Depression recognizes no age limits. Studies show even infants who are denied human contact become depressed. Sarah Hanly, a clinical psychologist with Cardinal Glennon Children’s Medical Center, says “There are risk factors for depression that parents and teachers should be aware of, including family history, a history of stressful events for the child such as abuse or loss of a loved one, constant family discord and problems in school.”
Hanly says that spotting depression early is especially important because half of all child and teen suicides are related to depression. Statistics reveal suicide is the third leading cause of death in 15- to 24-year-olds, and the fourth leading cause of death in 10- to 14-year-olds. Symptoms of depression include things like acting sad or bored, or being down on a consistent basis. If children express feelings of emptiness, hopelessness, and no hope for the future, that’s a big warning sign. They may withdraw, exhibit a prolonged lack of energy or have trouble sleeping. “Children also exhibit some symptoms that are different from adult depression. They more often act angry and irritable, while adults are more down and subdued. Young children with depression also report lots of physical symptoms like tummy, head or muscle aches. Older children may have a drop in grades or start experimenting with drugs and alcohol,” she warns.
Treatment options, Hanly says, have changed due to newer studies that show effective treatment involves a combination of antidepressant medications and cognitive behavioral or interpersonal therapy. The therapy focuses on changing distorted thinking patterns and developing better balance, problem-solving and relaxation skills. One technique is what Hanley calls behavioral activation, or ‘fake it until you make it.’ She brainstorms with the child about what he used to enjoy doing and have someone take charge of scheduling the activity and make sure he does it, in hopes that after a while he starts to enjoy it. She also encourages frequent aerobic exercise to activate the body’s natural mood elevators, endorphins.
Dr. Tim Jordan, a developmental and behavioral pediatrician, has a counseling practice called Children and Families, Inc. He says depression in kids is on the increase. “College health centers are jammed with students exhibiting depression and anxiety,” he reports. “We are diagnosing and medicating kids as young as 3 years old, and I’m concerned that we may be jumping the gun. Sometimes kids and their parents just need some help.” He says each generation has its own stresses. Because so many kids experience divorce and dads may not be around as much, and there isn’t as much extended family to build protection around kids, they can feel adrift.
Jordan sees kids who get burned out with their hectic schedules. When he talks to kids who are depressed he hears about their family lives. Sometimes another sibling has a problem so all the family’s energy is focused on that, and they become invisible. With both parents often working, they are distracted and may not take time to listen. Jordan clarifies that we all have things that happen in our lives, but what determines depression is what we make of those things. “Kids create a self-story to explain all these things happening. They construct this story in their heads, things like, The divorce is my fault or I am unimportant and unloved. We need to help kids see that they are not their story and that story can be changed.”
With girls, expectations today are that they be good at all the ‘girl stuff’ and the ‘boy stuff,’ like being good athletes, and when they grow up, they have to keep up and add on a family and career, according to Jordan. He clarifies that stress is not necessarily depression but it’s a slippery slope, and if the child is feeling stressed already, a big loss or mistake can throw him or her for a loop. “The camps have been very successful. If a child or teen is not suicidal, it’s reasonable to do cognitive therapy for a time to reframe things, release tension, and talk things out,” he says. “For many kids, that support is enough.”