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Can children really suffer from depression?
Yes. Childhood depression is different from the normal "blues" and
everyday emotions that occur as a child develops. On the other hand, just because a child seems
depressed or sad doesn't necessarily mean that he or she has depression. But if
these symptoms become persistent and disruptive and interfere with social
activities, interests, schoolwork, and family life, this may indicate that the
child has the medical illness called depression. Keep in mind that while
depression is a serious illness, it also is a treatable one.
How can I tell if my child is depressed?
The symptoms of depression in children vary. Depression often is undiagnosed and
untreated because the symptoms are passed off as normal emotional and
psychological changes that occur during growth. Early medical studies focused on
"masked" depression, where a child's depressed mood was evidenced by
acting out or angry behavior. Although this does occur, particularly in younger
children, many children display sadness or low mood similar to adults who are
depressed. The primary symptoms of depression revolve around sadness, a feeling
of hopelessness, and mood changes.
Signs and symptoms of depression in children include:
- Irritability or anger
- Continuous feelings of sadness,
hopelessness
- Social withdrawal
- Increased sensitivity to rejection
- Changes in appetite -- either
increased or decreased
- Changes in sleep -- sleeplessness or
excessive sleep
- Vocal outbursts or crying
- Difficulty concentrating
- Fatigue and low energy
- Physical complaints (such as
stomachaches, headaches) that do not respond to
treatment
- Reduced ability to function during
events and activities at home or with
friends
- Reduced ability to function during
events in school, extracurricular
activities, and in other hobbies or interests
- Feelings of worthlessness or guilt
- Impaired thinking or concentration
- Thoughts or talk of death or suicide
Not all children have all of these symptoms. In fact, most will display
different symptoms at different times and in different settings. Although some
children may continue to function reasonably well in structured environments,
most kids with significant depression will suffer a noticeable change in
social activities, loss of interest in school and poor academic performance,
or a change in appearance. Children also may begin using drugs or alcohol,
especially if they are over the age of 12.
Although relatively rare in youths under 12, young children do attempt
suicide, and may do so impulsively when they are upset or angry. Girls are more
likely to attempt suicide, but boys are more likely to actually kill
themselves when they make an attempt. Children with a family history of
violence, alcohol abuse, or physical or sexual abuse are at greater risk for
suicide, as are those with depressive symptoms.
Which children get depressed?
It is estimated that 2.5 percent of children in the U.S. suffer from depression.
Depression is significantly more common in boys under the age of 10. But by
age 16, girls have a greater incidence of depression.
What causes depression in children?
As in adults, depression in children can be caused by any combination of
factors that relate to physical health, life events, family history,
environment, genetic vulnerability and biochemical disturbance. Depression is
not a passing mood, nor is it a condition that will go away without proper
treatment.
Children with a family history of depression are at greater risk of
experiencing depression themselves. Children who have parents who suffer from
depression are at greater risk for earlier onset of depression than children
whose parents do not have depression. Longstanding family chaos or conflict
and alcohol or drug use among youth are also risk factors for depression.
How is the diagnosis made?
If the symptoms of depression in your child have lasted for at least two
weeks, schedule a visit with his or her doctor to make sure there
are no physical reasons for the symptoms and to make sure that your child
receives proper treatment. A consultation with a mental health care
professional who specializes in children also is recommended.
A mental health evaluation should include interviews with you (as the
parents)
and your child, and any additional psychological testing that is necessary.
Information from teachers, friends, and classmates can be useful for showing
that these symptoms are consistent during your child's various activities, and
are a marked change from previous behavior.
There are no specific medical or psychological tests that can prove
depression, but tools such as questionnaires (for both the child and parents)
combined with clinical interviews are used to make the diagnosis.
What are the treatment options?
Treatment options for children with depression are similar to those for
adults
and include psychotherapy (counseling) and medication. The role that family
and the child's environment play in the treatment process is different from
that of adults. Your child's doctor may suggest psychotherapy first, and
consider antidepressant medicine as an additional option if there is no
significant improvement.
What can I expect long-term?
Studies have found that first-time depression in children is occurring at
younger ages. As in adults, it may occur again later in life. Because
studies have shown that childhood depression may precede other depression and
anxiety disorders later in life, diagnosis, early treatment and close
monitoring are crucial.
A parent's perspective
As a parent, it is sometimes easier to deny that your child has depression.
You may put off seeking the help of a mental health care professional because
of the social stigmas associated with mental illness. It is very important for
parents to understand depression and realize the importance of treatment so
that your child may continue to grow physically and emotionally in a healthy
way. It also is important to learn about the future effects depression may
have on your child throughout adolescence and adulthood.
Parents should be particularly vigilant for signs that may indicate that
their
child is at risk for suicide. Warning signs of suicidal behavior in children
include:
- Many depressive symptoms (changes in
eating, sleeping, activities)
- Social isolation
- Talk of suicide, hopelessness, or
helplessness
- Increased acting-out behaviors
(sexual/behavioral)
- Increased risk-taking behaviors
- Frequent accidents
- Substance abuse
- Focus on morbid and negative themes
- Talk about death and dying
- Increased crying and reduced
emotional expression
- Giving away possessions
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