The symptoms of depression in children may not be obvious to parents. Irritability, chronic fatigue, apathy, somatic complaints, social withdrawal, sleep difficulties, and lack of interest in previously enjoyed activities indicate the possibility of childhood depression. Sadness and depression in children may be expressed through temper tantrums, boredom, low self-esteem, lack of motivation, and deterioration in school work. Sleep and eating problems may be expressed either way, too much or too little sleep and poor appetite or overeating.
Depressive symptoms may be acute (major depressive disorder), chronic (dysthymic disorder), or in response to a triggering life event (adjustment disorder with depressed mood). Also, normal grief symptoms that continue past two months and lead to impairment at school or home require intervention.
Advice for Parents in Dealing with Childhood Depression at Home
- Symptoms of childhood depression should not be ignored. Early intervention by a mental health professional is crucial to prevent deterioration in the child's functioning and recurring depressive episodes. Depression is highly treatable. I can't stress enough; it's vital that you seek professional treatment if you suspect that your child is depressed.
- Treatment for depression may or may not include antidepressant medication. Medications such as Prozac, etc. work well for many depressed children, however, there are risks. Recent warnings about suicide potential during antidepressant treatment underly the seriousness of the decision to treat children with medication. Also, there is the risk that symptoms will be exacerbated if the underlying problem is bipolar disorder rather than depression. Parents should work in partnership with the mental health practitioner to observe symptoms and behavior when the child is taking antidepressant medication.
- Keep a resource folder to organize your child's assessment and treatment records. Include practical information such as appointments, names and numbers, and insurance records. Be proactive in your child's treatment by utilizing simple behavior, mood, and symptom logs to record your child's progress. When you see a helpful article or handout related to your child's disorder, print or cut it out and keep it in your folder.
- Look for environmental factors that may be related to the child's depression. Address issues of grief and loss, marital discord, alcohol or drug abuse in your family, or your own mental health problems. Other environmental conditions that are related to childhood depression are physical or sexual abuse, changes in primary caregiver, ongoing problems with learning or peer interaction, and disruption of family housing or employment. Seek counseling for yourself and your child when these environmental issues are present in your family life.
- Build social support systems for your child and your family. Find ways to spend more time with your child; she needs your steady presence and support. Encourage her participation in group activities that are led by a caring adult. Some examples might be church groups, child support groups, Scouts, after-school sports and recreation groups. Talk to your child's teacher or school counselor about her condition, and enlist their support to encourage and motivate her.
- Help your child understand that depression is not forever. Talk about her feelings, and counteract hopeless thoughts and negative beliefs with encouragement and reality-testing. Find ways to build her self-esteem and sense of competence to lead the way out of a depressive episode or chronic dysthymic disorder.