What Is Major Depression
A type of mood disorder, major depression, goes far beyond the typical feelings of sadness that a child might experience. Instead, major depression is a persistently sad or irritable mood that affects a childs thinking and behavior at home, in school, and with peers.
The National Institute of Mental Health estimates that more than 10 percent of adolescents ages 12-17 experience major depression in a given year. It is on the rise in both children and adolescents. With early onset, childhood and adolescence depression can predict future episodes of depression into adulthood. Early and consistent treatment can help to lessen the risk of recurrence and reduce the severity of symptoms while improving functioning and well-being.
Can You Have Autism Adhd And Bipolar
Although it is unlikely, it is possible that there will be multiple conditions at the same time. Jane claims they are capable of living under all three conditions. They say that the best way to navigate life with all three conditions is to recognize your triggers and symptoms.
The term autism spectrum disorder refers to a developmental disorder that affects a persons ability to communicate, act, and interact with others. People with bipolar disorder are also at risk for depression. According to the Centers for Disease Control and Prevention, approximately 4.4% of adults in the United States will develop bipolar disorder at some point. You may be living with at least one mental health condition that can negatively impact your emotional well-being if you are diagnosed with autism. The challenge of dealing with multiple neurodivergences can be daunting. Sonny Jane, an educator, consultant, and advocate in Australia, shares her experience navigating the Kaurna Land. Understanding your triggers and symptoms will aid you in navigating your life with multiple neurodevelopmental disorders.
One in every six adults with bipolar disorder is also thought to suffer from ADHD. You will be able to manage both conditions if you use the most effective treatments and support available. All of these conditions are diagnosed only through the eyes of a mental health professional.
Antidepressants And Suicidal Thinking
While antidepressants can be an effective way to treat childhood depression, their use has been linked to serious side effects, such as suicidal thinking in people under age 25. Though this side effect is rare, the Food and Drug Administration now requires that all antidepressants carry a black box warning about this increased risk of suicide.
This does not mean that antidepressants should not be used by people in this age group. It simply means that they should be carefully monitored by doctors and caregivers, particularly in the first few weeks after starting an antidepressant.
If your child is having suicidal thoughts, contact the National Suicide Prevention Lifeline at 988 for support and assistance from a trained counselor. If you or a loved one are in immediate danger, call 911.
For more mental health resources, see our National Helpline Database.
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Ways To Help Your Child Cope
Here are some things you can do to support your child if you think they may be depressed:
Other Actions For Caregivers
If your child has depression or anxiety, it doesnt mean you or they have done anything wrong. Parents and children may experience various reactions to being diagnosed, including fear and shock. Some may even experience guilt, shame, or stigma. Your feelings are valid.
Know that depression and anxiety are common and treatable medical conditions that affect your thoughts, feelings, and behaviors, and sometimes require professional attention.
Getting help will allow your child to live a full, fun, satisfied, and successful life.
Its also important for caregivers to take care of themselves. Make time for yourself, for things you enjoy, and fill up your own tank. Your child is at their best when youre at yours.
Dr. Akilah Reynolds is a licensed psychologist in California. She practices at an academic psychiatric center and in private practice. Dr. Reynolds specializes in child psychology, parenting, depression and anxiety, and work-life balance.
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- Anxiety disorders in children. .
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Can Depression In Children Be Prevented
Children with a family history of depression are also at higher risk of depression. Children who have parents with depression tend to have their first episode of depression earlier than children whose parents donât have the condition. Children from chaotic or conflicted families, or children and teens who abuse substances like alcohol and drugs, are also at greater risk of depression.
Supporting A Child With Depression
Parents and caregivers may worry that they caused the childs depression or believe that they can cure it with love or discipline. Depression is a complex illness and rarely has one cause.
A loved one cannot cure a childs depression, just as they cannot cure a physical condition, for example, diabetes. Instead, parents should focus on building a supportive environment in which the child can recover.
People may want to try these strategies:
- Include the child as an active participant in their treatment. Encourage them to participate in making decisions as much as possible.
- Ask the child about any side effects of their medication and work with them to find treatments that are effective.
- Encourage the child to talk about their feelings and listen without judgment. Do not tell the child how they should feel.
- Create a home life that is as stable and secure as possible. Minimize conflict between adults and other family members, and work to help the child manage recent traumas.
- Educate other family members about depression so that they can offer support and help.
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A Note About Suicidal Thoughts
Suicidal thoughts are different from the intent to complete suicide. If your child makes suicidal comments, this is a cry for help and that something is wrong. Ask your child what is bothering them and how you can help. Asking your child about what is bothering them does not increase the chance of them completing suicide. If you are concerned about your childs suicidal thoughts or depressed behavior, please speak with the care team.
Treatment Options For Children With Depression
Depression in children can be effectively treated with a combination of psychotherapy and antidepressants. Mild depression may be treated with psychotherapy alone. More serious depression often requires an antidepressant medication. Many safe and effective antidepressants are currently available, although these agents are less well studied in children and adolescents. For the treatment to be fully effective, it is critical that the treatment should continue for several months, or longer. However, relapses are common and almost one half of the children diagnosed with depression are likely to suffer a relapse over a five-year follow-up period. Young people who suffer from depression are also likely to suffer from depression during their adult lives.
There is increasing evidence that strengthening attachment relationships in families can serve as a protecting factor against depression. Families are perhaps the major protective factor for children at risk for depression. Treatments must take into account family strengths which mitigate depression and family problems .
Comprehensive treatment of a depressive episode is likely to reduce the risk for short-term negative effects and prevent long-term negative outcomes . However, patients and their families should be aware that relapses are common and require prompt professional attention.
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If You Think Your Child Is Depressed
If you think your child may be depressed, it’s important to talk to them. Try to find out what’s troubling them and how they’re feeling.
See some tips on talking to younger children about their feelings and talking to teenagers.
Whatever is causing the problem, take it seriously. It may not seem like a big deal to you, but it could be a major problem for your child.
If your child does not want to talk to you, let them know that you’re concerned about them and that you’re there if they need you.
Encourage them to talk to someone else they trust, such as another family member, a friend or someone at school.
It may be helpful for you to talk to other people who know your child, including their other parent.
You could also contact their school to ask if the staff have any concerns.
Depression Rating Scales For Children And Teens
BDI: Beck Depression Inventory is a scale that uses 21 self-reported items that are used to measure various characteristics of depression. It takes around ten minutes to complete this test and is found in many different forms such as computer versions, card forms and paper copies .
BASC: The Behavioral Assessment System for Children is a multidimensional, multimethod approach that evaluates the child or adolescents emotional or behavioral disorder.
The diagnostic components of the BASC scale include:
- Structured Developmental History
- Teacher Rating Scale
- Parent Relationship Questionnaire
The scale aims to help give accurate differential diagnosis of emotional and behavioral problems for individuals 2-21 that can help clinicians develop treatment plans. The scale incorporates traditional and new constructs to help achieve an accurate diagnosis .
CDRS: The Children’s Depression Rating Scale was developed in 1979 to diagnose children 6-12 years old with depression. A score between 20-30 indicates borderline depression while a score of 30 indicates significant depression .
CDI: The Children’s Depression Inventory is a scale used by mental health professionals that measures the cognitive, affective and behavioral signs of depression in children and adolescents between the ages 7-17 .
Patient Health Questionnaire: Nine Items: Modified for teens Uses self report measures to evaluate depression. There are 9 criteria and it takes around 5 minutes to complete .
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Are Antidepressants Safe For Children To Take
The safety and efficacy of antidepressants for children and teens have been studied extensively. Prozac and other medications known as selective serotonin reuptake inhibitors have been shown to be safe in most studies and can be effective for teenagers, but should be carefully monitored by the prescribing physician.
Why Do Children Get Depressed
Because children are dependent on their parent for most of their needs, a significant source of depression in children is persistent turbulence in the family home or severe familial adversity, such as poverty Abuse or neglect are notable adverse childhood experiences that can reset childrens stress response so that even minor upsets can trigger depression. The loss of a parent or beloved caregiver is another source of depression in children, just as is the loss of a significant relationship among adolescents. Bullying is a form of abuse that can give rise to depression in victims. Developmental and learning problems can severely affect childrens sense of self and pave the way for depression. The in childhood is another contributor to depression, and it deprives children of an important source of joy. Among teenagers, there is mounting evidence that social media can have profoundly negative effects on mental health, especially among girls. Teens increasingly report they feel lonely they spend more time communicating electronically, less time face-to-face interacting with friends.
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Most Participants Were In Asia
The researchers sourced their studies from PsychInfo, Embase, MEDLINE, and the Cochrane Central Register of Controlled Trials databases from Jan 1, 2020, to Feb 16, 2021, as well as the unpublished studies server PsycArXiv on Mar 8, 2021. Of the final studies, the smallest consisted of 190 children and the largest had 13,002. Most came from East Asia , followed by North America , and Europe . None came from Africa.
The pooled cohort had a median age of 13.0 years, and 52.7% were female. Of the eight studies that reported racial or ethnic information, the average number of minority participants were 36.9%. In three of the studies, symptoms of depression and anxiety were reported by parents on behalf of their children, but the rest were self-reported.
While the commentary writers make it clear that this literature review is yet another reason to focus on children’s mental health during the pandemic, they agree with the researchers that future studies must look more at low- and middle-income countries, as well as populations who have been disproportionately affected by the pandemic.
What’s The Best Way To Help A Child With Depression
Aim for fast and effective action. Both the quality of parent-child communication and the tone of the family environment are important. If there are tensions in the household, seek to address and reduce them, even if it means marital therapy for the parents, Support is crucial. Let a child know you are aware of their struggles, that they are not alone, and demonstrate willingness to listen when they want to talk. Parents can help children understand their feelings by putting names to them and distinguishing one from the other, such as sadness and loneliness knowing what someone is feeling is a requirement for knowing what remedial steps are necessary. Parents can also help spot and bring awareness of a child to the negative self-talk that can trigger a downward emotional spiral. Going for walks or bike rides with a child has special value: It not only counters lethargy and presents opportunities for nurturing the parent-child bond, but outdoor activity is itself beneficial and involves exposure to sunlight, a natural antidepressant.
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How We Care For Children With Depression
The Boston Childrens Hospital Department of Psychiatry and Behavioral Sciences has long been at the forefront of providing expert, compassionate care to children and adolescents with mental health issues. Our approach to mental health care is evidence-based which means our treatments have been tested and proven effective through scientific studies, both here at our hospital and by other leading institutions worldwide. Boston Childrens has a dedicated Psychopharmacology Clinicto help determine whether medication might be a helpful addition to the treatment plan.
For children’s that need hospitalization, Boston Children’s Inpatient Psychiatry Service provides family oriented psychiatric assessment and treatment with the goal of returning your child to a more comfortable environment for ongoing care.
How Do Doctors Treat Depression
Common treatments for depression can include:
- Therapy, especially cognitive behavioral therapy or psychodynamic therapy. CBT is a type of talk therapy that helps challenge and change negative or unhelpful thoughts and behaviors. Psychodynamic therapy focuses on improving a persons level of self-awareness and understanding of how their past affects their present behavior.
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Should I Worry That My Child Will Commit Suicide
National surveys from the government show the overall risk. In 2019, for example, nearly 9% of high school students attempted suicide at least once over the course of a year. Thinking about suicide also continued to rise from previous years . Although less common, young children do attempt suicide as well.
Watch your child closely for the warning signs of suicidal behavior, including:
- Focus on death and dying.
- Giving away possessions.
- Combination of the two.
What Are The Signs Of Bipolar Disorder
The most common sign of bipolar disorder is extreme mood swings that range from manic highs to depressed lows. These highs and lows in mood usually come and go over the course of weeks or months. First signs of bipolar disorder usually appear around age 25. Some children can show signs as early as childhood and throughout their teenage years.
Other common signs of bipolar disorder include:
- Easily distracted
- Overly talkative or unable to focus on a single topic of conversation
- Flighty or scattered ideas
- Extremely goal-oriented activities that can be hard to distract them from
- Feelings of grandiosity
- Changes in sleep habits
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What Does Depression Look Like In Younger Children
When young children are depressed, Dr. Kovacs said, its not unusual for the primary mood to be irritability, not sadness it comes across as being very cranky. And children are much less likely to understand that what theyre feeling is depression, or identify it that way. It almost never happens that they say, somethings wrong because Im sad, Dr. Kovacs said. Its up to adults to look for signs that something is not right, she said.
The best way for parents to recognize depression in young children is not so much by what a child says as by what the child does or stops doing. Look for significant changes in functioning, Dr. Kovacs said, if a child stops playing with favorite things, stops responding to what he used to respond to.
This might mean a child loses interest in the toys or games or jokes or rituals that used to be reliably fun or entertaining, or doesnt seem interested in the usual back and forth of family life.
Youve had a kid who was one way and then you see that theyre more irritable and sad, said Dr. Egger, who is now the chief medical and scientific officer at Little Otter, a new online mental health care company for children. Children may seem flattened, have less energy or tire easily. And they may start complaining about physical symptoms, especially stomach aches and headaches. They may sleep more or less or lose their appetites.