10 Ways to Help When Your Child is Depressed

1. Recognize that clinical depression is a disease. Internalizing this fact will help your child in two ways. One, it will hopefully keep you from blaming yourself or your child. This is no one's fault. Second, if you think of depression as a disease instead of a choice your child is making, you won't say anything stupid like, "Why don't you just pull yourself together," or "Stop feeling sorry for yourself."

2. Don't freak out. This will definitely not help your child. Clinical depression can be successfully treated more than 80% of the time. As long as your child has a good doctor and supportive parents, he or she has a very good chance of recovering. Notice that last part - while everyone with depression really needs a good doctor, supportive parents are absolutely critical for a child with depression.

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Posted: Jul 17, 2009

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Most Depressed Teens Don't Get Treatment

(HealthDay News) -- Nearly one in 10 American adolescents have experienced at least one bout of major depression in the past year, but only about 39 percent of those cases received treatment, a new government report released Wednesday shows.

Conducted by the Substance Abuse and Mental Health Services Administration (SAMHSA), the report found that health insurance coverage was a major deciding factor in whether or not treatment occurred. For example, 42.9 percent of adolescents suffering from depression who were covered by Medicaid/CHIP received treatment, as did 40.6 percent of those covered by health insurance. But only 17.2 percent of adolescents without insurance coverage received the depression treatment they needed, the SAMHSA report found.

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Posted: May 14, 2009

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My bullied son's last day on Earth

Eleven-year-old Jaheem Herrera woke up on April 16 acting strangely. He wasn't hungry and he didn't want to go to school.

But the outgoing fifth grader packed his bag and went to school at Dunaire Elementary School in DeKalb County, Georgia.

He came home much happier than when he left in the morning, smiling as he handed his mother, Masika Bermudez, a glowing report card full of A's and B's. She gave him a high-five and he went upstairs to his room as she prepared dinner.

A little later, when his younger sister called him to come down to eat, Jaheem didn't answer.

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Posted: Apr 24, 2009

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Early Psychiatric Issues May Predict Suicide in Boys

(HealthDay News) -- Boys who suffer mental health problems may be at increased risk for suicide when they're teens or young adults, Finnish researchers say.

Their study included 5,302 people who were born in 1981 and followed until 2005. Between ages 8 and 24, 40 participants died (24 males, 16 females). Of those, 13 males and two females died from suicide. Overall, 54 males and females either completed suicide or made a suicide attempt serious enough to result in hospitalization.

Of the 27 males who committed suicide or made a serious suicide attempt, 78 percent had screened positive for psychiatric conditions at age 8, compared with 11 percent of the 27 females who committed suicide or made a serious attempt, said the researchers, who were from Turku University Hospital.

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Posted: Apr 08, 2009

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Depression pill OK'd for kids but probe goes on - Reuters

(Reuters) – Just weeks after prosecutors accused Forest Laboratories Inc of illegally marketing its anti-depressants Celexa and Lexapro to children and paying pediatricians kickbacks, U.S. health regulators have approved Lexapro for depression in kids.

Forest said Lexapro, its biggest product with annual sales of more than $2 billion, was approved by the U.S. Food and Drug Administration to treat major depressive disorder in adolescents aged 12 to 17 and as a maintenance therapy, meaning to maintain control of symptoms. It is already approved for adults.

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Posted: Mar 23, 2009

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Girls' Anti-Social Behavior Predictive of Later Depression

(HealthDay News) -- Anti-social behavior among young elementary school girls and increased anxiety in either boys or girls that age tend to predict whether they develop depression in adolescence, a new study shows.

However, showing signs of depression in first or second grade did not mean adolescent depression was imminent, said the report published in The Journal of Early Adolescence.

"When all the risk factors were analyzed, anti-social behavior and anxiety were the most predictive of later depression. It just may be that they are more prevalent in the early elementary school years than depression," study lead author James Mazza, a University of Washington professor of educational psychology, said in a news release issued by his school.

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Posted: Mar 02, 2009

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School or Daycare Avoidance/Refusal Part Two

I talked in a previous blog about school avoidance, and how it can be caused by clinical depression and anxiety in a child. 


My son Lawrence started kindergarten this school year. He was in a wonderful preschool the past two years, where he thrived. Of course we were concerned that he would have a little trouble adjusting to starting kindergarten, but while we got the "trouble adjusting" part right, we got the venue wrong. He's had no trouble adjusting to kindergarten - it's a problem with where he is the rest of the day that is generating phone calls to my husband and I.

 

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Posted: Feb 14, 2009

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School Avoidance/School Refusal Part One

Last week my son wanted to play hooky from kindergarten. As I was getting him ready for school, he said, "Mommy, my stomach hurts," trying to look as pathetic as possible. I had a feeling that the problem wasn't his stomach, but might have been connected with the fact that my husband was in the hospital recovering from shoulder replacement surgery. Whenever one of us is ill, Lawrence doesn't like being separated from us. Or perhaps the wish to continue playing "Lego Star Wars" on the Wii.

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Posted: Feb 14, 2009

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Children and Depression

Image%3A The Sisters by Frank Weston Benson

Introduction

A few years ago, my mother unearthed some pictures of me as a baby which I had never seen before. One showed me at about eight months old, crawling on the grass of Golden Gate Park. I was looking directly at the camera, my tongue sticking out of the corner of my mouth, and I was laughing. My face was lit from within, and looked happy, confident and even a little mischievious.

I was absolutely transfixed by that photograph for days. I would continually take it out of my wallet and stare at it, torn between laughter and tears. For a while I couldn't figure out what it was about the picture that drew me. Finally it hit me; this was the only picture of myself as a child that I had seen which showed me laughing. All the photos I had ever seen depicted a child staring solemnly or smiling diffidently, but never laughing. I looked at the Golden Gate Park picture and wished that I had remained that happy, and that depression had not taken away my childhood.

When I first was diagnosed with depression in 1990, I discussed my childhood with my doctor. Although it is hard to diagnose a child twenty years in the past, it seemed clear to both of us that I had suffered from dysthymia (mild, long-term depression) probably from the time I was a small child. I read up on children and depression and wished futilely that I had been diagnosed years ago.

While I was studying to be a teacher a few years ago, I gave a presentation on childhood depression to my classmates, many of whom had been teachers for years. I was saddened, although not surprised, by the number of them who told me after class that they had no idea children could suffer from depression. Although many myths and misunderstandings surround adult depression, even more surround childhood depression, and these people who dealt with children for hours each day knew no more about the topic than anyone else.

Misconceptions About Children and Depression

One of the most common responses to hearing that a child has depression is, "But what does he/she have to be depressed about?" This statement reveals two major misconceptions. One is the lack of understanding about clinical depression. It is not the same as the "blues" or "down" moods that everyone has from time to time, which may actually be caused by unhappiness with one's job, home life or other factors. Clinical depression may resemble these emotional dips, but it is much more pervasive, long-lasting, and life-threatening. It is not necessarily caused by an event or state of affairs in a child's life. The other misconception is that childhood is a carefree, trouble-free period in our lives. How many people can say that they didn't worry about peer acceptance, grades, or parental expectations? Adults often forget that children are powerless and have no control over their own lives. This can be a frightening and frustrating state of affairs to live through day after day.

Image%3A Ernesta (Child with Nurse) by Cecilia Beaux

Causes of Childhood Depression

As with adult depression, diagnosis of depression in children is not as clear-cut as it is for other ailments. There is no test that can be given which will positively say that an individual has depression, much less pinpoint the cause(s). The medical community still knows relatively little about the brain, how it works, and what makes it malfunction. In fact, anti-depressant properties of certain medications were discovered by accident in the 1950s while seeking a cure for tuberculosis.

We do know that certain children have risk factors in their lives which could predispose them to depression or could "trigger" depression. Among these are a family history of mental illness or suicide, abuse (physical, emotional or sexual), chronic illness and the loss of a parent at an early age to death, divorce or abandonment. However, some infants exhibit depressive symptoms at an early age before most of these factors come into play, so there is an argument to be made for depression being wholly chemical in some children. Each child's depression is individual, and causes will be different for each one. The depression could be wholly chemical, wholly due to psychological factors, or a combination of the two. More important than the cause is identifying the illness and treating it.

Symptoms of Depression in Children

  • Persistent sadness and/or irritability.
  • Low self-esteem or feelings or worthlessness. A child may make such statements as, "I'm bad. I'm stupid. No one likes me."
  • Loss of interest in previously enjoyed activities.
  • Change in appetite (either increase or decrease).
  • Change in sleep patterns (either increase or decrease).
  • Difficulty concentrating.
  • Anger and rage
  • Headaches, stomachaches or other physical pains that seem to have no cause.
  • Changes in activity level. The child either becomes more lethargic or more hyperactive.
  • Recurring thoughts of death or suicide.

Any change in a child's behavior that seems to have no external or physical cause should be looked at. A low mood which results from a loss (death of a loved one, moving, changing schools) which lasts more than a few weeks should be considered possible depression and checked out.

If the child has bipolar disorder, also known as manic depression, these symptoms could be present:

  • abrupt, rapid mood swings
  • periods of extreme hyperactivity
  • prolonged, explosive temper tantrums or rages
  • exaggerated ideas about self or abilities

Bipolar disorder is often mis-diagnosed as attention-deficit disorder with hyperactivity (ADHD), obsessive-compulsive disorder (OCD), oppositional defiant disorder or conduct disorder.

Related Disorders

Depression often goes hand-in-hand with other mental illnesses or disorders such as Attention Deficit Disorder, and, especially in teenage girls, eating disorders and self-injury. If any of these conditions are present, they need to be treated along with the depression for treatment to be effective.

Depression Treatment


The parents of any child who is in immediate danger of harming himself or others should consider hospitalization. This is a tough choice for parents to make, but it must be emphasized that children do commit suicide.

Calm Morning by Frank Weston BensonOnce a child has been diagnosed with depression, both psychotherapy and medication could be options. More and more, doctors are realizing that chemical imbalances often account for mental illness, but at the same time, the importance of psychotherapy cannot be discounted. If a child's depression has been caused wholly or in part by psychological factors, medication may relieve the depression, but the underlying cause will not be "cured" by medication alone. Therapy can help the child deal with his past in a healthy manner, and also in learning ways to cope with the very difficult process of growing up.

Antidepressant medication for children is a controversial topic. There are no long-term studies that show what kind of impact this medication will have on a child's development. The maker of the antidepressant Effexor, in fact, has warned against it being prescribed for children, and the U.S. Food and Drug Administration has issued the same warning for Paxil. There has also been some question as to whether the older tricyclic antidepressants are effective with children. Most professionals will recommend therapy as a first line of defense for a child with depression, except in cases where the child is severely depressed or suicidal.

But keep in mind that it is almost a certainty that depression will have negative long-term effects on the child and his family. From my own experience, I am positive that my growing up with depression had negative effects on the development of my personality. For instance, even with my successful treatment with antidepressants, it's very hard for me to completely shake the crippling shyness I grew up with. The decision of whether to treat a child with medication is wholly individual, depending on the severity of the child's depression and what toll it will take on the child's life without successful treatment. Parents should educate themselves as much as possible in order to make an informed decision.

Note: Bipolar disorder must be ruled out before a child is prescribed antidepressants for depression or stimulants, as these can trigger mania.

Parents of a child with depression should start looking for a child psychiatrist by contacting the nearest university medical center, mental health clinic or organization.

Posted: Feb 05, 2009

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