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Last Updated on May 31, 2018

Signs of Depression in Children (And How to Help Them to Overcome It)

Signs of Depression in Children (And How to Help Them to Overcome It)

Children, just like adults, can be depressed. Sometimes seemingly normal children with no major life issues can become depressed. It is the result of a chemical imbalance in the brain that causes clinical depression to occur. There are specific signs that you should recognize in your child if they are depressed. Getting them help and treatment is crucial to their mental wellness.

In this article, we will look into the signs of depression in children and how parents can help them to overcome it.

Signs of depression in children

The DSM (Diagnostic and Statistical Manual of Mental Disorder) is the widely accepted instruction guide that professionals utilize for diagnosing mental disorders. The DSM characterizes a Major Depressive Episode as depressed behaviors that consistently last for two weeks or longer. Therefore, if your child has been “down in the dumps”, feeling hopeless or having sadness for more than two weeks, it should be cause for concern and investigated.

Below are signs of depression according to the DSM manual. The individual must have at least five of these behaviors present for a period of two weeks or longer to be officially diagnosed as having MDD (Major Depressive Disorder). Below is a summary/generalization from the DSM manual:

  • Feelings of deep sadness or depressed mood that last most of the day (for two weeks or more). For children they can present as irritable rather than sad.
  • Diminished interest in activities (again majority of the day or all the time).
  • Significant weight loss (not through dieting), or a decrease in appetite. In children, they fail to make expected weight gains while growing.
  • Difficulty sleeping (insomnia).
  • Either a slowing of psychomotor abilities/actions or an apparent agitation of these psychomotor abilities. This means that they either have moments that lack purpose and seem to be done because of agitation and tension or there is a significant slowness/retardation of their speech and physical actions.
  • Fatigue and loss of energy.
  • Feelings of worthlessness or excessive guilt every day.
  • Difficulty thinking, making decisions, or concentrating every day. This may be reflected in their grades.
  • Preoccupation with death and dying or suicidal thoughts.

Please note that if your child is suffering from the loss of a loved one and is processing through the stages of grief, it is normal to have these signs of depression. If they seem to be stuck in the depression stage, then it is time to pursue grief counseling to help them along in the grieving process.

However, if they are not suffering from a bereavement or a medical condition that would cause the above symptoms, then they should be taken to a professional for possible diagnosis and treatment of MDD (Major Depressive Disorder).

How to help your child with depression

Depression is not to be taken lightly. Especially if suicidal thoughts are present. The child’s feelings and emotions are real and must be taken seriously. According to the National Institute of Mental Health (NIMH), suicide is the number two cause of death for individuals between the ages of 10 and 34.[1]

Professional help is recommended if you believe your child fits the criterion for MDD (Major Depressive Disorder). You can take your child to their paediatrician for an evaluation and referral. Depending on the severity of the symptoms, they may benefit from medication such as anti-depressants.

Most professionals do not dispense medication as the first remedy for depression. Instead therapy is the first line of defense against depression, with medication being paired with therapy if the therapy is not enough or the symptoms are severe enough.

Testing

There are assessment tools that professionals can utilize to help in properly determining whether your child is depressed. The three tools used in assessing depression in children are:

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  • The Children’s Depression Rating Scale (CDRS)
  • Children’s Depression Inventory (CDI)
  • Clinical Global Impression (CGI)

Taking your child to a professional mental health counselor, psychologist or psychiatrist can help ensure proper testing and assessment occurs.

Therapy

There are many types of therapy available today. It is important to find a professional that specializes in childhood depression and the treatment of such.

Cognitive behavioral therapy is one of the leading therapy methods in treating childhood depression. For younger children, play therapy is useful in treating childhood depression as children are often able to better communicate through play than conversation alone.

What parents can do at home to help their depressed child

Besides seeking for professional help, there are a couple of things that parents can do at home to help their depressed child:

1. Talk with your child about their feelings in a compassionate and empathetic manner.

It can feel high pressure to sit face to face and ask your child about their feelings. However, going on a walk, playing a board game or playing alongside your child (chose whichever is age appropriate for your child) can allow them to relax and open up about their feelings.

Ask your child open ended questions that require more than a simple yes or no to engage in more meaningful conversations. Never judge while they are being open and honest with you because it will inevitably cause them to shut down and move away from being open with you.

It is okay to allow for periods of silence during the conversations because sometimes the child is processing their thoughts and emotions during your time together. You don’t have to fill the space and entire time with talking as silence at times is helpful.

2. Provide activities that help them relax and de-stress.

For smaller children, there are simple ways to help them relax.

Provide play opportunities that they find relaxing such as coloring, painting, working with Play-do or clay, or playing with sand and sand toys. Again, find activities that interest your child and are age appropriate are helpful in making them relaxed.

3. Limit screen time.

Technology is not helpful in making your child less depressed. It can often be an escape that keeps them from further opening up about their feelings and emotions.

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Limit time in front of the TV, laptop, smart phone, video games and tablets, etc. Any electronics that seem to prevent your child from face to face interactions should be limited. Ask Dr. Sears cites that researchers have found kids who have higher levels of screen time are at greater risk for anxiety and depression.[2]

Provide alternate activities to replace the screen time such as hiking, crafting, drawing, constructing, biking and playing outside, etc. Some children may be so dependent on their screen time as their source for entertainment that they may need you to participate in alternate activities alongside them in order to get engaged in the activities.

You can’t simply tell your child to go outside to play if they are suffering from depression, lack friends and are used to sitting down and playing video games each day after school. Go outside with your child and do a nature hike or take your child to a playground and have fun together to get them engaged in these alternate activities.

4. Promote outdoor time and physical activities.

Encourage your children to take part in activities that especially involve nature such as nature hikes. Do these activities with them to help them engage in the activities. Again this is an opportunity for open conversations to occur and quality time to take place.

5. Help your child when problems and difficult tasks arise.

Assist them by helping them break down the task into smaller and more manageable parts. Children with depression often have difficulty taking on large problems and tasks and find them overwhelming. Helping them by breaking down the task into smaller and more manageable tasks will assist in helping raise their confidence when the small tasks are mastered.

Small tasks mastered lead to bigger tasks being mastered over time. It is a process over time, patience and a willingness to work alongside your child. This does not mean doing the task or taking on the problem solely yourself. Many times all the child needs is for you to break down the larger task into smaller more manageable tasks and for you to patiently talk your child through the completion of these smaller tasks.

6. Help your child reduce life stress.

When children are depressed, they have greater difficulty handling life activities in general. Cut back on activities that cause stress to increase and look for ways to help reduce stress in your child’s life.

7. Foster a positive home atmosphere.

Reduce or eliminate negative attitudes, language and conversations. Also avoid raised voices, passive aggressive behaviors and any form of physical violence in the home.

Make your home a safe haven for your child instead of an atmosphere that is ever volatile (in words, emotions or physically). Make it a calm environment that makes your child feel safe and secure mentally, emotionally and physically.

8. Help your child see the positive in life situations.

Point out the positives in a situation rather than the negatives. Help them see the bright side of any situation.

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Be a model of seeing the positive in life by speaking words that are uplifting, encouraging and positive. Resist the temptation to voice negative thoughts that come to mind as your child can feed off your emotions and words.

9. Believe your child when they talk about how they are feeling.

Listen to them patiently and take their words seriously. Do not discount or minimize their feelings. Express empathy and compassion when they do open up about their feelings. Help them utilize “I feel” statements in expressing their emotions.

10. Keep watch for suicidal behaviors.

Such behaviors include your child/teen researching this topic online, them giving away their possessions and a preoccupation with death.

Seek professional help immediately with the presentation of suicidal behaviors or thoughts. Keep this number on hand and use it when in doubt: National Suicide Prevention Lifeline Phone Number 1-800-273-8255.

11. Keep all prescriptions, alcohol, drugs and weapons locked and away from children and teens.

This is a given for all children, but even more imperative for children who are depressed as they have an increased likelihood to abuse drugs and alcohol. They also have an increased likelihood to attempt suicide. So keep weapons and tools such as ropes and knives that can used for suicide out of the child’s ability to use.

12. Spend quality one-on-one time with your child.

Make the time during your day, every day, to spend quality time with your child. You may have limited time and cannot provide an hour or more a day to dedicate to one-on-one time with your child, but you should provide a minimum of 20 minutes a day with your child spending quality one-on-one time together. Try the suggested activities listed in point #3.

13. Be an encouragement and supporter of your child.

Show love and not frustration or anger because of the situation and your child’s condition. Help keep your attitude positive so your child can also see the positive.

Provide daily words of affirmation that are not based on end results (such as a grade or a win) but instead praise the effort they put forth. If you praise the outcome, they will be disappointed when their efforts don’t pan out. If they are praised for their efforts regardless of the outcome, their confidence is built based upon something that they can control (the effort they put into things).

14. Help your child to live a healthy lifestyle.

Sleep is a very important factor in your child’s mood. Not getting enough sleep can cause an entire day to be upset. According to Sleep Aid Resource, children between the ages of 3 and 18 need between 8 and 12 hours of sleep each night:[3]

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    Ensure your child is eating a healthy and balanced diet, getting physical activity/exercise daily and plenty of sleep time.

    15. Help your child foster positive relationships and friendships with their peers.

    Set up play dates for your younger child and encourage older children to invite friends over to your home.

    16. Talk about bullying.

    It can be one of the causes of your child’s depression, so discuss their life outside of home and their interactions with their peers. Help them recognize bullying and discuss how to handle bullying properly.

    17. Help your child follow the treatment plan outlined by their doctor, counselor, psychologist or psychiatrist.

    Make sure you know the treatment plan that your child’s health care professional has outlined for child. This may include counseling session recommendations, medications and recommendations to follow through with in the home. Completing the plan will help provide optimal results for your child in the long run. A plan doesn’t work unless it is followed.

    18. Recognize that professional treatment takes time to show results.

    Don’t expect results for the first few weeks. It may take a month or longer, so be patient and understanding with your child.

    Depression in children is curable

    Depression in children can happen for a variety of reasons. It is quite treatable.

    Professional help is recommended if your child can possibly be diagnosed with a depressive episode. There are interventions that can be implemented in a professional setting, at home and at school. The key is having a plan of action to help your child.

    Ignoring the problem or hoping the depression will just go away is not a good plan. Treatment is imperative to curing depression in children.

    The first step is talking to your child’s paediatrician to get the ball rolling. He or she will refer you to specialists in your area that can help your child overcome and conquer their depression one day at a time. With you by their side, each step of the way you will get through it together and it is quite possible for your relationship with your child to be strengthened in the process as well. That can be your silver lining or positive outlook on the situation at hand.

    Featured photo credit: Unsplash via unsplash.com

    Reference

    [1]National Institute of Mental Health: Suicide
    [2]Ask Dr. Sears: It’s a Virtual World: Setting Practical Screen Time Limits
    [3]Sleep Aid Resource: Sleep Chart

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    Dr. Magdalena Battles

    Doctor of Psychology

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    Last Updated on June 18, 2018

    What Really Works: How to Relieve Lower Back Pain Effectively

    What Really Works: How to Relieve Lower Back Pain Effectively

    Eight out of ten adults experience lower back pain once in their lifetime. I am one of those people and I’m definitely not looking forward to my participation award. I know how it feels like to step out of bed and barely being able to put on your socks. Having lower back pain sucks. But 9 out of 10 patients that suffer from lower back pain don’t even know the primary cause of it.

    Video Summary

    Back Pain? Blame Our Evolution

    Once upon a time in our fairly recent past, our ancestors felt the urgency to stand up and leave our quadruped neighbors behind. Habitual bipedalism, fancy word for regularly walking on two legs, came with a lot of advantages. With two rear limbs instead of four, we were able to more efficiently use our hands and create tools with them.

    Sadly, life on two legs also brought along its disadvantages. Our spine had four supporting pillars previously, but now it only got two. The back is therefore naturally one of the weak links of our human anatomy. Our spine needs constant support from its supporting muscles to minimize the load on the spine. With no muscle support (tested on dead bodies) the back can only bear loads up to 5 pounds without collapsing [reference Panjabi 1989]. With well-developed torso muscles, the spine can take loads up to 2000 pounds. That’s a 400-fold increase.

    Most people that come to me with a history of a herniated disc (that’s when the discs between the vertebral bodies are fully collapsed, really severe incident), tell me the ‘story of the pencil’. The injury with the following severe pain usually gets triggered by picking up a small, everyday object. Such as a pencil. Not as you may think by trying to lift 100 pounds – no, but by a simple thing – such as a pencil.

    This tells us that damage in your back adds up over time, it’s a so called cumulative trauma disorder. Meaning back pain is a result of your daily habits.

    Sitting Is the New Smoking

    Whenever I sit for too long, my back hurts. In fact, 54% of Americans who experience lower back pain spend the majority of their workday sitting. But isn’t sitting something that should reduce the stress of your back? No, just the opposite.

    The joints between the bones of the spine are not directly linked to the blood supply. These joints instead get nourished through a process called diffusion. Diffusion works because molecules (such as oxygen, important for cells) are constantly moving and try to get as much space for themselves as they can. A key element for diffusion therefore is a pressure difference. In the image below the left room contains more moving molecules than the right, that’s why the molecules from the left are moving to the right. This way nutrition gets transformed into the joints, whereas toxins are transported out of the joints.

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    Sitting puts a lot of pressure on your spinal chord. The diffusion process therefore can’t function as efficiently. Nutrition and toxins can’t be properly transported, the joints get damaged.

      Sit Properly

      If sitting can play such a huge part in the creation of your lower back pain, how do you sit properly then?

      Is it better to sit with a straight back or should you rather lay back in your chair? Can I cross my legs when I’m sitting or should I have a symmetrical position with my feet? These are questions that I hear on a daily basis. The answer might shock you – according to recent science – all of them are right. The best sitting position is an ever-changing one. An ever-changing position minimizes the pressure on certain points of your spine and spreads it on the whole part.

        Credit: StayWow

        Stand Up More

        Even better than a sitting position is a stand up position. Standing dramatically reduces the pressure on your spine. If you’re forced to work on a desk the whole day though, you have two options.

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        Take breaks every hour of about 2-3 minutes.

        Set an alarm on your phone that goes off every hour! In that time you stand up and reach to the ceiling, on your toe tips with fully extended arms. You’re inhaling during the whole process. You do this activity for 20 seconds. Afterwards you’re walking through the office for the next 2 minutes. You might grab a healthy snack or some water in that time. The exercise relieves the pressure on your spine, while the walking makes sure that the joints on your spine are properly used.

        Or get a standing desk.

        One of the best companies on the market for Standing Desks, according to my research, is Autonomous. Autonomous offers a rather cheap Standing Desk, with the ability to change the height. Which means you can start the day standing and switch to sitting if you’re tired.

        Exercise for Lower Back Pain

        Sitting is an immobile position. Your joints are made for movement and therefore need movement to function properly. If humans are moving, all moving parts: e.g. the joints, bones and muscles get strengthened. If you’re in a rested position for too long, your tissues start to deteriorate. You have to get the right amount of activity in.

        But not too much activity. There’s a chance that going to the gym may even increase your risk of lower back pain. I know plenty of friends with chiseled bodies that suffer from pain in the spine regularly. Huge muscles do not prevent you from back pain. In your training you should focus on building up the muscles that are stabilizing your back and relieve pressure. Squats with 400 pounds don’t do the trick.

        The more weight you carry around, the more weight your spinal chord has to bear on a regular basis. That’s one of the reasons why huge, muscular guys can suffer from back pain too. One of the most important goals of your exercise regimen should therefore be weight loss.

        Here are some important tips for you to consider when starting an exercise regimen:

        Make sure you implement cardiovascular training in your workout routine.

        This will not only help you lose weight, it will also make sure that your arteries, which flow to the tissue next to your spinal discs, are free of placque and can therefore transport nutrients properly.

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        Important: If you have rather strong back pain, maybe even an herniated disc, don’t start running on a threadmill. Running is an high-impact exercise. Which means there are continuous, reocurring high pressure points on your spine. Your endurance training should therefore either be fast-paced walking or a training on the elliptical trainer for the beginning, because both have little to no stressful impact on your backbone.

        Focus on developing your whole core if you want to minimize your pain.

        There are some people that do hundreds of sit ups a day. While sit ups are a good exercise for your abdomen, it also puts pressure on your spine due to the bending movement. A sixpack workout routine is one-sided. Your abs may become overdeveloped in comparison to your back muscles. You’ve created an imbalance. A great way to train your abdominal muscles and back muscles simultaneously, is holding the plank position.

        Stretch only if you have tight muscles.

        I remember stretching every morning after I woke up. I took 10 minutes out of my day to just work on my flexibility and prevent injuries. Little did I know that I was actually promoting an injury, by doing so.

        Contrary to common belief, stretching is only partially beneficial to treating lower back pain. Stretching makes sense if tight muscles (such as the hamstrings) are forcing you to constantly bend your back. Stretching to treat pain doesn’t make sense if you’re already on a good level of flexibility. Hyper-mobility may even enforce back pain.

        If you found out that you had tight muscles that you need to stretch, try to stretch them at least three times a week. Don’t stretch your muscles right after you wake up in the morning. This is because your spinal discs soak themselves up in fluid over the nighttime. Every bending and excessive loads on your spine is much worse in that soaked-up state. Postpone your stretching regime to two-to three hours after you’ve woken up.

        Where to Start

        The key to improving your habits is awareness. Try to get aware of your back while you’re sitting down, laying down or lifting an object next time. This awareness of your body is called proprioception. For example, you have to be aware whether your back is bended or straight in this very second. Trust me, it is harder than you might think. You may need to ask a friend for the first few tries. But the change that this awareness can make in your back pain is absolutely fascinating. This consciousness of your body is one of the most important things in your recovery or prevention.

        Here are a few behavioural tactics that you need to be considering:

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        If you’re leaning forward more than 30 degrees with your upper body, support your spine with your arms.

        Ever tried to show a colleague of yours a complex issue and found yourself awkwardly leaning forward on their desk, pointing with your fingers to his paper? If that ever happens again, make sure you’re using the not-pointing arm to support yourself on the desk.

        Keep a straight back.

        Be it while exercising, stretching or standing. If you’re bending your back you’re putting stress on small areas of your spinal chord. A straight back redistributes the force to a bigger area. You’re minimizing the pressure. Remember this whenever you’re at the gym and reracking your weights, focus on having a neutral spine.

        Put symmetrical loads on your spine.

        I used to play the trumpet when I was a child. The instrument is pretty heavy. The trumpet gets transported in a big, metallic suitcase – with no wheels. Being the nature of suitcases, you only carry it with one arm, on one side of your body. This forced me to constantly lean on the other side with my upper body, while transporting the instrument from A to B. Not really the healthiest activity for your spine as you can imagine.

        If you have to carry heavy objects, carry them with both arms. Put the object in the middle of your body and keep it as close to your mass of gravity as you can. If this is not possible, try to carry the same amount on the left side than you do on the right side. This puts the stress vertically on a fully extended spine. The load is much better bearable for your spine.

        Stay Away From the Back Pain League

        Our world is getting more sedentary. We will continue to develop faster transportation, more comfortable houses and easier lives. While our technological progress definitely has its amazing benefits, it sadly has its downsides too. The danger for back pain will continue to rise on our ever-increasing motionless planet. It’s time to raise awareness.

        Featured photo credit: Pexels via pexels.com

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