Children and Depression

1. Children and Depression Information and Prevention

2. Training Objectives • Identify what depression is, as well as its many forms. • Identify the signs and symptoms of depression. • Recognize the causes of depression. • Identify things parents or caregivers can do when they suspect a child has depression, and ways to help a child who is depressed.

3. What is Depression? • According to the National Institute of Mental Health (NIMH), depression is a serious medical condition. It is not feeling sad for a few days, but rather it is feeling "down“, "low" and/or "hopeless" for weeks at a time.

4. Forms of Depression • According to the NIMH, depression can take many forms. • Major depressive disorder or major depression, is characterized by a combination of symptoms that interfere with a person’s everyday activities: eating, working, and sleeping. It is disabling and prevents a person from functioning normally. A major depressive episode may occur only once in a person’s lifetime or it recurs.

5. Dysthymic disorder is also called dysthymia. It is characterized by long-term (2 years or longer) but less severe symptoms that may not disable a person, but can prevent them from functioning normally or feeling well. One or more episodes of major depression may also be experienced.

6. There are other forms of depression that have different characteristics than major depression or dysthymia. • Psychotic depression occurs when severe depressive illness is accompanied by some form of psychosis, such as a break with reality, hallucinations and delusions.

7. Postpartum depression occurs when a new mother develops a major depressive episode within one month after delivery. It is estimated that 10 to 15 percent of women experience postpartum depression after giving birth.

8. Seasonal affective disorder (SAD) is characterized by the onset of a depressive illness during the winter months, when there is less natural sunlight. The depression generally decreases or lifts during spring and summer. SAD may be effectively treated with light therapy, but nearly half of those with SAD do not respond to light therapy alone. Antidepressant medication and psychotherapy are also normally used in treatment.

9. Bipolar disorder, also known as manic-depressive disorder, is not as common as major depression or dysthymia. Bipolar disorder is characterized by cycling mood changes. Changes can include extreme highs (e.g., mania) to extreme lows (e.g., depression).

10. Depression in Children • According to WebMD, children can be sad without having depression. When the sadness becomes persistent or disruptive behavior occurs that interferes with normal social activities, interests, schoolwork, or family life, these may be indicators a child is depressed. • Symptoms of depression vary in each child. The primary symptoms of depression revolve around feelings of sadness.

11. Signs and Symptoms of Depression • National Alliance on Mental Illness (NAMI) lists the following as signs of early on-set depression: • Persistent hopelessness and sadness • Withdrawal from friends and activities • Changes in eating and sleeping habits • Missed school or poor school performance

12. Increased irritability or agitation • Indecision, lack of concentration or forgetfulness • Poor self-esteem or guilt • Frequent physical complaints, such as headaches and stomachaches • Lack of enthusiasm, low energy or low motivation • Drug and/or alcohol abuse • Thoughts of death or suicide

13. Facts About Depression in Children • According to Kids Health, in the United States, depression is the most common mental health disorder. Each year it affects 17 million people of all age groups, races, and economic backgrounds. • As many as 1 in every 33 children may have depression; in teens, that number may be as high as 1 in 8.

14. Causes of Depression • According to Kids Health, there are many causes of depression. • Genetics is one cause. Research has shown that depression can run in families; however, not everyone who has the genetic makeup for depression gets depressed. Many people who have no family history of depression have the condition. So although genes are one factor, they aren't the single cause of depression.

15. Life events is another cause of depression. The death of a family member, friend or pet can go beyond normal grief and sometimes lead to depression. Other difficult life events, such as when parents divorce, separate or remarry, can trigger depression. Even events like moving or changing schools can be emotionally challenging enough that a person becomes depressed.

16. Family and social environment can also cause depression. Some teens may be experiencing a negative, stressful or unhappy family atmosphere. This can affect their self-esteem and lead to depression. High-stress living situations can also lead to depression. These include poverty, homelessness and violence in the family, relationships or community.

17. Substance use and abuse also can cause chemical changes in the brain that affect mood. Alcohol and some drugs are known to have depressant effects. The negative social and personal consequences of substance abuse also can lead to severe unhappiness and depression.

18. There are medical conditions which may also be a cause of depression. Some medical conditions can affect hormone balance, resulting in a change in mood. Some conditions, such as hypothyroidism, are known to cause a depressed mood in some people. When these medical conditions are diagnosed and treated by a doctor, the depression usually disappears.  

19. For some teens, undiagnosed learning disabilities might block school success, hormonal changes might affect mood, or physical illness might present challenges or setbacks.

20. If You Suspect Your Child Has Depression • According to Kids Health, depression can be successfully treated in more than 80% of people who have it; however, if depression goes untreated it can have deadly effects. It is the number one cause of suicide.

21. Depression can be treated with psychotherapy, medicine or a combination of therapy and medicine. A psychiatrist can prescribe medicine, and although it may take a few tries to find the right drug, most people who follow their prescribed regimen eventually begin to feel better.

22. The First Step • According to Kids Health, a parent’s first consultation should be with their child's doctor. The doctor will probably perform a complete examination to rule out physical illness.

23. If depression is suspected, the doctor may make a referral to a psychiatrist (a medical doctor who can make a diagnosis, offer treatment and prescribe medicine), psychologist (a health professional who can diagnose and treat depression, but is unable to write prescriptions), or licensed clinical social worker (a person who has a degree in social work and is qualified to treat childhood depression).

24. More Tips for Parents and Caregivers • According to the National Alliance on Mental Illness (NAMI), there are many things parents can do to help a child who has depression. • Parents should be aware of the behaviors that concern them and note how long the behaviors have been going on, how often they occur, and how severe they seem.

25. Parents should take their child to see a mental health professional or the child's doctor for evaluation and diagnosis. • Parents can get accurate information from libraries, help lines and other sources. • Parents should ask questions about treatments and services.

26. They should talk to other families with similar problems in the community. • Family support groups may be very important to a family experiencing depression. NAMI may have support groups in your area, or there may be other agencies who also offer support groups.

27. What Can Parents and Caregivers Do to Help A Child with Depression? • According to Kids Health, some parents may have some feelings of guilt. It may be important for them to receive some counseling as well. • Parents must make sure their child takes any prescribed medicines. They must encourage healthy eating too, as this may help improve mood and outlook.

28. Parents should make sure their child stays active. Physical activity has been shown to help alleviate the symptoms of depression. Physical activities, such as bike rides or walks, can be incorporated into the family's routine.

29. Children must know their parents care for them. Parents can tell their children they are there, they love and care about their child and want to hear what he or she has to say, even if it isn't pleasant. Although these things may be difficult for a child to believe, it is important for parents to say them.

30. Parents and caregivers should keep up treatment for children child and watch for warning signs. • Make sure the prescribed treatment is followed, whether it's medication, therapy or both.

31. Parents should call the doctor if they see signs that their child may be thinking about suicide. Untreated depression is the number one cause of suicide. If a child talks about suicide to their parents or anyone else, or shows warning signs such as giving belongings away and being preoccupied with death, call a doctor or a mental health professional immediately.

32. Parents should accept the situation and never tell their child to "snap out of it." At times, parents may need to remind themselves that it is not laziness causing their child's inability to get out of bed, complete chores or do homework. He or she simply doesn't have the desire or the energy.

33. For More Information, Visit these Websites • National Alliance on Mental Illness, http://www.nami.org/Content/ContentGroups/Helpline1/Facts_About_Childhood_Depression.htm • National Institute of Mental Health, http://www.nimh.nih.gov/health/topics/depression/depression-in-children-and-adolescents.shtml • Kids Health.org, http://kidshealth.org/parent/emotions/feelings/understanding_depression.html

34. Address: PO Box 208Jefferson City, MO 65102-0208 Telephone: (573) 751-5980(800) 487-1626(8 a.m. to 5 p.m. CST, Monday – Friday) Email: dls.stat@dss.mo.gov Missouri Department of Social Services State Technical Assistance Team