Ask the doctor: How can I tell that my child is depressed?

Do children get stressed or depressed?

Yes children get stressed and depressed due to many issues - when they witness family wrangles, when they have a lot of school work, when parents are absent or are too busy and have no time for them, leaving them with no one to discuss what they go through, and high expectations from parents and society.

What is the cause?

Depression is caused by multiple factors. There is the genetic predisposition and the environment. With the environment, there is modelling, where a child models how they see their parents cope with stress and anxiety. They can model learnt helplessness.

The other environmental factors could be stress at home and how the parents handle that. Parents sometimes pressure their children to perform and it can also be access to information online, especially now that some schools are doing remote teaching.

When they go online, they could access social media, which brings in comparisons and cyber bullying. There are a lot of factors and with the current policy of staying at home, there are places children cannot be allowed to access to play due to the mode of transmission of the virus. Currently, we are seeing a lot of higher rates of depression and stress among children. They are not going to school, and some are not engaged properly. Parents are also stressed and passing the stress on the children.

How can I tell that my child is depressed? What are some of the reliable symptoms?

Unlike adults, children show irritability as the first symptom of depression as well as disobedience. They will still show sadness, withdrawal, and a feeling of hopelessness, which can be seen in adults. But with children, the biggest is irritability. Depending on where the child is, sometimes they experiment with substances like glue, cigarettes and alcohol, depending on the environment, supervision and ease of access to the substances.

What should a parent do if they notice their children are stressed/depressed?

A parent should link up the child for care when they notice these signs. First mode of care is to listen to the child. Sometimes children commit suicide, that is why it is important to be non-judgmental when you are listening to them. It is also important to teach them how to take care of themselves. Reach out to a psychiatrist, psychologist or a nurse within your area.

Is it preventable?

There is the biological disposition that may not be altered, but it is possible to alter the environment and prevent depression. The strategy a parent will use is very important. The child needs an avenue that they can be able to release their stress. A parent can try to remold the environment to fit the child. 

How fast do children recover from depression and what does treatment entail?

Recovery in children depends on the point of depression. With proper psychotherapy, they can recover fast. In cases of a child who has lost their parent or has been exposed to trauma, they will suffer from anxiety and depression, and they will need proper treatment to recover. Relapse is possible, that is why proper cognitive behavioral therapy is required. Talk therapy will help the child speak out and cope while maintenance therapy will release the ongoing stress. If you help them and fail to make their environment safe, they will likely relapse.

Can my child develop other health complications due to depression?

Yes. If a child is not eating well due to depression, they will suffer from malnutrition. They can be stress eating and result in obesity. A lifestyle learnt in childhood is likely to go on in adulthood. Disorders like Anorexia nervosa are brought about in children who tend to fail to eat due to internal depression or Bulimia, where they overeat and they induce vomiting. With online access, children see what is valued in the west and they end up suffering from such complications.

What role should I play as a parent to help my child heal from depression?

Once the child has been confirmed to be suffering from depression, help them get the correct treatment while giving them the right support. Find out from the caregivers what you need to do as a parent. The best thing would be to prevent a recurrence by molding the environment. You may not change the child’s genetic predisposition but you can alter the environment by embracing calmness, teaching them how to deal with problems. But the key thing is being there for the children.

Be present and be able to relate with them while trying fun things. We see parents who only interact with their children when they are disciplining them, which is wrong. It shows there is no friendship. Simple things like participating in what they love, praising them and rewarding good behavior will account for positive parenting and build friendship.

The number of children suffering from depression is rising. Where are we going wrong as a society in addressing these issues? 

A lot has changed within the society. Urbanisation has brought its advantages and disadvantages. For example, when a parent has to work, they are forced to leave their children with caregivers, who might not instill the right values in the child. Social relatedness has reduced due to people being busy and failing to create time for their children. Stressors like Covid-19 have disrupted the lives of children who are not able to play freely or even go to school. While parents who are not able to work from home cannot supervise their children, failing to instill the right values gives room for the child to model values from anyone they see fit.

Parenting is key when it comes to children and bonding with them helps shape their behavior. Children translate spending time with them as love.

By Dr Catherine Syengo as told to Saada Hassan. Dr Syengo is a consultant psychiatrist.