Is My Child Depressed?

May I get straight to the point?  Depression is everywhere.  Like an octopus its tentacles are enveloping our small people from every angle.  Children around the world are being pulled under at an alarming rate.  The suburbs will not keep you safe.  The countryside does not lead to immunity.  The world feels its poisonous reach as depression leads all known disabilities worldwide.  This is not an American problem – this is a global epidemic and, no, I don’t feel epidemic is too strong a word.

“Common mental disorders are increasing worldwide. Between 1990 and 2013, the number of people suffering from depression and/or anxiety increased by nearly 50%, from 416 million to 615 million. Close to 10% of the world’s population is affected, and mental disorders account for 30% of the global non-fatal disease burden. ”  World Health Organization

We have to let go of the stigma.  We have to stop pretending that our children are not suffering.  Ignoring a problem does not mean you do not have a problem.  And we have a real problem on our hands.

“In 2015, an estimated 3 million adolescents aged 12 to 17 in the United States had at least one major depressive episode in the past year. This number represented 12.5% of the U.S. population aged 12 to 17.” -National Alliance on Mental Health

12-month Prevalence of Major Depressive Episode among U.S. Adolescents (2015)

With prevalence and incidence high, we must educate ourselves as parents and caretakers.  Education means you have the power to prevent and if prevention is too late for you; you will still be equipped to reverse your child’s depression.

What Is Depression?

Depression is a common mood disorder characterized by persistent symptoms that affect thinking, feeling and daily functioning.  As with all mental health disorders, symptoms may vary among individuals.  Children who experience depression may also be diagnosed with anxiety as more than half of all children with a primary depression diagnosis are labeled with an anxiety disorder.  To learn more about anxiety, read my previous post: Anxiety 101.

Common Symptoms In Childhood Depression:

  • Sad and/or irritable mood.
  • Difficulty concentrating.
  • Difficulty making decisions, large or small.
  • Changes in sleeping patterns – difficulty falling asleep, difficulty staying asleep, waking early or oversleeping.
  • Feeling lethargic and loss of energy.
  • Frequent crying and/or mood swings.
  • Changes in appetite: eating too little or overeating.
  • Thoughts of death or suicide (suicidal ideation).
  • School avoidance behavior or sudden changes in grades.
  • Changes in socializing patterns (withdraws from friends and family).
  • No longer finds joy in activities they once loved.  May have difficulty experiencing pleasure.
  • Hopelessness and low self-esteem.
  • Psychomotor agitation (pacing the floor or feeling “revved-up”).
  • Physically slow (moving and talking slow).
  • Physical pain complaints (headaches and stomachaches with no underlying medical cause).

Your child does not have to experience every symptom listed to qualify for a diagnosis of depression.  Conversely, your child may experience some of the symptoms and not be truly depressed.  It is important to sort out the scenario with a mental health professional if you are concerned your child may be struggling with depression or any other mental illness.  Don’t forget there is overlapping in symptom presentation among depression, anxiety, ADHD and OCD. 

Two types of depression are most prominent (major depressive disorder and dysthymia).  Anxiety and Depression Association of America notes “Major depression lasts at least two weeks and may occur more than once throughout your child’s life. Your child may experience major depression after a traumatic event such as the death of a relative or friend. Dysthymia is a less severe but chronic form of depression that lasts for at least two years.”

A traumatic event does NOT have to be a precursor to major depressive disorder.  It can occur all on its own but is typically triggered or worsened by stress.

Therapy:

Children are highly resilient little people and typically are open to the therapeutic process, which makes them excellent candidates for natural intervention.  Often they are not inhibited in the way most adults can be.  Play therapy is excellent for small children experiencing depression, as well as, narrative therapy and cognitive behavioral therapy.  You can find a list of therapy alternatives and resources in the mental health sector here.  I will always strongly suggest weekly therapy as it is most conducive to building a relationship with the therapist and getting to the root of the issue.  Bi-weekly is adequate but not ideal.  You want to start out weekly and then move to bi-weekly and then monthly and eventually taper off sessions altogether.  Read my article: What To Expect In Your Child’s Therapy Session to learn more.

The ADAA reports “About 80 percent of kids with an anxiety disorder and 60 percent with depression are not getting treatment.”  Avoiding or delaying treatment for your child will aid in worsening the illness.  Choose the treatment you feel to be most effective for your family but act immediately.  As a therapist, the complaint I heard most often from children and teens; “I wish my parents would have gotten me help sooner” is a surprise to most parents.  Across the board, children and teens are asking for help and we should not deny them.  The sooner a child learns healthy coping skills the better he/she will be at keeping recurrence to a minimum, as well as, negating the opportunity for depression to escalate to suicidal ideation and/or suicidal behavior.  Be proactive.  Prevention is always best.

If You Brought Your Child To My Office I Would Suggest:

  • First, head to your family doctor/pediatrician and get lab work done.  You would be checking vitamin D levels, vitamin B-12 levels and thyroid labs.  Many patients with depression are simply vitamin deficient or have a low-functioning thyroid.
  • Take a strong daily probiotic.  All the latest research is pointing to the gut-brain connection especially when it comes to depression.  I could write for days on this topic.  To avoid boring you death in this particular article, check out the work of Dr. Perlmutter, Dr. Brogan and Dr. Ramsey.   While you are at it, see what Harvard has to say about nutrition and your mental health.
  • Daily vigorous exercise for your child.  No ifs, ands or buts about it – exercise is key to alleviating symptoms of depression without the scary side-effects.
  • Reduce or eliminate sugar and simple carbohydrates.  Not only do these foods throw your child’s gut health out of whack, which can lead to depression; they mess with the circuitry of your child’s brain and not in a good way.  Sugar causes inflammation throughout the body.  Depression is now thought to be, in part, a disease of inflammation.  See the connection?  We want to reduce inflammation by consuming an anti-inflammatory diet. So throw out the processed foods, fast food, sugar and simple carbohydrates.
  • Daily journaling or drawing to sort through feelings and thoughts that are difficult for small people to articulate.
  • Less technology and more connection.  Children today are disconnected, horribly disconnected.  We need to stare less at our phones and more at each other.  Do whatever your family enjoys as a unit.  Eat meals together.  Play together.  Exercise together.  Read together.  Talk, talk, and talk together.  Children need to be heard.  If you, as the caretaker, are having difficulty with your own emotions, please seek help for yourself.  You are doing no one any favors by letting your own issues go.  Parents deserve to be happy too.  In fact, children do better when their parents are whole and content.

Food For Healing:

Dark chocolate, wild Alaskan salmon, darky leafy greens, berries, oatmeal, yogurt and kefir, walnuts, ground flax seed and chia seeds…The list could go on and on.  Think food from the Earth, think Omega-3 fatty acids, think organic and grass-fed if at all possible but especially with meat and dairy and you are well on your way to healing.  Click on the Pinterest picture to your left to get more ideas on food and recipes for preventing and treating depression.

 

 

Should I Medicate My Child?

I will always defer to the family with this question.  It truly is dependent upon the child’s situation.  The severity of the depression and length of time is relevant.  However, in most cases, I will advocate for medication as a last option.  If medication is desired, a child should meet with a psychiatrist as he/she will be the expert in the medication and the illness.

Anti-depressants are well-known to the American population as we are the only country besides New Zealand to advertise for such prescriptions.  Constant advertising makes us desensitized to what we are really talking about when we give children psychotropic medications. Because we are dealing predominantly with young people ages 18 and under, it is worthy to note that any medication prescribed will be considered off-label. Off-label means the medication is not originally designed for their growing bodies and minds and, therefore, may create significant side-effects including suicidal ideation and behavior. In many cases, medication can worsen symptoms in children and adolescents.  So often parents are unaware that the decision to medicate may actually be causing more harm than good.  Medication has its place in the medical community for those who truly need it.  Your average child will be able to combat depression without it.  Remember most psychotropic medications work slowly.  It may take up to two to three months to see improvement.  This can be frustrating for youth, families, and clinicians.

 

Childhood depression can be prevented and reversed!  Find a community of support and begin to make the needed changes.  Please know you are not alone in your struggles.  And there is always hope.  Always!

If you or a loved one is having thoughts of harming yourself or someone else, please contact a  health care professional in your area immediately or contact The National Suicide Prevention Lifeline at 1-800-273-8255.  Trained professionals are there to help you 24 hours a day- 7 days a week!