Depression and Children: What to Look For and How to Help
Depression is a mood disorder which affects how people think and behave, and how they feel, both physically and mentally. Depression often starts in adolescence or early adulthood but it occurs in people of all ages, including young children. Genetic, neurophysiological, and relationship factors can result in depression, and all may be involved when depression is severe or chronic.
Changes in thinking:
Negative self-evaluations indicating poor self-esteem
Negative outlook on the present and future
Tendency to view mistakes and failures as catastrophic
Difficulty concentrating
Thoughts of suicide
Changes in behaviour:
Increase or decrease in eating
Increase or decrease in sleeping
Withdrawal from activities and friends
Sudden outbursts of anger or tears
Irritability
Changes in feelings:
Unhappy
Worried
Guilty
Rejected or lonely
Helpless or hopeless
Fearful
Changes in physical health:
Headaches
Stomach aches
Weight loss or weight gain
General sense of being unwell or fatigued
When children demonstrate a number of these symptoms lasting more than two weeks and there is no discernable explanation such as an illness, loss, or significant change, depression may be the cause. It’s always important to talk to children regularly about their feelings and concerns, especially about their relationships. Being bullied or rejected by peers can be particularly painful and children are often too ashamed to volunteer the information. Talk to your child’s teacher to find out if he or she has noticed a change or is aware of a problem. Take your child to your doctor and discuss your concerns.
In The Whole Brain Child (2012), Daniel Siegel, M.D. and Tina Payne Bryson, PhD. argue that it’s critical for parents to affirm and explore children’s hurt and angry feelings rather than to minimize them or invalidate their experience. It is only by expressing and interpreting painful events-with the help of caring adults-that children can integrate them into their narrative of themselves, learn from them, and develop resilience in the face of future painful events. This goes against old fashioned ‘common wisdom’ which says that children should be told, “forget about it,” “it wasn’t so bad,” and “buck up.”
Medication can be effective for children suffering from depression but doctors are less inclined to prescribe it before other approaches have been tried. Getting the right dosage is tricky as children are growing all the time, there are side effects, and it’s preferable to be proactive about children’s mental health rather than to rely on medication. Children can be taught to problem solve, to minimize set-backs, and to view negative feelings as unpleasant but transitory. Learning these skills not only helps to lift depression but serves to ward off future depressive episodes. Encouraging children to exercise, socialize and participate in activities is also very important as children who do these things, are less likely to become depressed.
Having a depressed child in the family can be very challenging for parents and siblings. Feelings of guilt and frustration are typical for parents who both worry they are responsible for their child’s depression, and exasperated by the amount of time, attention, and reassurance the child requires. Siblings tend to feel irritated and resentful. The good news is that counselling for the depressed child with parent involvement can produce significant and positive changes for the whole family. New and better strategies for expressing negative feelings, resolving conflict, and managing stress tend to benefit everyone.
Sometimes depression is secondary to other mental health problems such as Attention Deficit Hyperactivity Disorder, Autistic Spectrum Disorder or a Learning Disorder. If this is the case, treating the depression in isolation will not be effective. Children with developmental or behavioural problems often become depressed because they get so much negative feedback and feel dejected and misunderstood, as a result. These children need to be assessed and provided with appropriate help to address the underlying difficulties. Tell your child’s daycare staff, teachers, and your family doctor if you’re worried. The sooner the problem is identified, the sooner it can be addressed.
Depression in children can occur as a result of chronic family conflict and/or parental neglect due to parents’ mental illness. Doctors, teachers, daycare staff and family members need to be vigilant so that such cases don’t go undetected.
With each individual, depression is experienced differently and its meaning is different. Even when depression seems to come on suddenly and to have no identifiable precursor, there are almost always antecedents such as a disappointment or failure which was not adequately addressed or resolved. Developing an understanding of how one deals with stress and disappointment and learning to manage these better, can be enormously beneficial in reducing the number and severity of future depressive episodes. It is for this reason that doctors are increasingly advised by their medical associations to prescribe psychotherapy for depression.
About The Author
Janet Morrison, M.A., C. Psych Assoc. is a psychological associate in private practice and a senior lecturer at the Factor-Inwentash Faculty of Social Work, University of Toronto. Over the past 30 years she has assessed, treated and supervised treatment of children in long-term care, as well as, consulted for Children's Aid Society and group homes across Ontario.