In support of the 2017 World Health Day theme "Depression: Let's Talk", Clinical Psychologists Dr Eve McAllister and Dr Daniel Stark from Great Ormond Street Hospital for Children (GOSH) are calling for parents to be aware of the signs and symptoms of depression in children. According to the World Health Organization, depression is the leading cause of disability worldwide, affecting over 300 million people. This World Health Day, GOSH are urging parents to be aware of the signs and symptoms of depression and other common mental health difficulties in children. Whilst depression is rarer in younger-children (~4%), it typically becomes more evident in young-people as they move towards adolescence (10-20%) . "Depression is one of the most common mental health conditions worldwide, including the Middle East," reports Dr Daniel Stark, Clinical Psychologist at the London-based hospital, which treats over 1,500 children from the Middle East every year. In a new report published by the WHO this year, it is estimated that 4.5% of the KSA population are suffering with depression . Depression is a common mental health condition that negatively affects how people feel, the way that they think and how they act. It usually involves a child feeling sad or becoming significantly more irritable and finding it more difficult to get pleasure out of activities. It may include negative thoughts, such as ‘I'm not good enough,' ‘nobody likes me' or ‘I'm terrible at this.' Depression can also include physical symptoms, such as fatigue, weight loss or gain, sleeping difficulties and finding it difficult to concentrate. Children with depression may wish to withdraw from day-to-day activities that they previously enjoyed. Some older children with depression may also experience thoughts of life not being worth living or thoughts of harming themselves. Transitions or changes in a child's life may trigger the onset of a mental health difficulty, such as depression or anxiety. "Parents may see these challenges arise following times of change, such as moving school or moving home, or moving to a new country," Dr Eve McAllister said. "Depression may also be linked to another underlying mental health condition. For example, if your child has become very worried about speaking in public, asking and answering questions in school, and wants to avoid social gatherings at home, then they may be experiencing social anxiety. This shyness, can then lead to depression if it leads to your child becoming isolated from peers". Depression is very common in young people who already have physical health conditions too. "Looking at the scientific literature, young people with a physical health condition are often more likely to experience depression compared to their peers. In addition, it is often their mental-health rather than their physical health difficulties that has the biggest impact on quality of life," Dr Daniel Stark reports. "Depression is being increasingly recognized in younger-people," Dr Daniel Stark explained. "It's important for parents to know that depressed children do not always look like depressed adults. However, the good news is that there are good, evidence-based treatments for children who are experiencing difficulties with their mood." Dr Eve McAllister also said parents need to be mindful if their child is presenting with many physical symptoms, for example if a child is often complaining of stomach aches or having frequent days off school, as this can be a sign of a mental health condition. "It may be a sign that the child is feeling anxious about school. For example, if the child is complaining of stomach pain or headache more often during the school-week compared to at the weekend." For parents who are worried that their child has depression or a mental health condition, Dr Eve McAllister, urges parents that the first step is ensuring the child gets a thorough assessment from a mental healthcare professional. "It's important to think and talk about what has led to the range of symptoms. A qualified healthcare professional that specializes in mental health, such as a clinical psychologist or psychiatrist, should be able to offer or recommend treatments that are evidence-based. This means the results are rigorously tested and shown to be effective in treating children who are experiencing depression." "Depression shouldn't be a stigmatizing condition, we should be talking about it. It is a common difficulty and the good news is that it is very treatable condition that can lead to big improvements in children's functioning and wellbeing at home and at school," Dr Daniel Stark noted. What parents need to know about depression in children and teenagers: Causes: As in adults, depression in children can be the result of a combination of factors which may include: friendship difficulties; challenges in school; stressful life events and family factors. It can also be maintained by children finding it difficult to return to activities they previously enjoyed. Symptoms: Depression usually involves a child feeling sad or becoming significantly more irritable, and finding it difficult to get pleasure out of activities. Depression can also include physical symptoms, such as fatigue, weight loss or gain, sleeping difficulties and finding it difficult to concentrate. Children with depression may wish to withdraw from day-to-day activities that they previously enjoyed. Communication: If you think your child is depressed, it would be important to think about what your child may be finding challenging, and to speak with your child and their teacher about the changes you have noticed. It will be important that you communicate with your child in a supportive way. Treatment: Speak to your child's pediatrician to identify a suitable professional. They may recommend a thorough assessment from a qualified mental healthcare professional (e.g. Clinical Psychologist or Child and Adolescent Psychiatrist). They should be able to offer treatments that are evidence-based. — SG
