What Are Risk Factors For Childhood Depression
It’s important for parents and caregivers to understand the risk factors for depression in children, which can include anxiety, family history of mental disorders, hormonal changes in puberty and life stressors.
“Chronic anxiety is one of the most common risk factors we see for depression in children,” explains Alice Ann Holland, Ph.D., ABPP, Research Director of the Neuropsychology Service at Children’s Health and Assistant Professor at UT Southwestern. “This is anxiety that hasn’t been properly diagnosed or treated for anywhere from months to years, which wears children down emotionally over time.”
Risk factors for childhood depression can include life stressors such as:
- Changing to a new school
- Conflict in the home
- Parental separation or divorce
- Starting school
In addition to the above life stressors, adolescents and teens may also deal with the following situations that can trigger depression:
- Academic stress, especially related to college admissions
- Athletic performance pressure
- Dating relationships, including negative relationships and breakups
- Sleep deprivation
Child Depression Ages 6
Children, like adults also suffer from depression, although their symptoms may not be the same. Additionally, children respond well to treatment. Depression is defined as an illness when the feelings of depression persist and interfere with a child or adolescents ability to function.
About 5 percent of children and adolescents in the general population suffer from depression at any given point in time. Children under stress, who experience loss, or who have attention problems, learning, conduct or anxiety disorders are at a higher risk for depression. Depression also tends to run in families.
The behavior of depressed children and teenagers may differ from the behavior of depressed adults. Child and adolescent psychiatrists advise parents to be aware of signs of depression in their youngsters.
Signs of depression in children. If one or more of these signs of depression persist, parents should seek help:
- Frequent sadness, tearfulness, crying.
- Persistent boredom low energy.
- Low self esteem and guilt.
- Extreme sensitivity to rejection or failure.
- Increased irritability, anger, or hostility.
- Difficulty with relationships.
- Frequent complaints of physical illnesses such as headaches and stomachaches.
- Frequent absences from school or poor performance in school.
- Poor concentration.
- A major change in eating and/or sleeping patterns.
- Talk of or efforts to run away from home.
- Thoughts or expressions of suicide or self destructive behavior.
GET HELP
When Should I Seek Help For My Child’s Depression
If you are concerned that a child or young person is depressed and they have been experiencing symptoms for a long time it is important that you seek help. It is important that a professional who knows about depression in children and young people carries out the assessment. Physical examinations are also recommended to ensure that there is no underlying illness causing the symptoms.
Going to your family doctor is the recommended first step as they will be able to provide guidance about where to get further help. This may involve a referral to child and adolescent mental health services, which can provide specialist assessment and interventions for depression.
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How Is Depression Diagnosed In Children
If the symptoms of depression in your child have lasted for at least 2 weeks, schedule a visit with their doctor to make sure there are no physical reasons for the symptoms and to make sure that your child gets proper treatment. A consultation with a mental health care professional who specializes in children is also recommended. Keep in mind that the pediatrician may ask to speak with your child alone.
A mental health evaluation should include interviews with you and your child, and any other psychological testing that is needed. Information from teachers, friends, and classmates can be useful for showing that these symptoms are consistent during your child’s various activities and are a marked change from previous behavior.
There are no specific medical or psychological tests that can clearly show depression, but tools such as questionnaires , combined with personal information, can be very useful in helping diagnose depression in children. Sometimes those therapy sessions and questionnaires can uncover other concerns that contribute to depression such as ADHD, conduct disorder, and OCD.
Some pediatricians start using mental health screens at a child’s 11th-year well visit and each year after.
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.
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What Is The Treatment For Depression In Children And Young People
Medicine and psychological therapy are the 2 researched treatments for depression – these can happen independently or in combination. The treatment chosen will often depend on how severe the depression is and personal preference.
Antidepressant medicine influences the chemicals in the brain to improve a person’s mood and can be helpful for moderate to severe depression. A doctor needs to prescribe medicine and you need to take it for a number of weeks to experience a difference. People usually keep taking the medicine for a number of months. Antidepressant medicine is not addictive. Doctors will discuss with you how the medicine works and any potential side effects, which are usually short-lived and easily manageable.
Psychological therapy is effective in learning ways to overcome depression. Each person’s experience is different, and the focus of therapy is on thoughts, feelings and behaviours and learning new ways to deal with difficult situations and to change the way people think about events and situations.
The Werry Centre for Child and Adolescent Mental Health fact sheets.Mental Health Information New Zealand. 2002. Depression in childhood and adolescence. Mental Health Foundation: Wellington.
What Causes Depression In Children
As in adults, depression in children can be caused by any combination of things that relate to physical health, life events, family history, environment, genetic vulnerability, and biochemical disturbance. Depression is not a passing mood, nor is it a condition that will go away without proper treatment.
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Who Can Treat Depression In Children
Different types of mental health professionals can help your child with symptoms of depression. Masters-level professionals licensed in the state of Texas include marriage and family therapists , professional counselors and social workers . Doctoral-level mental health professionals include psychologists and psychiatrists . These abbreviations after a provider’s name will tell you what level of training they have.
Psychiatrists typically provide medication management rather than weekly therapy, although some offer both. It is important to know that research shows that medication alone is less effective than a combination of medication plus therapy. However, mild cases of depression may not require medication at all, only therapy/counseling. A licensed mental health provider can help determine the best treatment for your child.
The Effects On Children
For parents with depression, there are the obvious detrimental symptomsemotional pain, lack of motivation, loss of joy in once-joyful activitiesand even physical troubles such as gastrointestinal distress and reduced immunity. But research has found that children of depressed parents are about three times as likely to suffer from major depression, anxiety disorders, or substance abuse as children whose parents hadn’t been depressed.
All kids have developmental needs that include feeling securely attached to a safe, caring adult and having a caregiver who is both physically and emotionally present and can model adequate coping mechanisms, says LaToya Gaines, Psy.D., a clinical psychologist and former school psychologist in New York City. Untreated mental-health concerns can threaten a parent’s ability to fulfill these needs. “When we’re depressed, we have difficulty connecting,” says Kristen Granchalek, LCSW, a Chicago-based therapist specializing in women’s issues, anxiety, and emotional reactivity. “Our faces don’t respond in a way that mirrors our children’s emotions, which they need for healthy development and to feel cared for.” With anxiety, kids can absorb their parent’s chronic worrying and, says Granchalek, “internalize the belief that the world is not okay.”
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When To Get Medical Help
If you think your child is depressed, or you’re concerned about their general wellbeing, make an appointment with them to see a GP.
If necessary, the GP can refer your child to a local children and young people’s mental health service for specialist help.
CYPMHS is used as a term for all services that work with children and young people who have difficulties with their mental health or wellbeing.
You may also be able to refer your child without seeing a GP.
Read more about accessing mental health services.
Treatment Of Pediatric Major Depression With Psychotic Features
No controlled studies of pharmacological treatment of psychosis associated with pediatric MDD exist. To date, only two controlled studies of antidepressants have shown efficacy in treatment of pediatric MDD. Fluoxetine proved superior to placebo in a study of 96 children and adolescents with MDD based on CGI and Hamilton Depression Rating Scale . Paroxetine proved superior to placebo in a study of 275 adolescents with MDD, according to HAM-D and CGI rating. An open study of chlorpromazine plus nortriptyline for psychotically depressed adolescents showed some benefit from the combination, however, neither nortriptyline nor chlorpromazine now appear desirable as treatment in pediatric mood disorders or pediatric psychosis because of their side effect profiles.
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Why Is My Child Depressed
Things that increase the risk of depression in children include:
- family difficulties
- physical, emotional or sexual abuse
- a family history of depression or other mental health problems
Sometimes depression is triggered by 1 difficult event, such as parents separating, a bereavement or problems with school or other children.
Often it’s caused by a mixture of things. For example, your child may have a tendency to get depression and also experienced some difficult life events.
What Are The Symptoms Of Depression
While each child may experience symptoms differently, some of the most common include:
- persistent feelings of sadness
- loss of a parent, caregiver, or other loved one
- loss of a relationship, such as moving away or loss of boyfriend/girlfriend
- failure to accomplish tasks such as learning to read, or keeping up with peers in other activities
- chronic illnesses, such as diabetes
- other psychiatric disorders
- other developmental, learning, or conduct disorders
There are biological, psychological, and social factors that can contribute to depression separately or in combination.
- Depression is thought to be caused by a difference in the structure and function of your childs brain that controls the intensity of sad or irritable moods.
- There may be a genetic component. If other members of your family have had depression, your child is more likely to develop it, too.
- A stressful environment at home, school, or in the community can contribute to depression.
- Children may experience depression if they feels unhappy with their environment and powerless to make any change to it.
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What Is The Onset Of Depression
The Cleveland Clinic reports that depression can affect people of any age, including children. Although children naturally have mood swings as they grow and develop, depression is different.
Depression in childhood impacts how children engage with loved ones and in activities. Children normally enjoy running, playing, and hanging out with friends. However, if they start experiencing depression, kids can withdraw socially and instead spend more time isolated in their rooms. Further, they may not engage in typical childhood activities like sports, arts and crafts, and doing their schoolwork.
Childhood depression can be hidden and therefore easily missed, Dr. Bhatia writes. Timely recognition and treatment can be life-changing and life-saving.
In fact, according to the MHA report, in September 2020, over half of 11-17-year-olds reported having thoughts of suicide or self-harm more than half or nearly every day of the previous two weeks. From January to September 2020, 77,470 youth reported experiencing frequent suicidal ideation.
How To Parent While Depressed
Depression can make the work of parenting feel impossible. But theres consensus from both mental health experts and parents who have raised their children amid feelings of hopelessness and despair: Help is out there, and the sooner you access it, the better life will be for you and your family.
When Maddie was single and in her early 20s, she began experiencing intense fatigue and lack of motivation, “a quiet undercurrent of sadness that was never so debilitating that I couldn’t get out of bed but that would flare up for months at a time.” Negative thoughts with themes of insecurity and fear of abandonment played on a loop in her mind. Upon seeing an Instagram pic of friends enjoying a night out, for instance, she’d hear a voice in her head, taunting, “Of course they didn’t invite you you’re boring and annoying.”
When the Seattle-based teacher was 29 and her elder daughter was 2 years old, the thoughts returned. Except now, they accused her of being a horrible mother. “I’d be bathing my daughter and worrying about when she’d stop loving me, or lying in bed next to my husband, thinking, ‘When will he figure out what a fraud I am and leave?’ The kids were at a hard age, motherhood still felt new, and I was overwhelmed with working and parenting, feeling like I was doing everything poorly,” Maddie says. “I’d get them to bed and sit on the stairs and cry, thinking, ‘They deserve better than me,’ but I had nothing left to give.”
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Can You Get Postpartum Depression After The First Year
by Kate Kripke |
While I cant make a blanket statement about each and every woman who calls me, more times than not these womenone, two, or three years past the birth of their little onesare struggling with a form of maternal distress that dates back, in one way or another, to their pregnancy, postpartum, or even before. While these moms wouldnt technically have postpartum depression any longer, they are often struggling with what I will call here continued postpartum distress that was never adequately supported when they first noticed symptoms.
When we use the terms prenatal/antenatal and postpartum depression, we are really simply talking about an episode of depression or anxiety that occurs sometime during pregnancy or the first year postpartum. We believe that early symptoms, whether mild or severe, are caused by hormonal shifts during pregnancy or following delivery, physiological stressors like sleep deprivation and nutrient depletion, psychological strain including thought patterns that are likely to cause distress , and/or other environmental stressors such as trauma, relationship conflict, or changes in finances, employment, or residence.
However any one or more of the following are usually what we discover when we are together in my office.
Withdrawal From Friends And Family
Most children will change friends at some point and spend varying amounts of time with their parents. As children go through puberty, they naturally pull away from their families and start identifying more with peers. This is an important developmental step that should not be confused with social withdrawal.
When social withdrawal is associated with depression, it can contribute to a child’s negative social experiences, which can reinforce depressive symptoms .
Children who are depressed may dramatically pull away from friends, family, and others who they were once close to. They tend to keep to themselves and avoid interactions altogether. They may stop participating in class, social, and extracurricular activities.
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Your Child’s Safety Is Your Number One Priority
If your child or teen is engaging in behaviors that cause you concern for their immediate safety such as discussing plans for suicide or other forms of self-harm immediately take them to the nearest emergency room or call 911. Your child’s safety is the top priority. “Better safe than sorry” should be your guiding philosophy in such situations.
When Should I Call The Doctor
Call a healthcare provider if your child has any signs of depression or anxiety. If your child is showing signs of suicide, get help right away. You can call the National Suicide Prevention Lifeline at 800.273.8255. This hotline connects you to a national network of local crisis centers for free and confidential emotional support. The centers support people in suicidal crisis or emotional distress 24 hours a day, 7 days a week. In an emergency, call 911.
A note from Cleveland Clinic
While it may be difficult to watch your child dealing with depression or anxiety, help is available. The right treatment can ensure your child continues to grow and thrive throughout their development. In addition to medical help, you can support your child by making sure they have a healthy environment at home, at school and in the community. Always let your child know they can communicate openly and honestly about their feelings.
Last reviewed by a Cleveland Clinic medical professional on 11/17/2020.
References
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Anxiety And Depression In Children
Find information and resources for parents on how to help children cope
Many children have fears and worries, and may feel sad and hopeless from time to time. Strong fears may appear at different times during development. For example, toddlers are often very distressed about being away from their parents, even if they are safe and cared for. Although fears and worries are typical in children, persistent or extreme forms of fear and sadness could be due to anxiety or depression. Because the symptoms primarily involve thoughts and feelings, they are sometimes called internalizing disorders.