Posted by: jedwardswright | April 15, 2011

Could My Child Be Depressed? Part 2

Symptoms

Many of the symptoms of depression in children are the same as those for adults, but a child may be less able to articulate what he or she is feeling. This is why it is important to teach your children “feeling words” from an early age. Simple terms such as sad, mad, and glad (or happy) are a good place to start. As children mature, more subtle terms can be introduced: upset, jealous, guilty, and even frustrated, which is an emotion that children and teens feel a lot. If you use expressive words to describe your feelings, your children will begin to pick up on that.

Many of the following symptoms happen to all children at some point or another. Symptoms of clinical depression  (Major Depressive Disorder or MDD) will be persistent and more intense than in most of their peers. Particular symptoms to watch for include:

  • Irritability or anger including crying, outbursts or temper tantrums
    • Parents don’t tend to associate angry behavior with depression, but anger may be the child’s way of showing that he or she feels sad or hopeless
  • Chronic headaches, stomachaches or other forms of physical distress that do not respond to treatment and have no apparent cause
  • Ability to cope with schoolwork and social situations declines
  • Lack of concentration or restlessness
  • Self-isolation: not wanting to go to school or social gatherings, avoidance of public places, retreating into bedroom
  • Lack of interest in formerly pleasurable activities
  • Bullying or being bullied
  • Changes in sleeping habits/fatigue and low energy
  • Changes in appetite
  • Chronic fears or worries
  • Lack of self-esteem
  • Negativity , which may include obsessions about death, evil or crime
  • Extreme anxiety over stressful situations or change: exams, speeches, doctor’s appointments, traveling, moving
  • Extra sensitivity to perceived rejection, insults or injustice
  • Self-harm: pounding head against objects, pinching, cutting, purging
  • Substance abuse
  • Suicidal thoughts or threats
    • Do not allow your child to be alone.
    • Immediately seek medical attention for your child.

Certain situations in a child’s background may predispose him or her toward having depression. Abuse, trauma, alcoholism or substance abuse in the home may tip off a genetic tendency to depression, either at the time or many years later. A family history of depression or other mental health conditions may also be a factor.The onset of puberty can be a trigger point for some youth, as hormonal changes can affect brain chemistry.

Treatment

While psychotherapy by a licensed child or teen psychologist or treatment with medications may be used individually, most experts now recommend a combination of the two. Therapy alone cannot address the physical causes of MDD, and even effective medication may not relieve established negative trends in thinking and behavior.

For younger children in particular art therapy can be an effective way of identifying issues and giving the child a means of expressing difficult feelings that they cannot articulate. Cognitive Behavioral Therapy (CBT) is a type of talk therapy that is proving effective for many adults and children, as it promotes self-esteem and more positive thought patterns.

Many parents are understandably reluctant to give their children prescription antidepressants. I would strongly suggest consulting with a child psychiatrist regarding any possible medications for your child. Psychologists have degrees in psychology and cannot prescribe or diagnose medical conditions. While your family doctor or pediatrician can write out a prescription, their training in mood disorders was likely limited, whereas psychiatrists are MDs who specialize in mental health conditions. If your child had a heart condition you would want a cardiologist to examine him or her, and if your child may have clinical depression, you want a psychiatrist, who is the specialist in that field of medicine.

Your doctor should advise you that some antidepressants have had the opposite effect on some young people, triggering suicidal feelings, so close observation and monitoring are required until it is clear how your child is responding to the drug. For this reason, sometimes hospitalization is suggested until the patient is more stable. However, for most depressed young people, treatment is the safer option.

The earlier people with MDD/clinical depression are treated, the better they will respond. Debilitating depression later in life may be averted by intervention at a younger age, and certainly, treatment before a deeper depression occurs may prevent suicide attempts. Children as young as eleven, twelve or thirteen with MDD can have suicidal thoughts, so while you shouldn’t panic you should take signs of despair and self-destruction very seriously.

It can be frightening and upsetting for parents to consider the possibility that their child has a mental health condition. Remember that MDD is usually responds well to treatment and that most people with depression go on to live full and productive lives. There are adults all around you every day who have depression and you aren’t even aware of it. That is good news, because it means that their treatments are working and they fit right in. Be encouraged by that thought, and have the courage to make an appointment for your child right away.

Resources

WebMD: Depression in Children

Mayo Clinic: Depression Treatment for Children

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