Rachele Kanigel
CONSUMER HEALTH INTERACTIVE

Note: This article has been localised for an Irish audience.

Decades ago when today's parents were still children, parents might have dismissed very real signs of depression as sulkiness or chronic moodiness. Today, doctors know that depression can affect even young children, and sometimes it can follow them throughout their lives.

Adolescent girls are twice as likely to suffer from depression as boys their age. By recognising the signs, you can help your child through a dark time, even if you don't know what's causing it.

Not necessarily: normal sadness or grieving is not depression. Don't worry if your child occasionally feels blue or down in the dumps. Life has its ups and downs, and it's normal for children to grieve over a loss or feel sad for a few hours or days at a time. But if his melancholy lasts for more than a couple of weeks or seems to interfere with his regular activities and relationships, he may be clinically depressed.

Depression is far more than a temporary change in mood; it's marked by a prolonged sense of hopelessness and a lack of energy and enthusiasm that can last for weeks, months, or (in rare cases) even years at a time.

It might seem logical that the most obvious symptom of depression would be sadness, but many depressed children say they don't feel sad or gloomy. Interestingly, one of the key signs of depression in children is chronic irritability. Children may be depressed if they have trouble getting along with other kids and family members or have dramatic swings in mood. Other signs of depression include lack of energy, inability to concentrate, poor performance in school, a sense of hopelessness and helplessness, and frequent complaints about physical ailments like headaches or stomach aches.

Depression often goes hand in hand with other physical and mental health problems. Some children may be depressed because of a chronic illness, such as diabetes. A youngster who has an eating disorder or a substance abuse problem, as well as children who are constantly defiant, disagreeable, and getting into trouble with authorities, may also suffer from depression.

Psychiatrists still don't completely understand depression, but most believe it's caused by a combination of biological and environmental factors. Many people who are depressed have a family history of depression or other mental illness. A child who has one depressed parent, for example, has a 25 percent to 50 percent chance of suffering depression himself. If both parents have had problems with the disease, his chance goes up to 75 percent.

But depression is based on more than just genes. Traumatic life events -- abandonment; violence in the family; chronic problems in school; a difficult move; or physical, sexual, or emotional abuse or neglect at home, school, or by other trusted carers -- often trigger depression. Sometimes a loss such as the death of a beloved pet, a loved one, or parents' separation, can result in depression as well as grieving.

They may not know the exact cause, but scientists do know that depression is related to changes in brain chemistry. The specific changes involve chemicals called neurotransmitters, which help relay messages from one nerve cell to another. When there is a drop in certain neurotransmitters, the brain doesn't function normally, leading to depression and other forms of mental illness.

If your child exhibits any symptoms of depression, ask yourself three questions: is this behaviour new? Is it long-lasting (going on for several weeks or more)? Are the symptoms interfering with his ability to function at home, in school, or with his friends?

If you answer yes to any of those questions, you should probably have your child evaluated by a child or adolescent psychologist, psychiatrist, or other licensed mental health professional trained to work with children and adolescents. Your family doctor can refer the child to the appropriate specialist.

Research has repeatedly demonstrated that psychotherapy, especially cognitive behavioural therapy, is an effective treatment for depression. In some cases, drug therapy may be needed as well.

Most psychologists take a comprehensive approach that looks at your child, his family and social group, and the factors that may contribute to his depression. In addition to counselling your child, a psychologist may also suggest family therapy or parent counselling and treatment for any related conditions your child has, such as substance abuse or an eating disorder.

Whether children can benefit from drug therapy must be decided on a case-by-case basis by the psychologist and parents. Doctors can prescribe antidepressants to under-18s at their own discretion. Parents who are concerned about the lack of safety data may prefer alternate treatments. Experts also caution that doctors should prescribe antidepressants only in cases of persistent, severe depression, or when therapy is impossible or is not working. It should not be used to treat children suffering from painful situations like the death of a friend or relative, family violence, conflicts at home or school, or the loss of an important relationship. In those cases, using drugs can actually mask the real cause of the depression and keep a child from getting effective treatment. If he's depressed because of family strife or an abusive teacher, for example, the depression may end if family conflicts are resolved or he's transferred to another teacher.

Although some experts believe drug treatment can be useful, they stress that it must be combined with therapy: medication alone won't cure the problem. Depression can be a chronic disease that often recurs, and to successfully battle it, a child must develop new coping skills.

Your family GP can refer you to a child psychologist or a psychiatrist.

If your child has another mental health problem related to depression, such as substance abuse or an eating disorder, he may need to be referred to a professional with expertise in that area. It's important that you and your child have a good rapport with the psychologist.

When you meet with the psychologist, he or she will probably begin by doing an interview, get a complete family history, and give you child a standardised test for depression such as the Beck inventory.

Always take this threat seriously. Suicide is a leading cause of death for teens aged 15 to 19. Get your child evaluated immediately by a licensed professional to see whether he should be hospitalised. Also, get professional advice on how to make your home safer for your teenager, which usually means moving razor blades, pills, and guns, if you have them, out of the house.

Studies indicate that one in four teenagers seriously contemplate suicide, and one in 10 try to kill themselves. Girls are more likely to try suicide, but boys, who tend to choose more violent methods, are more likely to succeed. Be especially concerned if your child begins giving away treasured possessions or stops talking about his future. If you suspect he may be considering suicide, get help immediately -- and again, make sure that he can't get hold of a firearm. Organisations like Aware and The Samaritans can offer confidential emotional support for those with suicidal feelings.

By recognising your child is depressed early on and by seeking treatment you can help him or her find the skills to get it under control. And if depression runs in the family, it can also help you and others get the same help.

This article has been revised by Vhihealthe for its audience and may contain, among other things, information or medical practices that are unique to Ireland. Neither Consumer Health Interactive nor the original author make any warranty as to the accuracy of the article as revised, and assume no responsibility for modified content.

Further Resources

The Samaritans can be contacted at LoCall 1850 60 90 90, www.samaritans.org Aware -- Helping to defeat depression Depression phone line: 01 6766166.

First published March 14, 2002
Copyright © 2002 Consumer Health Interactive

or find more on: Back to top of page

See all readers' comments Comments Name (optional) E-mail (optional)