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Depression in Children and Adolescents

What is Depression in children and adolescents?
Over the course of their development, children and adolescents will display signs of sadness or moodiness.  This can come from a fight with a friend, difficulty in school, or a move to a new neighborhood or city.  This is especially true with developing teens who are going through hormonal changes. 

Depression, as opposed to “normal” sadness or moodiness, is a serious mood disorder that can take the joy from a child's life.  Depression is a serious condition that affects both children—even young children-- and adolescents, with a higher percentage occurring in teens.  What differentiates typical sadness or moodiness from a major depression is the duration—lasting weeks or months—and the intensity--helplessness or hopelessness or feelings of worthlessness, as opposed to sadness or moodiness.  

Despite heightened awareness, many children still don’t get the help they need.  At times this can due to the difficulty of differentiating between depression and normal moodiness.  In addition, depression in children may present differently than depression in adults.

Symptoms of Depression in Children and Adolescents 
Children and teens with Depression may appear bored, irritable or sad most of the time.  They may lose pleasure in activities or things they used to enjoy.  They may lose or gain weight, or sleep too much or too little.  They may feel hopeless, guilty or worthless. They may have trouble concentrating, thinking, or making decisions.  And they may think about death or suicide.  

Very young children may lack energy and become withdrawn. They may show little emotion, and have trouble sleeping.

Grade-school children may have a lot of headaches or stomachaches. They may lose interest in friends and activities that they liked in the past. Some children with severe depression may see or hear things that aren't there (hallucinate) or have false beliefs (delusions). 

Teens may sleep a lot or move or speak more slowly than usual. Teens with severe depression may hallucinate or have delusions.

Depression takes many forms.  In a milder form, a child will feel a “little down” most of the year, or more may have a mild, ongoing form of depression called dysthymia. Severe depression can cause a child to want to die, and may cause suicidal thoughts or suicide attempts.

What causes Depression in Children and Adolescents?
Depression may be biologically caused by an imbalance of brain chemicals that affect mood.  But it can also be caused by circumstances in the environment that will ultimately affect brain chemicals, such as physical or sexual abuse, other traumatic events, a death of a loved one, or going through their parents’ divorce.  In addition, a family history of depression will make the child more prone to depression.  Some medications, such as steroids or narcotics for pain relief, can cause depression as well.

How is Depression diagnosed in Children and Adolescents?
The diagnosis of depression must be done by a licensed psychiatrist or other mental health professional. During the course of a clinical/psychiatric interview, a full family history is obtained in addition to a description of physical or vegetative (eating and sleeping) symptoms, feelings and behaviors.

Some diseases can cause symptoms that look like depression. So the child may have tests to help rule out physical problems, such as a low thyroid level or anemia.

It is common for children and adolescents with depression to have other problems too, such as anxiety, attention deficit hyperactivity disorder (ADHD), or an eating disorder. The licensed psychiatrist or mental health professional may ask detailed questions about these problems so that your child can obtain the most accurate diagnosis, which in turn will lead to the best treatment.

What is the best treatment for Depression in Children and Adolescents?
One of the first and most important steps in treating depression in children and teens is psychoeducation for the child and his or her family. Understanding depression will go a long way in helping children, adolescents and their family members get the proper help they need. It will also help family members avoid blaming themselves and may at times help parents or other family members see the depression in themselves.

Depression is often treated with some form of psychotherapy, depending on the age of the child.  For younger children, play therapy is often utilized.  Older children and adolescents often benefit from cognitive-behavior therapy, which helps them restructure and reframe negative patterns of thinking into more realistic and positive ways of thinking and feeling.

Anti-depressant medication is most often used when the child or teen is severely depressed.  Yet medicine alone is not the best practice.  Combining medication with therapy is often the treatment of choice. 

It is important to note that anti-depressant medication often does not start working until 1-3 weeks; it may take up to 8 weeks to see improvement.  Children and teens may need to try several medications before they find the one that works best for them.  Parents need to be aware that some medications can cause increased suicidal thinking. Parents need to monitor their child closely if he or she is on medication.  If child begins withdrawing from family and friends, talks about death and/or has a suicidal plan, they should be attended to immediately by their Doctor or therapist.  At times, they may need to be taken to the Emergency Room and hospitalized.  A hospital is sometimes the safest way to monitor and treat an extremely depressed or suicidal child or teen. 

Parents can also help their child feel better by urging the child to eat a healthy diet, get regular exercise and get enough sleep.  It is important for parents to make sure that their child or teen keeps their therapy appointments and takes their medication.  And perhaps most importantly, parents need to set aside time to talk with and listen to their child or teen and tell them how much they are loved.  Children and teens need to feel that their parents truly care and will be there for support and protection. 

At OHEL we can help.
The diagnosis and treatment of depression in children and adolescents can be done by one of our licensed mental health professionals or by one of our licensed psychiatrists.  OHEL’s competent mental health professionals can provide the help needed to empower children and teens impacted by depression and allow them to regain control and improve their quality of life.

Remember, at OHEL, we are only a phone call or a click away from your road to recovery.

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