UK, Cambridge University Press, 2020, 84 pp., $9.99,

In the United States, an estimated one in six children has a mental, behavioral, or developmental disorder. Even without those diagnoses, millions of young people will experience feelings of depression, stress, or anxiety by the time they reach 18 years of age.1 This guide serves to equip parents, teachers, friends, social workers and family doctors (specifically mentioned) with screening and evaluation tools for common mood disorders. Authors Philip Graham and Nick Midgley are child and adolescent psychiatrists and psychotherapists, respectively. As longtime members of the Royal College of Psychiatrists, their collective experience offers a wide breadth of anecdotes, academic knowledge, and clinical pearls.

This concise yet comprehensive book is an excellent resource for anyone involved in the care of children. Teenage angst and moodiness are often attributed to puberty and hormonal changes. It can be very difficult, even for physicians, to distinguish physiologic from pathologic troublesome thoughts. Since depression is one of the most common serious diseases in school-aged children (p. 4), the authors present a modified Patient Health Questionnaire (PHQ-9) that encourages parents to be vigilant for new irritability, disturbed sleep, or appetite changes (p. 7).

Unfamiliar with the two previous editions (1995 and 2005), I surmise the sections on social media, screen time, and cyber bullying have been newly added or revised. Nevertheless, the authors still include topics such as physical and verbal abuse, academic pressure, and substance use as issues that have challenged families for decades.

The first few chapters of the guide were the most valuable. The authors describe common symptoms of depression paired with quotes from actual teenagers indicating concerns that could easily be ignored. The example of a 14-year-old child who feels tired all the time and slowly loses interest in previous hobbies (p. 3) serves to remind us that depression isn’t simply an unhappy mood, self-harming behavior, or recurring thoughts about death. When a 17-year-old girl states, “I don’t exercise as I should; I can’t be bothered putting on make-up,” an unwitting parent might call this departure from previous behavior a “phase,” especially since when asked directly if depressed, this child reported feeling simply “bored”.

For an experienced clinician routinely performing a HEADSS (Home, Education/Employment, Activities, Drugs, Sexuality, Suicide) exam at adolescent visits, this guide would predominantly reinforce existing knowledge without much new information. Providers seldom seeing adolescent patients or trainees in family medicine may especially find this guide’s content illuminative. Overall, the authors provide practical advice and information about the emotional support and psychological help anyone can give.


  1. Cree RA, Bitsko RH, Robinson LR et al. Health care, family, and community factors associated with mental, behavioral, and developmental disorders and poverty among children aged 2–8 years — United States, 2016. MMWR. 2018;67(5):1377-1383.

Lead Author

Arindam Sarkar, MD

Affiliations: Baylor College of Medicine, Houston, TX

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