Depression in Children

Depression can occur in people of all ages. It is defined as a low mood that is marked with apathy, sadness and an aversion to things that ordinarily bring joy to the affected person. Learning to identify the signs and symptoms of depression is the first step towards seeking a diagnosis and eventually treatment aimed at recovery.

Can Kids Suffer from Depression?

Yes. It is a misconception that children are not prone to depression simply because of their age. In fact, depression among children is more common than you think. It was only after 1980 that depression was included in the list of childhood diseases.

Types of Depression in Kids

Depression can range from moderate to severe and is characterized by certain specific symptoms. If your child has been suffering from five or more of the associated symptoms for at least two weeks, then it is likely to be major or severe depression.

• Dysthymia is a category of depression where symptoms are milder, but the condition tends to be chronic and persistent.
• Seasonal affective disorder is depression that has to do with exposure to natural light. It surfaces in winters when the hours of daylight are fewer.
• Bipolar depression wherein your child is likely to go through an emotional rollercoaster of up and downs is yet another type found in kids though less frequently.
• Adjustment disorder is diagnosed when depression occurs after an event that has been upsetting to the child such as the death of a close one.

Causes of Childhood Depression

It is not possible to pinpoint one particular cause of depression in children. A combination of factors such as physical health, family history of depression or mental illness, genetic vulnerabilities, the environment they live in, and biochemical imbalances are usually responsible for depression in children.

Scientists believe that depression is brought on by changes in brain chemistry especially the neurotransmitters that are responsible for sending messages between nerve cells. Traumatic life events such as abuse, being bullied, the death of a parent or divorce can all act as triggers.

Girls are thought to be more vulnerable to childhood depression than boys mainly due to biological differences and their interpretation of events and response to these as opposed to boys. The following are certain psychological factors that might have led to depression:

• Low self-esteem
• Too much self-criticism
• Having a negative body image
• Clinical anxiety
• Cognitive or learning disabilities
• Attention Deficit Hyperactivity Disorder (ADHD)
• Trouble with social interaction

Children with little to no physical activity and those who perform poorly at school are also at risk of going into a depression.

Signs & Symptoms of Depression in Children

The symptoms of clinical depression can last for weeks, months, and years if it is left untreated. This can have a bad impact on your child’s daily life including activities at school and even simple activities like getting out of bed after waking each morning. Besides being moody and irritable, if your child shows five or more of the following symptoms, then it is likely that they are depressed and need help:

• Being sad and tearful often
• Feeling irritated and rebellious
• Anger and temper tantrums
• Frequent changes in mood
• Lack of concentration
• Doing badly in school
• Feeling guilty
• Low self-esteem
• Keeps complaining about headaches stomachaches, or other physical discomforts
• Overcome by feelings of helplessness and hopelessness
• Changes in appetite
• Fluctuations in weight
• Distances self from social interactions and prefers to be alone
• No longer interested in things that were once enjoyable
• Problems with sleep
• Expressing thoughts about inflicting harm on themselves
• Engaging in reckless or harmful behaviour

With children, it can be difficult to identify depression with accuracy and based solely on these symptoms. But if your child has been displaying some of these symptoms for more than a few weeks, then it is best to consult a doctor. Depressed children are also likely to have other difficulties also such as eating disorders, conduct disorders, or problems with substance abuse.

How is Depression Diagnosed in Kids

If your child has been showing some of the symptoms associated with depression for more than a couple of weeks, you should take him or her to a doctor for consultation. You may be referred to a mental health professional who can accurately diagnose your child’s depression through a series of evaluations.

As part of the evaluation, the physician might want to speak with you as well as your child and any other caregivers including your partner. Information might be sought from teachers, classmates, and friends to pinpoint a pattern of behaviour. Questionnaires may be given to you and your child and the physician will have to rely on this type of analysis as there is no specific child depression test as such that can provide a definitive diagnosis.

Since depression is associated with quite a few other disorders such as autism-spectrum issues, bipolar disorder, post-traumatic stress disorder (PTSD), and anxiety disorders, the evaluations will also screen for these. Your child’s medical history will also be analyzed as childhood depression can be the side-effect of some types of medications.

What are the Complications?

If your child has depression, it can put them at a risk for many mental health issues in the long run. Childhood depression can result in poor academic performance as well as problems with alcohol or drug abuse. As adults, such children might be unable to hold a job for long and face difficulties in adjusting to life as part of a family. ‘

It is also possible that some depressed children might harbour suicidal thoughts and as a parent, it is important for you to be aware of warning signs of this. Flags for suicidal behaviour include talk of suicide or death and dying, focusing on the morbid, giving away of their possessions, and increase in risk-taking.

Treatment for Childhood Depression

The treatment for childhood depression is similar to that followed for adults suffering from depression. Psychotherapy and medication are used individually or in combination as part of the treatment process depending on the severity of the condition. Mild to moderate childhood depression is often treatable with psychotherapy alone.

If that does not suffice, then anti-depressants may be prescribed in addition to the therapy. This is usually required in severe cases of depression. Anti-depressants are useful in rectifying the chemical imbalance and can take up to a few months to prove effective. Pinpointing the right medication and the dose can also take time. Also, medication alone will not cure the problem and has to be accompanied by therapy.

You are also likely to come across plenty of alternative treatments such as herbal remedies and supplements that are easily available. However, the veracity of these has not been proven and some might even be detrimental to your child’s overall well-being.

Can Depression in Kids Be Prevented?

Yes, to a certain extent childhood depression can be prevented. For this, it is important that children are brought up in a nurturing environment which fosters a healthy attachment between the child and parents. Being attentive about your child’s needs, providing them love and care, and encouraging gradual independence can all make a difference. When your child is surrounded by supportive adults, has a strong family, maintains a healthy relationship with peers, develops good coping skills, and is emotionally regulated, there is no place for depression.

How to Find a Good Therapist

Your child’s doctor will be able to provide you with some references when seeking a therapist. Besides this, you can ask friends and family or other health providers. Checking their affiliations and researching about the reputation of the therapists on your list can prove helpful in narrowing down your choices. If your insurance provides coverage for the treatment, then you might have to factor in that as well and look for an approved therapist. If your child has been diagnosed with another mental health problem associated with the depression such as an eating disorder, you will need to look for a professional who specializes in that also. It is also important for your child to build a rapport with the therapist. So, the best thing is to opt for a trial session with a couple of the shortlisted professionals and see which one your child feels most comfortable with. Here are some points to tick off your list at the initial meeting with the therapist:

• Professional qualifications, certifications, and experience in the field
• Types of treatment likely to be suggested
• How long the treatment might take
• Cost involved and mode of payment
• The recommended involvement of parents in the therapy
• Expertise in dealing with any associated mental health problems your child may have been diagnosed with
• What the usual outcome is likely to be

Helping Your Depressed Child

Dealing with depressed children can be stressful and requires a great deal of time and effort. The first step is to speak to your child about their feelings and moods while conveying to them that you are on hand whenever your child wants to talk. Lend an ear, be supportive, and demonstrate your love as much as possible without going overboard.

Here are some other things you can do to help your child through this difficult time:

• Ensure your child has a nutritious diet and gets adequate sleep and rest each day along with a moderate amount of physical activity.
• Be patient and kind even when your child throws a temper tantrum, acts grumpy or pushes you away. Mind your words and circumvent arguments whenever possible.
• Eliminate events and situations that stress out your child as much as possible.
• Encourage your child to take up interest or hobby and be diligent about pursuing it.
• Make sure that your child takes any prescribed medication on time and arm yourself with knowledge about possible side-effects and ways of handling them.
• Follow the suggestions and advice offered by your child’s therapist as this can help speed up the recovery process.

Depression can have a profound impact on all spheres of your child’s life and prevent them from making the most of available opportunities. Offering your support and taking time out to be with your child is integral to the recovery process.

This information is just a guide and not a substitute for medical advice from a qualified professional.