Depression among children is alarmingly common. Statistics published by the Centers for Disease Control and Prevention (CDC) state that 3.2% of children aged 3-17 years — or approximately 1.9 million youths — have been diagnosed with depression. Just as worrisome is the fact that millions of other children have undiagnosed depression, which may put them at even greater risk of developing additional mental health issues or attempting self-harm or suicide.
“Children, like adults, are not always going to be happy and upbeat every moment of the day,” commented psychologist Dr. Alexis Schottenstein, who specializes in family and marriage therapy. “However, when bouts of sadness or lethargy persist and start to interfere with school, social interests, family, and other critical components of a young person’s life, then it is vital for parents to take the matter seriously.”
According to Dr. Alexis Schottenstein, here are some of the symptoms that may suggest that a child could be suffering from depression: excessive sensitivity to rejection (or perceived rejection), vocal or crying outbursts, social withdrawal, intense anger or ongoing irritability, dramatic changes in appetite or sleep patterns, fatigue and low energy, difficulty concentrating, physical complaints that do not respond to treatment, and thoughts of death or self-harm.
Monitoring the severity of symptoms
It is important to bear in mind that not all children who suffer from depression will manifest all of the symptoms noted above by Dr. Alexis Schottenstein. Parents should pay close attention to both the severity and especially the duration of any of these symptoms. For example, temporary social withdrawal, low energy, or irritability may not be linked to depression. However, if symptoms persist for several days or weeks, seeking help from a qualified healthcare professional is the appropriate next step.
Parents should also be aware that even if the above-noted systems persist, this does not necessarily mean that their child will be diagnosed with depression. In some cases, the underlying cause that is triggering these worrisome symptoms is a medical issue. For example, children with an underactive thyroid (hypothyroidism) may experience fatigue, lack of energy, and loss of appetite — all of which may also be present in cases of depression.
“It is very important for parents not to overreact and panic if they believe that their child may be suffering from depression,” commented Dr. Alexis Schottenstein, whose practice is located in Buffalo, NY. “At the same time, while parents should do some research on the web to become more familiar with some of the issues, they should not start diagnosing their child or trying to develop a treatment plan on their own. While they have the best of intentions, parents who do not seek advice from a qualified and experienced healthcare professional could end up doing more harm than good.”
Parents should also be a bar in mind that there are various treatment options available. For mild to moderate depression in children and teens, cognitive behavioral therapy (CBT) may be effective. Meta-analyses have found that up to 60 percent of children treated with CBT for anxiety disorders (including depression) experience a significant decrease in symptoms. This impact continues four years post-treatment.
“CBT is a kind of talk therapy that can help children identify certain unhelpful or painful thoughts and behaviors, and then learn how to change them,” commented Dr. Alexis Schottenstein. “For example, children who are prone to severe tantrums or violent outbursts of anger can, over time, learn to reframe and therefore neutralize the triggers that compel them to behave in this painful way.”
Other models of CBT that may be effective for children with depression include role modeling. The therapist acts out a positive and desired behavior — such as demonstrating impulse control — and then having the child do the same. Gradually and carefully exposing a child to a situation that triggers depression or anxiety can also significantly improve time. CBT therapy can be implemented on its own or in combination with medication. Furthermore, depending on each child’s unique needs, sessions may be one-on-one with the therapist, involve the child and parents, involve the family, or involve a group of other children who experience the same problems.
“Whether their child engages in CBT or any other kind of therapy with or without medication, parents need to be patient and not expect quick fixes or overnight improvements,” commented Dr. Alexis Schottenstein. “Parents should also not be overcome with feelings of guilt or shame if they believe that their child might be depressed, or if this belief is confirmed by a therapist or other qualified healthcare professional. There are many reasons why children become depressed, and parents who start blaming themselves or others limit their ability to be part of their child’s solution. For this reason, many parents of depressed children also benefit from therapy, either together with their child or in one-on-one sessions.”
The last piece of advice that Dr. Alexis Schottenstein has for parents is one that parents should heed, regardless of whether they vaguely suspect or strongly believe that their child may be suffering from depression: do not ignore the situation.
“Some parents are afraid of reaching out for help because they are worried that they will be judged, or that they will make things worse for their child and family,” commented Dr. Alexis Schottenstein. “While this perception is understandable — especially considering the stigma surrounding depression and mental health issues — is it not helpful or responsible. Parents must put the needs of their child first, and that means reaching out for professional guidance and support. Depression is a real problem and not just a phase. If left undiagnosed and untreated, it could become much more painful and difficult for a child, and follow them into adulthood. It could also overwhelm them with thoughts of self-harm or harming others. Fortunately, competent and compassionate help is available. The past and the present may be very difficult, but the future can be better for all.”
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