Childhood Depression and Anxiety: Signs, Diagnosis and Treatment

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heart of hearts something has changed in their child and it is not going away,” Benoit tells WebMD. “A child who is unhappy about a friend who treated them badly, they normally will get over that in a couple of days. But parents know when something is sticking and not going away. Most kids bounce back from an adverse experience in just a few days. Depressed children are still sad after a couple of weeks.”

Childhood Depression

Can school-aged children — even Separation anxiety. The most common childhood anxiety disorder is when a child fears there is a threat to his family. There’s a deep-seated fear that something bad is going to happen to one of the family members — or to the child. Being apart from their family is scary to these kids. They may get very real headaches, stomachaches, or Generalized anxiety disorder. These kids worry excessively about the future. “They worry about how they will do in college, even though they’re in third grade,” Koplewicz says. “You ask, ‘How did you do in soccer?’ ‘Two goals,’ they’ll answer. ‘That’s good,’ you say. ‘Yeah, they say, but I’m worried about the spelling test tomorrow.'”

“Hoping it is a phase, hoping the child will grow out of it, is a very big mistake,” Koplewicz says. “All these disorders cause distress and dysfunction. It makes people feel hopeless. And hopelessness is what makes people want to hurt themselves. It isn’t depression, it is hopelessness.”

Signs Your Child Is Depressed

According to the American Academy of Child & Adolescent Psychiatry, any of these symptoms may mean your child is depressed:

  • Frequent sadness, tearfulness, and/or crying
  • Hopelessness
  • Decreased interest in activities or inability to enjoy previously favorite activities.
  • Persistent boredom; low energy. “The hallmark of depression is this inability to have joy,” Dolgan says. “There’s this low energy, this shutting away, shutting down.”
  • Social isolation, poor communication. “A child given the opportunity to play with friends who prefers to be alone” may be depressed, Dolgan says.
  • Low self-esteem and guilt. “The kids feel they’re not good or not worth very much,” Dolgan says. “I often ask, ‘Are you important to somebody?’ Depressed kids say no.”
  • Extreme sensitivity to rejection or failure
  • Increased irritability, anger, or hostility
  • Difficulty with relationships
  • Frequent complaints of physical illnesses such as insurance companies are less willing to pay for mental health care than for physical health care.

    “As a nation we don’t treat psychiatric illness as we do physical illness,” he says. “There are not enough experts. We have to demand from symptoms of depression before tackling any long-term issues.

    “The comprehensive treatment is individual and family work. Parents are in the mainstream of the treatment,” he says. “The short-term goal ought to be symptom reduction. You have to work on symptoms. And if some situation is prompting or triggering the depression, you know that from meeting the parents.”

    medications should know that there is a side effect to not taking medications, too — kids remain sick,” Koplewicz says. “Medications for these disorders shouldn’t be controversial — if a teen or child or adult has been properly diagnosed with this disorder. Then it is effective and remarkably safe if properly monitored. But first, you have to have the disorder. You need someone to really clarify and say this is not a response to a bad life situation, this is acute clinical depression.”

Child Demoralization

Unfortunately, many children have very good reasons to be sad and to feel depressed. Such children, Koplewicz stresses, do not have depressive disorders. They are demoralized.

“A lot of kids’ life experiences are very depressing. They live in poverty. Their parents are abusive or neglectful or just divorced and still fighting. They are in inadequate educational systems. All those are depressing situations,” Koplewicz says. “These situations don’t necessarily create depression, but they may create behavioral symptoms. These kids may become rambunctious, unhappy, tearful. But we are not talking about the same thing as adult depression. You should feel badly when life is crummy.”

And it’s not only underprivileged kids whose lives can make them act depressed, says Alvin Rosenfeld, MD, a child and adolescent psychiatrist in private practice in Connecticut and New York.

“Much that looks like depression is the product of over-pressured, overscheduled youth and families,” Rosenfeld tells WebMD. “When you cut back, the symptoms diminish.”