CHILDHOOD DEPRESSION: SYMPTOMS, CAUSES AND TREATMENTS - ARTE

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 by being irritable, moody, and difficult to please.

Depression can appear at any age, although its prevalence increases with the age of minors. It can also occur in boys and girls, although it is true that women are more likely to suffer from this problem.

There is a growing trend of the appearance of this problem in developed countries. Thus, the incidence figures for this disorder are estimated at around 10% in total of children affected by depressive-type mood problems.

Normally, parents go 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 could be anything but depression.

Is it normal for children to have depression?

In general, psychological problems are often poorly understood, especially when minors suffer, whose only mission should be to play, have fun and enjoy life.

It is quite common that parents tend to misinterpret and belittle the problems of children, since they apparently lack responsibilities and problems and have to be happy.

Because we are selfish and it is very hard for adults for a child to suffer, so we tend to pretend nothing is wrong.

However, it does happen. Children feel and suffer the same as adults. The basic emotions: joy, sadness, fear, anger… do not discriminate according to age. Both the positive and the negative ones, the ones that make you feel good and with which you have a little worse time, are all part of adults and children.

The world of children is complex and, although we adults have a simpler vision of it due to learning and experience, they have many things to discover and understand and they have the right to feel insecure, nervous, afraid…

The problem is that their way of expressing discomfort is sometimes not understood by adults since, for example, they can express a great feeling of sadness with tantrums.

Thus, this misunderstanding influences the tendency to put aside the problems of the little ones, when really what you have to do is pay more attention to them and know what they want to tell us.

Symptoms of childhood depression

As in most psychological problems, not all people have the same symptoms or in the same intensity. In the case of childhood depression, the most common symptoms that we professionals use as criteria for diagnosis are:

Main symptoms

Expressions or signs of loneliness, sadness, unhappiness and / or pessimism.
Changes in mood
Irritability: easily angered.
Hypersensitivity: cries easily.
Negativism: it is difficult to please.
Negative self-concept: feelings of worthlessness, inability, ugliness, guilt.
Persecution ideas.
Desires to run away and escape from home.
Suicide attempts.

Secondary symptoms

Aggressive behaviors: difficulties in relating to others, easy to get into fights, little respect for authority, hostility, sudden anger and arguments.
Sleep disorders: Insomnia, restless sleep, difficult to wake up in the morning…
Changes in school performance: problems concentrating and memory, loss of interest in extracurricular activities, reduced performance and effort in tasks, refusal to go to school.
Socialization problems: less group participation, less nice and pleasant with others, withdrawal, loss of desire to be with friends.
Somatic complaints: headaches, stomach aches…
Decreased physical and mental energy.

Causes

To find the origin of a child's depressive state, it is important to know their life history from all areas (family, school, social life…), since it is likely that some event or lifestyle could be the trigger.

A direct cause - effect relationship cannot be established between a specific event and depression, as the same event can have different emotional consequences for each person.

How each one copes with the different situations that life presents depends both on their personal characteristics and the environment in which they find themselves. For example, if the environment around you is highly conflictive and stressful, it is very likely that you will develop this and / or some other type of psychological or behavioral problem.

It is also important to take into account the biological vulnerability of certain people that will make them prone to depression. Here is a list that summarizes the main personal, family and social factors associated with depression in children:

Personal factors

Sex: girls, especially from the age of 12, are more prone to depression.
Age: the older, the more symptoms.
Temperament: children withdrawn and fearful in unfamiliar situations. Inflexible and with problems adapting to changes. They are easily distracted and with low persistence.
Personality: introverted and insecure children.
Self-esteem: low self-esteem and poor self-concept. Sociability. Social skills deficit: aggressiveness or withdrawal.
Dysfunctional cognitions: pessimism. Difficulties in solving problems. Self-criticism. Perception of the world as uncontrollable.
Coping: they tend to avoid and escape from situations that cause them some kind of discomfort. Social withdrawal. Avoidance of problems through imagination.

Socio-family factors

Life events: negative life events that have occurred.
Social support: the perception of low social or family support.
Socioeconomic level: low economic level.
Context: it is more associated with urban contexts, more than in the case of children living in rural environments.
Family aspects: conflictive relationships between family members, either between parents, between siblings, between parents and a child…
Family breakdown: sometimes the separation or divorce of the parents can be an influencing variable, especially if it is conflictive.
Family history: depressed parents, especially cases of maternal depression have been studied.
Other types of problems such as schizophrenia, substance use, behavior or personality disorders.
Parenting guidelines: families that are too strict with the rules and with few emotional ties.

Treatment and intervention

The approach to depression in children can be done from different fronts both medical and psychological.

Pharmacotherapy

The same medications are used as in the case of adults, these are called tricyclic antidepressants and selective serotonin reuptake inhibitors (SSRIs). Its use is controversial since its efficacy and safety in children has not been fully proven

Cognitive - behavioral treatment

Within psychological intervention, the approach from this approach is the one most used for its efficacy and utility. The techniques used are:

Scheduling pleasant activities: it has been shown that the lack of a stimulating and positive environment can be a cause and reinforcer of depressive state, so including pleasant activities in the daily lives of children will help them improve.
Cognitive restructuring: used to identify and modify the negative automatic thoughts that children have.
Training in problem solving: adequate strategies are taught to face situations that may be conflictive and that children 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 convenient to train the child to control those attacks of anger and irritability that are so frequent in depression.
Relaxation: relaxation techniques are used above all to cope with stressful situations and due to the frequent coexistence of depressive problems with anxiety problems.

Although these mentioned techniques are applied directly with children, it is necessary for parents to be involved in the treatment and work with them on those aspects related to the children's problem.

They are usually taught more positive methods of discipline, how to help increase children's self-esteem, improve communication in the family, plan leisure activities as a family…

Also, in the occasions in which the 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 childhood depression is a consequence of a malfunction of the family system, so the intervention focuses on modifying the patterns of family interaction.

Normally, most of the interventions carried out with minors must include the participation of parents and this is often not to their liking.

Recognizing that your child has problems, in part, because you encourage them is usually quite hard to accept and many are reluctant to participate in change for this reason.

However, it is important that they understand that they are an important part of your child's recovery. After all, parents (and the family in general) are in charge of showing the world to children, being their main source of socialization and discovery.

References

Abela, J., Hankin, B., (2008), Cognitive Vulnerability to Depression in Children and Adolescents: A Developmental Psychopatology Perspective, 35-78.
Achenbach, TM (1985). Assessment and taxonomy in child and adolescent psychopathology. New York: Sage Publications.
Alan EK, Nancy H., French, RN, MS, Alan S., (1983), Assessment of Childhood Depression: Correspondence of Child and Parent Ratings, Journal of the American Academy of Child Psychiatry, 22, 157-164.
Bragado, C., Bersabé, R. & Carrasco, I. (1999). Risk factors for behavior, anxiety, depressive and elimination disorders in children and adolescents. Psicothema, 11, 939-956.
Cole, David A., Carpentieri, S., (1990) Social status and the comorbidity of child depression and conduct disorder. Journal of Consulting and Clinical Psychology, 58, (6), 748-757.
Pearlman, M, Y., Schwalbe, K., Cloitre, M., (2010) Grief in childhood: Fundamentals of treatment in clinical practice, American Psychological Association.

CHILDHOOD DEPRESSION: SYMPTOMS, CAUSES AND TREATMENTS - ARTE - 2024