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Depression in Children. Prepared by: Tanya Zhao Asian Health Coalition of Illinois Asian Mental Health Partnership Initiative. What is Childhood Depression?. Depression is a mental health disorder that describes someone who is constantly down and sad for no apparent reason.
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Depression in Children Prepared by: Tanya Zhao Asian Health Coalition of Illinois Asian Mental Health Partnership Initiative
What is Childhood Depression? • Depression is a mental health disorder that describes someone who is constantly down and sad for no apparent reason. • People assume that children do not get depression, because children are generally happy and energetic. • However, childhood depression has increased dramatically. 1 in 3 American children suffers from depression, 4% of children under 6, according to 2001 National Institute of Mental Health (NIMH) statistics.
Is it just a phase? • Sadness is a very common emotion and it doesn’t always mean depression. However, if a child seems to be depressed for a long time, it might be a good idea to see a doctor. • Untreated Depression may be associated with increased risk for: • Anxiety Disorder • ADHD • Problems in school • Drug and Alcohol use/abuse • Conduct Disorder • Violent Thoughts • Suicide attempts
How can I tell if a Child is Depressed? • Changes in: • How they look • How they act • How they feel • How they think
Changes in How they Look • Changes in appetite or weight. • Children who usually have a healthy appetite may suddenly lose interest in eating or may eat too much to self-medicate their feelings. • Sleep disturbances • Children with depression may have difficulty falling asleep and staying asleep once they do. Some may also wake too early or oversleep. Sluggishness -Children with depression often talk, react, and walk slower. They may be less active and playful than usual. • Agitation • Depressed children may show signs of agitation by fidgeting or not being able to sit still.
Changes in How they Act • Avoidance and withdrawal • Children with depression may avoid everyday or enjoyable activities and responsibilities, and may avoid friends and family members. • Clinging and demanding • The depressed child may become more dependent on some relationships and behave with an exaggerated sense of insecurity. • Activities in excess • A depressed child may appear to be out of control in regard to certain activities. He or she may spend long hours playing a video game or overeat.
Changes in How they Act (continued) • Restlessness • The restlessness brought on by depression may lead to such behaviors as fidgeting, acting up in class, or reckless behavior • Self-Harm • Depressed individuals may cause themselves physical pain or take excessive risks. Self-injury is one example of such behavior.
Changes in How they Feel • Sadness • They may cry easily. Some children will hide their tears by becoming withdrawn. • Loss of pleasure or interest • They may complain of feeling "bored" or reject an offer to participate in an activity that they usually like. • Anxiety • The child may become anxious, tense, and panicky. Sometimes what makes them anxious may also be the source of depression. • Turmoil • The child may feel worried and irritable. They may brood, and become moody or angry.
Changes in How they Think • Difficulty organizing thoughts • This could lead to problems in school or an inability to complete tasks. • Negative view • Children with depression may view themselves, their life, and their world in a very negative light. • Worthlessness and guilt • Depressed children may obsess over their perceived faults and failures, feel tremendous guilt, and declare themselves worthless.
Changes in How they Think (Continued) • Helplessness and hopelessness • Children with depression may believe that there is nothing they can do to relieve their feelings of depression. • Feelings of isolation • A child who has been picked on frequently may become very sensitive to slights from his peers. • Suicidal Thoughts • Children with depression may wish that they were dead and express these thoughts.
What causes Depression in Children? • Many factors are involved in the development of depression: • Genetic vulnerability (e.g. faulty production, transmission or reception of neurotransmitters and biochemical agents) • Developmental events (e.g. early childhood stressors, learned helplessness, object loss) • Psychosocial stressors (e.g. adults stressors, grieving) • Physiological stressors (e.g. medical conditions, disease, viral infections) • Personality traits (e.g. characteristics that influence reactivity to stress)
What causes Depression in Children? • There are some family and social risk factors that may increase the likelihood of a child being depressed: • Separation, divorce of parents, or even close relatives. • Death of a loved one or a pet. • A move from one town, or even one neighborhood, to another. • Academic, sports, or athletic failure. • An injury or physical illness resulting in hospitalization or restricted activity. • Embarrassment, shame, guilt or loss of "face". • Failure to live up to personal expectations. • Repeated physical, emotional or verbal abuse.
Treatment • Psychotherapy • Helps the individual examine and correct negative thought patterns and erroneous negative assumptions about himself. • Encourages the individual to use positive coping behaviors instead of giving up or avoiding situations. After therapy is over, children may benefit from scheduled or "as-needed" booster sessions. • Sometimes it helps for the whole family to be involved in therapy.
Treatment • Medication • Medication is usually for more severe cases of depression. It should only be used if psychotherapy is not enough. • An older type of medication – tricyclic antidepressants – have been effective with children who have depression and ADHD. However, tricyclics may cause heart rhythm change, so children on tricyclics need to be monitored. The general effectiveness of tricyclics are debated. • SSRIs (Selective Serotonin Reuptake Inhibitors) are a relatively newer type of anti-depressant. SSRIs don’t have as many side-effects as tricyclics, and are generally less toxic. However, the dosage of these medications need to be continuously monitored in children and should be kept as low as possible.
Advice to Parents: • What can I do as a parent? • A normal depression is usually temporary, can come and go, but should diminish over time. Allow the child space and time. • Maintain a regular and nutritional diet. Avoid meal skipping. A proper diet is a critical source of energy and the child's ability to cope and recover. • Maintain a regular sleep cycle. Avoid sleeping or napping during the day if it is difficult to sleep during regular times. Irregular sleep patterns can prolong or worsen symptoms of depression.
Advice to Parents • Stay involved and avoid extended isolation from positive activities and influences. • Maintain regular or routine physical activity. Physical activity can help relieve or manage depression. • Spend time with the child, be caring, listen well, and be understanding. • Take time on a regular basis to help the child enjoy pleasurable activities and recreational interests. • Urge your child to get regular exercise, eat a healthy diet, and get enough sleep. • See that your child takes any medicine as prescribed and goes to all follow-up appointments. • Make time to talk and listen to your child. Ask how he or she is feeling. Express your love and support. • Remind your child that things will get better in time.
Advice to Parents • If symptom’s don’t seem to get better: • Seek immediate advice and consultation from a qualified health care professional. • Seek medical advice if you suspect health problems or symptoms are not explained and there has not had a medical evaluation for the child's symptoms. • Seek consultation regarding drug and alcohol use. Drug and alcohol use by children is never appropriate. • Learn more about any medications the child is taking. Ask your physician and pharmacist about potential interactions and side-effects.
