Depression

Is your child:

• Experiencing a serious case of the blues?
• Crying for no reason or excessively crying over something small?
• Displaying sadness that impacts day-to-day functioning and pleasure in life?
• Seeming withdrawn?
• Sleeping all the time or not much at all?
• Eating too much or hardly eating anything?
• Not interacting as much with peers anymore?
• Always seeming on the edge of tears?
• Crying or withdrawing from peers on the playground?
• Crying when asked to follow directions or rules?

Some children cry frequently for apparently no reason at all. They may seem particularly sensitive and always look pensive and weighted down. Others may call him or her “an old soul.”

Some children ask a lot of questions about death or about illness. They fixate on sadder things in life, looking at the glass always as half empty and never as half full.

Some children make statements like “I hate myself” or “I hate my life.” Sadness may seem to take over your child’s life. If your child is less interested in participating in activities that he or she used to really enjoy, eats or sleeps less or more than usual, then depression may be present.

Many children who are depressed do not cry much but seem irritable nearly every day. Depression can impact attention and processing speed. That is, in school, a child who becomes distracted and starts working very slowly may be showing signs of depression.

Another major sign is withdrawal. Children who used to have friends but who start pulling away are showing concerning symptoms. If your child drops out of boy scouts and soccer, preferring to be home alone, depression should be considered.

Clinically, these symptoms discussed above are symptoms of major depression in a child. Children can become depressed; it is important to take these symptoms seriously and to seek help for your child.

Depression is a diagnosis that includes pervasive sadness or loss of interest in activities your child used to enjoy. Low serotonin levels in the brain can cause depression, and these symptoms can be inherited through genetic predisposition. Situational variables can also impact depression.

A child who experiences loss, changes at home, traumatic events, or feels like a failure because of learning challenges or low self-esteem may become depressed. If depression runs in your extended family, there is a greater likelihood that your child may suffer from depression. Take heed of the symptoms, and seek help.

An interesting factor to consider is whether you consider yourself and your child to be an optimist or a pessimist. Psychology research has confirmed for decades that optimists find more well-being and success. In his seminal work, the Optimistic Child, Dr. Seligman describes,

“But pessimism is an entrenched habit of mind that has sweeping and disastrous consequences: depressed mood, resignation, underachievement, and even unexpectedly poor physical health. Pessimism is not shaken in the natural course of life’s ups and downs. Rather, it hardens with each setback and soon becomes self-fulfilling. America is in the midst of an epidemic of pessimism and is suffering its most serious consequence, depression.” [5] p.7

 If your child is a pessimist, the Optimistic Child has some good suggestions. For now, there are a few basic ideas for ways to foster more optimism in your child. It is important to see how your child is ‘attributing’ negative events in life.

People who see events as permanent are pessimistic; those who see events as changeable have a more optimistic outlook.

People who see negative events as global and pervasive have more of a pessimistic view; those who see negative events as specific are generally of the optimistic view.

Finally, those who see negative events as internal and general personality traits (I am such a slob) are more pessimistic, and those who see events as internal and behavioral (This room is a mess, but I can clean it up) tend to be more optimistic.

When bad things happen in your child’s life, help him or her to see the glass as half full by looking at these events as changeable (not permanent), specific (not global), and behavioral (not personality traits). [5], p.64

In addition to working with your child to find a more optimistic viewpoint, there are a lot of actions you can take to help your child (see What to do section).

If you are concerned about sadness or depression, there is a lot you can do to help your child.

Spend time together. Read together, watch movies, and visit the zoo or the park. Just take time to be together. Be careful of your tone and your own irritability around your children.

Make plans. The making of plans can be a safeguard against depression. As hard as it is sometimes to get some interest going, there has to be something your child doesn’t mind doing. Plan a party, a road-trip, a day at the mall to pick out some new shoes, or a concert that is coming to town. Having something to look forward to can build hope in your child.

Listen to your child. When your child shares symptoms or negative self-statements like “I hate myself,” hear them. Never say “no you don’t.” Instead, say, “I hear that you feel really awful right now. I’m here to help. Together we can try to make it better.”

Get your child involved. guide him or her to take part in pleasant events that he or she used to enjoy. If your child used to like dance class, is she interested in trying a new class? If your child used to play guitar, does he want to get involved in a local music school or band?

Actively support your child in identity formation. Older children and teenagers tend to be caught in the throes of identity development. Embrace this process.

It’s your child’s chance to really decide what he or she stands for, and what is important. Help your child truly explore who he or she is by:

• making a collage
• taking an art or pottery class
• picking up a new instrument
• identifying places he or she would like to visit
• checking out some books of interest at the library

Build healthier habits. Patiently work with your child on eating, sleeping, exercise and social patterns. Healthy habits help foster resilience and overcome depression symptoms.

Seek help from a professional. Consider a psychologist or counselor for therapy supports and if symptoms are significant. Cognitive Behavior Therapy is a best practice treatment for depression and is often very effective. Expert in CBT, Aaron Beck describes the development of the CBT approach,

“Upon questioning his other depressed patients, Dr. Beck began to notice that all of them experienced “automatic” negative thoughts such as these and that this second stream of negative thoughts was tied to their emotions. He began to help them identify, evaluate, and respond to their unrealistic and maladaptive thinking and when they did so, they rapidly improved.” [2], Chapter 1

Beck also cites over 500 studies verifying the efficacy of the CBT treatment approach. This news is promising for individuals with depression, as it is often true that therapy alone can treat depression. Individuals gain a sense of hope and control over their lives and begin to heal their maladaptive patterns of thinking and behavior. In some cases, a psychiatrist or pediatrician should be consulted, who may recommend dietary changes or medication.

Keep an ear out for suicidal thoughts. If your child talks a lot about death and dying, there may be serious safety concerns. In that case, seek help right away. You can call 911 or go to the emergency room if your concerns are significant. Also, consider reaching out to the school counselor or school psychologist. For parents with concerns about suicidal thoughts for their children, the Suicidal ideation article includes a list of resources and strategies.

If your child is struggling with a similar problem, not directly addressed in this section, see the list below for links to information about other related symptom areas.

• Sadness could be related to Attachment: was there a death in the family or loss of a caregiver?
• Could it be related to Mood swings: associated with another mood disorder?
• General anxiety: depression and anxiety fall on a continuum. Extreme anxiety can lead to feelings of worthlessness and can result in depression.
• Sadness could be related to Learning challenges (Educationally Identified Disabilities) such as dyslexia or dysgraphia that may lead to lowered self-esteem.
• Suicidal ideation: If tantrums are accompanied by negative statements and suicidal threats, low self-esteem and depression may be a factor.
• A Situational Variable: like a bullying peer or an abrasive teacher or abuse or mistreatment by someone else in the child’s life may lead to depressive symptoms. This reaction is called an adjustment reaction.
• Depressed mood could be related to a Medical Condition: Consider your child’s appetite and ability to eat and to appropriately utilize the food consumed.

Children who have significant problems in this area may have any of the following potential disabilities. *Note, this does not serve as a diagnosis in any way. See ‘Where to Go for Help’ section for professionals who can diagnose or provide a referral.

• Depression: depressed mood, or, in children, irritability that is pervasive; decreased interest or pleasure in activities that used to be enjoyable
• Bipolar Disorder: depressed mood, alternating with periods of elevated mood, pressured speech, goal-directed activity; in children, cycles tends to blend together
• PTSD or Adjustment Reaction (Trauma and Attachment Disorders): anxiety and depressed mood, resulting from traumatic events of real or threatened death or serious injury, loss of loved ones
• Dyslexia, Dysgraphia or Dyscalculia or Learning Disabilities (Educationally Identified Disabilities): deficits in learning can impact self-esteem
• Attachment Disorder (Trauma and Attachment Disorders): sadness and extreme behaviors that stem from challenges in attachment to primar

If your child is struggling with this symptom to the point that it is getting in the way of his learning, relationships, or happiness, the following professionals could help; they may offer diagnosis, treatment, or both.

• CLEAR Child Psychology: to obtain a customized profile of concerns for your child, or to consult ‘live’ with a psychologist.
  • If there are concerns about suicide, please call 911 or visit your nearest emergency room.
• Psychotherapist or Play Therapist: to treat emotional symptoms
• Psychologist or Neuropsychologist: to consider a full assessment to look at symptoms in mental health and/or behavioral context

These professionals may recommend or administer the following tests for this symptom:

• Roberts, BASC-3, Clinical Interview, RCMAS, CDI-2, Human Figure Drawing, Brief Projective Measures: emotional assessment through drawing tasks, open ended questions, interviews, rating scales, and sometimes storytelling (Neuropsychological or psychological evaluation)
• WISC-V: establish a baseline of intellectual abilities, which can help us understand emotional knowledge and symptoms and determine what interventions may work best (Psychological or School Psychological evaluation)
• TOL-2, CTMT, WCST, TOVA: Assessing areas of executive function may help to determine the skills and resources a child has, like ability to plan, organize, and attend (Neuropsychological evaluation)

[1] Kroncke, Anna P., & Willard, Marcy & Huckabee, Helena (2016). Assessment of autism spectrum disorder: Critical issues in clinical forensic and school settings. Springer, San Francisco.

Springer: http://www.springer.com/us/book/9783319255026

Amazon: https://www.amazon.com/Assessment-Autism-Spectrum-Disorder-Psychological/dp/3319255029/

[2] Judith S. Beck & Aaron T. Beck (1995).  Cognitive Distortions Cognitive Behavior Therapy: Second Edition, Basics and Beyond https://www.amazon.com/Cognitive-Behavior-Therapy-Second-Basics/dp/B005HROKHU/ref=sr_1_2?s=books&ie=UTF8&qid=1475442113&sr=1-2&keywords=beck%27s+cognitive+therapy

[3] The Cognitive Behavioral Workbook for Depression https://www.amazon.com/Cognitive-Behavioral-Workbook-Depression-Step/dp/1608823806

[4] Beck institute: www.beckinstitute.org

[5] Seligman, Martin, Ph.D. (1995). The Optimistic Child: A revolutionary program that safeguards children against depression and builds lifelong resilience. Houghton Mifflin, New York.

[6] Huebner, D.  What to do when you grumble too much: A Kid’s Guide to Overcoming Negativity. https://www.amazon.com/What-When-You-Grumble-Much/dp/1591474507/

[7] Yamada, Kobi & Besom, Mae (2016). What Do You Do With A Problem? Compendium, Inc. https://www.amazon.com/What-Do-You-Problem/dp/1943200009/

Suicide Prevention Resource Center (July 2017)

Suicide Prevention Resources for Teens

Sendi, Kevin (2017). Signs of Depression in Children

Link: https://www.youtube.com/watch?v=u5sW4J78ZaA

Image Credit:
Description: Sad boy sitting on swings at outdoor playground. Sad lonely…unhappy mood
Stock Photo ID: #142841816 (Big Stock)
By: Veja
Is my child depressed
Previously Licensed on: May 21, 2017
Stylized by Katie Harwood exclusively for Clear Child Psychology

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