Depression in childhood and adolescence is a distressing experience for both the young person and their family members. This can leave families feeling despondent and with a sense of not knowing what to do next or how to provide the best support for their loved one.
How common is depression?
Depression is not a rare condition. In young people under the age of 18 years between 2% and 9% of the population will have depression at one time or another. Those who suffer from depression have an increased risk of self-harm and suicidal behaviours.
Features of childhood depression
Features of childhood depression vary with the literature linking these features by assuming that the depressed child has suffered a loss of some sort. That is, either a loss of an important relationship, an attribute such as loss of health or academic/sporting ability or loss of social status as in the loss of friendship. Common features include:
- Bias towards negative events
- Negative view of the self, world and future
- Excessive guilt
- Suicidal ideation
- Inability to focus
- Depressed mood
- Inability to experience pleasure
- Irritable mood
- Anxiety and/or sense of dread
- Physical slowness
- Fatigue
- Dysregulated sleep
- Aches and pains
- Loss of appetite or overeating
- Deterioration in family relationships
- Withdrawal from friendships
- Poor school performance
Assessment
As those who suffer from depression are at a higher risk of suicide and self-harming behaviours, the first priority is to assess risk of harm. Once these risks have been managed further assessment of the depressive illness can take place.
Assessment includes a multi-modal approach including clinical interview with the caregivers, child and school if needed. As well as questionnaires and cognitive and scholastic testing if there are suspected learning issues. This is to ensure that the clinician has a comprehensive understanding of the concerns leading to, and maintaining, the depressive illness.
Treatment
Treatment involves education, interventions focusing on self-monitoring, improving sleep, increasing physical activity, increasing pleasant activities, improving unhelpful thinking patterns, changing negative family relationships, improving social skills, and appropriate school-based interventions.