The childhood depression is characterized by sadness, apathy, irritability, negativity, hypersensitivity, negative self or even suicide attempt. Children can express this sadness through crying or showing irritability, mood swings and difficult to please.
The depression can occur at any age but its prevalence increases with age of the children. It can also occur in boys and girls, although it is true that women are more likely to suffer from this problem.
There is an increasing trend towards the emergence of this problem in developed countries. Thus, the incidence figures of this disorder are estimated around 10% in total of children affected by depressive-type mood problems.
Usually parents come to professionals expressing concern for their children, especially with complaints about their bad behavior at home or at school and irritability, thinking that the problem they have can be any less depression.
Is it normal for children to have depression?
In general, psychological problems are often poorly understood, especially when children suffer, whose only mission is to play, have fun and enjoy life.
It is quite common for parents to tend to misinterpret and disparage children’s problems, as children seemingly lack responsibilities and problems and have to be happy.
Because we are selfish and it is very hard for adults that a child suffer, so we tend to do like nothing happens.
However, it does happen. Children feel and suffer just like adults. The basic emotions: joy, sadness, fear, anger … do not discriminate according to age. Both positive and negative , those that make you feel good and with which you spend a little worse, all are part of adults and small.
The world of children is complex and although adults have a simpler view of it due to learning and experience, they have many things to discover and understand and have the right to feel insecure, nervous, afraid …
The problem is that their way of expressing the discomfort sometimes is not understood by the adults since, for example, they can manifest with temper tantrums a great feeling of sadness.
Thus, this misunderstanding influences that it tends to leave aside the problems of the little ones, when really what has to be done is to pay them more attention and know to see what they want to tell us.
Most Common Symptoms
As in most psychological problems, not all people have the same symptoms or the same intensity.
In the case of childhood depression, the most common symptoms used by professionals as criteria for diagnosis are:
- Expressions or signs of loneliness, sadness, misery and / or pessimism.
- Changes in mood .
- Irritability: gets angry easily.
- Hypersensitivity: crying easily.
- Negativism: difficult to please.
- Negative concept of self: feelings of uselessness, incapacity, ugliness, guilt.
- Persecution ideas.
- Desires to run away and escape from home.
- Attempted suicide.
- Aggressive behaviors: difficulties in relating to others, ease of fighting, little respect for authority, hostility, sudden anger and arguments.
- Sleep disturbances : Insomnia, restless sleep, difficult to wake up in the morning …
- Changes in school performance: problems concentrating and memory loss of interest in extracurricular activities, less performance and effort on tasks, refusal to go to school.
- Problems of socialization: less participation in group, less sympathetic and pleasant with others, withdrawal, loss of desire to be with friends.
- Somatic complaints: headaches, belly …
- Decreased physical and mental energy.
How does child depression manifest itself?
Most children are not able to express their discomfort in an explicit and literal way. If some adults find it difficult to identify them, imagine a child whose cognitive development is significantly lower.
Therefore, it may be difficult for parents to identify this problem, especially considering that the manifestations change depending on the evolutionary stage in which the child is.
In fact, in the case of children who can not express themselves verbally, it is important to be aware of their behavior, how they play, the gestures, with whom they relate …
If you are a parent, uncle, cousin, brother … or you just know a child you suspect may have this problem, then I leave you with a classification made by Nissen (1971) of the different forms of expression of depression according to the evolutionary stage of children:
- Pre-school age : rejection of play, agitation, shyness, tantrums, encopresis, insomnia, hyperactivity, feeding difficulties and other somatic symptoms.
- School age : irritability, insecurity, resistance to play, learning difficulties, enuresis , tantrums, touching genitals …
- Pre-adolescence and adolescence : rumination of thoughts, suicidal impulses, dejection, feelings of inferiority, headaches and psychosomatic symptoms.
During childhood, physical and motor manifestations predominate, and as children grow older, the role of cognitions becomes more prominent and negative thoughts and beliefs appear on the scene .
There are also some differences according to the sex of the minors:
- In girls : inhibition and withdrawal, anxiety, difficulties to make friends, conformism, mutism, aggression, tantrums, food compulsions.
- In children : the above symptoms may occur in addition to school difficulties, sleep disturbances and spontaneous crying reactions.
What can cause childhood depression?
To find the source of the depressive state of a child, it is important to know their life history from all walks of life (family, school, social life …), since it is probable that some event or lifestyle can be the trigger.
It is not possible to establish a direct cause – effect relationship between a particular event and depression because the same event can have different emotional consequences in each person.
How each face the different situations that life presents depends as much on their personal characteristics as on the environment in which they are.
Thus, for example, if the environment around you is highly contentious and stressful, it is very likely that you develop this and / or any other psychological or behavioral problem.
It is also important to take into account the biological vulnerability of certain people that will cause you to be prone to depression.
Below you will find a table summarizing the main personal, family and social factors that are associated with depression in children:
|Girls, especially from age 12, are more prone to depression.|
|The older, more symptomatology.|
|Children are withdrawn and afraid of unknown situations.Inflexible and with problems of adaptation to the changes.
They are distracted easily and with low persistence.
|Children who are introverted and insecure.|
|Low self-esteem and poor self-concept.|
|Deficit in social skills: aggressiveness or withdrawal.|
|Pessimism: perception of greater probability of negative events.|
|Difficulties in solving problems.|
|Perception of the world as uncontrollable.|
|They tend to avoid and escape from situations that cause them some kind of discomfort.Social withdrawal.
Avoidance of problems through imagination.
|Negative life events that have occurred.|
|The perception of low social or family support.|
|Low economic level.|
|It is more associated with urban contexts, rather than with children living in rural settings.|
|Conflicting relationships between family members, be it between parents, between siblings, between parents and some child …|
|Sometimes separation or divorce from parents can be an influential variable, especially if it is conflicting.|
|Depressed parents, especially have been studied cases of maternal depression.Other types of problems such as schizophrenia, substance use, behavioral or personality disorders.|
|Families too strict with rules and with few effective ties.|
Treatment and intervention
Dealing with depression in children can be done from different medical and psychological fronts.
The same drugs are used as in the case of adults, these are called tricyclic antidepressants and selective serotonin reuptake inhibitors (SSRIs). Its use is controversial because its efficacy and safety in children has not been fully tested
Cognitive behavioral therapy
Within the psychological intervention, the approach from this approach is the most used for its effectiveness and utility. The techniques used are:
- Programming pleasant activities : it has been shown that the lack of a stimulating and positive environment can be a cause and a reinforcer of the depressive state, so that including pleasurable activities in the daily life of children will help them to improve.
- Cognitive restructuring : used to identify and modify the negative automatic thoughts that small children have.
- Problem-solving training : Appropriate strategies are taught to deal with situations that may be conflicting and that young people do not know how to handle.
- Social skills training : the child is taught strategies and techniques to interact with others effectively. For example, how to behave in certain situations, improve the way you communicate …
- Training in self-control : It is advisable to train the child to control those attacks of anger and irritability so frequent in depression.
- Relaxation : relaxation techniques are used mainly to deal with stress situations and the frequent coexistence of depressive problems with those of anxiety.
Although these techniques are applied directly to children, it is necessary for parents to become involved in the treatment and work with those aspects related to the problem of children.
They are usually taught more positive methods of discipline, how to help increase the self-esteem of children, improve communication in the family, planning family leisure activities …
Also, on occasions when parents present emotional problems or some psychological pathology, it is necessary to work them to improve the state of the children.
Systemic family therapy
Part of the idea that child depression is a consequence of a malfunction of the family system, so the intervention is focused on modifying patterns of family interaction.
Usually, most interventions involving minors should involve parental involvement and this is often not to their liking.
Recognizing that your child has problems, in part, because you foster them is often hard enough to accept and many are reluctant to be involved in change for this reason.
However, it is important that you understand that they are an important part of your child’s recovery. After all, parents (and the family in general) are responsible for showing the world to children, as their main source of socialization and discovery.
It is important not to confuse depression with …
Although children can express depression in many different ways, it does not mean that these manifestations are necessarily signs of the presence of this problem.
Thus, for example, social withdrawal is a frequent sign that a minor is depressed, however, it does not have to be due to depression.
In fact, social withdrawal is more related to anxiety problems and even appears as a problem in itself, without connection with any other.
Social withdrawal can be caused by the child being introverted and timid and costing him more, which can be added to the fact that the partners reject him or go unnoticed among them or even problems in the attachment attachment with their caregivers.
Neither should sadness be confused with a negative event, such as mourning after the loss of a loved one, with a depressive state.
In cases of mourning, it will not be considered depressive disorder until emotional distress exceeds the first two months or generates a great interference in daily life.
On many occasions, children are taken to the mental health professional’s office for problems that are not so much for the children as for the parents themselves.
But it is often easier to see the problem in the other than in yourself and recognize that you are doing wrong, more when you are father or mother, is complicated. Although as they say, the first step is to recognize it.