It might initially be difficult to determine whether a child is just “down in the dumps,” or whether he or she is experiencing a major depressive episode. Parents can watch for symptoms that are persistent, troubling, and interfering with typical life functioning. In a major depressive episode, many of the following signs may be observed:
- It’s persistent. First, the sadness has been ongoing for at least two weeks or more, without lifting. It’s causing changes in the family dynamics or is contributing to family stress at home.
- Loss of enthusiasm. The child is no longer interested in activities that were once stimulating and fun. He might participate in his weekly team sports, for example, but he doesn’t really want to. Everything seems like drudgery.
- Guilt. He or she may feel guilt about something that has happened recently. A change in family circumstances, or a situation with friends is “her fault.”
- Worthlessness. The child makes statements like, “I don’t belong in this family,” or “I wish I were never born,” or “Everyone would be happier if I weren’t around.” The child may also put himself down. “I’m so dumb; I can’t do anything right.”
- Physical Symptoms. She complains that her “stomach hurts” or that she has “headaches” frequently. Other bodily complaints may surface. Despite doctor visits, there doesn’t seem to be a medical explanation for the symptoms.
- Irritability. Your child may seem grouchy all the time, constantly grumbling about everything that’s going on. Her outlook is negative. She may predict that certain events will be “boring,” or certain actions “won’t work.” He seems to only see the worst of most situations.
- Changes in appetite. Either she seems to eat constantly, and is putting on weight, or she is dropping weight noticeably. He may not want to eat the things he used to love.
- Trouble sleeping. The child may be wake in the night, consumed with worries, or she may nap all afternoon and has trouble getting up in the morning. She’s constantly “tired,” and may be late to school because it’s so difficult to get her going.
- Preoccupation with death. All children may occasionally ask questions about death and dying. But a child who seems to constantly worry about death or talks about dying and “not being around anymore” should be evaluated.
- Trouble concentrating. If he or she suddenly has lost focus at school when previously this wasn’t a concern, this could be a symptom of depression. A lack of concentration which appears later in childhood and is inconsistent with previous behavior should not be viewed as a symptom of ADHD. ADHD does not “appear” in late childhood, but is typically seen in the earliest school experiences.
- Teacher concerns. Your child’s teacher may report that your child is behaving differently, is not completing assignments, or the quality of her work has changed. The teacher may have also noticed changes in your son or daughter’s social behaviors. Maybe your child is sitting alone at lunch, away from other children, or is irritable with classmates. If you believe your child may be depressed, contact your child’s teacher and ask whether changes have been observed. In true depression, the symptoms will be observed at school as well as home.
I think my child may be clinically depressed! What should I do?
Make an appointment for your child to receive a psychological assessment through the public school system, or start with your child’s pediatrician. Your child may be referred to a psychiatrist. Don’t allow anyone to give you the “brush off.” Explain very carefully what you are seeing and how long the symptoms have been going on.
Treatment should include counseling to discuss the environmental factors contributing to the depression, and to help the child work through difficult and confusing emotions. In severe cases, medication may be suggested to assist the child on a biochemical level. It is possible that norepinephrine and serotonin levels may be lower than normal, and certain medications may help. Medicating children should always be a last resort, but when the quality of a child’s life is in jeopardy, it may be an important consideration. However, medication has not always been seen as an effective strategy in combating depression, especially in the case of children.
Be sure that your child is getting sufficient exercise, is eating properly, and is going outdoors for adequate amounts of time each day. It may also be beneficial to provide him or her with a journal to write down thoughts and emotions. Scheduled, quality one-on-one time with Mom or Dad is also very important.
For more information about helping your child with depression, see my next blog: Ten Ways to Help Your Child With Depression Succeed in School.
Kristyn Crow is the author of this blog. Visit her website by clicking here. Some links on this blog may have been generated by outside sources are not necessarily endorsed by Kristyn Crow.
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