Departments
Health Matters
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Week of 2 April 1999 |
Vol. II, No. 29 |
Health Matters
Caring for kids: depression or just the blues?
My nine-year-old seems depressed. How can I tell if he is really depressed or just merely blue? What can I do to help him?
It's a good sign that you are not ignoring your child's sadness. Many children have emotional and behavioral problems that parents might interpret as signs of depression. For most children, however, these behaviors are short-lived and are not cause for long-term concern.
"Many parents worry when their child feels blue because they have heard or read that this is an early sign of the serious mental illness known as depression," says Donald S. Gair, M.D., a child and adolescent psychiatrist at Boston Medical Center and professor of psychiatry at Boston University School of Medicine. "You should put that worry aside for now and talk with your child about the events that may be affecting him." If, however, the sadness is persistent, your child's behavior changes, or if you can't find a reason for the blue mood, then you should seek advice from a school psychologist, your pediatrician or family physician, or a child/adolescent mental health clinic.
"Parents should never ignore their own worries about their children," Gair says. "They should seek reliable advice until they are reassured either that there is nothing to worry about or that proper treatment for a diagnosable condition has been initiated. I would strongly advise that parents not try to make any specific diagnosis by themselves."
The common symptoms of clinical depression in children include persistent sadness; irritability; an inability to enjoy previously favorite activities; complaints of physical illnesses, such as headaches and stomach aches; boredom, low energy, and poor concentration; and a change in eating or sleeping patterns. Since there are no telltale signs of depression, however, a child psychiatrist or mental health professional will not diagnose or rule out depression simply by using this checklist.
According to Gair, confusion often arises over the use of the term depression. Many people use the term when they feel sad, which everyone -- child, adolescent, and adult -- feels from time to time. Clinically, the term means the diagnosis of a serious mental illness known as depressive disorder. "Any child can show any or even, briefly, all of these symptoms without it necessarily meaning they are clinically depressed," says Gair. "If several of these symptoms persist, however, it becomes more likely that the child is suffering from, or vulnerable to, either a significant depression or some other condition that may require medical intervention."
A number of risk factors can predispose children to depression or trigger depressive behavior. Among them are a family history of mental illness or suicide; emotional, sexual, or physical abuse; chronic illness; and the loss of a parent to death, divorce, or abandonment.
Depression is among the more diagnosed major mental disorders in adolescents and adults (about 5 percent of the U.S. population in each of these age groups). According to the American Association of Child and Adolescent Psychiatry, depression exists as well in about 2 percent of grade school children, or about one million kids, in the general U.S. population.
With the dramatic effectiveness of such medications as Prozac, depression in adults has been widely publicized recently. According to Gair, what helps adults also can help children. Psychotherapy, medication, and family counseling can be used to treat depressed children as well as depressed adults. Psychotherapy is used to help children recognize and change negative thinking patterns; antidepressant medications alter the action of the brain to improve mood, sleep, appetite, energy levels, and concentration. And family counseling helps family members retain patience and cooperation during the disruptive time when one family member is seriously ill.
"Parents should be courageous enough to talk to someone about their child's emotional and behavioral state," says Gair, "and mental health professionals should be open and forthcoming so that children with significant depression can get the help they need."
"Health Matters" is written in cooperation with staff members of Boston Medical Center. For more information on depression or other health matters, call 638-6767.