Understanding Depression in Children
The key to emotional wellbeing is the ability to keep our emotions in check and know whether our emotion is appropriate to the circumstances. However, children may need some extra guidance in learning how to communicate and manage this. Read further to understand depression in children
It is normal for children to feel sad, flat, agitated and irritated, but when these emotions linger and affect the child’s ability to function, it might be an indication of a more serious mental health issue, such as depression or anxiety. It helps the child greatly if the parents are aware of the symptoms and signs of depression and anxiety. One key sign is that the child may not want to make an effort with people or activities they once enjoyed. This is not about the people or the activity, it is about how the child’s perception and ways of thinking have started to affect the way they function. When a child feels depressed, they struggle to find positive things about themselves that warrant love and care from others. In some cases, if symptoms of depression become more severe, and remain undiagnosed, a child may develop thoughts of self-harm and/or suicide.
WHAT IS DEPRESSION?
Depression is a mood disorder, characterised by symptoms that last for weeks, months, or even longer. Some to look for our sadness, irritability (short tempered, easily frustrated, impatient), negative thinking, feelings of worthlessness and rejection, poor self-esteem and suicidal ideation. Other signs are loss of energy, poor concentration, disruption in sleeping pattern, changes in appetite, limited motivation, isolation and withdrawal, and self-harm.
WHAT IS AN ANXIETY DISORDER?
The key features of an anxiety disorder include excessive fear and anxiety, leading to a disruption in the child’s normal behaviour. Fear is an emotional response usually related to thoughts of immediate danger and the need to escape. Anxiety relates to alertness and muscle tension in preparation for danger and readiness to be cautious or avoid particular situations of perceived threat. The anxiety disorders listed below generally start during childhood.
Separation Anxiety Disorder
- Persistent worrying and excessive distress about being separated from attachment parents, to a degree that is inappropriate to their stage of development.
- The child worries about harm coming to their parents and therefore struggles to be separated from them.
- A child may experience nightmares and physical symptoms of distress, such as vomiting, bed-wetting or digestive issues.
Selective Mutism Disorder:
- A consistent failure to speak in social situations where a child is expected to talk, such as school.
- Although the child may talk at home or with others they trust, their failure to speak can have an effect on how they perform in academic or normal social communications.
Specific Phobia Disorder:
- Fear, anxiety and avoidance related to a specific object or situation
- The fear, anxiety or avoidance is almost immediately induced by the trigger situation and is out of proportion to the actual risk posed.
Social Anxiety Disorder:
- Fear, anxiety and avoidance of social interactions and situations that involve the possibility of being scrutinised, or spoken to in a way that means the child has to explain themselves.
- The child dreads being evaluated negatively by others, embarrassed, humiliated, rejected or worries about offending others.
- Other anxiety disorders include Panic Disorder, Agoraphobia, and Generalised Anxiety Disorder.
Signs of Anxiety:
- Withdrawal – isolation, keeping to themselves
- Excessive clinginess and insecurity – constantly by the side of the parent
- Difficulty with daily functioning – toilet- related, hygiene, sleeping, or eating
- Decreased academic performance
- Poor self-esteem – negative, demeaning or self-deprecating remarks
- Poor attention or concentration
- Regressive behaviours – for example, bed-wetting, wanting the light on at bedtime, wanting to sleep with parents, etc.
- Nervous habits – such as eye twitching, hair twirling, nail biting, etc.
- Increased hypervigilance – startled responses, jumpiness, agitation or hyperactivity
- Anxiety or panic
• Behavioural problems – e.g. a sudden change in attitude, aggressiveness
- Changes in physical health – headaches, stomach aches, nausea, worsening asthma, skin changes such as the onset of eczema.
WHAT CAN YOU DO IF YOU SUSPECT YOUR CHILD IS DEPRESSED OR ANXIOUS?
Young children communicate and express themselves through words and play. Observing your child in various environments such as at home, school, or with friends, can provide clues as to how they are feeling about themselves and others. Sometimes children who are stressed and upset may play fighting games with their toys.
If you notice this, ask your child questions, such as “Wow, these toys are really angry with each other, what are they angry about?” or“She seems upset, what’s bothering her?” If your child talks about his or her toys and their emotions, use this opportunity to ask your child if he or she ever has similar experiences.
Engage in Conversation
Chat with your child in a private space, with minimal interruption. Encourage them to talk about what is bothering them. If your child is struggling to speak openly, try talking about your own mood and different emotions, such as depression and anxiety. Your child may not want to discuss this topic, or may have trouble articulating how they feel, but you will have provided an opening for further discussion.
Model Effective Communication
The best way for a child to learn about emotions and how to express them is to learn from others. Modelling open communication about feelings can reduce the stigma or discomfort often associated with depression and anxiety. Talking about emotions can reduce the fear children associate with them. From the earliest toddler age, encourage them to say out loud to you ‘I feel angry’ or ‘I feel sad’ if anything upsets them. This way, they already feel safe and view it as normal to communicate their feelings to you.
The Power of Listening
When your child starts to open up about their experiences and emotions, listen. Try not to correct, judge, placate, or downplay their experiences – just listen. It is empowering for a child to be listened to and believed.
Keep the Door Open for Another Talk About it
If your child has difficulty in talking to you, end the conversation with ‘Let’s chat about this again, is that ok? It’s my job to check in and see how you are feeling.’ Children rarely say ‘no’ to someone caring for them. Teenagers can sometimes be a little bit trickier and may seem disinterested, but even so, giving them the offer and showing you care can make the difference between feeling isolated and supported.
Arrange a Visit to Your Local Doctor or Pediatrician
If you continue to be concerned about your child’s mood, arrange a visit to
the doctor to have a complete physical exam and chat about the symptoms that worry you. If the doctor believes your child has depression or anxiety then they can a make a referral to a specialist, such as a psychologist or specialist counsellor to investigate further and help your child to feel better.
Creating a Safe Place at Home
Therapists play an important role in helping children work through their symptoms of depression, but the role
of a parent is crucial. Helping your child to create a balanced lifestyle with nutritious food, a healthy sleep routine, fun physical activity (a regular visit to a trampoline park or splash park are really excellent), and quality time together will help your child learn and navigate the symptoms of depression and anxiety. Being open, approachable, easy to talk-to and providing a safe place to talk, will foster a healthy relationship and freedom to talk through your child’s experiences of depression and anxiety.
Refrain from Judgement – Be Kind and Patient
It can be incredibly frustrating and taxing to help someone with depression – and the symptoms in your child may not be obvious to you for a while. It can be upsetting listening to your child saying negative things about themselves that
you know to be untrue – but this is your child’s experience and how they feel, so don’t make it about how you feel. Listen. Understand. Don’t judge. Be kind and patient with your child. Be kind to yourself. Parents make mistakes. We do not get it right all of the time. Make sure you have someone you can chat with; your spouse, sibling, friend, or a professional. Seeing your child depressed can be overwhelming and heart-breaking. It is important that you have support through this difficult journey.
Always consider the context for your child’s mood. If there has been a death in the family, an illness, change of home or school, international relocation or the arrival of a new sibling, the context can provide valuable clues as to why your child feels differently to usual. When a child shows signs of depression or anxiety, consider if there has been any major life events or changes, as these events may offer a valid explanation of why your child is behaving a certain way.
Reading about mental health diagnoses like depression and anxiety will almost certainly cause a big emotional reaction in both you and your child. These reactions commonly include fear, worry, distress, confusion and sadness, and these are normal and can provide the impetus for seeking further information and support.
CHILDREN’S MENTAL HEALTH & COUNSELLING SERVICES IN THE UAE
- The Lighthouse, Centre for Wellbeing – 04 3802 088, lighthousearabia.com
- Camali Clinic for child and adult mental health (Dubai) at Dubai Healthcare City – 04 2766 064 / 058 2976 331 Abu Dhabi: 02 6660 363 / 058 2976 331, camaliclinic.com
Supplied by Dr Emma Campbell, School Psychologist, Victoria International School of Sharjah