Children and Depression

sad-child-by George Hodan.jpg

The World Health Organization (WHO) has made a startling claim. They state that, globally, fully 50% of all mental illnesses experienced in a lifetime begin by age 14. These illnesses include depression, anxiety disorder and obsessive-compulsive disorder, among others.

Increasing numbers of children are being diagnosed with depression every day. It is estimated that 2.0% to 2.5% of children will experience at least one episode of depression before the age of 18. There is a higher incidence of depression in boys below the age of ten. By the time children reach 16, girls are significantly more likely to be depressed than boys.

It is only in the past couple of decades that depression in children has received serious attention. Children go through developmental phases and it can be difficult to distinguish normal moodiness from true depression.

Causes of Depression in Children

As with adult patients, there can be triggers to depressive episodes. Environment, family relationships, school issues, life events, genetics and biochemical disturbances are all potential triggers for depression.

Diagnosing Depression in Children

Like adults, depression is a disorder of mood. Unfortunately, because children often evidence changing moods as a normal part of development, depression can be missed.

Many of the adult symptoms of depression are the same in children: feeling sad or hopeless, irritable or angry; having feelings of guilt or worthlessness; experiencing difficulty in concentration or clear thinking; sleeping too much or too little; changes in eating patterns.

Other symptoms are more common in children: extreme social sensitivity or social withdrawal; vocal outbursts or crying; physical complaints, like stomach aches or headaches that persist despite treatment.

Suicide

While it is rare under the age of 12, children do sometimes attempt suicide. Adults are more likely to plan a suicide, while children are more likely to act impulsively. Girls are more likely to attempt suicide, but boys are more likely to be successful. When children are raised in an environment of violence, substance abuse or physical or sexual abuse, the incidence of suicidal thinking and attempts is higher.

Treatment

The “gold standard” for treating adults with depression is treatment with medication and/or psychotherapy. Psychotherapy for children can take different forms:
Play Therapy for children between the ages of 3 and 12 can be very effective. Therapists encourage the use of toys and play scenarios to determine the source of the depressive feelings and redirect the responses the child exhibits to these sources.
Art Therapy is another form of therapy that allows children to non-verbally express their concerns in a non-threatening manner. For the very young child it allows them to describe family relationships or concerns they have visually, when they don’t have the vocabulary to explain their feelings verbally.
Animal-Assisted Therapy relaxes children and allows them to feel comforted and calmed.
Operant Behavior/Applied Behavioral Analysis is used in more severe cases, especially with low-functioning children. Behavioral changes are encouraged and rewarded incrementally.

Sources: WebMD, Kid’s Mental Health and National Institute of Mental Health, NIH

Photo image courtesy George Hodan

 
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