Treatment Of Depression In Children

Treatment Of Depression In Children | These 5 Approaches Do Not Rely On Medication

Treatment of depression in children: Need, behaviour therapy, cognitive therapy, cognitive behaviour therapy, family therapy & Medication

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Incidence

Treatment of depression in children: Despite the high rates of depression in children  (10 to 14% lifetime prevalence) studies show that less than half of them receive help for their problems.

In fact, only 7% of adolescents who committed suicide had received any kind of prior help. This is largely due to it being unrecognized and to some extent under-acknowledged. We adults cannot believe that children can be depressed.

Recognise it

Hence the first step towards treatment of depression is to recognize its presence. Diagnosis needs an open mind and understanding of child development.

Children express and experience depression differently at different ages. From a withdrawn tearful child to an angry irritable and argumentative one, depression can be masked. Family history and genetic influences along with identification of stresses is needed.

Analyse it

Apart from the diagnosis, treatment of depression requires analyzing the psychosocial, academic and family situations of the child. Each of these need to be unraveled and addressed. The family and possibly school should be involved.

Treatment Of Depression In Children | https://www.singhaniaclinic.com/depression-in-children/treatment-of-depression-in-children/ These 5 Approaches Do Not Rely On Medication

Treatment Of Depression In Children

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Treat it

The treatments for youngsters with depression include:

1. Behaviour therapy

The aim of this treatment is to elicit positive reinforcement and reduce punishment from the environment.

  • Focus on increasing pleasurable activities and events so that the youngster gets skills to be able to engage in rewarding activities.
  • Social Skills Training helps to teach the child assertiveness, communication, how to accept and give feedback, social problem solving and conflict resolution skills to increase more positive social interactions. In some children, anger management is also taught.
  • Daily self-monitoring of symptoms, structuring activities and scheduling them will help the child become more active.
  • Relaxation training
  • Coping Skills

2. Cognitive therapy

The youngster is taught about distorted thinking. They taught to identify and eliminate negative thoughts like – ‘It’s my fault’; “What’s the point” and replacing them with more positive thoughts like ‘I am an interesting person” or “She really likes me”.

Many children get stuck in a loop of negative thinking and set too high standards for themselves. They fail to reward their successes and focus on their failures. They are taught not be self-critical and think more logically and rationally.

Example:

Two girls, Ayesha and Sara ask friends to come to their home after school. Both the girls’ friends say they can’t because they have too much homework.

Irrational Thinking: – Ayesha feels rejected and thinks,’She does not like me and I have no friends’

Rational Thinking: – Sara thinks ‘Oh well she is busy today maybe next weekend we can meet. She is still my best friend’

3. Cognitive behaviour therapy

This is the most common and successful form of treatment. It combines elements of the behaviour therapy and cognitive therapy in an integrated approach. CBT leads to more adaptive behaviour and rational thinking. The child is taught the relationship between mood, thinking, and behaviour.

4. Interpersonal psychotherapy

This is used mainly for adolescents because depression affects relationships and in turn, affects mood. It explores family and interpersonal interactions that maintain depression. The youngsters are taught how to identify their own negative thinking that increases or propagates depression and then learn to rectify it.

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5. Family therapy and parent effectiveness training

Negative parent-child interactions result in negative thinking changing maladaptive family interactions is important. Parents may be taught to effective forms of discipline, ways to manage anger and ways to change negative thinking. Increasing family fun activities, improving family communication and effective problem solving are important components.

6. Medications

SSRI or Selective Serotonin Reuptake Inhibitors are effective in shortening the depressive episode in children.

It should not be used as first line or as the only treatment. Fluoxetine has been FDA approved for children (US Food and Drug Administration). Studies show a moderate improvement in depression with 40 to 60% improved on medication as compared to 20 to 30% on placebo.

A boxed warning appears on all SSRI as per FDA requirements about risk of suicidal thinking.

Thus using medication for more severe forms of depression, using them in conjunction with psychosocial therapies and using them for short periods like 6 to 9 months is recommended.

Conclusion

In view of the recurring nature of depression, its high prevalence and its impact on the child’s social, academic functioning and behaviour, early identification and intervention is advocated.

Some studies have shown that giving CBT or Cognitive Behaviour Therapy and problem-solving approaches to children with subclinical symptoms of depression helped to alleviate their problems and prevented a full-blown depression disorder when followed up over a 2 year period.

Treatment Of Depression In Children | https://www.singhaniaclinic.com/depression-in-children/treatment-of-depression-in-children/ These 5 Approaches Do Not Rely On Medication

Treatment Of Depression In Children

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Treatment Of Depression In Children was last modified: March 27th, 2017 by Dr. Rajeshree Singhania

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