Childhood depression has always existed and has been a prominent diagnosis among children as young as toddlerhood all the way to adolescents. But since the pandemic began and children have been forced to be socially isolated with limited escape mechanisms and coping skills they may have depended on in the past, I have personally and professionally seen depressive symptoms worsen over the last year, even with children that have generally been happy in the past. Children are meant to play with friends and are designed to socialize in peer groups. Sure, limited social interactions can happen to a certain extent virtually, but having face-to-face, physical, sensory contact with others is what really helps to fuel them. Not only have our children been socially isolated, but since quarantine and mandatory stay at home orders, places that were helpful for a child’s mental health in the past like playing at a park, going to a restaurant, or even to a local zoo have been shut down and they have been cut off access to them.
According to Web MD, “up to 3% of children and 8% of adolescents in the U.S. suffer from depression. Depression is significantly more common in boys under age 10. But by age 16, girls have a greater incidence of depression.”
It’s absolutely normal for children to get sad from time to time, it’s the natural ebb and flow of life. It’s also common for your child to have a bad day, a bad week, or even get into a funk. This can happen to everyone – especially during these unusual, challenging times. But if you see your child’s behaviors and symptoms persist or get worse, that is when it is time to intervene. Don’t wait too long, it’s always better to be proactive than reactive, just try to be present and mindful of how they are acting and decide what steps you need to take from there. Diagnosable depression has very specific criteria, so if you want to get your child assessed, I have some resources for you at the end of this blog.
As a parent, it is important to listen to your gut. If, for any reason, big or small, you believe your child or adolescent is depressed, act on your instincts! Try not to panic as there are many interventions you can do to try and help them, but the one takeaway I have is, to always take it seriously. If your child has severe depression and talks about suicidal ideation, it’s not just a desperate act for attention, they are seeking for help and support. And please do not assume that your child is too young to feel a certain way. Children can show signs of depression at an early age and suicide has happened as early as 6 years old – at least from what I have researched. According to CNN, suicide under the age of 13 happens every 5 days. Suicide is a terrifying word and a more tragic act, and as a parent it is scary to hear your children expressing this type of ideation, but there is support, help, and resources out there, so don’t be afraid to seek them out. There is no stigma attached to your child’s wellbeing. This is their life!
I want to note that mourning, adjustment disorder, post traumatic stress, and experiencing grief and loss due to a specific recent traumatic life event will be addressed in later blogs.
Signs of Childhood Depression
How has your child been behaving lately? Have you noticed your child withdrawing from activities they used to love? Have they shown less motivation and excitement about school and school activities? Maybe they don’t want to attend school (virtually or in person) or have any desire to complete their homework. Are their grades suffering? Have you noticed them arguing with their teacher, family members, or friends? Have you noticed them being more emotional than usual? Are they having multiple mood fluctuations and changes? Are they gaining excessive weight or losing weight at a rapid pace? Possibly they have been sleeping more than normal or not sleeping enough and possibly suffering from insomnia. Maybe they lack energy or desire to get out of bed or out of the house. If they are depressed, they might not be taking care of their personal hygiene and it’s a struggle for them to brush their teeth or take a shower. Or maybe your child is becoming very rigid, argumentative, or easily rattled and frustrated. For some children and adolescents, you will not only see signs of withdrawal and worthlessness, you will also see more hopelessness. They will say things like “what’s the point” or “it doesn’t matter anymore” or “nothing is going to get better.” The more these behaviors interfere in everyday life and the more these emotional states persist, the more likely your child is depressed.
Symptoms of Childhood Depression
Unlike adult depressive symptoms, childhood depression can look a little different and may be misinterpreted as something other than depression. When most people think about depression, they think of sadness and hopelessness, which can still be prominent features of childhood depression, but children, especially young children, will more likely display irritability and anger. Anger is in fact a secondary emotion with the underlying emotions being sadness and fear. And with having to face an unknown global pandemic on top of being forced away from school, friends, parks, etc, it’s no wonder our children are sad, fearful, and angry! If your child is depressed, they may show indecisiveness, guilt, or lack of concentration and focus. Your child may also show physiological signs of distress like persistent headaches, stomach aches, and other bodily pain.
According to the DSM 5, to be diagnosed with Major Depressive Disorder, an individual must have 5 or more symptoms (listed in the book) that are present in the same two-week period and represent a change from previous functioning. At least one of the symptoms must be either depressed mood or loss of interest or pleasure. Furthermore, “symptoms typically cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.”
Solutions to Childhood Depression
So what can you do to support your child and help them cope if you think they are depressed? First determine if your child’s symptoms and behaviors are mild, moderate, or severe. A self assessment can determine your next steps. Depression is not something anyone should be ashamed of, so remember you can’t just snap your child out of being depressed. It can take time, so try to be patient, open to conversation, be empathetic, and validate their emotions. First and foremost, make sure your child is physically healthy by getting a check up with their pediatrician. This doctor can also recommend a local therapist and or psychiatrist if needed. But you will want to rule out any medical condition and or substance abuse first, before you work on mental wellness. They also will be able to prescribe antidepressants or any other medication to help your child’s physical chemistry that might be affecting their mental health. Next, make sure you are helping your child maintain a health diet, an adequate amount of sleep, and are encouraging them to exercise frequently.
Mild Depressive Symptoms
If your child has newly onset, mild depressive symptoms, you can try a few things at home before seeking professional help, but know that professional help is always available to you. Here are a few coping skills that have worked for my clients in the past:
Fresh Air: Schedule fresh air breaks throughout the day. Go on a walk, Take a bike ride. Play at the park. Go on a neighborhood scavenger hunt. Eat a picnic lunch outside. Play in the backyard.
Empowerment: Help them feel important and valued. Empower them to be in charge of something around the house. Give them a chore or job to do that will make them feel like they have a purpose. Maybe it’s setting the table for dinner or picking a show to watch on television as a family after dinner, or even let them decide what is for dinner. They can help make dinner, too!
Social Interaction: We all need someone to talk to! Some children are still completely virtually learning, so face to face physical contact can be tricky. If you don’t feel safe meeting in person, schedule weekly virtual playdates. If you feel safe enough for your child to be outdoors, socially distanced and wearing a mask, have your child meet up with one other friend for a bike ride or to play at the park. And if you are willing, invite a friend over to your home. It doesn’t so much matter at this point what you do, just do something, and make it consistent, like a weekly soccer practice or dance class.
Join a Club: There are so many online classes your child can take! If there isn’t something available or open in person, sign your child up for an interactive art, music, or cooking class to do with other peers online!
Growth Mindset Exercises: There are many growth mindset exercises you can do with your child to shift their thinking more positively. In fact, I just wrote a blog on this topic with conversation starters, interactive questions, and affirmation examples that you can read here!
Play: Let your child have sufficient time away from life demands like school, homework, chores, and other tasks and give them adequate time to play! Play with comforting items like stuffed animals, sensory toys, fidgets, puppets, dollhouses and figures, and even a telephone so they can “talk to someone” other than a parent or sibling is vital to their overall wellbeing and mental health.
Moderate Depressive Symptoms
If you believe your child is moderately depressed and showing increasing signs of hopelessness, I would consider seeking professional help at this level. Don’t feel like you should be the only person to help your child. It takes a village, remember? But in the meantime, here are some coping skills to supplement you can try at home:
Journaling: If your child is old enough to write, have them externalize their emotions on paper instead of keeping them inside. Encourage them to journal once a day. They can write freely or you can get them a gratitude journal so they can focus on the positive aspects of their life. If they aren’t old enough to write, give them a journal without lines so they can draw their emotions on paper!
Physical Exercise: Encourage your child to get adequate exercise, which is known to significantly improve mood. Take them on a walk or ride a bike with them. Take a yoga class together! Go on a hike or go for a run! If they are older, purchase some free weights and have them lift weights. Just keep them moving and active!
Grounding Exercises: Have them walk in the backyard with their bare feet. The receptors and physical sensations on their feet will trigger a grounding feeling and help with overall mindfulness. Or you can have them try a sensory exercise like taking a moment to see, smell, hear, taste, and touch various things in the room to become more present and regulated.
Art Therapy: I truly believe that art heals the mind and body. Give your child a blank canvas and let them draw out their emotions in a creative, non-judgmental space. If they need more inspiration or structure, provide them with a step by step art project or craft!
Sandtray Therapy: A professional can really help you with this in a therapeutic setting, but if you want to try a similar method, get a large plastic bin and fill it with soft play sand. Purchase multiple small figures, fences, trees, rocks, gems, etc and let your child tell their story in the sand. Their story might change each day, but again, this is a play therapy technique that helps children and adolescents express their emotions in a creative, non-judgmental space.
Puzzles: Puzzles are a great way for your child’s brain to focus on something other than their emotional state. Have them work on a puzzle alone or with a family member or friend!
Severe Depressive Symptoms
As I previously mentioned, you can start with your child’s pediatrician if you’d like. They might be able to give you a clinical referral for a therapist or psychiatrist. They also will be able to prescribe necessary medication, if needed, and rule out any substance abuse or medical condition. If you believe your child is in trouble and would like to find a trained, licensed mental health professional in your area to assess risk or to receive ongoing therapeutic services, please visit Psychology Today. I love this resource because you can filter your search by gender, specialization, and even insurance company. If you think your child may be suicidal, please call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255). They provide free, confidential support 24 hours a day, 7 days a week. You can also text “NAMI” (National Alliance on Mental Health) at 741741. If you are facing an emergency, please dial 911.
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