Misconceptions About Children and Depression
One of the most common responses to hearing that a child has depression is, “But what does he/she have to be depressed about?” This statement reveals two major misconceptions. One is the lack of understanding about clinical depression. It is not the same as the “blues” or “down” moods that everyone has from time to time, which may actually be caused by unhappiness with one’s job, home life or other factors. Clinical depression may resemble these emotional dips, but it is much more pervasive, long-lasting, and life-threatening. It is not necessarily caused by an event or state of affairs in a child’s life. The other misconception is that childhood is a carefree, trouble-free period in our lives. How many people can say that they didn’t worry about peer acceptance, grades, or parental expectations? Adults often forget that children are powerless and have no control over their own lives. This can be a frightening and frustrating state of affairs to live through day after day.
Causes of Childhood Depression
As with adult depression, diagnosis of depression in children is not as clear-cut as it is for other ailments. There is no test that can be given which will positively say that an individual has depression, much less pinpoint the cause(s). The medical community still knows relatively little about the brain, how it works, and what makes it malfunction. In fact, anti-depressant properties of certain medications were discovered by accident in the 1950s while seeking a cure for tuberculosis.
We do know that certain children have risk factors in their lives which could predispose them to depression or could “trigger” depression. Among these are a family history of mental illness or suicide, abuse (physical, emotional or sexual), chronic illness and the loss of a parent at an early age to death, divorce or abandonment. However, some infants exhibit depressive symptoms at an early age before most of these factors come into play, so there is an argument to be made for depression being wholly chemical in some children. Each child’s depression is individual, and causes will be different for each one. The depression could be wholly chemical, wholly due to psychological factors, or a combination of the two. More important than the cause is identifying the illness and treating it.
Symptoms of Depression in Children
- Persistent sadness and/or irritability.
- Low self-esteem or feelings or worthlessness. A child may make such statements as, “I’m bad. I’m stupid. No one likes me.”
- Loss of interest in previously enjoyed activities.
- Change in appetite (either increase or decrease).
- Change in sleep patterns (either increase or decrease).
- Difficulty concentrating.
- Headaches, stomachaches or other physical pains that seem to have no cause.
- Changes in activity level. The child either becomes more lethargic or more hyperactive.
- Recurring thoughts of death or suicide.
Overall, the most important factor is change. Any change in a child’s behavior that seems to have no external or physical cause should be looked at. A low mood which results from a loss (death of a loved one, moving, changing schools) which lasts more than a few weeks should be considered possible depression and checked out
Treatment
The parents of any child who is in immediate danger of harming himself or others should consider hospitalization. This is a tough choice for parents to make, but it must be emphasized that children do commit suicide.
Once a child has been diagnosed with either major depression or dysthymia, both psychotherapy and medication could be options. More and more, doctors are realizing that chemical imbalances often account for mental illness, but at the same time, the importance of psychotherapy cannot be discounted. If a child’s depression has been caused wholly or in part by psychological factors, medication may relieve the depression, but the underlying cause will not be “cured” by medication alone. Therapy can help the child deal with his past in a healthy manner, and also in learning ways to cope with the very difficult process of growing up.
Antidepressant medication for children is a controversial topic. Currently no medications have FDA approval for use with children, although most of the major drug companies have submitted data. There are no long-term studies that show what kind of impact this medication will have on a child’s development. There has also been some question as to whether the older tricyclic antidepressants are effective with children. But keep in mind that it is almost a certainty that depression will have negative long-term effects on the child and his family. The decision of whether to treat a child with medication is wholly individual, depending on the severity of the child’s depression and what toll it will take on the child’s life without successful treatment. Parents should educate themselves as much as possible in order to make an informed decision.