Depression is a mental disorder in which a person experiences depressed, depressed mood and a decreased or even complete loss of the ability to experience pleasure. Depression does not only affect adults, as many people are accustomed to thinking.
This disease is also being diagnosed in children. Moreover, this disease can manifest itself almost from birth. The disease is included in the International Classification of Diseases (ICD-10) under code F32 and has three degrees: mild, moderate and severe.
In some cases, childhood depression may be mistaken for ASD, especially at an early age. This is due to the similar symptoms of both disorders. With autism spectrum disorder, children also experience problems with communication, communication, and behavior, as with childhood depression.
A depressed state in a child inhibits cognitive development and therefore requires mandatory correction. You can prevent negative consequences if you identify the signs of an incipient disease in time.
Causes of depression
Depression in a child can be caused by:
- family situation (frequent conflicts between parents, lack of parental care or, conversely, overprotection);
- frequent changes of place of residence and school, which leads to the inability to make friends;
- problems at school (underachievement or difficult relationships with peers);
- hormonal changes in the body during adolescence;
- severe stress (loss of loved ones, divorce of parents, traumatic situations).
Moms tell
Here are some stories from life (names of mothers and children have been changed). In all cases, the diagnosis of depression was made by a doctor.
Elizaveta, Yegor’s mother: “It all started in the fifth grade. He seemed to be having difficulty coping with the new demands of school. He said that he didn’t want to go to school, that he wouldn’t go, that his stomach hurt. He vomited several times before school. Then he began to say that his legs could not walk. In general, it began to seem to me that this was a strange, unfamiliar child: mine never slammed doors or screamed hysterically. Conversations with him turned into walking through a minefield: you never know what he will react to and where he will explode. He began to have difficulty falling asleep at night, cried, shouted that he would not get enough sleep, that he would not be able to go to school in the morning, and as a result he stopped sleeping completely. He had a headache all the time and began to have severe migraines.
I almost stopped studying - I got two and three grades in all subjects, one notebook for all my lessons, I didn’t do my homework, after school I hung out with my friends in other people’s yards. Friends said - maybe he had started adolescence? But what is the teenage age of a little ten year old?
Then it became completely scary: he started talking about the meaninglessness of life, about the fact that he didn’t want to live, that everything around him was just a dream...
He did nothing, sat at home and played with his cars, which he loved to play with when he was two years old. He refused to wash, get his hair cut, brush his teeth, comb his hair, or change his clothes. He complained that he could not read - the letters did not form words, did not understand the meaning of what he read, could not solve the problem because he did not understand what it was about. It was only then that I realized what was wrong with him - and ran with him to the doctor.”
Tatyana, Anton’s mother: “Two of Anton’s classmates bullied him right during breaks in the corridor, under the teacher’s nose, humiliated him. And at that time he also had an exacerbation of bronchial asthma. The result is a complete loss of working capacity, loss of all school skills, severe fatigue, drowsiness and, at the same time, very poor sleep; noticeable decrease in self-esteem, fears, wrote several times at night.
The exacerbation of asthma could not be stopped for a long time, an infection developed, resulting in pneumonia. I assumed depression and went with him to a clinical psychologist and neurologist. The first took him to classes, the second prescribed treatment. It helped, he was released, but then he recovered for more than two years, and to this day it all echoes with self-doubt.”
Galina, Seryozha’s mother: “It all started in the fourth grade, in the fall. Children with communication difficulties are probably prone to this in principle.
In conversations before going to bed, he began to express fears for his life and especially for mine. There was a global fear of death. He cried. A teacher at school noticed a sharp decline in academic performance and worsening behavior.
Something had to be done to help the child. The doctor found out everything. The treatment helped quickly, and that was the end of it. Perhaps because, as the doctor said, we caught depression at the very beginning stage.”
Marina, German’s mother: “My son turned 13, he went to seventh grade. Almost simultaneously, the father left the family and the grandmother, whom the son loved very much, died. The son was lying on the sofa hugging the cat and doing nothing. He built houses from pillows and blankets. Lost appetite. Dizziness and lightheadedness appeared.
My son started leaving school after two or three lessons. I didn’t study my lessons at all, and I explained this by laziness, lack of willpower: “I want, I will, I’m going to - but tomorrow, today I can’t.” Then I became seriously ill. While I was in the hospital, my son lived with relatives, refused to wash or brush his teeth, skipped school, lay in bed, and cut off all social contacts. Treatment was prescribed, but it did not help much, although sleep and appetite were restored. The whole school year is gone. Now he is studying at home, teachers come, but he cannot study his unloved subjects for more than 40 minutes, he immediately gets headaches and lightheadedness.”
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Symptoms of depression in children
Depression in a child can be expressed as follows:
- the slightest insult, remark or other insignificant reason leads to tears;
- loss of appetite;
- loss of interest in previously favorite activities, apathy;
- isolation;
- mental and physical inhibition;
- sleep disorders;
- frequent complaints of fatigue and malaise;
- groundless feeling of anxiety and attacks of fear.
Physical manifestations may also occur in the form of gastrointestinal disturbances, difficulty breathing, heart pain, or itchy skin and rashes.
The most dangerous manifestation of depression in a child can be thoughts of suicide. They do not appear at the very beginning of the disease, but after a long time. The child may consider the suicide plan in detail. This phenomenon is most widespread among adolescents.
Psychoneurological department
Depression in young children is a difficult topic for most parents. Although children have always been vulnerable to mental health problems, many children have undiagnosed depression. They are viewed as shy, aloof and lazy, stubborn or disobedient. More recently, as emotional problems have increased, depression in children is often explained as a temporary reaction to stress (adjustment disorder), attention deficit hyperactivity disorder (ADHD), oppositional defiant disorder, or some other misfortune. While children have these and other disorders, they often coexist with depression or are diagnosed instead of depression.
Depression is one of the mental, emotional and behavioral disorders that can begin in childhood and adolescence. Depression in children and adolescents is a serious problem and can lead to academic failure, alcohol or other drug use, and even suicide. When children are depressed, they tend to lack energy and enthusiasm and often become withdrawn and unable to concentrate and enjoy life. If they are in school, they usually do poorly due to low concentration and motivation to study. Sometimes they are irritable and unhappy or even aggressive. They often resort to self-deprecation: they may call themselves stupid and ugly, incapable of loving and being loved, worthless, or even hopeless. They may be preoccupied with topics of death and dying, and sometimes they may think about or even attempt suicide. Even young children can do impulsive, dangerous, painful things or even commit suicide, although their ideas about death are quite different from adults.
The occurrence of depression increases in subsequent generations and begins at an earlier age. Despite the fact that adolescent and adult women are diagnosed with depressive disorder twice as often as men. Boys under 12 years of age suffer from depression more often than girls.
Signs of depression.
There are two main types of depression: depression, which lasts at least two weeks, and mild but chronic dysthymic disorder (a mood disorder characterized by mild depression), in which severely depressed mood seems to be related to the child's or personality's temperament. Dysthymic disorder occurs in childhood and may begin before adolescence. These children, when engaged in their activities, seem to be absorbed in an unhappy stupor, and only have short periods of improvement in their mood and outlook. Major depressive disorder, the most severe and most disabling form of depression, affects approximately 1% of preschool-age children and 2% of school-age children at any given time. In addition, about 2% of children suffer from dysthymia. More than two thirds of children with dysthymia develop depression within 5 years.
Young children often don't talk about the feeling of depression, so mysterious, non-specific physical complaints (headaches, stomach aches, other aches and pains) may be the first signs of severe depression in a school-aged child. Other young children with depression may also be irritable or anxious when separated from their parents; poor concentration and hesitation or exaggerated fears.
Not all children who suffer from severe depression become depressed, but instead may act irritable or moody, moving from extreme sadness to sudden anger. Usually, there are other clues or signs that a child is depressed. He/she may lose interest or pleasure in favorite activities. The child may complain of fatigue or lack of energy to perform daily activities, or have trouble sleeping. Children with depression may have trouble concentrating or making decisions, feelings of worthlessness, anger or guilt, which may mean suicidal thoughts or thoughts of death.
Signs of childhood depression :
- Regular sadness, crying and/or hopelessness. • Lack of interest or inability to engage in activities. • Poor concentration. • Social stratification, feelings of loneliness, and/or poor connections with others. • Low self-esteem, guilt, increased sensitivity to rejection. • Increased irritability, anger or hostility; difficulties in relationships with partners. • Headaches and/or abdominal pain. • Frequent absence from school or unsatisfactory performance. • Significant change in taste (food) and/or sleep pattern. • Talks or tries to run away from home. • Thoughts or expressions about suicide or suicidal behavior.
Causes of depression in children.
Depression is a complex condition. Most likely rooted in genetic and/or biochemical predisposition, depression can also be associated with unresolved grief, perhaps in response to early real or imagined losses. Depression may also reflect that the child has learned to feel helpless rather than feeling motivated and seeking solutions to problems in life. Some serious depression children experience in early childhood are associated with stress, including childhood trauma or the death of a parent or significant other.
They may live in families where they regularly witness or are victims of parental aggression, prohibitions or harsh punishment, or conflicts between parents. Such family pressure can contribute to the development of depressed mood in a child. Depression also runs in families. Often one of the parents of a child with depression suffers from the same disease. Thus, both genetic risk and life experiences may contribute to a child's depression.
Depression usually interferes with a child's social and academic performance. When a child is severely depressed, their school performance declines and they lose interest in school and their peers. Sometimes symptoms of anxiety, frustration, and decreased concentration can mislead parents or teachers into thinking that the child has attention deficit disorder, when in fact, the child is depressed. It is not uncommon for children who are assessed for one condition to be diagnosed with other disorders because two different disorders can coexist.
Associated disorders.
More than half of children with depression also have at least one mental disorder, usually an anxiety disorder, attention deficit disorder, conduct disorder, or oppositional defiant disorder or eating disorder. Almost a third of children diagnosed with attention deficit hyperactivity disorder and 20-30% were initially diagnosed with depression end up suffering from bipolar disorder, which is characterized by extreme mood swings from elation to severe depression.
Risk factors.
All risk factors come down to two main groups: congenital and environmental.
Children with depressed parents have a much higher risk of developing depression. From studies with twins and twins and other siblings who were raised together and apart, it is estimated that 50% or more of the risk of childhood depression is inherited. Children under stress, those who have experienced loss, those who abuse substances (including tobacco), those with chronic illnesses, and those with attention and learning disorders or conduct disorders are at higher risk of depression .
Among pure environmental factors, it is worth highlighting: the death or divorce of parents, the inability of the child to adapt to impractical demands or assessments, living in accordance with strict moral beliefs on the part of the parents; failure to form strong emotional bonds in infancy due to abandonment or neglect; too much punishment and criticism with too little reward or praise, physical, emotional or sexual abuse; intimidation;. and traumas such as terrorism or natural disasters.
Recent research points many of the core symptoms of depression in adolescents and adults are anhedonia (a psychological condition characterized by an inability to enjoy normally enjoyable activities), sadness and irritability, low energy levels, recent changes in energy levels, low self-esteem, crying, hyperactivity that begins after the age of 2 years, and playing or talking about topics related to death are also characteristic of depression in children. Difficulty experiencing joy when exposed to pleasant aspects of everyday life is especially common among the most retarded children.
Signs of depression based on age
From birth to 3 years: Depression may manifest itself as feeding problems, developmental delays that have no identifiable physical cause, tantrums, lack of playfulness, individuality and less expression of positive feelings in general.
Ages 3-5: May be unlucky, subject to phobias and exaggerated fears, prone to delays or regression in important developmental milestones such as toilet training, and prone to over-apologizing for minor mistakes and problems such as spilling food or forgetting to put toys away .
Ages 6-8: Vaguely expresses physical complaints, aggressive behavior, clings to parents, and does not accept new people.
Ages 9-12: Expresses morbid thoughts, worries excessively about school work, insomnia, and blames self for disappointing parents and teachers.
A child who exhibits some or even all of these traits does not automatically mean that the child has a depressive disorder. When these signs and symptoms are present, especially if the symptoms are severe and/or persist regularly for a month or more, it is important to get a diagnosis from a mental health professional who specializes in children, especially if the child has other risk factors. Early diagnosis and treatment may lead to a reduction in depressive episodes, help avoid future episodes, and prevent potentially dangerous or unfortunate outcomes such as self-harm or suicide.
Examination and treatment
For children with mild depression, cognitive behavioral therapy is usually the first step. Cognitive behavioral therapy is a type of psychotherapy that involves helping people develop coping skills that enable them to cope better, change situations, and teach them how to change destructive or negative thoughts. Family members may be invited to participate in therapy sessions. In cases involving long-term or severe depression, the drug may be recommended to accompany psychotherapy. Rarely, medications are prescribed to children under the age of 5 or 6 years. Psychotherapy, however, can be effective for preschool children. To help the youngest children, psychotherapy is aimed at parents, the goal is to teach them how to help their child. Children and adolescents rarely require hospitalization for depression.
Medicines
Medication is sometimes used as part of a complete approach to treating a child's depression. Research is currently being conducted to find out the role of the medication and the child's response. Some recent studies have shown improvement with the use of antidepressants. Antidepressants are increasingly prescribed: fluoxetine, imipramine, nortriptyline, paroxetine and sertraline. Other antidepressants include bupropion and venlafaxine. For an older child, before starting medication, specific symptoms of depression are determined in a conversation between the child, parent and doctor. Possible side effects of the medicine must be described in detail.
Hospitalization - Depressed children should always be assessed for risk of suicide or self-harm to others. If a child is contemplating dying by suicide or has a well-thought-out plan, hospitalization may be necessary. Otherwise, if the child is functioning normally and the family is relatively supportive, intensive care may be replaced by outpatient treatment.
Psychiatrist Sviridov P.N.
Treatment of childhood depression
It is almost impossible for a child to get out of a depressive state on his own, especially if it lasts long enough and is aggravated by suicidal thoughts. Therefore, the primary task of parents is to seek medical help in a timely manner. An experienced psychiatrist will make the correct diagnosis, help you understand the causes of depression, together with your parents, outline a plan for eliminating them and prescribe treatment. Do not try to treat the disease yourself. An unprofessional approach can aggravate the situation and lead to irreparable consequences.
