By Dr. Maryann Rosenthal
Over 11 million prescriptions were written last year for kids with depression. That did not include those who didn’t even see a doctor.
Growing up is never easy. It is a time of upheaval and emotional storms. The very openness children exuded and were rewarded for seems to invite penalties as they grow beyond adolescence They are exulting in their hoped-for independence even as they are frightened by the demanding, often-uncaring world of adulthood. During this confusing period, they end up changing from one mode to the other so often and so rapidly that it confounds their parents. Teenagers often turn to actions that provide emotional stimulation to counteract feelings of self-induced emptiness and low self-esteem.
All kids get sad or upset about things now and then: getting a bad grade on a test, arguing with a friend, being grounded, or being without a date for a big dance. These temporary disappointments are not necessarily depression, but stress in its many forms and the inability to deal with stress is a major factor in creating and exacerbating the problem.
Changes in behavior are normal as our kids try to figure out who they are and what they believe in. Most depressed kids are troubled by who they are, how others perceive them, and what parents, peers, and the world at large expect of them. Researchers believe depression affects 3 percent to 5 percent of preteens and up to 15 percent of adolescents with girls suffering from depression at twice the rate of boys. In an alarming study by Seventeen magazine, 28 percent of girls said they feel depressed every day or at least a few times a week. Girls are looking to peers for validation and it is often hard for them to retain a positive self-image. Adolescent girls undergo more life changes than boys and for yet unknown reasons, they are more vulnerable to negative life events, while the sources of stress in boys are more commonly school performance or other factors outside of social relationships, such as a move to another home. The good news is that serious depression in our children is treatable but it is often difficult to diagnose. The symptoms may be mistaken for Attention-Deficit Hyperactivity Disorder (ADHD) causing misdiagnosis and incorrect treatment.
What should parents and teachers look for?
You really have to tune in and judge the signs of depression against your child’s usual and normal behavior. Depression is different from “the blues” because it is longer in duration and more intense. Parents, friends, and teachers are crucial allies in the treatment of childhood depression. Don’t ignore your instincts and if you think there’s something wrong with your child, chances are you’re right. It’s a real danger sign when stress becomes too much to deal with and a child just feels like giving up, where life becomes overwhelming and hopeless.
If your child experiences two or more of these symptoms for two consecutive weeks, it might be depression and not just “the blues”:
• Decline in school performance
• Change in eating/sleeping habits
• Persistent unhappiness
• Inability to concentrate
• Irritable or angered easily
• Aggressive, impulsive, or reckless behavior
• Excessive guilt or anxiety
• Withdrawal from people and activities previously enjoyed
• Physical aches and pains
• Talk about death or suicide-this should always be taken seriously
Fortunately, there are effective treatments for childhood depression. First, you must overcome any discomfort or embarrassment that you might feel about the problem. A real key is to be able to talk calmly with your child about it.
Your physician can offer guidance and help with a referral to a mental health practitioner A good mental health evaluation should include discussions with teachers and other family members.
Psychotherapy, especially cognitive behavioral therapy should be part of every treatment plan and may be all that is necessary. Medication can be a powerful weapon against depression but should be prescribed only by an experienced physician in close consultation with family. Medication doesn’t work for everyone and may make some depressed kids feel worse.
Clinical depression has biological origins and has been linked to an inherited imbalance in brain chemicals, although family environment is a contributing factor. Depression is in part a disorder of relationships. The depressed person withdraws and breaks connections with the larger traditions of which we are a part, such as family, culture, and religion. Part of the antidote is strengthening those relationships.
All of the medications and therapy in the world will not help a child if their home environment is a root cause of problems. In other words, depression is a family matter that involves everyone. Nurturing a child’s self-esteem and confidence, staying active, exercising, and developing good eating habits can help alleviate stress and depression in our children.
It’s important that you look out for serious depression and doubly important that you heed the great deal of research that shows that the more family-like connections a person has, the more inoculated against depression they are.
Dr. Maryann Rosenthal’s new book “Be A Parent Not a Pushover is available in bookstores everywhere. Dr. Maryann tells how to find a balance between loving your children and setting limits for them, to generate trust, confidence, resilience, and integrity.