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Understanding depression in children

Learn about depression in children, teen depression, depression symptoms in teenage females, pmdd, dysthymia and other depressive disorders

It is normal for our child to go through phases when they feel down or behave differently. However, for some, these phases stay around for a longer period and may adversely affect their work at school, social interactions, and other day-to-day activities. This could be an indication that they may be suffering from depression.

Reaching out to healthcare professionals for advice will help shed light on whether our child is clinically depressed. Support and guidance are crucial to help our child overcome depression. As parents, we play a key role in supporting them in their journey towards better mental health.

What is depression?

Depression is a mental health condition that causes persistent feelings of sadness and loss of interest. It can affect the way our child eats, sleeps, feels, and thinks.

Children with depression may face difficulties in their relationships and daily tasks, and may be unable to work towards their goals.

Common misconceptions:

But did you know?
Just like adults, children can also develop depression. It is different from feeling sad every now and then. The sadness felt during depression can be intense and overwhelming, affecting a child’s day-to-day functioning.
Children do not develop depression.
But did you know?
Depression is more than feeling sad. It involves a loss of interest or pleasure in activities once enjoyed, being affected by persistent feelings of sadness, and other physical symptoms such as changes in appetite, quality of sleep, and social behaviour.
Depression is only about being sad.
But did you know?
Depression is not a sign of weakness, but a medical condition triggered by a combination of genetic, psychological, and environmental factors.
It is unrelated to the strength of our mind or character.
Depression is a sign of having a weak mind or character.
But did you know?
Some people mistakenly believe that they can ‘snap out’ of depression if they allow themselves to wallow in their grief and that they can cure it with a positive mindset or a change in attitude.
In fact, depression is a serious condition that affects the way we act, think and behave and can lead to changes in our daily life/activities.
Read more about the causes.
We can simply ‘snap out’ of depression.

Some common depressive disorders include:

Causes

Depression is caused by a combination of biological, psychological, and environmental factors.

Signs & symptoms
of depression

A child may experience depressive symptoms similar to what adults may experience.

If our child experiences five or more of these common symptoms for more than two weeks, they may have depression.

The symptoms can be described using the acronym

In SAD CAGES

Loss of

IN

terest in activities

S

leep disturbances

A

ppetite changes

D

epressed mood or feelings of sadness over a sustained period

C

oncentration difficulties

A

ctivity level changes

G

uilt or shame

Low

E

nergy

S

uicidal thoughts due to feelings of helplessness and hopelessness

Additionally, other symptoms may include:

Being easily irritable, angry, or upset

Sharing negative comments
about themselves

These signs and symptoms can be managed with early treatment.

The following depressive disorders also have their individual symptoms:

Symptoms of dysthymia occur for at least two years. They include having a depressed mood and at least two of these symptoms:

Low self-esteem

Feelings of hopelessness

Poor appetite or overeating

Low energy or fatigue

Sleeping too much or too little

Poor concentration or difficulty making decisions

Diagnosis

To diagnose depression, a healthcare professional will conduct a detailed clinical interview of our child in which they will request for:

  • Past medical and psychiatry history
  • Family history
  • Current symptoms
  • Impact on their functioning

A standardised questionnaire, physical examination, and blood tests may be administered to assess for the presence and severity of depression.

Treatment

Depression is treatable. When depression is recognised and treated, our child’s quality of life can be greatly improved.

Treatment may consist of drug (antidepressant medication) and/or non-drug therapy. Often, a combination of both medication and psychotherapy is used. Patients may also be taught effective ways to deal with life stresses.

Medication

It is natural for us to be concerned about our children taking medicines for depression. Understanding when and how medications are prescribed can help ease our concerns.

Severity of depression:

Treatment type:

Psychotherapy
(Medication often not needed)

Helps to:
  • Process feelings and challenges
  • Cope in more adaptive ways
Treatment type:
  • Psychotherapy
  • Medication (Doctor will advise on best choice of medication e.g. antidepressants)
Helps to:
  • Correct biochemical imbalances in the brain (usually takes 1-3 weeks for improvements to occur)

Non-drug therapy

Psychotherapy

Psychotherapy involves talking things through with a healthcare professional.

Talking to someone who can listen and understand them without passing judgement can be a relief to our child. Additionally, our child can learn how to solve problems and cope with life stresses better with the guidance of the healthcare professional.

Cognitive behavioural therapy (CBT)

CBT is a form of psychotherapy found to be effective in treating depression. It helps our child to recognise and change negative thinking and behavioural patterns.

Supporting
our child
with depression

Here are a few ways we can help our child who is going through depression:

Speak to our child about depression

Our child might not know why they are feeling so sad or why they are not enjoying the things that they used to.

Explain to them what depression is after consulting a counsellor or mental health professional and assure them that we will be there for them during this difficult time.

Encourage them to seek professional support

If our child is studying in a local school, we should reach out to their teacher to discuss our concerns. The teacher will work closely with the school counsellor to understand their needs and make a referral, if needed.

To help our child feel more comfortable going for treatment, we can:

Assure them that their information will be confidential
Offer to accompany them to their appointments
Get information about other services available to them, such as psychological therapy services or depression support groups

During treatment, the healthcare professional may suggest that our child speak with them one-on-one without a parent present. This will give them space to express concerns they may not be comfortable expressing in our presence.

The healthcare professional's aim is not to keep things from us, but to encourage and support our child in sharing their problems.

Be open-minded and refrain from judging

Depression can drain a person’s energy and motivation. At times, our child might appear irritable, impatient, say hurtful things or lash out at us in anger. As parents, we can try not to take it to heart.

Our child may find it difficult to talk about depression, but we can help them feel more comfortable in sharing their struggles by:

  • Acknowledging and seeking to understand what they are going through
  • Making it clear that we love and support them unconditionally
  • Not judging or criticising them
  • Avoid telling them to “snap out of it” or “just be positive”

Be patient with them

Scolding or urging our child to stop being upset will not help. It will only shame them and make them hide their struggles from us.

Build a positive relationship with them

Having a positive relationship with us can help make them feel that they are not alone and are being supported in this difficult journey. We can build a positive relationship by spending quality time and being in the moment with our child.

This means setting aside a dedicated time of the week (or day) to spend time with them as well as showing acceptance of the struggle they are facing and giving them our fullest attention.

Encourage them to reach out

A support system can be made for our child to reach out and talk about their emotions. This consists of trusted people who can support them in their times of need such as us, their friends, relatives, school counsellors, or teachers.

Encourage them to exercise

Regular exercise not only improves their health, but endorphins (‘feel good’ hormones) released during exercise can improve their mood.

If possible, exercise together with them. Play a sport like badminton or bring them down to the park. Explore more exercise ideas here.

Guide them through relaxation exercises

Explore ways of relaxation with them, such as:

  • Deep breathing exercises where they practise the action of breathing deeply, as a method of relaxation
  • Progressive muscle relaxation where they tense a group of muscles as they breathe in and relax them as they breathe out
  • Guided imagery (e.g. they imagine themselves at the beach feeling the warm breeze on their skin)

Practice good sleep habits

Poor sleeping habits have been found to worsen depressive symptoms which might then worsen sleeping habits, leading to a vicious cycle. Learn how we can help our child have a good night’s sleep here.

Eat a balanced diet

A balanced diet may help improve our child’s mood. Here are some ideas that we can try for their meals.

Manage unhelpful thoughts

Sometimes, unhelpful thinking patterns may magnify the negativity of the situation. For example, our child may overgeneralise and think, “I have failed once, I will fail for sure again”.

We can support them by encouraging them to share with us. This can help them identify negative thoughts and assist us in understanding what they are experiencing. We can then help them reframe such thoughts in positive ways and focus on the good things around them.

Provide them with routines

A fixed and simple routine can help distract our child from the negative thinking patterns they might have. It can also provide a source of comfort as things are more predictable for them.

Set realistic goals

Setting and accomplishing goals can be overwhelming when one has depression. However, by breaking down goals into manageable pieces, they can feel more achievable.

Start planning out goals with our child by identifying what they feel they can do and working our way from there.

Break down tasks into smaller chunks using the SMART goal framework: Specific, Measurable, Achievable, Realistic, Timely. Affirm them regularly whenever they hit a goal.

Recognise achievements

Celebrate our child’s successes, however small, while comforting and reassuring them during their struggles. While these gains may seem insignificant, they are very big milestones for our child.

Acknowledging these seemingly small accomplishments is a powerful motivator and tool that encourages them to keep pressing on and keep trying.

Actively monitor their progress

Actively monitoring our child’s progress can help them with the process of getting better. In order to do so we can:

Read up more on the treatment our child is receiving to understand how it works
Share with our child if we observed any changes in their mood and behaviour during the period they are receiving treatment
Ask the healthcare professional questions pertaining to the treatment our child is receiving and report any behavioural changes that we may have noticed

If our child is under medication, we should remind and supervise them in taking their medication as prescribed.

Self-care matters

Taking care of our child with depression while juggling our own life demands can take a toll on our physical and mental well-being. Ultimately, the lack of self-care will make it more challenging for us to care for our child.

Practising and prioritising self-care will allow us to recharge and be in a better state to provide our child with the support they need during their struggles with depression. Take a look at some tips on managing stress and emotions to keep ourselves healthy.

Self-care matters when helping others with their mental wellbeing or providing emotional support to others

Mental health services

Belle, Beyond the Label helpbot, is an interactive platform for users to find mental health resources and services in a private and convenient manner. If you or anyone you know is overwhelmed with stress or anxiety, you may find the help you need via Belle.

Chat with Belle now.
Get access to Belle

You may also visit here for more mental health resources or download the list of community mental health services including your nearest GP here.


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