Childhood Depression A Way too Common Occurrence

Childhood depression. Two words that shouldn’t go together. Unfortunately, they do. And way too often.

It is estimated that one in every thirty-three children is clinically depressed. And sadly, suicide is the sixth leading cause of death in children ages five through fourteen.

Childhood depression does not always look like adult depression. Kids often hide their sadness. What shows instead is irritability.

Why are so many kids depressed? There are many answers.

Genetic vulnerability is a big one. If your dad is depressed; your mom, bipolar; your grandmother anxious; and your great-granddad the victim of suicide; there’s a good chance that you may struggle with mental health issues. Is it fair? No. It just is. It’s called genetic loading. The genes from our family tree get passed to us, whether we like it or not. 

But genes are only part of the story. How children are raised, and how they are taught to look at the world, also play a big part. If children are raised by depressed parents, they learn to look at the world negatively. If children are neglected, they learn they don’t matter. If children are abused, they learn to believe they are worthless. Similarly, if parents control everything in their children’s lives, children learn they are not competent and if children grow up with constant fighting, they learn that their worlds are scary. The result of any of these is often childhood depression. 

O.k., easy for me to sit here and talk about all the ways parents can destroy their kids. But I’m a parent and raising kids is hard. And I, like all parents, am imperfect. Besides, some kids are depressed because they are, not because we ruined them. So let’s leave this part like this. If your parenting needs improvement, work on it. But realize that your kids, like you, may have been born with a predisposition toward depression. There may not be anyone to blame.

Peer pressure, taunting. and bullying can also do a number on kids, even little kids. I have a client who is seven years old and told by the other kids that she smells. I have other young kids who sit by themselves on the playground because other children refuse to play with them. When kids are tormented by their peers, they feel sad and learn to hide their feelings. Children can cause other children to be depressed. One sign that bullying may be going on is if your child, who previously enjoyed school, suddenly no longer wants to go.

Treatment for Childhoood Depression

O.k., as much as it pains us, we know there is such a thing as childhood depression. We know that some kids are severely depressed. But what do we do about it?

Family therapy is often important. Often a child takes on the dysfunction of the family. A skilled therapist can help sort out the causes of the child’s depression. Small changes made by different members of the family often help greatly.

Cognitive therapy, also known as Cognitive Behavioral Therapy or CBT, is helpful too. Here a therapist helps the child correct negative and false thoughts. Let’s use the example of a young boy who is being harassed by an older group of boys at school. This boy might be saying to himself, “Nobody likes me. Nobody will ever like me.” The cognitive therapist will help this child realize that while this particular group of boys is giving him a hard time, it does not mean that others do not like him. The therapist will help the boy identify those who do like him and help him with his social skills. Sometimes, kids just need to learn how to approach others. The therapist will help the boy learn to be more assertive. This, in itself, may end the bullying. The boy will also be taught some relaxation skills so the strain of childhood will take less of a toll. 

Medication can be helpful too, but I know many parents are opposed. So often I hear parents say, “But he’s so young.” Whether or not to use medication is a difficult decision, but here are some guidelines. Start by discussing your child’s depression with your primary care doctor. If she suggests you see a psychiatrist, do so. Ask the psychiatrist if there are other avenues to try before medication. The psychiatrist may recommend therapy or a social skills group be tried first. If it is obvious your child is having significant problems, but the problems are not clear, consider a neuropsychological evaluation. Your child’s primary care doctor can make a referral for this test or you, as the parent, can request it yourself. The neuropsychological evaluation is usually a six to ten hour test, performed over several days, by a doctor of psychology. Insurance usually pays for it and the testing is not distasteful to the kids. The results can provide you and your providers with much information and help you determine whether medication would be helpful.

Some other suggestions. If you do start your child on medication, don’t feel shy about reporting any side effects to your psychiatrist. Your psychiatrist is there to help you and there are no stupid questions when it comes to your child. Childhood depression can be treated.