Can Children Really Have Depression?
Yes. Depression in childhood is distinct from the regular “blues” and everyday mood changes that children experience during their development. Just because a kid feels sad doesn’t actually prove they have major depression. But if the sorrow becomes chronic or disrupts typical social interactions, hobbies, academics, or family life, it may suggest they have a depressive condition. Keep in mind that while depression is a severe condition, it’s also a curable one.
How Can I Tell if My Child Is Depressed?
The signs of depression in youngsters differ. The illness is often undetected and mistreated because symptoms are passed off as typical emotional and psychological changes. Early medical research focused on “masked” depression, when a child’s gloomy mood was demonstrated by acting out or aggressive conduct. While this does happen, particularly in younger children, many youngsters express melancholy or low mood comparable to adults who are depressed. The basic symptoms of depression focus around melancholy, a feeling of despair, and mood swings.
Signs and symptoms of depression in children include:
- Constant emotions of hopelessness and despair
- Withdrawal from society
- Vulnerability to criticism
- Hunger changes, either elevated or diminished
- Alterations in sleep (excessive sleep or sleeplessness)
- Outbursts of speech or tears
- Concentration problems
- Tiredness and insufficient energy
- Physical symptoms that do not respond to therapy (such as stomach pains and cramps)
- Disappointment with activities and events at home or with acquaintances, at school, with leisure activities, and with other interests or hobbies
- Feelings of insignificance or remorse
- Impairment of thought or focus
- Suicidal thoughts
Not every child will exhibit all of these symptoms. Indeed, the majority will exhibit a variety of symptoms at various times and in various circumstances. While some children with considerable depression may continue to do well in organized contexts, the majority of kids with severe depression may exhibit visible changes in their community activities, loss of enthusiasm in school, low school performance, or a difference in demeanor. Additionally, children may begin taking drugs or alcohol, particularly if they are past the age of 12.
Although suicide attempts by kids under the age of 12 are uncommon, they can occur – and may occur spontaneously when they are disturbed or angry. While girls are more likely to attempt suicide, boys are more likely to succeed. Kids with a familial violence history, alcohol misuse, or sexual or physical abuse, as well as those with symptoms of depression, are at a higher risk of suicide.
Which Children Suffer from Depression?
Depression affects up to 3 percent of children and 8 percent of teenagers in the United States. The disease is substantially more prevalent in males less than the age of ten. However, by the age of sixteen, girls had a higher prevalence of depression.
Teens are more likely to suffer from bipolar disorder than younger children. However, bipolar illness in children and adolescents might be more severe. Additionally, it may occur in conjunction with or be concealed by conduct disorder (CD), obsessive-compulsive disorder (OCD), or attention deficit hyperactivity disorder (ADHD).
What Causes Childhood Depression?
As with adults, depression can be induced by a variety of factors including physical wellbeing, life circumstances, family background, surroundings, genetic factors, and biochemical imbalance. Depression is not a transient mood state, nor is it a disorder that will resolve on its own.
Can Childhood Depression Be Prevented?
Children who have a family history of depression are also at an increased risk. Children with depressed parents are more likely to have their first bout of depression than children without depressed parents. Kids from chaotic or dysfunctional households, as well as children and teenagers who engage in substance addiction, such as drugs and alcohol, are also at an increased risk of depression.
How Is Childhood Depression Diagnosed?
If your kid’s depression symptoms have persisted for at least 2 weeks, plan a visit with their physician to rule out any medical causes and to ensure that your child receives correct therapy. A visit with a child-focused mental health care specialist is also advised. Bear in mind that the pediatrician may want an individual consultation with your kid.
A mental health examination should consist of conversations with you (the primary caretaker or parent) and your kid, as well as any necessary psychological tests. Teacher, peer, and colleague reports can help demonstrate that these symptoms are constant throughout your child’s numerous activities and represent a significant change from earlier behavior.
Although no single medical or psychological test can definitively detect depression in children, methods such as questionnaires (for both the kid and parents) paired with private details can be extremely helpful in diagnosing depression in children. Occasionally, those treatment sessions and assessments may reveal other factors that relate to depression, such as OCD, ADHD, and conduct disorder.
Mental health screenings are initiated by some doctors at a child’s 11th-year well visit and continue each year thereafter.
What Treatment Options Are Available?
Children with depression have comparable treatment choices as adults, including therapy (counseling) and medication. Your child’s doctor may initially recommend counseling and then explore antidepressant medication if there is no change. The most recent research indicates that the most effective treatment for depression is a mix of psychotherapy and medication.
However, research indicates that fluoxetine (Prozac) is useful in treating depression in kids and teens. The FDA has approved the medication for the management of depression in children ages 8 to 18.
The majority of drugs used to treat childhood depression have a black box warning concerning the risk of raising suicide ideation. It is critical to begin and monitor these drugs under the supervision of a competent practitioner and to discuss the potential dangers and advantages with them.
Managing Bipolar Disorder In Children
Therapy and a combination of medications, often an antidepressant and a mood stabilizer, are typically used to treat children with bipolar illness.
Antidepressants should be used cautiously in children with bipolar illness, as they might precipitate episodes of manic or hyperactive behavior. Medication management for children must be integrated into an entire treatment plan that includes counseling and frequent primary care visits.
The FDA advises that antidepressant drugs may raise the risk of suicide ideation and behavior in kids and teens who suffer from depression or other mental illnesses. Consult your physician if you have any questions or concerns. Additionally, if your kid is put on these meds, it is critical to maintaining constant contact with the doctor and therapist.
What To Expect From Your Physician
Maintaining a positive connection with your physician is critical, since the more involved and devoted an individual is to their therapy, the more likely they will be successful. A qualified clinician should ensure that you understand the therapy goals and that your queries are addressed seriously. Additionally, you should feel comfortable being candid about your progress.
Jill Emanuele, Ph.D., senior director of the Child Mind Institute’s Mood Disorders Center, notes that one of the first things she does with a new patient is to develop a positive connection. “You get to know the person, you make them comfortable. You establish a safe space where you show them that you’re listening and you care. Often enough we’re the first person that’s listening to them in a way they haven’t experienced before, or have not experienced often.”
Dr. Emanuele says she attempts to address a patient’s resistance to therapy. “Maybe they’ve had a difficult experience with therapy before, or they don’t really trust adults, or perhaps they are shamed by their behavior or what they’re feeling, and they don’t want to show it to another person.” A good doctor would attempt to overcome this reluctance, explain how therapy works (and how it may differ from prior experiences), and earn their patient’s confidence.
If your kid has not yet received an official diagnosis, his or her physician should conduct an examination as well. This is to establish that your child does have depression and to rule out the possibility that he may also have another mental health or learning condition. Depression is not uncommon in children who have undiagnosed anxiety, ADHD, learning problems, and other concerns. If your kid suffers from many problems, his treatment approach should include addressing each one.
Depression Therapy in Children
Several types of therapy are deemed “evidence-based” for managing depression, which signifies that they have been investigated and confirmed to be successful clinically. The following is a breakdown of a few of them:
Behavioral cognitive treatment (CBT). Cognitive-behavioral therapy is the gold standard for treating depression in children and adolescents. CBT helps by equipping individuals with the skills necessary to cope with symptoms such as depression and unhelpful ideas (such as “nobody really likes me” or “life will always be the same”). In CBT, children and therapists work cooperatively to accomplish specific goals, such as identifying harmful thinking patterns.
The treatment’s core tenet is to teach patients that their ideas, feelings, and behaviors are all interrelated and that altering any one of these aspects affects the others. For instance, one strategy known as “behavioral activation” encourages individuals to engage in activities and then monitor the effect on their mood. In Dr. Emanuele’s words, “We set up a hierarchy of activities they can start to engage in. The idea is to get moving and active, so you do not only get that physical momentum, but you also start to experience more positive thoughts from having success and interacting more with others.”
Behavioral activation helps persons with depression overcome the isolation they frequently encounter, which can reinforce their gloomy mood.
Dialectical Behavior Therapy(DBT). Dialectical behavior therapy may be beneficial for individuals suffering from more severe depression. DBT is a type of cognitive-behavioral therapy that was created for those who struggle with extremely unpleasant emotions and may indulge in hazardous conduct, self-harm such as cutting, and suicidal thoughts or attempts.
To handle extreme emotions, DBT participants start practicing mindfulness (being emotionally present and focusing exclusively on one task at a time, without judgment) and problem-solving capabilities such as enduring distress, being faced with challenging situations healthily and interacting more efficiently with family and friends. DBT is a highly organized treatment that involves both personal and group therapy. DBT for kids comprises sessions in which parents and their kids work together to develop skills.
Psychotherapy on an interpersonal level (IPT). Social ties can occasionally have an effect on and even perpetuate depression. When someone is sad, her relationships may suffer as well. Interpersonal therapy works by improving the health and supportiveness of a child’s relationships. Children develop abilities for more effective communication of their emotions and expectations, they develop problem-solving skills for resolving disagreements, and they learn to recognize when their interactions are affecting their emotions.
IPT has been developed for depression-stricken teenagers to assist in resolving common teenage relationship challenges, such as intimate relationships and communication difficulties with parents or classmates. This specific kind of interpersonal therapy, called IPT-A, is generally a Twelve to sixteen-week course of treatment. Parents will be required to attend a portion of the sessions.
Cognitive treatment based on mindfulness (MBCT). While its efficacy in teenagers is still being evaluated, mindfulness-based cognitive therapy has been demonstrated to be effective in young adults and adults with depression.
MBCT is a technique that combines cognitive-behavioral therapy (CBT) and mindfulness. Mindfulness encourages individuals to be completely present at the moment and to notice their thoughts and emotions objectively. This can assist them in interrupting negative thinking patterns that might perpetuate or contribute to a depressive episode, such as being self-critical or trying to focus on unpleasant things in unproductive ways.
Although MBCT was first intended to assist those experiencing recurrent bouts of depression, it can also be used to treat individuals experiencing their first episode of depression.
Medication therapy. Kids and teens who suffer from depression may also improve with medication, and physicians frequently prescribe medicine to manage more serious depression or when psychotherapy alone is ineffective.
The most often recommended medications for depression include selective serotonin reuptake inhibitors (SSRIs) such as Lexapro, Prozac, and Zoloft as well as serotonin-norepinephrine reuptake inhibitors (SNRIs) such as Strattera and Cymbalta. Additionally, these drugs are referred to as antidepressants.
Dr. Nash notes that occasionally, young individuals (and their families) express concern about using depression medication. People frequently express concern that medicine would alter their personality or cause them to feel “drugged.” Additionally, they fear developing a medicine addiction.
She takes these issues seriously and communicates expectations to patients and their families. The proper prescription at the right amount should not make a youngster feel drowsy or alter his personality, but it should alleviate his depressive symptoms. Additionally, she clarifies that antidepressants are non-addictive. “You don’t have an urge to take them, or seek them out to the detriment of your relationships,” she says. When it’s time to stop using antidepressants, it’s unusual for patients to experience persistent withdrawal symptoms if they go off the medicine slowly and under the guidance of their doctor.
Monitoring for Suicidal ideation
The FDA gave a notice that certain antidepressant drugs may raise the risk of suicide ideation in kids and teens. Numerous studies have demonstrated that the advantages of antidepressant drugs exceed the risks of not receiving therapy, and hence they continue to be given to adolescents. To ensure patient safety, a procedure has been devised for prescribing professionals to assist them in closely monitoring patients during their adjustment to a new medicine for any worsening of depression or onset of suicidal thoughts.
Going off medication
To prevent a return of depression, Dr. Nash recommends that children remain on medication for a minimum of one year after experiencing no symptoms of depression. Additionally, she emphasizes the need of considering the “ideal” moment to discontinue the medicine. For instance, it is not a good idea to discontinue his prescription just before the SATs or when he is about to enter college.
To minimize adverse reactions, your kid should not abruptly discontinue the medicine. It is critical to taper off antidepressants gradually, under the supervision of a specialist who will check his health.
Participation of family members
Drs. Nash and Emanuele both highlight the need of including families in the treatment of a child’s depression. “Part of treatment, especially in the beginning, is to teach parents about depression and how therapy works, says Dr. Emanuele. “It’s really important that parents understand the concepts behind the treatments so that they can coach their child, day-to-day, to use the skills that they’re learning.” Dr. Emanuele continues by noting that parents frequently benefit from acquiring the skills as well.
Professionals can also assist parents in communicating with a kid who is depressed, which can be challenging at times. Children who are depressed may want to withdraw from family or may view even well-intentioned parental care as criticizing rather than caring. It is critical to understand how to be helpful. According to Dr. Emanuele, she assists parents in developing a situation-specific plan that teaches them when to lean in and when to back off. Clinicians can also guide how to promote more favorable interactions.
Receiving this help may be a huge comfort for parents who are suffering due to their child’s condition. Naturally, as a child begins to feel better, the parents will begin to feel better as well.
According to studies, children are developing depression for the first time at younger ages than in the past. Depression, just like it does in adults, may recur later in life. Depression frequently manifests along with other health disorders. And, since depression is a precursor to more severe mental disease later in life, accurate diagnosis, treatment, and vigilant supervision are critical.
As a parent, it might be tempting to reject the notion your kid suffers from depression. You may be hesitant to seek assistance due to the societal stigma linked with mental illness. It is critical for you, as the parent, to recognize depression and the critical nature of therapy for your kid to continue growing emotionally and physically in a healthy manner. Additionally, it is critical to seek knowledge regarding the long-term impacts of depression on your kid during the adolescent years.
If you feel your kid or adolescent is sad, listen to their worries. Even if you believe the issue is trivial, keep in mind that it may feel very genuine to them. It is critical to maintaining communication with your child, even if he or she appears to want to retreat. Attempt to refrain from instructing your youngster what to do. Rather than that, listen carefully and you may learn more about the issues that are producing the troubles.
If you’re stressed and therefore unable to communicate with your kid, or if your concerns have persisted for a long time, seek professional assistance.