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Childhood Depression PDF Print E-mail

Depression hurts! The pain may not be as tangible as a sore throat, stomach ache or a broken arm; but it’s just as real, disturbing, and disruptive to normal functioning – if not more so – to the individual who has it. Adults who are depressed may or may not be able to identify what triggered it, may or may not be willing or able to talk about it, and may or may not just “snap out of it”. Feelings of guilt (“It’s my fault I can’t make myself better”) and helplessness or hopelessness (“What’s the point? I’m too far gone and I hate my life!”) further contribute to the downward spiral. Children and adolescents may have the same feelings, but are often much less able to talk about it depending on their developmental stage, cognitive functioning, and language skills. All they know is that they feel bad.

Roughly 5% of kids at any given time suffer from depression. Common triggers are:
• Suffering a loss such as a family member, a close friend, or a pet
• Stress - such as being bullied at school, family conflict, problems with friends
• Frustration due to academic difficulties / learning disorders such as ADHD
• Chronic illness
• LGBT teens whose parents are unsupportive or ostracized at school

Depression and other mood disorders often run in families, so some individuals may be biologically more susceptible to a mood disorder when stressed.
Here are some common signs of depression:
• Low energy, poor appetite, boredom, apathy
• Changes in sleeping or eating habits
• Irritability, acting out, hostile attitude
• Isolation from friends and family
• Anhedonia – lack of interest in favorite activities
• Poor concentration, sadness
• Thoughts of running away from home or suicide

Realize that even though a child doesn’t look sad, if (s)he’s getting into trouble or is just chronically irritable, depression may be present. It can also be somewhat difficult teasing out what’s “normal” teenage moodiness and what’s actual depression. If you’re not sure, it’s much better to be safe than sorry, so ask your pediatrician for help sorting things out.

Untreated adolescent depression may lead to self-medicating with drugs or alcohol, sexual promiscuity, encounters with law enforcement, increased risk for motor vehicle accidents, and any other forms of self-harm or risky behaviors.

The ultimate self-harm behavior obviously is suicide. Some alarming statistics:
• Suicide is the 3rd leading cause of death in the 15 to 24 years old age group behind accidents and homicide.
• Adolescent males are 4 times more likely to commit suicide than girls.
• 60% of suicides involve guns
• Having a gun in the home increases the risk of adolescent suicide by 5 times!

Treatment for depression usually consists of a combination of counseling or therapy -individual psychotherapy (IPT) or cognitive behavioral therapy (CBT) - and medication. For treating serious depression, child and adolescent psychiatrists are best qualified to handle this.

Unfortunately, insurance reimbursement issues and the limited number of such specialists can be obstacles. But recognizing depression early and seeking treatment is essential. Another issue is that parents (and patients) are often resistant to the idea of taking medication. This is understandable and it’s certainly true that side effects may occur. However, 30 years of experience with SSRI drugs indicate a high degree of safety and effectiveness. These medications and the newer mood-stabilizer class of drugs can literally be life-saving.

As parents, we are our kids’ ultimate advocates. We do whatever it takes to help our kids be happy and successful. If that means medication or financial sacrifice or time commitment on our part, than that’s what we do. That’s our job.

Don’t wait if you think your child’s in trouble; call your child’s primary care provider for help. He or she can get the ball rolling to help your child. And if you must have a gun, keep it locked up, unloaded, in a safe place.

Healthy Kidz Doc is written by a board-certified pediatrician who's practiced in Santa Cruz County since 1986. www.healthykidzdoc.yourmd.com



Childhood Depression

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