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Can children suffer from depression? Yes. Many adults may not realize it, but an estimated 5 percent of children and adolescents are believed to be clinically depressed. My child seems sad; is he suffering from depression? Not necessarily: Normal sadness or grieving is not depression. Don't worry if your child occasionally feels blue or down in the dumps. Life has its ups and downs, and it's normal for children to grieve over a loss or feel sad for a few hours or days at a time. But if his melancholy lasts for more than a couple of weeks or seems to interfere with his regular activities and relationships, he may be clinically depressed. Depression is far more than a temporary change in mood; it's marked by a sense of hopelessness and a lack of energy and enthusiasm that can last for weeks, months, or (in rare cases) even years at a time. The good news about depression is that it's almost always treatable. The key is identifying the problem and getting help. What are the symptoms? It might seem logical that the most obvious symptom of depression would be sadness, but many depressed children say they don't feel sad or gloomy. Interestingly, one of the key signs of depression in children is irritability. Children may be depressed if they have trouble getting along with other kids and family members or have dramatic swings in mood. Other signs of depression include lack of energy, inability to concentrate, poor performance in school, a sense of hopelessness and helplessness, and frequent complaints about physical ailments like headaches or stomachaches. Depression often goes hand in hand with other mental health problems. A youngster who has an eating disorder or a substance abuse problem, as well as kids who are constantly defiant, disagreeable, and getting into trouble with authorities, may also suffer from depression. How do I know if my child is depressed? If your child exhibits any symptoms of depression, ask yourself three questions: Is this behavior new? Is it long-lasting (going on for several weeks or more)? Are the symptoms interfering with his ability to function at home, in school, or with his friends? If you answer yes to any of those questions, you should probably have your child evaluated by a child or adolescent psychologist, psychiatrist, or other licensed mental health professional trained to work with children and adolescents. What causes depression? Psychiatrists still don't completely understand depression, but most believe it's caused by a combination of biological and environmental factors. Many people who are depressed have a family history of depression or other mental illness. A child who has one depressed parent, for example, has a 25 percent chance of suffering depression himself. If both parents have had problems with the disease, his chance goes up to 75 percent. But depression is based on more than just genes. Traumatic life events -- abandonment; violence in the family; chronic problems in school; a difficult move; or physical, sexual, or emotional abuse or neglect at home, school, or other trusted caregivers -- often trigger depression. Sometimes a loss such as the death of beloved pet, a loved one, or parents' divorce, can result in depression as well as grieving. They may not know the exact cause, but scientists do know that depression is related to changes in brain chemistry. The specific changes involve chemicals called neurotransmitters which help relay messages from one nerve cell to another. When there is a drop in certain neurotransmitters, the brain doesn't function normally, leading to depression and other forms of mental illness. How is depression treated? Research has repeatedly demonstrated that psychotherapy, especially cognitive behavioral therapy, is an effective treatment for depression. In some cases, drug therapy may be needed as well. Most therapists take a comprehensive approach that looks at your child, his family and social group, and the factors that may contribute to his depression. In addition to counseling your child, a therapist may also use family therapy or parent counseling and treatment for any related conditions that may be discovered, such as substance abuse or eating disorders. What about anti-depressants? Whether children can benefit from drug therapy must be decided on a case-by-case basis by the therapist and parents. Although the Food and Drug Administration (FDA) has not endorsed using antidepressants for anyone under 18, doctors can prescribe them at their discretion. Parents who are concerned about the lack of safety data, however, may prefer alternate treatments. Talk to his therapist about options. Experts also caution that doctors should prescribe antidepressants only in cases of persistent, severe depression, not to treat kids suffering from painful situations like the death of someone close, family violence, conflicts at home or school, or the loss of an important relationship. In those cases, using drugs can actually mask the real cause of the depression and keep a child from getting effective treatment. If he's depressed because of family strife or an abusive teacher, for example, the depression may end if family conflicts are resolved or he's transferred to another teacher. Although some experts believe drug treatment can be useful, they stress that it must be combined with therapy: ********** alone won't cure the problem. Depression can be a chronic disease that often recurs, and to successfully battle it, a child must develop new coping skills. How do I find a good therapist? Talk to your doctor, your health providers, family members, clergy, and friends; they may be able to refer you to someone they're familiar with and trust. The American Psychological Association, (800) 964-2000, can also connect you with the state or local referral agency in your area. If you belong to a health maintenance organization, you may not have these options. Instead, your plan will refer you to two or three providers, and that's where you'll start. Once you have the names of several people, ask them some questions like these about their background: Are you a licensed psychologist/psychiatrist? What are your degrees? Are you board- certified? (If the therapist is a psychologist, ask if he or she is certified by the American Board of Professional Psychology; if he or she is a psychiatrist, ask about certification by American Academy of Child and Adolescent Psychiatry.) How long have you been practicing? What's your specialty? What treatment do you usually use? How long does treatment usually take? What are your fees? Will you accept my insurance coverage? Do you have a sliding scale fee? Can you set up a payment plan? When you meet with the therapist, he or she will probably begin by doing a interview, getting a complete family history, and giving your child a standardized test for depression such as the Beck inventory. If your child has another mental health problem related to depression, such as substance abuse or an eating disorder, look for a professional with expertise in that area. Finally, it's important that you and your child have a good rapport with the therapist you choose. Find someone your child can talk with comfortably. |