Depression in children or Childhood depression is comparable to clinical depressive disorder which is seen in adults. The difference between the depression among adults and children is that children are more likely to show the symptoms of aggressiveness, self destructive attitude, anger and impatience while adults might show signs of sadness. Children who experience chronic stress struggle with concentration, anxiety, ability to learn and are at bigger risk of depression.
Signs and Symptoms Of Depression In Children Include:
Below are the ways to find out if your kid is a victim of childhood depression:
- Anger or irritability in the child
- Persistent feelings of anger or gloom
- Withdrawal from social situations, kid doesn't socialize with kids or peers of his age
- Sensitivity to rejection in an increased manner
- Increased or decreased changes in appetite in child
- Insomnia or hypersomnia- disturbed sleep pattern in child
- Crying or vocal outbursts
- Child finding it difficult to concentrate
- Child experiencing reduced energy levels and fatigue
- Physical complaints and sudden aches in children that do not respond well to medications
- Inability of the child to function well in social events and at home or school as well as with extracurricular activities.
- Feeling guilty or worthless
- Lack of concentration or impaired thinking
- Child having suicidal thoughts.
Not all the above listed symptoms are seen in children who suffer from depression. Different kids may show different signs in different scenarios. Whilst this is the case, some children may continue showing a reasonable behavior when they are subjected to a structured environment. Children who are suffering from significant depression may show changes while being a part of social activities and may lack good academic performances. Children may also be interested in making a habit of using alcohol or drugs and this is seen in those who are above 12 years of age. Children who have a history of sexual and alcohol abuse along with violence as well as physical assault in the family may show symptoms of depression.
What Should the Parents do if They are sure That Their Child is Having One or More Symptoms of Depression?
It is advisable for the friends and family members to seek an evaluation related to mental health and find a cure for the child who is in depression. A physician may be consulted by the family members for getting a complete medical care. Once the kid is undergoing treatment, the parents can encourage him / her to follow a healthy style of living that will grant a mental stability at all times. This includes encouraging the kid to exercise regularly, follow a healthful diet, sleep adequately and engage in social activities while participating in activities that lead to stress management. The family can help the distressed kid by not allowing them to engage in risky behavior habits.
What are the Possible Treatment Options for Childhood Depression?
A treatment may be recommended by the health care professional if the symptoms show the signs of clinical depression in your child. The approach may carefully address to all the conditions that are elevating or worsening depression. A child who is showing hormonal deficiency may receive an adequate treatment that deals with the problem. Apart from this, supportive therapy like behavior and lifestyle changes, psychotherapy and complementary therapies along with medication may be suggested for various degrees of distress/depression in child. If the signs & symptoms of depression in child are rigorous to be treated alone with medication, psychotherapy may be used in combination for getting faster results. This will help in alleviating the symptoms and when medication is followed by a successful psychotherapy session, it will foster a better state of mind in child.
Many physicians will design a six month course for treating major depression in children and this may also prevent its recurrence in some cases. The treatments that are provided for childhood depression may have a positive impact on the behavior of a child with his or her family, peers and in school as well. Without proper treatment, the symptoms of depression in child will last longer and might not show any sign of improvement. They may even get worse and by seeking enough treatment, the probabilities of restoration are extremely high.
Psychotherapy or Talk Therapy for Depression in Children
Psychotherapy or sometimes referred as talk therapy and can involve actively engaging with a professional therapist to solve the issues that are associated with depression in children. It can intervene with the depressive symptoms and produce positive changes that are biochemically good for the brain of the growing kid. Cognitive behavioral therapy and interpersonal psychotherapy can be used for treating childhood depression. Psychotherapy or talk therapy usually takes from few weeks to months to show some signs of improvement in children. Each treatment goal targets for getting rid of the signs and symptoms of depression in children. Intensive psychotherapy or talk therapy may be used for treating severe childhood depression or the ones that are associated with psychiatric signs.
Interpersonal Therapy for Managing Childhood Depression
Interpersonal Therapy helps in alleviating the symptoms and helps a child in recovering from the depressive situations. It also helps in the child in coping with relationships and emotions as well. Interpersonal Therapy or IPT makes use of two major strategies for achieving the objectives:
- The 1st step is to educate the child and his or her parents about the course of depression. The interpersonal therapist will lay an impact on treating the depressive symptoms in children and one can anticipate getting healthier with a complete course of treatment.
- The 2nd aspect is to define the problems like interpersonal conflicts and abnormal grief that the child is likely to be suffering from. Once the troubles are understood, the therapist will set certain goals for getting rid of these problems leading to childhood depression. He or she will actively participate with the family members and find the right treatment technique for reaching the targets.
Cognitive Behavioral Therapy for Handling Depression in Children
CBT therapy has proven to be compelling in treating childhood related depression. CBT treatment helps in alleviating childhood depression and reduces the likelihood of its recurrence. This will be done by changing the ways a child thinks about certain matters. The therapist will use three basic techniques in CBT that will help a child in achieving the goal of the treatment.
- Didactic-Component: Didactic component part helps in setting up a positive expectation from therapy and promotes cooperation of the child with the processes involved in the treatment.
- Cognitive-Component: Cognitive component helps in identifying the assumptions and thoughts that impact the behavior observed in a child. It particularly addresses to those thoughts that may compel the child to be depressed.
- Behavioral-Component: Behavioral component uses techniques of behavior modification that teach a child to deal with the problems in an effective way by using better strategies.
Medications for Treating Children Who are Suffering from Depression
Selective serotonin reuptake inhibitors or SSRIs are the most common type of medication prescribed for treating depression in children. SSRI medication affects the serotonin levels in the head. As for most physicians, these medicines are often the primary choice as they have a very high level of performance and are considered to be safer than any other medication. Following are few of these medicines that are commonly prescribed.
- Fluoxetine (Prozac)
- Escitalopram (Lexapro)
- Paroxetine (Paxil)
- Sertraline (Zoloft)
- Citalopram (Celexa)
- Fluvoxamine (Luvox)
The Food & Drug Administration or FDA has approved the use of only Lexapro and Prozac for the treating childhood depression. This medication is, however, prescribed for children above 8 years of age. The usage of antidepressants in children who are of the younger ages is often considered as off label.
Despite Food & Drug Administration or FDA's approval for the use of these drugs in schizophrenic teens rather than the ones that are suffering from depression, atypical neuroleptic medicines such as risperidone (Risperdal) and aripiprazole (Abilify) may be prescribed at times. These are only prescribed when the child is suffering from severe distress / depression and fails to show any signs of improvement. In certain cases, these antidepressants are also prescribed in children suffering from bipolar disorders.
Non neuroleptic mood stabilizer medicines are used in combination with an anti-depressant for treating children suffering from serious unipolar depression. These kids do not show any signs of improvement even after multiple trials of a variety of antidepressants. Lamotrigine (Lamictal), divalproex acid (Depakote) and carbamazepine (Tegretol) are types of non neuroleptic mood stabilizers used for treating unipolar depression in children.
Of all the non neuroleptic mood stabilizers, Lamictal or lamotrigine has its unique ability for treating unipolar depression and aids outstanding improvement when used in combination with an antidepressant. This has potential side effects and is, therefore, only used in children who are above the age of 16 years.
Atypical antidepressant medicines work in a different way than the SSRIs which are commonly used. Medications like buproprion (Wellbutrin), duloxetine (Cymbalta), venlafaxine (Effexor), desvenlafaxine (Pristiq) may be prescribed when SSRIs (Selective serotonin reuptake inhibitors) fail to show some signs of improvement.
More than half of kids who follow the antidepressant medication show signs of improvement at a better rate. This may begin from 1 to 6 weeks of medication and its effectiveness will make a sufferer feel better. The physician who has prescribed the medication will see if the medicine is effective and the symptoms of childhood depression have improved or no. if not, he or she may change the dose or prescribe another medication.
Once the symptoms of depression in the child start to show signs of improvement, the doctor will ask the family to continue the child's medication for a period of six months or so. This is done to avoid recurrence of the symptoms due to early withdrawal from the medication that is prescribed. When the medications are stopped suddenly, the child may show some withdrawal effects that will vary according to the medications that are being consumed.
Side-Effects of Antidepressant Medicines in Children with Depression
The unwanted side-effects of antidepressant medications may vary from children to children and from drug to drug:
- Most common side-effects consist of tremors, constipation, dry mouth, nausea, insomnia, upset stomach, dizziness, and blurred vision.
- In certain cases, a child may become more depressed when the medication is in beginning course and there may be attempts of suicide observed. Children and adolescents are vulnerable to such thoughts and may affect their brain as well. When considering following these medications, it is necessary to understand all the possible risks and the outcomes that are associated with it. When this is being done, care has to be taken to understand the risks involved if the treatment is left incomplete or stopped abruptly.