Depression In Children: Introduction

Depression In Children | Requires Intervention If You Want Your Child To Live A Fulfilling Life

Depression in children: What is it, its causes, prevalence, treatments, medication and lifestyle initiatives

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Depression in children: Introduction

To define it as a disorder it must fulfill certain criteria:

  • Anhedonia or loss of interest or pleasure
  • Low self-esteem
  • Sleep disturbances
  • Appetite changes

These should be present for 2 weeks or longer and affect social life and work or school functioning.

Problems arise whilst diagnosing depression in children for two reasons:

  • They are unable to express their feelings
  • The effect of development changes the classical symptoms of depression seen in adults

Hence a child may become more difficult, aggressive and even hyperactive –known as Masked Depression in the past.

Also, these children may lose interest in having friends or school work. And may become addicted to computers and television.

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Depression in children: Common disorder

Depression is the second most common disorder seen in primary medical practice. Some studies show that 57% of children with learning difficulties also have depression.

Depression impacts the quality of life and causes functional impairment. Apart from that, suicide is one of the most worrying complications of depression.

Treating depression requires:

  • A complete evaluation of the symptoms
  • Physical and laboratory evaluation to assess causes
  • Environmental contributors
  • Impact of this complex disorder on the child

Depression in children: Causes

Depression can be caused by medical problems like diabetes, hypothyroidism, and effect of certain medicines.

It can be part of other mental disorders like Anxiety.

Children with attention deficit hyperactivity disorder (ADHD), language delay as well as children who have suffered from bullying or parental abuse are at a higher risk for depression.

Depression is also part of mood disorders.

Depression includes Dysthymia,  Bipolar disorder, Minor depression, Situational adjustment reaction with depressed mood,  Grief, and Seasonal Affective disorder.

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Depression In Children

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Depression in children: Treatment decisions

Prognosis and treatment decisions must be based on specific diagnoses.

  • Major depression and dysthymia are both responsive to drug therapy and psychotherapy
  • Individuals experiencing normal grief may have symptoms of depression and can exhibit the complete syndrome of major depression
  • Normal grief should be differentiated from other mood disturbances because prognosis and treatment are different
  • Minor depression, and in particular situational adjustment reaction with depressed mood, should be differentiated from major depression because drug therapy has not been shown to be effective. Supportive counseling and careful assessment over time are indicated
  • Patients with bipolar disorder and depression require mood stabilizer medication before or concurrently with antidepressant medication to prevent precipitating a manic episode
  • Seasonal Affective Disorder involves recurrent episodes of major depression, usually occurring in the fall and winter months, and may respond to light therapy

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Depression in children: Managing depression

Psychotherapy

This includes:

  • Cognitive therapy
  • Interpersonal therapy
  • Problem-Solving therapy
  • Cognitive Behaviour therapy

Therapy may include identifying negative habitual thinking and restructuring mistaken beliefs.

It would include identifying  errors in thinking such as:

  • Overgeneralizing
  • Magnifying negatives
  • Minimizing positives
  • Catastrophizing

With more realistic and effective thoughts, thus decreasing emotional distress and self-defeating behavior.

Medication

Medication forms an important part of treatment though certain types of depressions like minor depression do not respond well to them.

Common drugs used include second generation anti-depressants like Selective Serotonin Reuptake Inhibitor (SSRI), Serotonin-Norepinephrine Reuptake Inhibitor (SNRI) or Bupropion.

The medicine usually needs to be continued for 4 to 9 months to achieve complete remission. Unfortunately, 50% patients may have a relapse. A certain percent may need life-long treatment.

Drug treatment coupled with psychotherapy gives the best results.

Lifestyle changes

Finally, and importantly lifestyle changes should be made to remove stressors and allow recovery from precipitating events.

Yoga, breathing, sleep hygiene, regular physical exercise and a nutritious diet are some of the lifestyle changes that are effective.

To conclude, Depression is a real but complex disorder with many sub-types. Treatment includes psychotherapy, medication and lifestyle changes.

Medical causes, contributors, and co-morbid conditions must be ruled out. Treatment aims are complete remission and prevention of the high of relapse.

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Depression In Children

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Depression In Children: Introduction was last modified: March 23rd, 2017 by Dr. Rajeshree Singhania

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