Recognizing the Depressed Child and Adolescent
“The best cure for worry, depression, melancholy, brooding, is to go deliberately forth and try to lift with one’s sympathy the gloom of somebody else.” Arnold Bennett (1867-1931), British Novelist
Parenting is inherently difficult work. Patience, endurance, and restraint are common traits that parents develop as they set boundaries, teach morals, and discipline their children. More difficulties compound when children and adolescents begin showing signs of depression. Signs of childhood depression include:
- Irritability or anger
- Continuous feelings of sadness and hopelessness
- Social withdrawal
- Increased sensitivity to rejection
- Changes in appetite—either increased or decreased
- Changes in sleep—sleeplessness or excessive sleep
- Vocal outbursts or crying
- Difficulty concentrating
- Fatigue and low energy
- Physical complaints (e.g. stomachaches, headaches) that do not respond to treatment
- Decreased ability to function during activities at home, school or friends, hobbies, or interests
- Feelings of worthlessness or guilt
- Impaired thinking or concentration
- Thoughts of suicide
But let’s be realistic. It’s very difficult for parents to tease out an underlying depression given the host of childhood and adolescent growing pains and spectrum of emotions. In other words, what’s normal and what’s not? When should anxious parents get a little more anxious? Let’s take these questions one step at a time.
Although not all children and adolescents will express the same symptoms, research studies suggest that three key indicators are most common in diagnosing depression: changes in social activities, reduced academic performance, and a change in appearance. A closer look at these indicators reveals a common denominator that can help parents discern a possible problem—a change.
Of course, the very nature of childhood and adolescence is all about change. So, let’s add one more word into our assessment for depression—patterns. Usually a depressive episode is not labeled as such unless the behavior lasts at least two weeks. Therefore, if a child is having physical complaints coupled with feelings of worthlessness, impaired concentration, regular outbursts, and wishes to socially isolate for over two weeks, parents should get nervous—especially if the pattern cycles over a period of time and represents a significant change on how they originally acted. “Where did my little boy go?”
Now, a word of caution. In the Book of Psalms found in the Bible, a passage reads “as a man thinketh in his heart, so is he.” If we assume that we have “a depressed child” then we will have a depressed child. Be careful about developing patterns on how you react to your children. If a child is labeled or seen as a troublemaker, scapegoat, or crazy, parents can consciously or subconsciously brand them with those identities for a very long time.
If you feel that your child could be struggling with depression, I suggest seeking out a psychological evaluation to assess the level of impairment, any diagnoses, and a suitable, comprehensive treatment plan. Parents who rush into treatment strategies without understanding the full spectrum of symptoms may be missing out on a crucial component of care that their children may critically need.
By Matthew Barkdull, LMFT, MedFT