When The Blues Just Won't Go Away: Helping Children Deal With Depression
Children, like adults, need loving support from others in order to manage and overcome feelings of painful and persistent sadness.
By Victor Parachin
Illustration by Joel Snyder
At age 8, Daniel was often on the verge of tears, especially during the school day. Even at his young age he understood the social stigma attached to boys who cry, so he did his best not to let anyone see his tears. Normally a motivated student, his schoolwork was now suffering. One morning during recess, his teacher noticed Daniel quietly crying at a classroom table. Asked what was wrong, the boy said: "My parents have separated and I'm very sad."
Lisa is a 15-year-old high school freshman. She is also on the school junior varsity volleyball team. At the beginning of the season, Lisa was so skilled, the coach had considered moving her up to the varsity. More recently, however, the coach became alarmed because Lisa's interest and enthusiasm for the sport was waning. She frequently missed practices and was late for a game. The coach also noticed she had lost some weight and was moody. When he asked if something was troubling her, Lisa said: "I feel lonely. Other girls have lots of friends and things to do, but I don't really have even one good, close friend."
Lisa and Daniel both exhibit signs of depression and contradict the popular concept that children have a joyful, carefree life.
Research indicates that children, like adults, experience depression in varying intensity. According to Dr. Michael Sorter, a psychiatrist at the Children's Hospital Medical Center in Cincinnati, Ohio, approximately five percent of adolescents experience depression. "We're talking about a big number of kids," he notes.
Like adults who are depressed, children need loving support from others in order to manage and overcome feelings of depression. There are several effective ways for adults to help:
Understand depression triggers.
Specific events and family history are predictors of depression in children.
"Often there's a strong familial connection," says Dr. A. Reese Albright, chief of St. Vincent's Hospital and Medical Center in New York City. "A child who is depressed is more likely to have parents or other close relatives who have suffered from depression."
Other factors which can trigger depression in a child include
- parental separation or divorce.
- children with a chronic medical condition or disability.
- death of a family member, friend, or even a pet.
- remarriage and adjustment to a blended family.
- a move to a new neighborhood.
- starting in a different school.
- children with histories of abuse, either physical or sexual.
Recognize the symptoms of depression.
Even the best parents can sometimes fail to notice signs of depression in children because they are so distracted and preoccupied with their own careers, marriages, and daily parenting tasks.
In order to avoid missing important clues about depression, train yourself to recognize its signs. The National Institute of Mental Health (NIMH) lists the following as symptoms of depression:
- a persistent sad, "empty," or anxious mood.
- loss of interest or pleasure in ordinary activities.
- decreased energy; fatigue.
- sleep disturbances such as insomnia, early waking, or oversleeping.
- eating disturbances indicated by either weight loss or gain.
- difficulty concentrating, remembering.
- feelings of pessimism.
- feelings of guilt, worthlessness, helplessness.
- thoughts of death or suicide.
- excessive crying.
- chronic aches and pains which don't respond to treatment.
Respond to the symptoms you see.
"Pretending there is not a problem is not an effective response, since the problem is likely to remain. It is equally important to avoid reacting in a negative fashion to a depressed individual," advises Dr. Stephen Merson, in his book Depression.
"The first step must be to encourage the person to describe his situation. The most effective way of doing so is through patient and sympathetic listening, which allows painful sentiments to be voiced. Make it clear that you are available and willing to help."
Professional intervention may be necessary if depressive behavior continues for a prolonged period of time. According to NIMH, when four or more of the symptoms for depression persist for more than two weeks, an accurate diagnosis and professional treatment should be sought. Such prolonged sad feelings move from the level of normal youth moodiness into the field of a possible clinical depression. Professionals you can turn to for help include a school counselor, psychologist, physician, psychiatrist, or family therapist.
Promote physical activity.
Various studies demonstrate that regular exercisers produce greater than average amounts of beta-endorphin, the body's natural hormone which increases pain tolerance and generally improves one's mood. Enroll the child in a martial arts class or a community soccer or other sport league. At the minimum, suggest that the child engage in some form of daily exercise_bicycling, jogging, swimming, or even simply walking.
If the child is younger, you, as the caring and concerned adult, can offer to join the child in a daily exercise routine. Not only will there be the benefit of physical activity, but the time together will provide a golden opportunity to talk and explore feelings.
Often those who are depressed withdraw from family and friends. Do whatever you can to encourage a depressed child to maintain contacts with others.
Friendship not only fills lonely hours but prevents a depressed child from feeling completely alone and different. Friendship generates healthy feelings of being loved and accepted. Additionally, friendships offer crucial support when a person is in an emotional crisis.
A recent study done by the University of Minnesota Medical School of 3,600 teens--more than a third of whom were depressed and 5.9 percent of whom had attempted suicide in the previous six months--revealed that when young people are seriously troubled by depression, they're much more likely to turn to their friends before they would consider talking to an adult. Of 54 possible coping choices, talking with a mother was 31st; talking to dad 48th; and talking with a teacher, guidance counselor, clergy, or therapist all tied for last place--54th.
One lesson from that study for caring adults: Encourage a child who is depressed to spend time with his or her friends. Suggest they invite companions to the house on a weekend or bring a friend home after school.
Recommend ways of releasing feelings.
New York psychiatrist Helen De Rosis advises young people to "Cry, pound pillows, and complain to friends who can take it. This is a safe way to permit feelings of anger to surface. Anger is a very important part of depression and unless these feelings are released in some way, it is difficult to overcome depression."
Another effective way for young people to alleviate depression is through the keeping of a journal or diary in which feelings can be written out.
"Write what you do and how you feel about all of this," Dr. De Rosis urges young people. "Ask yourself what impossible expectations you were trying to meet when you began to feel depressed. If an answer doesn't occur to you right away, don't worry. You may think of it a few days later."
Stimulate positive thinking.
"Youngsters with a tendency to become depressed think negatively," notes Douglas H. Powell, Ed.D., in his book Teenagers: When to Worry and What to Do. "They obsess about what's wrong with their lives, overestimate their flaws and underestimate their positive attributes, believe they can't do anything about them, and think that everyone is as focused on their imperfections as they are."
Dr. Powell advises caring adults to help youths identify the positives which take place in their lives on almost a daily basis: a good grade report, a pleasant conversation with a friend, a compliment given by a teacher, a difficult task completed, and so forth.
Finally, parents should not compound youth depression by feeling guilty. Rather than blame yourself for your child's depression, commend yourself for recognizing it and for taking the steps to help correct it.
Victor Parachin, a frequent contributor to this column, is the author of Grief Relief: How to Overcome Loss and Live Again (Chalice Press, 1991).
Depression in Children: Some Helpful Books
Down Is Not Out: Teenagers and Depression, by Essie E. Lee and Richard Wortman, M.D. (Julian Messner, 1986).
Depression, by Dr. Stephen Merson (Ward Lock Family Health Guides series, Ward Lock UK, 1995).
The New Teenage Body Book, by Kathy McCoy, Ph.D., and Charles Wibbelsman, M.D. (Berkeley Publishing, 1992).
Teenagers: When to Worry and What to Do, by Douglas H. Powell, Ed.D. (Doubleday, 1987).
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