Childhood Depression
A Way too Common Occurrence

Childhood depression. Two words that seem like they should not 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. Consider this is your family. Daddy is depressed, mom is bipolar, great-granddad committed suicide and your brother, well, something's off there. So what do you know? You, the youngest kid in the family, is depressed. 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 big parts. If children are raised by depressed parents, they learn a negative way of looking at the world. If children are neglected, they learn they don't matter. If children are abused, they learn to believe they are worthless. If parents control everything, children learn they are not competent. If children grow up with constant fighting, they learn their world is scary. The result: childhood depression.

O.k., easy for me to sit here and spew parental wisdom. 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. If you want to blame anyone, go through your family tree and find a relative like my Aunt Louise who called her psychiatrist every morning, carried around her bed pan and seldom got out of bed. Did this gene that my Aunt Louise so embodied cause childhood depression for some of the kids in the family? I think so.

Another point worth mentioning and one I am going to delve into when I talk about teen depression are peers. Peers can be ruthless, even with little kids. I have a client who is seven years old and told 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. Children can cause other children to be depressed.

Treatment for Childhoood Depression

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. This 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.

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