Tag Archives: Childhood Depression

Childhood Depression: Risk Factors And Why It Is Underdiagnosed.

Undiagnosed Childhood Depression

Whilst there are many similarities between childhood depression and adult depression, there are also some important differences. One such difference is children displaying objectively observable symptoms of depression often deny that they are depressed.

Certainly this was true in my case as a child. For example, I would have felt a deep sense of (completely irrational and undeserved) shame had my contemporaries realised how deeply unhappy I was, as if being unhappy was some kind of contemptible personal and moral failing (or, as I would have thought at the time, yet another contemptible personal and moral failing).

childhood_depression

Although each child’s experience of depression differs, there are certain symptoms which frequently present themselves. These include:

– disrupted sleep or a need to sleep too much

– impaired concentration (which may lead to academic underachievement)

– low levels of energy

– mood changes

– increased irritability/anger

– general negative outlook on life

– self-harm

– loss of concern about appearance

– increased irritability

– increased proneness to become angry/enraged

– social withdrawal

– loss of interest in previously enjoyed activities

anhedonia (inability to feel pleasure)

– deterioration in behaviour at school and in academic performance

– physical problems such as headaches and stomach ailments (particularly in younger children who may not otherwise seem depressed; such children – although they will themselves be unaware of this – are described by psychologists of somaticizing their internal feelings of mental distress).

Unfortunately, too, because being depressed increases a child’s vulnerability, and other children quickly sense such vulnerability, a depressed child may become the target of school bullies, significantly exacerbating the depressed child’s problems, particularly as his/her depression may make his/her attempts at social interaction awkward and painful anyway, nevermind having to cope with bullies on top of this.  Again, this was close to my own youthful experience.

And, of course, having social difficulties is psychologically devastating for a child. This is because children have a profound need to feel they are accepted by their peers and that they ‘belong’.

 

What Factors Put Children At Risk Of Developing Depression?

About 95℅ of adolescents who develop clinical depression have chronic problems such as:

– the experience of significant trauma

– being the victim of abuse within the home

– living in a home in which there is domestic violence

– parental divorce/separation/disharmony

– parental neglect

– parental alcoholism/misuse of drugs

– living in a financially poor household

– living in a single parent household

– being taken into care by the local authority

– being placed in an institution for young offenders

– being in constant conflict with parents/primary caregivers

– living with a mentally ill patent

– being a young care / parentified

 

Comorbidity:

Depressed children are likely to have comorbid (simultaneously occurring) mental health conditions such as alcoholism, drug dependency or ADHD (Attention Deficit And Hyperactivity Disorder).

 

Prevalence:

Depression amongst children is less prevalent than it is amongst adults, but it still affects:

Approx. 7℅ of adolescent children

Approx. 3 ℅ of pre-pubertal children

 

Why Childhood Depression Is Significantly Underdiagnosed:

Sadly, as in my own case, the fact that a child is suffering from depression often goes unacknowledged. This can make the child’s condition much worse; for example, if one of the depressed child’s symptoms is outbursts of rage and anger, s/he may be blamed and punished for this, serving only to lower the child’s self-esteem further.

Indeed, this could lead the child to turn the anger s/he feels in on herself/himself, resulting in self-harm, suicidal thoughts and/or suicidal behaviour.

Appropriate education of parents, teachers and others who come into frequent contact with children about child mental health issues would increase the likelihood of childhood depression being picked up in its early stages which would, in turn, improve the chances of effective treatment.

Also, it would be helpful if young people themselves were taught more about childhood mental health issues, not least because another reason depression in the young is underdiagnosed is due to the stigma that, even in the 21st century, still attaches itself being diagnosed with a psychiatric illness (as I allude to at the start of this article).

 

Treatment:

This should focus on the ‘whole child’ so that:

– any other conditions the child has may be addressed eg. excessive drinking, social phobia, inappropriate anger

– problems that exist in the family as a whole may be addressed (children who come from dysfunctional families / stressful family environments have a much higher incidence of depression)

– if the child’s parents have a mental illness (making it more likely the child will suffer from mental health problems) that this, too, is addressed.

For Information About Available Help – Click here.

David Hosier BSc Hons; MSc; PGDE(FAHE).

Were You A Depressed Child? The Possible Causes.

 

depressed child

I was a depressed child myself – always crying or having some kind of hysterical tantrum, and, on top of this, I was precociously pessimistic and cynical – which is one of the reasons I opted to study psychology at University in London; I wanted to understand the illness better. Indeed, my undergraduate dissertation comprised a study of the effects of childhood depression on academic performance (the results demonstrated a significant inverse correlation, supporting my hypothesis).

In my experience, many people who study psychology are motivated to do so by a wish to understand their own psychological problems, or those of someone to whom they are close, so I was by no means an exception.

Above: Withdrawal: one (dysfunctional) coping mechanism young people may use to deal with depression

How Is Depression Manifested In Children?

Different children display signs of suffering from depression in different ways. Some symptoms that they have are similar to those of adults, whereas others are more age-specific.

Symptoms may include:

– needing too much sleep

– disrupted sleep (including insomnia and nightmares)

– a negative view of self, others and the world in general (this is sometimes referred to as a negative cognitive triad)

– poor concentration which can, in turn, lead to academic underachievement.  (Certainly, in my own case, I was frequently preoccupied with problems relating to my home- life when I was at school; a couple of times I even had to leave lessons due to fits of weeping. I sometimes wonder if I could have achieved more had my home life been less dysfunctional).

– irritability/general hostility/outbursts of rage and aggression (eg destroying household objects – plates, vases etc – in fits of temper).

– low self-esteem

– impaired concentration

– clearly failing to meet academic potential/ decline in academic performance

– loss of interest in personal hygiene/appearance

– loss of ability to derive any pleasure from life (sometimes referred to as anhedonia, click here to read my article on this)

– poor motivation

– unwarranted self-blame

– a pervasive sense of hopelessness and helplessness

– social impairment (often linked to loss of confidence or perceived sense of personal inadequacy)

– self-harm (requires professional intervention even in apparent absence of other symptoms)

– suicidal thoughts (requires professional intervention even in apparent absence of other symptoms)

– withdrawal (including from family and socially in general). After I was thirteen and had moved in with my father and step-mother I hardly ever spoke to them at all, nor did they give the impression of having an overwhelming desire to speak to me(!) When we did interact it was almost invariably confrontational. My father would leave for work early, leaving myself, my step-mother and step-brother. My step-mother and step-brother (her biological son) would have breakfast together and I would breakfast alone. This was an arrangement which seemed to suit both parties equally well; certainly no one ever suggested altering it

– delusions ( in very severe cases ) – requires professional intervention

But Aren’t All Teenagers Moody?

Many are, but clinical depression goes significantly beyond what some may describe as ‘normal teenage moodiness’. The more of the above symptoms a young person has, and the greater their intensity, the more likely it is that s/he is suffering from clinical depression.

The Statistics:

Approximately:

1 in a hundred pre-adolescents are suffering from clinical depression at any given time

3 in a hundred adolescents are suffering from depression at any given time

NB:

95% of clinically depressed young people have at least one of the following difficulties to cope with :

– divorced or separated parents

– witness domestic violence at home

– live in a dysfunctional family in which there is significant disharmony

– have suffered a form of abuse (sexual/physical/emotional)

– have a mentally ill parent (eg one who is clinically depressed)

– live in poverty

– are in local authority care

– are in a young offenders’ institution

– are significantly bullied at school

Other Factors Linked To The Development Of Depression In Young People:

– FAMILY DYNAMICS: research suggests that young people with demanding and critical parents are at greater risk of developing depression as are young people whose parents minimise their child’s successes and achievements whilst over-focusing on their perceived failures.

– FEELINGS OF HELPLESSNESS: because of the nature of childhood, young people often feel utterly trapped in their situation and powerless to do anything about it (click here to read my article that examines the link between feelings of helplessness and depression).

– GENES: Research suggests that young people may inherit a genetic predisposition to developing depressive illness but that this is not enough on its own to cause the illness – it seems environmental stressors must also be experienced for the predisposition to become actualised. However, the relationship between genetic inheritance and the development of depression is a highly complex one and requires further research.

Treatment:

Young people are often reluctant to talk about their mental state as they often feel (needlessly) embarrassed and ashamed about it. Certainly that was true in my own case. Young people tend not to like having such potentially stigmitizing attention drawn to them or being seen as ‘different’ from their peers. It follows, of course, that few are willing to put themselves forward for treatment. Because of this, depression can remain largely hidden in young people.

 

Above: Young people may not wish to discuss their inner feelings or may be embarrassed/ashamed about doing so.

The problem is made worse by the fact that parents, teachers and doctors are sometimes liable to underestimate a young person’s level of distress and inner emotional turmoil. Being repeatedly told to ‘cheer up’ or ‘count your blessings’ is not, sadly, going to cut it.

Due to the above, it is estimated that only approximately one in four young people who would be likely to benefit from treatment for their condition actually receive it.

It is vital that the treatment of depression in young people includes tackling its underlying environmental causes (such as a dysfunctional home life). Treatment options iinclude:

– cognitive-behavioural therapy

– guided self-help

– family therapy

– interpersonal therapy

– educational psychologists

– psychiatrists

– social workers

– family therapists

Above eBook now available on Amazon for instant download. Click here for details.

 

David Hosier BSc Hons; MSc; PGDE(FAHE)