Depression in Children

What is depression?

Depression is a severe mental illness characterised by persistent low mood that interferes with one’s  day-to-day activities.

Can children really suffer depression?

Yes.  Children can have sadness for a prolonged duration of time (more than 2 weeks) and in an intense way that may  interfere with how they  play with their friends,  interact with their siblings and other family members or affects their schoolwork. It may also affect their growth and development emotionally and physically. In developed countries where there is easier access to healthcare and more knowledge on mental illness it is estimated that 3% of children and 8% of adolescents suffer depression.

How can I tell if my child is depressed?

Depression is often undiagnosed and untreated because we assume it is the usual mood swings in child and adolescent development. When the symptoms listed below persist beyond 2 weeks and seam to affect the child’s day-today activities, it is advisable to seek the advice of a doctor (psychiatry clinic link)

  • Acting out, tantrums or angry behaviour (termed as kisirani in Swahili)
  • Sadness or low mood that is persistent
  • Your child suddenly or progressively withdraws from friends and prefers to stay alone most of the time which isn`t in keeping with their personality
  • Appetite changes thereby eating too little or too much.
  • Sleep changes evidenced by sleeping too much or too little
  • Crying a lot or verbal outbursts
  • Difficulty concentrating in their school work which may be noted as a drop in academic performance
  • Saying they are always tired and cannot do simple tasks that they previously did. This may be wrongly interpreted as laziness.. It is important to rule out a physical illness too.
  • Recurring physical complaints that have been investigated with no identifiable medical cause commonly headaches and stomach aches.
  • Thoughts of death or taking their own life. (Suicide link)
  • Feeling excessively guilty for their mistakes even when they pass.

What is the worst that could happen if I choose to ignore my child’s depression?

Depression has been shown to be the major cause of disability among adolescents by the world health organisation. You may be put off seeking help for your child because of the social stigma associated with mental illnesses  or fear the medication. There is no harm is making a consultation and making an informed decision afterwards.  When you ignore your child’s depression:-

  1. They may be unable to perform optimally in their academics
  2. Your child could face problems in their social life that would in turn worsen their emotional development due to being misunderstood by their peers, teachers or any other acquaintances. This is because they may exhibit behavioural symptoms like always being angry, verbal outbursts, fighting or completely avoid social interaction.
  3. They may turn to drugs of abuse or alcohol as they approach teenage hood.

What would put my child at risk of depression?

  • Life events like death of a loved one, relocating to a new environment or parental conflict.
  • Parental depression
  • Physical health problems like long-term illnesses
  • Disturbances of the chemicals in the brain
  • Genetic vulnerability which we can all do nothing about. Having a biological relative that suffers depression should instead make the parent/guardian more vigilant and keen in picking up symptoms early and seeking the necessary assistance.

What can I do to reduce the chances of my child suffering depression?

  • Ensure that the child`s environment is not chaotic. You should try to minimise any family conflicts as much as possible whether verbal, physical or non-verbal in the home.
  • Have structured routines for the child
  • Keep children away from substances including alcohol, cigarettes, cannabis and so on.

What should I expect when I visit a psychiatrist?

  • A detailed history of the symptoms will be taken by your doctor.
  • The psychiatrist will thereafter conduct a full physical examination of your child
  • You may be sent to the laboratory or radiology department for tests if the doctor feels he/she needs to rule out a physical reason for your child`s symptoms first.
  • The doctor may request to talk to your child alone . A mental state examination is carried out by a series of questions and keen observation while in the consultation room. It is advisable to allow your child to be him/herself and speak their mind.
  • You may be requested to fill in one/several forms or questionnaires. These are filled in by the parent/ guardian, teachers and the child/teenager him/herself if they are of age. Friends, classmates, siblings and nannies may also be interviewed to gain a better picture of the problem. The questionnaires also help rule out other conditions that may mimic or be present together with depression like Attention deficit hyperactivity disorder, conduct disorder, anxiety among others.

NB:- There is no specific laboratory test or x-ray that can confirm depression.

How is depression in children treated?

Once the diagnosis is confirmed the doctor will recommend a specific type of talk therapy (psychotherapy or counselling). This may be adequate or he/she may also recommend a combination with medication. ( antidepressants are rarely used in children but are important when recommended by a qualified mental health worker. There are types that are approved internationally for use in children). You may also be referred as parents/guardians for parent management training.

What will happen to my child in the long run once they are diagnosed with depression?

Depression when diagnosed and treated early may completely subside within several months.

There is also a chance of recurrence later on in life. Close monitoring and awareness by both the child as they grow and their parent is beneficial.

Top 10 warning signs of suicide in children

  1. Many depressive symptoms (link to symptoms)
  2. Preferring to stay alone by isolating themselves from family and friends
  3. Talk of hopelessness, helplessness or wanting to die
  4. Increased reckless behaviour or being uncontrollable especially toward teenage years
  5. Frequent accidents
  6. Giving away their personal belongings like toys, books, clothes etc.
  7. Crying a lot or reduced emotional expression
  8. Always focusing on negative themes in their artwork drawings, poetry, compositions, stories or comments in conversation
  9. Starting to use alcohol or other substances
  10. Research on the internet or from books on methods of suicide.

What if I am depressed and feel I cannot tell anyone?

Seek help from the nearest Gertrude’s Children Hospital and you will be assisted by any health care worker on how to see a mental health professional. Depression is a common illness and it is treatable.

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