Depression in children is a growing phenomenon. The very existence of depressive mood disorders in children was in doubt a few years ago, whereas currently the incidence of depression in childhood is rising with each new generation, and in parallel, the rate of childhood suicide is also rising.
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For this reason, parents need to recognize the symptoms and signs which may indicate the presence of depression, so that the child is diagnosed and treated adequately in time to prevent its many complications.
Symptoms that suggest depression
In very young children
Babies and toddlers are obviously unable to express their feelings and thoughts verbally. Parents may be concerned about depression if they pick up symptoms such as:
- An apathetic attitude on the part of the child, with loss of interest in play and hobbies which were previously attractive
- Withdrawal from others, including the parents and/or babysitters who were close to the child
- Delayed development or if the child loses the gains already made. For example, a child stops talking after speaking a few words, or does not show any interest or ability to learn self-care
- Failure to thrive is a term that includes poor weight gain in spite of good care and generally good health
In school-age children
Children who already attend school may also display symptoms of anxiety by their behavior rather than their words. Such symptoms may include:
- Physical disorders such as headaches and abdominal pain
- Anxiety over separation from the parents
- Intense reluctance to go to school without any obvious cause
- Irritability, aggression or outbreaks of bullying behavior
- Temper tantrums and angry outbursts
Parents and teachers may also look for stressors at home and at school, such as:
- Excessive or harsh criticism
- Childhood trauma
- Poor performance at school
- Conflict within the family
Adolescents in many respects are challenging to diagnose and treat because many of the symptoms of depression overlap with what modern society expects as ‘typical teenage behavior.’ In their struggle to develop their own independent thinking, personality, and values, they may separate from their caregivers and from authority figures. At the same time, their need for a social identity may drive them to become part of their peer groups. The special dangers of this age group lies in their increased capacity to destroy themselves through successfully planned and executed suicide attempts, as well as resorting to substance abuse, sexual encounters and violence. This coincides with a peak experience of despair and pessimism, making the likelihood of suicide much higher.
Symptoms of this age group can be more intense than those of younger children and may include:
- Low mood
- Feelings of sadness and hopelessness
- Anger and irritability
- Guilt and worthlessness
- Low self-esteem
- Suicidal ideas and thoughts centered on death
Parents need to take notice if their child shows changes in behavior such as becoming more withdrawn, spending time alone and becoming reluctant to talk or interact with them or with other former friends. Other red flags include not wanting to participate in games and activities they used to enjoy, feelings of sadness and anxiety, or restless behavior. Academic performance may drop, as may involvement in team or group activities. The important thing is that these symptoms are not merely passing phases, but persistent over days and weeks.
Problems with lack of energy or interest, coupled with disturbed eating, sleeping, and self-image should always be taken notice of, if they continue to plague the child for more than a couple of days. Again, signs of excessive anxiety, and symptoms such as abdominal pain or headache which do not have any physical basis and are not relieved by treatment, should be investigated as possible signs of depression.
Parents will do well to ask their pediatricians about such symptoms and signs. Following such discussions, the child can be properly evaluated and referred for further management and treatment as required.
Reviewed by Yolanda Smith, BPharm