Depression in children and adolescents is a very real and potentially devastating condition.
Depression affects children, adolescents, and adults. It affects people from all income levels and ethnic backgrounds. Research estimates indicate that at least 2-6% of all children and 10-35 % of all adults are diagnosed with depression in their lifetime. Unfortunately, less than 20% of children receive the help that they need. Because you are now reading this, you are taking action to help your child, and that is a very important choice.
Depression is caused by a number of factors.
These factors include genetics, chemical imbalances in the brain, and/or environmental stressors. Children today experience peer stress, academic pressure, divorce, poverty, and violence. They also have fewer “buffers” to prevent stress, such as the involvement of extended family members. Other mental health concerns, such as learning disabilities, ADHD, and/or anxiety may also increase the likelihood of depression due to the additional burdens that they place on a child’s resources. It is important not to blame yourself for your child’s concerns, but to move forward, and pursue help.
Depression is also treatable.
The most effective treatments are “multi-modal,” meaning there are many different parts to help target these concerns. Effective treatments for children and adolescents often include medication, psychotherapy, interpersonal therapy, and school support. Depression does not usually get better on its own. Without treatment, 70% of children will have another episode within five years.
Medication itself is not a cure, but is often seen as something that will lessen the severity of your child’s symptoms, and help to prevent future episodes. It may help other treatments become more effective. As a parent, it will be your responsibility to monitor your child’s symptoms and side effects, discussing them with your health care provider. It will also be your responsibility to supervise your child’s medication compliance, even as your child’s symptoms improve. Improvement will be based on your ability to work together, and your child’s ability to make good choices for himself/herself.
Some parents with depressed children/adolescents feel overwhelmed and frustrated.
Their parenting skills may not be as effective as usual, and they may struggle with setting limits with a child who is frequently sad, irritable, and unmotivated. Although there is no easy answer, there are some options for consideration.
Some parenting practices decrease the impact of depression on children and adolescents.
Fristad and Arnold (2004) described a number of suggestions. Some of which are found below:
- Maintain Realistic Expectations. If your expectations are too high, your child is more likely to suffer failure, and you may be more likely to experience conflict with your child. If you are feeling chronically frustrated with your child, it is time to work on this goal. Prioritizing the more important issues, and dealing with them first will be important. For example, medication compliance and school attendance may be your first big hurdles. As your child improves, responsibilities can be increased. However, keep in mind that expectations may need to be adjusted over time, depending on your child’s functioning. You want your child to experience success.
- Find Balance with Rules. As Greene (2001) discusses, too many rules can cause parents and children to become “stuck” in a series of ineffectual interactions. This conflict can cause them to become more oppositional, irritable, and overwhelmed. Not enough rules, however, may confuse a child, particularly if they are currently feeling ineffectual and lethargic. Effective parenting often combines positives, communication, compromise, and structure.
- Simplify Your Child’s Life. Make rules brief. Keep routines. Be specific. Be brief. Praise your child’s success.
- Maintain Flexibility. Your rules, expectations, etc. may need to be adjusted, depending on your child’s recovery. If something isn’t working, be ready to compromise, or set new goals. Being stuck with something that isn’t working is going to increase conflict, and hence, depression.
- Give the Depression a Name. Discuss the symptoms of depression. Talk about what is more difficult when depression is present. It is very important to remember that your child is not his/her symptoms (e.g., irritability, lack of energy, low motivation). List all of your child’s positive traits. Think of these as tools to fight the depression.
- Increase Positive Interactions in Your Family. Increase your praise, even if you think you already provide many positives. Count your blessings, and make this a daily family goal. Practice acts of kindness. Invest time and energy in family and friends. Practice physical self-care (i.e., exercise, balanced diet, vitamins, etc.) for both you and your child. Develop family coping skills for hardships. Normalize your child’s concerns by having other family members, including parents, practice the same coping skills. Schedule family fun nights.
Your child is one of your greatest blessings. The experience of parenting provides a great deal of reward, enrichment, and purpose to our lives. Through our children, we make positive changes in our world and ourselves. His/her future is one that will rely on you, teachers, and other adults to foster qualities that shape a future marked by happiness, self-esteem, and optimism.
Fristad, M. & Arnold, J. (2004) Raising a Moody Child: How to Cope with Depression and Bipolar Disorder. Guildford Press: New York.
Greene, R. (2001). The Explosive Child. Harper Collins: New York.
Brooks, R. & Goldstein, S. (2003) The Power of Resilience. Contemporary Books: Chicago.
Author: Cindy Anderson
Dr. Anderson is a Board Certified Clinical Child Psychologist. She also owns Hope Springs Behavioral Consultants. Dr. Anderson has achieved a high degree of specialization in working with children and families. She holds a Ph.D. in Clinical Psychology and completed APA Accredited internship and postdoctoral training in Clinical Child and Pediatric Psychology. She prides herself as a life-long student and tries to learn something new every day.
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