Depression Across The Ages: Recognizing Childhood Drepression
Everyone experiences unhappiness at some point in life. A feeling of sadness is an appropriate and healthy emotional response under a variety of circumstances, particularly those involving change and loss. It is easy to see how a certain level of sadness can touch the lives of every age group, ethnicity, and gender. But when sadness becomes more than just situational and lasts longer than what is emotionally healthy, it is time to consider the possibility of depression.
More than just a state of sadness, depression brings with it a sense of hopelessness and a loss of interest in life’s pleasures. Those suffering from depression perceive their days as disappointing and their lives as meaningless with no purpose. Depression in its mildest form may cause social withdrawal and isolation and major depression may kill.
Until about 30 years ago, many believed that childhood depression was impossible. The idea of a depressed toddler or school-aged child was ridiculous. Teens, in particular, did not experience depression as they were naturally moody and irritable. While this may be true even by today’s standards, we now know that children can experience depression at any age. Though these depressive symptoms may manifest in much the same ways as adults, there are often distinctions that are unique to their developmental age.
Within recent years, researchers have increasingly found that infants as young as six months old are cable of exhibiting the classic signs of depression. These include:
· No smiling/laughing
· Lack of interest in the environment
· Failure to thrive
· Developmental delay and regression
· Lack of eye contact
· Slow movements and lethargy
· Lack of responsiveness and interaction with others
· Problems eating and sleeping
Though the cause of infant depression is unclear, some researchers suspect it is due to genetic factors or interactions between the infant and a depressed mother. Research also suggests that some infants are born depressed after being exposed to high levels of stress hormones during pregnancy.
While it is becoming more and more accepted that preschoolers can suffer from depression, the symptoms often go unnoticed and the condition undiagnosed. For most children, the preschool years are a time of transition into more independent social functioning. Diagnosis of any mental health disorder at such a young age would, understandably, be cause for debate. A typical preschooler’s tantrums and mood swings should not be pathologized. In addition, preschool aged children are often still learning about emotions and lack the verbal skills necessary to describe their feelings and experiences. In children so young, behavior is more often the mechanism used to express emotions. These things make diagnosing preschoolers tricky as parents must first recognize what behaviors are symptomatic of depression.
Not surprisingly, the most pervasive symptom of preschool depression is sadness. It is not enough to simply be sad, however. The misery of depression persists across time lasting for long stretches. It occurs in different places and continues in the presence of different people. Though the symptoms of depression in preschoolers are much the same as the symptoms for adults, they are often “downsized” and less obvious. For example, while adults may consider suicide, children are more likely to engage in morbid play and create scenarios depicting violence or death. The biggest indicator that your preschooler may suffer from depression is anhedonia. This is an inability to find joy in activities that are normally pleasurable. This child does not get excited when friends come over or when it is time to play their favorite game. They frequently are unable to process and resolve the sadness and will lash out in frustration and self-criticism. They are often prone to guilt and may have changes in sleep, appetite, and activities when compared to their healthy peers.
Adults with depression often report that some element of their struggle has been with them for as long as they can remember. This gives credibility to the idea of preschool depression and to the possibility that early detection and treatment are possible. But what should that treatment look like? Prescribing antidepressant medications to children so young is cause for major controversy. After all, these little brains are still in their formative years, introducing mind altering drugs may do more harm than good in the long run. Instead, the limited treatment options have focused primarily on parent-child play therapy. This type of therapy normally involves a professional watching parent and child through a one-way mirror while coaching the parent by way of an earpiece and microphone.
Symptoms of depression in children ages 6-12 often includes fatigue, boredom, apathy, difficulties in school, negative self-statements, decreased concentration, and anxiety. Children in this age group who are suffering from depression may frequently complain of physical illness such as stomach pain or headaches. These signs are often overlooked by parents who assume that a depressed child needs to show signs of sadness. Children exhibiting anger and aggression may also be suffering from depression but may not be allowing themselves to express these feelings.
Newly developed language skills have opened up treatment options for school-aged children suffering from depression. Cognitive behavioral therapy, in which the child learns to reframe negative thoughts into more positive ones, has shown to be a promising treatment choice. Family counseling may also be helpful and in some situations, the use of antidepressant medications. Parents should discuss the possible risk and side effects of these medications prior to use.
Suicide is the second leading cause of death in adolescents. The symptoms of depression in teens are often masked by the raging hormones and moody behavior indicative of the age group. Teenagers often do not have the experience to recognize depression themselves and rarely accept such a diagnosis from their parents or even from professionals. Depression symptoms in teenagers include:
- Disruptive, behavioral problems
- Preoccupation with body image and performance
- Poor school performance
- School absenteeism
- Talk/threats of running away
- Sexual acting out
- Social isolation
- Drug/alcohol use
When behavior such as crying or social isolation lasts for more than a week, parents need to recognize that this may not just be a passing phase. It is normal for teenagers to experience and express a wide variety of emotions, but when concerning behaviors become excessive it is time to take a closer look at what may be going on with your teen.
Child development is complex. As children’s personalities grow and change, depressed behavior may be mistaken for normal development. Normal changes, during the adolescent years in particular, may be difficult for parents to cope with but are not necessarily symptomatic of depression. Even professionals may have difficulty identifying when the line between normal growth problems and depression is crossed. To further complicate matters, mental illness still carries a badge of shame. Concerns regarding labeling and medicating children make many reluctant to follow up on concerning behaviors. The challenge for parents and professionals is to recognize how depression may express itself at different stages in development and to overcome adult reluctance to believe that children can suffer so deeply.