Depression in Children & Adolescents

Childhood is commonly perceived to be a “stress-free” time period with limited responsibilities or burdens. As such, depression in children and adolescents is frequently disregarded as a real problem. However, depression can be a very real experience for many children and it is critical to recognize and address these concerns early, mitigating any long-term impact.

According to research, depression affects 2% of prepubescent children and increases up to 5-8% of adolescents. The clinical spectrum can range from sadness to Major Depressive Disorder (MDD, also known as Depression). Of course, many children will experience the occasional sadness and this is part of growing up and would not be a cause for concern. On the other hand, if the sadness is persistent, interferes with normal social activities, interests, schoolwork, or family life, it may indicate a depressive illness.

Many well intentioned adults may remark “They are too young, what do they have to get depressed about?” , “When I was that age, I was so happy!”, these statements are part of the problem, perpetuating the stigma and belief that depression is not a real illness and causing children to be fearful of expressing their emotions. Hence It is critical that you create an environment of open communication in your house and validate your child’s feeling, this is not only important in enabling the child to freely expression their emotions but will making them feel loved, understood and supported.

How do you know if your child is depressed?

In most cases, depression is often undiagnosed and untreated in children. Some of the common signs include:

• Feeling or appearing depressed, sad, tearful, or irritable

• Vocal outbursts or crying

• Not enjoying things as much as they used to

• Social Withdrawal (Spending less time with friends or in after school activities)

• Changes in appetite and/or weight

• Sleeping more or less than usual

• Feeling tired or having less energy

• Feeling like everything is their fault or they are not good at anything

• Having more trouble concentrating

• Caring less about school or not doing as well in school

• Having thoughts of suicide or wanting to die

• Children also may have more physical complaints, such as frequent headaches or stomach aches.

• Depressed adolescents may use alcohol or other drugs as a way of trying to feel better

Note: Not all child have all these symptoms. In fact, most will display different symptoms at different times and different settings. Although most children may continue to function reasonably well, most kids with severe depression will suffer a noticeable change in social activities, loss of interest in school and poor academic performance, or a change in appearance, as well as substance abuse.

For more detailed descriptions of the childhood depressive disorders, refer to the below document.

Childhood Depressive Disorders

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If you are unsure if your child has depression, you can also try asking them how they are feeling. They may respond that they are feeling unhappy or sad, some may say they feel like harming themselves, they want to be dead, or that they are/have considered killing themselves. These should be taken very seriously as children and adolescents are at an increased risk of self-harm and suicide.

Comorbidity

Comorbidity is when an individual is identified with two or more medical conditions. In the case of childhood depression, it is often the case rather than the exception that the child may have another Psychiatric Disorder, the most common are listed below:

• Anxiety disorders

• Attention deficit hyperactivity disorder

• Oppositional defiant disorder

• Substance use disorders

Cause of Depression

The exact causes of depression are unknown but research has shown that both environmental factors and genetics play an important role in the development of depression. Also, Depressed people tend to be more pessimistic about the future, themselves, and their surroundings which put them at risk for depression. Additionally, chemicals in the brain called neurotransmitters (such as serotonin, norepinephrine, and dopamine) have proven to be involved in depression.

Risk Factors for Depression

It is not always clear what gives rise to depression in a particular person, but there are certain risk factors that seem to increase the chance that a child or adolescent will develop depression. These include:

• History of depression in a parent or sibling

• Family dysfunction or conflict with a caregiver

• Exposure to early adversity (such as abuse, neglect, the loss of a loved one in early life)

• Problems with friends or school

• Gender dysphoria and/or identifying as gender nonconforming, lesbian, gay, bisexual, transgender, queer, and/or questioning

• Negative outlook or poor coping skills

• Previous bouts of depression

• History of anxiety disorders, learning disabilities, attention deficit hyperactivity disorder, or significant defiance or conduct problems

• History of brain injury or low birth weight

• Chronic medical illness

Note: If you think your child or teenager may be depressed, it is important to seek help. Speak to your paediatrician, school counsellor or a qualified mental health profession for more information. You need to make sure a comprehensive assessment is made and other medical conditions (that may have similar symptoms such as Lupus, Thyroid problems, Vitamin B deficiency etc.) are ruled out.

If your child is diagnosed with depression, don't be dismayed - there are several effective treatments for depression. Sometimes you may not be able to ‘cure’ depression but at the very least you can manage it. Treatment may include psychotherapy (or "talk therapy"), meetings with the family, and, with your permission, discussions with your child's school. Cognitive behavioural therapy (CBT) and interpersonal psychotherapy (IPT) are forms of psychotherapy shown to be effective in treating depression. Treatment may also include the use of antidepressant medication. However, please discuss carefully and understand the potential risks and benefits of any medicine before incorporating it into your child’s treatment plan.

Disclaimer: The following information is not a suitable replacement for therapy or professional help. Mental health is very complex and there are various individual differences due to circumstances, genetics and life experience. All information published has been generalised and done in good faith. However, we will not be liable for any actions taken as a result of this website/post. If you are facing mental health concerns, it is important you reach out to a professional. You may also contact us at tashya1@gmail.com for further support.