Childhood is often seen as a happy time without worries or responsibilities. As we take a closer look at our childhoods or that of others, we recognize that being “blue”, feeling sad, worried or anxious are everyday emotions that children go through as they develop.
A recent review by Dr. J. Casarella with WebMD deals with depression in childhood. She notes that just because a child seems sad doesn’t necessarily mean depressed. However, if this sadness becomes persistent or interferes with normal social activities, interests, schoolwork, or family life, it may mean that they are suffering from a depressive illness.
Sometimes depression seems to come out of nowhere and other times when children are stressed or grieving. Bullying and spending a lot of time on social media can be associated with depression. Depression has also been linked to other problems such as attention problems, learning problems, behavioral problems or anxiety disorders.
It is important to understand that depression is not caused by one thing, but possibly by a combination of factors interacting with each other. The two factors can be grouped into two broad categories: biology and psychology. Biological factors include genes, hormones, and chemicals in the brain.
Genetic factors are suggested because depression is often familial. However, a person can inherit the gene that makes them vulnerable but never have the disease. Hormonal changes occur during depression.
The brain undergoes some changes before and during the depressive episode. Certain parts of the brain are affected, causing certain hormones to be over / underproduced. Drugs can be effective in the treatment.
Neurotransmitters are chemicals that help nerve cells communicate. It is believed that during depression the activity of one or more of these chemicals is reduced. Many antidepressants increase neurotransmitters in the brain.
The main symptoms of depression, which are similar in children and adults, are sadness or bad mood, feelings of hopelessness, and mood swings. Young children may have a depressed mood and take action or behave in anger.
Some of the signs and symptoms of depression in children include bad mood; social withdrawal; more or less appetite or sleep; tears; tired; physical problems (upset stomach and headache); decreased interest in activities at home, at school, with friends; impaired thinking and concentration; and most importantly, thoughts of death or suicide.
The lifetime prevalence of major depressive disorder among 13-18 year olds in the United States is 11% (about 1 in 10), and about 7% of depressed teens attempt suicide. Suicide deaths in the 15-24 age group are around 5,000 per year and rates during the pandemic crisis are increasing.
Call 911 immediately if you tried to kill yourself today, if your child is confused, or if you think it is a life-threatening emergency. Go to the emergency room if there are threats of suicide or if they have a suicidal plan or thoughts. Call your doctor right away if your child cannot calm down or is severely depressed.
The National Suicide Hotline is 800-273-8255. The local Teen Health Center is also a mental health resource.
Sally robinson is a clinical professor of pediatrics at the UTMB children’s hospital. This column is not intended to replace the advice of your child’s doctor.