Childhood Depression


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Childhood Depression

  1. 1. ==== ====Click Here For Information On How To End Your Depression<a href="" target="_top">ClickHere!</a>==== ====Childhood depression is a very real but sometimes elusive illness that affects the young today. Wetake a look at what it actually means and how unity and support in the family can help fight its holdover a child.At the recently concluded Asia Pacific Suicide Prevention Convention 2006, we learnt a fewstartling facts about children and suicide. For example, in a worldwide survey, 7.3% to 38% of thechildren surveyed demonstrated suicide ideation, which is the idea of wanting to kill themselves. InSingapore, close to 4.7% of children entertain this morbid thought. While the figure may bealarming, there is no need to panic as it is actually not uncommon to think about suicide.Ask anyone in the street if he had thought about suicide before and the answer will most probablybe a `yes. Thinking about something as serious as killing oneself and actually doing it are twodifferent matters. Out of all childhood suicides, approximately 23.5% are associated with mentalillness such as depression, schizophrenia and others. Seeing the numbers and understanding thatdepression is one of the key causes that drive our young to suicide. It is time we understand a littlemore about this elusive illness called "Childhood Depression".The Definition of Childhood DepressionIn a 2004 article published by the American Academy of Child and Adolescent Psychiatry , childhood depression is defined as "anillness when the feelings of depression persist and interfere with a child or adolescents ability tofunction."Feelings of depression are represented in the forms of mood, physical, mental and behaviouralchanges in a child. Dr Ken Ung, Senior Consultant Child, Adolescent &amp; Adult Psychiatrist&amp; Psychotherapist at Adam Road Hospital describes the signs of childhood depression aspersistent "irritability or loss of interest, loss of appetite and weight, poor sleep , lethargy,headache, stomach pain, loss of concentration, preoccupation with self-harm or suicide, refusal togo to school, increased temper tantrums and antisocial behaviours such as smoking, drinking andrunning away from home. Any combination of these changes that lasts for more than two weekscould spell a child falling into depression and warrants a closer look.Many of the symtoms listed are actually applicable to both adults and children but there are tellingdifferences. Age, in a non-categorical way, does make a difference in the presentation ofdepressive behaviour. "We dont tend to categorize (childhood depression) in terms of agegroups," says Dr Ung, " but we can generally say that adolescent depression tends to look more
  2. 2. like adult type depression , whereas, childhood depression can be more `a typical perhapsmanifesting in bodily pains and behaviour changes. The closer the age of a child to adulthood - themore we can expect to see an adult-type depression.Types of childhood depressionThere is no clear categorization of childhood depression. According to Dr Ung, "Typing depressionis notoriously difficult and fashions come and go. We now tend to type it according to severity i.e.mild, moderate and severe. Sometimes, we use the term `reactive depression to denote the typethat is due to a reaction to some stress (such as the sudden passing of a loved one). Althoughvery rare in children, `psychotic depression refers to the presence of psychotic symptoms, whichare symptoms that show that the person has lost touch with reality, i.e. hearing voices, believingirrational, bizarre or incredible thoughts."Another childhood psychiatry expert, Dr Sharon Chan of Sharon Chan Child Guidance Clinic, whohas been practicing child psychiatry since 1988 concurs, "I am not sure that there is such acategorization (of childhood depression).. because the entity is still controversial, it follows adultdepression patterns (sic) - chronic, single episode or recurrent, adjustment disorder, bipolar etc."Bipolar disorder, also known as manic-depression, is a type of mood disorder marked by extremechanges in mood, energy levels and behaviour. Symptoms can begin in early childhood but moretypically emerge in adolescence or adulthood. Children with bipolar disorder usually alternaterapidly between extremely high moods (mania) and low moods (depression). These rapid moodshifts can produce irritability with periods of wellness between episodes, or the young person mayfeel both extremes at the same time. Parents who have children with the disorder often describethem as unpredictable, alternating between aggressive or silly and withdrawn.Stages of childhood depressionAccording to a Harvard Medical School Publication, " The picture changes with age. Up to agethree, the signs (of childhood depression) may include feeding problems, tantrums, and lack ofplayfulness and emotional expressiveness. AT ages 3-5, depressed children may be accident-prone and subject to phobias. Even before age 5, they may show signs of self-reproach byapologizing unnecessarily for minor mistakes and transgressions like spilling food or forgetting toput clothes away. Children of early school age (6-8) sometimes show depression with vaguephysical complaints and aggressive behavior. They may cling to their parents and avoid newpeople and challenges. At ages 9-12, some common symptoms are morbid thoughts and lyingawake worrying about schoolwork. By then, children have enough intellectual capacity and socialunderstanding to think about reasons for their depression , and they may blame themselves fordisappointing their parents."When asked for his opinion on this analysis, Dr Ung says, " I think that this is a good guide by andlarge. Nevertheless, this is merely a guide and should not ne taken as set in stone. For example, a12 year old boy may show signs of depression by aggressive behaviour and phusical complaints."For Dr Chan, "Depression before the age of six is very rare. In fact, I do not think that there isgeneral agreement that it exists. In a young child, the common emotional condition is anxiety, notso much depression. From six years onwards, I would agree with the given description."
  3. 3. Children under stress, who experience loss , or who have attention , learning , conduct or anxietydisorders are at a higher risk for depression. Depression also tends to run in families.Lenas experienceLena (not her real name) is a 17 year-old student who recently suffered a relapse and fell intodepression once more. Lena has been troubled by depression since the age of 12. Once again,she has no appetite for food, is feeling listless and confused, lost alot of weight and is isolatingherself from others.Lenas mother, 49 year old clerical staff Sonia (not her real name), recounts her daughtersexperience with depression, " It all started after Lenas father passed away. At first , nothingseemed wrong. SHe was very sad but she did not shed a tear at his funeral. It was a year afterthat she started to miss him badly. This was compounded by being bullied in school and stressedby schoolwork. Always a quiet child, Lena became even more withdrawn. She had troublesleeping, would cry for no reason, refused to eat and talked about hurting herself."Seeing her daughters condition, Sonia brought Lena to a Polyclinic which referred them to apsychiatrist at a hospital. Lena was given antidepressants and started having regular therapysessions with psychiatrists and counsellors. She tried to follow their advice of not thinkingnegatively, to focus on developing her interests and to make a timetable for each day. Everydaywas a struggle but she managed to recover with time."She said she liked the counselling sessions where she could talk to someone about her feelingsand problems." say Sonia of Lenas reaction to treatment. "Slowly, she got better to the point thatshe was more cheerful and could laugh and giggle like a normal young girl. She even enrolled inyoga classes that helped her gained fitness and to relax."For Sonia, being supportive of Lena through the down times and being sensitive to her needs areher priorities. "I told her that her health is more important than studies. When Im at work, I try tocall her and talk to her whenever I can. She will tell me things like, " Mummy, Im useless and Idont know what to do," and I will try to encourage her to look on the bright side, not to think toomuch..etc.. I have to try to give her lots of love, my full support and attention."TreatmentWhat most doctors agree on is that medication should not be used unnecessarily on children andthat when used, it should be accompanied with the right counselling and therapy. " Its interestingthat recent studies have not been able to prove that antidepressants work in children. This couldbe because children are not mini adults and what works for adults may not work for kids," says DrUng.There is also little research of how antidepressants work on children and prescription drugs mayincrease the risk of self-harm for some vulnerable ones. However, Dr Ung adds, "To keep aperspective on things, the increase of antidepressants prescriptions is small, probably around 2%in affected children given inactive medications (placebos) to about 4% of those on activemedication."
  4. 4. Counselling, it seems , plays the key role in helping children recover from depression. "A goodcounsellor will try to get information from parents, child and school and will try his or her best toco-ordinate the counselling to incorporate all these parties. Cognitive-behavioural therapy is one ofthe commonest forms of counselling techniques used nowadays - it seeks to change the negativethoughts of the child to more realistic and positive ones and also t help the child makeaction/behavioural changes that will help lift the mood," adds the psychiatrist.Cyber HelpWith the computer-savvy generation of today, some children or teens may choose to express theirthoughts and feelings in cyber space. is a community website launced inMarch to provide information and counselling services for depression. A `diary services allowsmembers to post daily updates on their mental and emotional experiences while a `letterboxservice provides them with an opportunity to ask questions to a panel of experts. Most importantly,a service like this seeks to educate the public on the existence of depression and encourage thosewho are depressed to seek help. Following examples, depressed children may be inspired by astrong sense of community to step out of a possible state of isolation. Adults too, can visit togather more information and advice before deciding how best to seek help.Understanding is Key."Sometimes, depressed children are mistakenly labelled as lazy, stubborn or difficult," says DrChan. This is largely due to a lack of knowledge and understanding on the adults part. Children,unlike adults are dependent on their families and guardians to identify their troubles and seek help.Dr Ung adds," One common misconception is that the child is mad. This is totally not so. Anotheris that the child is `weak. Some famous people who are strong of character and have suffereddepression include Abraham Lincoln. Another misconception is that it is incurable or that the childis `bad. Depression is a very treatable condition and the change of behaviour from depressionshould not be mistaken for `badness. Source: