Childhood Depression: When to Worry

As parents we face a ton of information coming at us about childhood mental health issues. Many of these problems didn’t even have names 25 years ago. Childhood depression, a host of anxiety disorders, ADHD, impulse control, aspergers, sensory disorders, learning problems and others.
I am going to tackle some of these one per week in hopes of helping you to know what to worry about, and what you should let go of. If you have a topic you would like addressed email me at davidwenzel@riverridgecounseling.com.
Let’s start with childhood depression.
When do we first see depression in kids? Approximately 2% of children suffer from diagnosable depression at any given time. Under age 10 it is more common in boys, but by 16 it is more common in girts.
What are the symptoms? Irritability, feelings of sadness or anger, withdrawing from relationships, change in appetite (either direction), sleeplessness or increased sleep, impaired concentration, low energy, ongoing physical complaints that don’t seem to respond to normal treatment, loss of interest in activities, sense of worthlessness, academic problems, and thoughts of death. For more detailed information about symptoms, follow this link.
When should I worry, and when should I tell myself it is just normal? Being moody is part of childhood. Social challenges, academic pressures, worries about conforming, having friends, developing sexuality, tensions at home are all normal. You can unlock when to be concerned and when not to be concerned by considering three key issues: frequency, severity, and endurance. Ask yourself some of the following questions: Does the problem seem transient? (it came on due to a particular situation and then went away) How severe was/is the child’s reaction? Does the reaction seem to “fit” the event, or was it more severe than one might expect? How often does the child experience a significant change in mood? Does the episode last more than two weeks? Is the mood interfering with social activities, academics, interests and family life? Thoughts of suicide should always be attended to.
What should I do if I am concerned? I encourage parents to take multiple approaches, all at the same time. Get an appointment with a trusted pediatrician to determine if all is well on the physical front. Evaluate nutrition, sleep and exercise. Call a counselor who has experience with children. Assess what is going on at home (is there conflict in the home the child is responding to), explore social and academic stress, and examine the child’s worries.
I encourage you to pursue behavioral, relational, and emotional interventions before turning to medication. I am not against medication, however I believe it needs to be utilized very carefully, and should fall in line after other, less invasive, interventions.

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