Many parents who come with specific behavioural or academic problems in children are taken aback when they are told that their child is depressed. The usage of the term depression itself makes the parents so uncomfortable that either they try to argue within the professional say that these may be temporary blues which every one experiences on regular basis caused by transient events or just fail to turn up for the next session. Some even request the professional not to mention the term “depression” in the report whenever the same is demanded by the professional or the institution that referred the child for consultation.
One of the least recognised and acknowledge fact is children having depression.These are primarily because most of the adults feel that, children have no problems, worries or responsibilities which would make them prone to depression. But what they fail to understand is that the children’s problems, worries and responsibilities are big enough for them to become stressed and if adequate support is not available it can very well lead to depression. Moreover they are dependent on parents in every way, and the parents expect their children to live a life as per the parents aspirations and manage the problems by the methods and directions provided by the parents Any independent move by the child to handle their problems on their own or in consultation with anybody else is only felt as an act defiance which only leads to further pressure from the parents to tow the expected lines. These factors only create a feeling of powerlessness, lack of control and helplessness in children which only escalates the status in the children who are already stresses or prone to depression.
In case of adolescents, most of the behavioural, cognitive and emotional changes are viewed as a natural part of their developmental process and parents turn a blind eye to their deterioration even when its obvious. It’s a well known fact that adolescence is a period of stress and storm and they have to handle multiple pressures both internal and external which can easily make them prone to depression. But parents never even think about the possibility even though they know that their child is undergoing a lot of turmoil which can be difficult for them to manage by themselves.
The other important reason why parents find it difficult to acknowledge this fact is because children are not so articulate as adults in expressing their emotions. Most of the time it is manifested through behavioural problems or deterioration in performance, on various functionalities for which parents have their own interpretations which actually clouds their rational mind from looking into the possibility of the child being depressed.
One more factor, that make diagnosis of depression challenging even for professionals is that most of the behavior and cognitive symptoms when existing alone can be diagnosed for other disorders such as mood deregulation disorder, oppositional defiant disorder, intermittent explosive disorder, attention-deficit / hyperactivity disorder, conduct disorder, anxiety disorders and autism spectrum disorders specifically Asperger's syndrome. In case of adolescence, it can also be diagnosed for substance use disorders. Many a times even when the parent decide to take a professional help they only project a single behaviour or problem which they feel as most significant or the most disruptive ignoring many other changes which they feel insignificant or the after effect of the significant one. This can mislead the professional and unless and otherwise the professional is willing to spend time to collect all other relevant information they may misdiagnose it for some other specific disorder. The difference between these disorders and childhood depression in childhood depression there are multiple symptoms along with explicitly noticeable emotionality. The other important difference is that the changes in behaviour, thought process and emotions occur in a short period of time which is quite obvious to people who see these children regularly
What every parent needs to understand is that depression in children are a reality, a highly prevalent mental health issue and its life threatening. The increase in the number of suicides among children and early adolescents for flimsy reasons which is just a nano percentage of the depressed population is the proof for the same. The prevalence rate of depressive disorder is estimated to be 2% in children and 4-8% in adolescence and 70% of children with a single depressive episode will experience a recurrence within five years, with the Lifetime prevalence of depressive episode being 20% by the end of adolescence.
Untreated depression in children, can lead to devastating consequences, including consistent problems in school, at home and with friends, the loss of critical developmental years, increased risk for antisocial behavior and in some cases even suicide. Just like every other health issues depression in children can also be cured with early diagnosis and appropriate intervention.
Listed below are few signs and symptoms which you should look for in your child which would be early warnings for you, of your child being prone to depression. These signs and symptoms can be categorized under four major functional areas of everyone’s life.
Behavioral
Ø There may be sudden or gradual changes in activity levels. They may show lack of interest in the activities which were pleasurable to them or even their day today responsibilities which they had been doing without ant push. The child may either show lethargy in his activities or involve excessively in activities which the parents had been denying him from doing
Ø School,refusal and high resistance to academic related activities are one of the symptoms which is commonly seen
Ø Frequent expression of being tired and being bored about everything failure to involve in any of his activities inspite of consistent encouragement can also be witnessed
Ø There may be noticeable increase of sluggishness in their actions, reactions and even play and entertainment related activities
Ø The children may withdrawal tendencies. They may suddenly or gradually move into isolation or keep themselves occupied in activities which are done in isolation such as playing video games. Places of isolation become their preferred and favourite ones and you can find them escaping to such places at the first opportunity.
Ø There may be a sudden or gradual loss of interest in family affairs or involvement with their favourite family member or even friends.
Ø In some children there may a dynamic opposite behaviour. They make show an increased level of dependency and express an exaggerated sense of insecurity in the form of fear of doing even very simple things such a short absence of parents.
Ø Sometimes the children may show excessive interest in praying, repeating a few acts etc to ward off their fear
Ø In some cases they may involve in self-injurious behaviour hitting or biting themselves and in other times they may involve in reckless or aggressive behaviour for which they are sure to be punished physically. Sometimes it may even go the extend of attempting suicide
Ø Sometimes they may become over-demanding and throw temper tantrums whenever their demands are not met
Ø In case of adolescents there are possibilities of the child involving in substance abuse which includes, tobacco, alcohol and other dangerous psychotropic drugs
Emotional
Ø The child may look sad cry frequently for even simple issues or provocations which can be explicitly look as unreasonable. Some times the crying spells may for long spells even without any provocation
Ø The child may show highly sensitive reactions such as being upset, disturbed, offended or disappointed even for simple criticisms or negative experience
Ø There may be a significant increase in expressed anger, and even aggressive reactions even without any reason. Sometimes they may pick up fights with their friends parents or siblings without any provocation
Ø The child may become anxious, tensed and even panicky for no apparent reasons. They may show startled reactions even regular happens that happens abruptly such as noise of the horn etc.
Ø Expression of fear about even simple things, known people and situations , environments they have been already exposed to. They even show excessive avoidance to everything they fear about
Ø They may be seen worried, brooding a lot, getting irritated and frustrated even for very simple happenings frequently. They may also have difficulty in making choices regarding simple things
Physical
Ø There may be a significant change in appetite which may range from starving to overeating. This may even lead to significant weight loss or weight gain in a short period of time. Sometimes these children are found to be skipping regular meals and spending time munching junk foods excessively.
Ø They may also have sleeping problems which range from lack of sleep to excessive sleep. In some cases the sleep is disturbed, the sleep cycle is disrupted and they may also have nightmares because of which they feel drowsy most of the time.
Ø The children who are depressed may also fake illness. In some other cases, they may complain of pain in various parts of the body or even show symptoms of some specific illness which cannot be diagnosed by physical examinations.
Ø Enuresis (bed wetting) and encorpasis (inability to control their bowel movements) which develops after the control is already established also point towards depression
Cognitive signs
Ø There may be deterioration in attention and concentration which reflects in most of their activities. They may also been seen drifting into their fantasy world irrespective of the task they are engaged in. They also have difficulty with their short term memory because of the same.
Ø They may have feelings or worthlessness and self-depreciating thoughts which are expressed by self-criticisms and good for nothing mindset even for simple failures.
Ø Poor self-esteem and low self-confidence which is expressed consistently through their inability to complete even simple tasks is one more important indicator.
Ø They may show pessimistic attitude towards everything, every event and even everybody they come across
Ø They have significant feelings of guilt and express the need to be punished even over their perceived faults. They blame themselves even for mistakes in which either they have a limited role or no role at all.
Ø These children may express the belief that they are destined to suffer nad have to live their life the way it is which is an indication of strong feelings of hopelessness
Ø They have strong feelings of helplessness and they have strong feelings that nobody can help them and hence they have difficulty in seeking help. They feel they are all alone in this world because they believe that there is nobody around whom they can trust, who would understand and help them
Ø Suicidal thoughts which are expressed as death wishes are the clear signs of depression and if these thoughts are witnessed, then have no doubts, the child is suffering from depression.
Depression should be addressed just like any other physical illness. Children cannot articulate their emotions or even identify that they are depressed. So it’s the responsibility of the adults specifically the parents and teachers to recognize it by observing the changes that happen in their behaviour, emotions, physical health and habits and their cognitive process and take appropriate measures. Its not necessary that the child should have all the symptoms mentioned above for the child to be diagnosed. If the child has even half of the symptoms mentioned above you need to become cautious because you child may be in depression or prone to depression.
If your child is experiencing even half of the above said symptoms, it is a good to get an evaluation by a professional clinical psychologist with experience in handling childhood disorders. If their child is either found to be depressed or prone to depression then effective intervention measures and appropriate support can be provided to prevent the condition from escalating and also safe guard them from social isolation, losing their self confidence, developing negative self-esteem and safety risks that result from persistent depression