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Articles - Depression in Young Children
OAK LEAVES FAMILY SERVICE
COLUMN -OCTOBER, 1999 DEPRESSION IN YOUNG CHILDREN... MORE COMMON THAN WE
THINK.
I'm concerned about my nephew. He is seven
years old and has always been a healthy and happy child. For several months
now, my sister has been concerned about his performance in school and his
social interactions.
A friend suggested that he may be depressed. That seems impossible for a
child so young with two loving parents and a very comfortable life style.
He doesn't seem to be sad and he has never complained about school or anything
else beyond what seems normal for any healthy child.
Is it possible that my nephew is suffering from depression?
Your friend may be right. Your nephew may be suffering from the illness
of depression. Unlike the normal and short-lived depressed moods that result
from disappointment, loss or frustration, the illness of depression leaves
a child unable to escape his or her feelings of sadness for long periods
of time.
Learn more about depression in children
through the following resources:
- The American Psychiatric Association Washington, DC (202) 682-6000
- Fillmore Center for Human Services
1010 Lake Street
Suite 500
Oak Park, IL
(708) 386-2100
- The American Psychiatric Association http://www.psych.org
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Studies of children aged six to twelve have shown that as many as one in
10 suffer from the illness of depression. Children as young as three or
four can suffer from depression.
How can you tell if a child is suffering from depression? Helen Fleisher,
LCSW and Program Director for the Fillmore Center for Human Services office
located in Oak Park notes two primary issues for adults to be aware of when
dealing with depression in children: "It is important to remember that younger
children have difficulty identifying and articulating their sad feelings
or understanding what may be causing those feelings. Because of this, symptoms
are different in younger children than in teens and adults."
1. "Look for changes in behavior."
Acting out or increased aggressive behavior
Irritability
Lethargy
Withdrawal from family and friends
Difficulty separating from parents
In attentiveness
Physical complaints - chronic stomach aches, etc.
A decline in school performance
Often it is in the school environment the problem becomes apparent. Children
are able to manage their stresses until school places more demands on
them and their coping abilities become insufficient.
2. "Also remember that a child's perception of his world and life may
be very different from our adult view. It is the child's perception that
counts."
This is why many parents overlook depression as a possibility. They care
for their child and provide for them in every possible way. "My child has
a wonderful, loving family, a good school environment and is not neglected
in any way. What does he have to be depressed about?"
Remember that any sustained feelings of sadness or frustration can lead
to depression. What seems trivial to us as adults may seem daunting to a
young child.
So what causes depression in children? Nature vs. Nurture
Ms. Fleisher points out that as with many emotional and mental disorders
and illnesses, a genetic component does exist with depression. Children
whose parents or other relatives suffer from depression tend to be more
susceptible to the disease. "It is important to note, however, that genetics,
environmental factors, or a combination of the two can all lead to depression."
Regardless of any biological predisposition, sustained periods of stress
or inadequate coping skills can cause depression in any child. Unlike adults,
children are unable to control their lives and make changes to situations
which they find difficult or upsetting. If those situations are short-lived,
a child will often recover quickly. But their resilience fades when the
stress continues for a longer period of time. Feelings of helplessness and
insecurity grow to unmanageable levels and the child is unable to recover
on his own.
Sid Wax, LCSW, Clinical Director at Family Service and Mental Health Center
of Oak Park and River Forest cautions against generalizing when it comes
to the causes of depression in children. "One child may develop the illness
of depression over consistent bullying at school while another may adapt
to the loss of a parent without showing any signs of sustained depression.
Every child is different. The biological or genetic component is in part
responsible for this difference but so, too, are the child's individual
coping skills and unique environment."
Some situations which can lead to depression include:
- Death - In cases where the loss disrupts the child's life significantly
and for a long period of time - usually the loss of a parent.
- Divorce - Particularly in cases where the child is subjected to frequent
changes in his/her living arrangements and schedule or subsequent major
adjustments such as re-marriage.
- Abuse - Sustained physical, mental and emotional abuse from any source
including parents, other adults or even children can lead to depression.
- Neglect - Often overlooked, physical, mental and emotional neglect
are common causes of depression. Families struggling to overcome a loss
or other trauma may inadvertently overlook the needs of a child. It
is also possible for a child to feel neglected in families with very
busy schedules.
Disruptions - Moving, changing schools, a mother going back to work, or
the arrival of a new baby are events which can lead to depression as well.
When to worry/Where to go
Once you have become aware of changes in your child's behavior, demeanor
and performance, note the duration, frequency and intensity of the symptoms.
Don't take chances, seek evaluation as soon as a negative trend appears
to have developed. As with physical ailments, depression is most easily
overcome with early detection and intervention.
If your child is school-aged, teachers and school social workers or a mental
health professional are a good place to start. They can screen your child
for other possible problems such as attention deficit disorder, learning
disabilities or anxiety disorders. Usually, a committee of professionals
will assess the child and a recommendation will be made for the proper course
of action.
If your child is a pre-schooler, seeking the advice of a mental health professional
is recommended. Your child's pediatrician or your family doctor can also
help you determine if depression is a possibility and if so, can recommend
a specialist to you.
Treatment
Treatment for children aged 3 to 10 often includes play therapy. This involves
the child being observed by a therapist while playing with toys, or dolls
or drawing. In this way the therapist is able to look for patterns and actions
in the play which hint to the turmoil beneath the surface. Older children
often respond to more traditional talk therapy.
What about medication? Is it common for medications to be prescribed? Are
they safe?
Though it is generally not thought to be the first course of treatment,
medication can be used in the treatment of children with depression. The
American Academy of Child and Adolescent Psychiatry emphasizes that medication
be used only as a part of a comprehensive program which usually includes
psychotherapy.
If you have a question or an area of mental health concern that you would
like addressed in this column, please forward to : Sid Wax, LCSW, Clinical
Director - Family Service & Mental Health Center of Oak Park & River Forest,
120 South Marion Street, Oak Park, IL 60302 Attention: Sid Wax.
Located at 120 S. Marion, Oak Park, Family Service & Mental Health Center
of Oak Park & River Forest is a not-for-profit social service and mental
health agency that provides counseling, psychiatric and prevention/education
programs to men, women, youth and families. To learn more about our programs
or to make an appointment, contact us at (708) 383-7500.
  
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