The permanent development of society has not been able to stop the number of people suffering from depression to halt the alarming growth in recent years. Depression is a mental health problem that can occur as early as the age of 4-5 years. Why does depression occur in children? How do we find it? How do we manage it? How do we prevent it? The ATLAS Parenting Specialist, Simona Podaru, answers our questions in the following material.
According to the Romanian Journal of Pediatrics, depression affects up to 1% of preschoolers, 2-3% of school children, and 5-8% of adolescents. Gender distribution is equal until around the age of 15 when girls are twice as affected as boys.
Martin Seligman, former president of the American Psychological Association, mentioned:
When children who have become a pessimist stumble on a pebble in their heads, this turns into a giant mountain. Terrified for fear of failure, they will be more inclined to err precisely because of their fear.
Pessimism, once installed in a child’s psyche, can lead to depression and resignation, and school performance will fall well below the child’s capacity.
The same specialist also claims:
In most cases, poor grades at school are not an indicator of low capacity, but of a negative self-image. Children who consider themselves less bright or incapable very often give up on a challenge. Not because they would not be motivated or endowed, but because they did not learn the optimism necessary to overcome obstacles.
The tendency towards optimism or pessimism is innate, but it is not, however, unchangeable. Experts say that immunisation from apathy and discouragement is taught daily, instinctively, just like a mother tongue. This happens especially during childhood.
Optimistic children are more reliable in dealing with difficulties, achieve better results at school and extracurricular activities, have better relationships with parents and friends, get sick less often, and are less depressed.
It is essential to convey to our children the conviction that any situation can be changed, to teach them to keep anxiety and bad thoughts under control, to send to them the security they need.
Why does depression occur in children?
Specialist studies have not indicated a specific cause that would generate the phenomenon of depression in children.
Risk factors for the development of a depressive disorder were classified into four categories:
1. Biological factors:
- a history of depression in the family,
- use of psychoactive substances or alcohol by their parents,
- chronic medical disorders.
2. Psychological factors
- Psychiatric disorders: anxiety, post-traumatic stress disorder, use of psychoactive substances,
- hyperkinetic disorder with attention deficit,
- eating disorders;
- low self-esteem,
- significant losses.
3. Family factors
- mental disorders of parents,
- the conflict between parents and child,
- negative parenting style, manifested by rejection or non-involvement.
4. Social factors
- delinquent behaviour,
The child is not seen and accepted for what he is, is exposed to suffering over which he cannot control or express, resolve, or change.
He tends to look for solutions on his own. When he really has the courage to talk about what he feels and can’t necessarily identify himself as a source of suffering, there is an imminent risk of not being heard or understood. If we talk about cases where one of the parents may also suffer from depression, things can get even more complicated. This is where our specialists can intervene in a personalised manner.
How does depression manifest in children?
If a child has periods when he is depressed or sad, it doesn’t necessarily mean he is depressed.
We can interpret as signs of depression in children one or more of the following symptoms, always present for more than two weeks, and significantly affecting the daily life of the child:
- obvious behavioural problems;
- social withdrawal, lack of desire to communicate;
- lack of joy to play and explore, lack of energy and interest in the activities he liked;
- tantrums and aggression;
- excessive sensitivity;
- tolerance to low frustration;
- difficulty concentrating;
- changes in sleep and food schedule with effect on body weight;
- headache or stomach pain, frequent illness;
- changes in activity level, the child becoming either very agitated or very quiet;
- sudden mood swings, irritability, and nervousness;
- developmental regression (e.g., the child returns to habits he had when he was younger);
- feelings of guilt or devaluation;
- exaggerated fears that make him dependent on the presence of an adult (for example, the child “hangs” from an adult and wants to sit nestled in his arms in a state of apathy);
- thoughts or words about death or suicide.
Although the diagnostic criteria are the same as in adults, in children and adolescents, depression is harder to diagnose. Although depression is a severe condition, it can be treated effectively, especially if it is identified by specialists as close to onset as possible. Complete the PHQ-9 Questionnaire for early identification of depression. Early identification is an important factor in the subsequent therapeutic approach.
How can we prevent depression in children?
For the physical and mental health of the child, the most crucial aspect is the quality of the relationship he has with the parents.
A healthy relationship means trust, safety, and the transmission to the child of the belief that he is loved, accepted (regardless of his performance), and that he can always rely on his parents. It is important for parents to succeed in being present and involved in the child’s life so that they can know them, know what stages of development they are going through, encourage them to talk about how they feel.
The child needs our constant attention and care, and when we feel that he is asking for more/too much attention, it means that what we offer him, in reality, is not enough for him. Sometimes we can be misled by a quiet child who does not directly ask for our attention.
Psychologists have adopted a concept of physics, “resilience” to apply it to the ability of some people not to let themselves be brought down by adversity and defeat, refusing to become a prey of depression and pessimism. George Vaillant, an American psychiatrist, one of the world’s leading specialists in resilience, argues that resilience is a matter of interpretation and is an attitude that is mostly taught in the family climate.
It is the personal characteristics, such as temperament, but especially those of the environment: the emotional support provided by the family and the social ambience in which the child grows up, the style of education, the sense of humour, the ideals and values that are transmitted to it.
Another important factor is the time your child spends in front of screens (TV, phone, tablet, laptop). Experts recommend:
- no TV or tablets for children under two years old
- less than one hour per day for children between 2 and 5 years of age
- maximum of 2 hours per day for older children
Instead, we can offer alternative activities such as a walk in the park, a trip to the mountains/forest, physical time spent 1 to 1 with the child, activities with his friends, games and outdoor movement, sports activities.
Parents are role models for the child, and therefore they need to pay attention to themselves in the first place, to the way they manage difficulties, negative emotions, to the way they relax, how they relate to others. Everything I do is an example for the child and can be the most telling support I can offer. In most cases, it is sufficient for a child to recover from the support and unconditional love of a single person to rely on.
The parent is best able to intervene in:
- cultivating the autonomy and discretion of the child;
- providing an ambience for the child to explore;
- helping the child overcome difficulties instead of avoiding them;
- giving the child the freedom to make mistakes;
- encouraging him to make autonomous decisions;
- creating opportunities to make him feel competent;
- entrusting the child’s responsibilities according to his or her age;
- explaining the reasons for its successes and helping in predicting them;
- discussions about the causes of failures;
- support to the child in proposing objectives;
- conveying one’s optimism and confidence in the future;
- avoiding situations that are incomprehensible to the child;
- be an example for the child.
What are the steps in treating depression in children?
It is essential to identify early signs of depression in children and to turn to specialists for guidance and treatment. In some more uncomplicated cases, the specialist will recommend a period of waiting, vigilance, close observation of the child, and the help of a psychotherapist. If necessary, the specialist may prescribe, in addition to therapy and drug treatment.
Our licensed and verified specialists are here at all hours of the day and night if you need help identifying your child’s problems. You can chat with one of them for free through ATLAS Help Line – 031 630 2020, a 24/7 hotline.
If you want to talk directly to the ATLAS parenting specialist, Simona Podaru, you can contact her and tell her what’s on your mind. The important thing is not to suffer in silence; we are here to help. Let’s be good!