Depression is a form of mental illness that affects the whole body – it impacts the way one feels, thinks and acts - and is also a serious health problem that affects people of all ages, including children and adolescents. Sad or irritable moods and a general loss of interest affecting the appetite, sleep, activity level and concentration, are all signs of depression in a child. Though depression is treatable, if left untreated it can lead to academic failure, alcohol or other drug use, and even suicide. “Depression is not a sign of weakness or a negative personality, but is a major public health problem and a treatable medical condition” remarked Dr. Adil A. Jam'ah a Psycho-socialist and director of the social work department at Hera General Hospital in Makkah. “Childhood depression is different from the normal ‘blues'' and everyday emotions which take place as a child develops. Just because a child seems depressed or sad, does not necessarily mean they have depression. But if these symptoms become persistent, disruptive, and interfere with social activities, interests, school work and family life, it may indicate that the child has clinical depression.” Symptoms of depression in children include: u Irritablity or anger u Continuous feelings of sadness, hopelessness u Social withdrawal u Increased sensitivity to rejection u Changes in appetite – either increased or decreased u Changes in sleep – sleeplessness or excessive sleeping u Vocal outbursts or crying u Difficulty in concentrating “Not all children have all of these symptoms. In fact, most will display different symptoms, at different times and in different settings. Although some children may continue to function reasonably well in structured environments, most kids with significant depression will suffer a noticeable change in social activities, loss of interest in school and poor academic performance or change in appearance,” added Dr. Jam'ah. “Although relatively rare in children under the age of 12, young children may attempt suicide – and may do so impulsively when they are upset or angry. Moreover, girls are more likely to attempt suicide, but boys are more likely to actually kill themselve when they make an attempt. Children with a family history of violence, alcohol abuse, or physical or sexual abuse are at greater risk for suicide, as are those with classic depression symptoms.” According to the National Institute of Mental Health in the United States, 20-40% of adolescents with major depression develop a bipolar disorder within five years of first experiencing the signs. Among both children and adolescents, depressive disorders confer an increased risk for illness and interpersonal and psychosocial difficulties that persist long after the depressive episode is resolved; in adolescents there is also an increased risk for substance abuse and suicidal behavior. Studies have found that first-time depression in children is occurring at younger ages than previously, and - as in adults - it may occur again later in life. Depression also often occurs at the same time as other physical illnesses, and because studies have shown that depression may precede more serious mental illnesses later in life, diagnosis, early treatment and close monitoring are crucial. “As a parent, it is sometimes easier to deny that your child has depression. You may put off seeking the help of a mental healthcare professional because of the social stigma associated with mental illness. It is very important for you – as the parent – to understand depression and realize the importance of treatment so that your child may continue to grow physically and emotionally in a healthy way. It is also important to seek education about the future effects depression may have on your child throughout adolescence and adulthood,” warned Dr. Jam'ah. According to him, the warning signs of suicidal behavior in children include: u Many depressive symptoms u Social isolation u Talk of suicide, hopelessness, or helplessness u Increase in attention-seeking behavior (sexual/behavioral) u Increase in risk-taking behavior u Frequent accidents u Substance abuse u Focus on morbid and negative themes u Talk about death and dying u Increased crying and reduced emotional expressiveness u Giving away possessions “Bipolar disorder is more common in adolescents than in younger children. Bipolar disorder in children can, however, be more severe than in adolescents. It may also co-occur with, or be hidden by, attention deficit hyperactivity disorder (ADHD), obsessive compulsive disorder (OCD), or conduct disorder (CD),” he added. Symptoms of depression often go undiagnosed and untreated because they are passed off as normal emotional and psychological changes that occur during growth. According to the Center for Mental Health Services and National Institute of Mental Health, as many as one in every 33 children and approximately one in eight adolescents may have depression. Children under stress, who have experienced loss, or who have attention, learning, or conduct disorders are at a higher risk for depression. “As in adults, depression in children can be caused by any combination of factors that relate to physical health, family history, circumstances, the environment, genetic vulnerability and biochemical disturbance. Depression is not a passing mood, nor is it a condition that goes away without proper treatment,” stated Dr. Jam'ah. Interestingly, children with a family history of depression are at greater risk of experiencing depression themselves. Children who have parents that suffers from depression tend to develop their first episode of depression earlier than other children. If parents or other adults in a young person's life suspect a problem with depression, they should: u Know the warning signs of depression and note how long problems have been going on, how often they occur, and how severe they seem. u See a mental health professional or the child's doctor for evaluation and diagnosis. u Get accurate information from libraries, hotlines and other sources. u Ask questions about treatments and services. u Talk to other families or find a family network organization. There are no specific tests – medical or psychological – that can clearly show depression but tools such as questionnaires (for both the child and parents) combined with personal information can be very useful. Treatment options for children with depression are similar to those for adults, including psychotherapy - counseling and medicine. Your child's doctor may suggest psychotherapy first, and consider anti-depression medication as an additional option if there is no significant improvement.
