Children and DepressionChildren and DepressionInformation and Information and

PreventionPrevention

Training ObjectivesTraining Objectives• Identify what depression is, as well as Identify what depression is, as well as

its many forms. its many forms. • Identify the signs and symptoms of Identify the signs and symptoms of

depression. depression. • Recognize the causes of depression. Recognize the causes of depression. • Identify things parents or caregivers Identify things parents or caregivers

can do when they suspect a child has can do when they suspect a child has depression, and ways to help a child depression, and ways to help a child who is depressed. who is depressed.

What is Depression?What is Depression?

• According to the National Institute of According to the National Institute of Mental Health (NIMH), depression is a Mental Health (NIMH), depression is a serious medical condition. It is not serious medical condition. It is not feeling sad for a few days, but rather it feeling sad for a few days, but rather it is feeling "down“, "low" and/or is feeling "down“, "low" and/or "hopeless" for weeks at a time. "hopeless" for weeks at a time.

Forms of DepressionForms of Depression• According to the NIMH, depression can According to the NIMH, depression can

take many forms. take many forms. • Major depressive disorder or major Major depressive disorder or major

depression, is characterized by a depression, is characterized by a combination of symptoms that interfere combination of symptoms that interfere with a person’s everyday activities: with a person’s everyday activities: eating, working, and sleeping. It is eating, working, and sleeping. It is disabling and prevents a person from disabling and prevents a person from functioning normally. A major functioning normally. A major depressive episode may occur only depressive episode may occur only once in a person’s lifetime or it recurs.once in a person’s lifetime or it recurs.

• Dysthymic disorder is also called Dysthymic disorder is also called dysthymia. It is characterized by dysthymia. It is characterized by long-term (2 years or longer) but less long-term (2 years or longer) but less severe symptoms that may not severe symptoms that may not disable a person, but can prevent disable a person, but can prevent them from functioning normally or them from functioning normally or feeling well. One or more episodes of feeling well. One or more episodes of major depression may also be major depression may also be experienced.experienced.

• There are other forms of depression There are other forms of depression that have different characteristics that have different characteristics than major depression or dysthymia. than major depression or dysthymia.

• Psychotic depression occurs when Psychotic depression occurs when severe depressive illness is severe depressive illness is accompanied by some form of accompanied by some form of psychosis, such as a break with psychosis, such as a break with reality, hallucinations and delusions.reality, hallucinations and delusions.

• Postpartum depression occurs when a Postpartum depression occurs when a new mother develops a major new mother develops a major depressive episode within one month depressive episode within one month after delivery. It is estimated that 10 to after delivery. It is estimated that 10 to 15 percent of women experience 15 percent of women experience postpartum depression after giving postpartum depression after giving birth. birth.

• Seasonal affective disorder (SAD) is Seasonal affective disorder (SAD) is characterized by the onset of a characterized by the onset of a depressive illness during the winter depressive illness during the winter months, when there is less natural months, when there is less natural sunlight. The depression generally sunlight. The depression generally decreases or lifts during spring and decreases or lifts during spring and summer. SAD may be effectively summer. SAD may be effectively treated with light therapy, but nearly treated with light therapy, but nearly half of those with SAD do not respond half of those with SAD do not respond to light therapy alone. Antidepressant to light therapy alone. Antidepressant medication and psychotherapy are also medication and psychotherapy are also normally used in treatment. normally used in treatment.

• Bipolar disorder, also known as Bipolar disorder, also known as manic-depressive disorder, is not as manic-depressive disorder, is not as common as major depression or common as major depression or dysthymia. Bipolar disorder is dysthymia. Bipolar disorder is characterized by cycling mood characterized by cycling mood changes. Changes can include changes. Changes can include extreme highs (e.g., mania) to extreme highs (e.g., mania) to extreme lows (e.g., depression).extreme lows (e.g., depression).

Depression in ChildrenDepression in Children• According to WebMD, children can be sad According to WebMD, children can be sad

without having depression. When the without having depression. When the sadness becomes persistent or disruptive sadness becomes persistent or disruptive behavior occurs that interferes with behavior occurs that interferes with normal social activities, interests, normal social activities, interests, schoolwork, or family life, these may be schoolwork, or family life, these may be indicators a child is depressed. indicators a child is depressed.

• Symptoms of depression vary in each Symptoms of depression vary in each child. The primary symptoms of child. The primary symptoms of depression revolve around feelings of depression revolve around feelings of sadness. sadness.

Signs and Symptoms of Signs and Symptoms of DepressionDepression

• National Alliance on Mental Illness (NAMI) National Alliance on Mental Illness (NAMI) lists the following as signs of early on-set lists the following as signs of early on-set depression: depression: Persistent hopelessness and sadnessPersistent hopelessness and sadness Withdrawal from friends and activitiesWithdrawal from friends and activities Changes in eating and sleeping habitsChanges in eating and sleeping habits Missed school or poor school Missed school or poor school

performanceperformance

• Increased irritability or agitationIncreased irritability or agitation• Indecision, lack of concentration or Indecision, lack of concentration or

forgetfulnessforgetfulness• Poor self-esteem or guilt Poor self-esteem or guilt • Frequent physical complaints, such Frequent physical complaints, such

as headaches and stomachaches as headaches and stomachaches • Lack of enthusiasm, low energy or Lack of enthusiasm, low energy or

low motivation low motivation • Drug and/or alcohol abuse Drug and/or alcohol abuse • Thoughts of death or suicide Thoughts of death or suicide

Facts About Depression in Facts About Depression in ChildrenChildren

• According to Kids Health, in the United According to Kids Health, in the United States, depression is the most common States, depression is the most common mental health disorder. Each year it mental health disorder. Each year it affects 17 million people of all age affects 17 million people of all age groups, races, and economic groups, races, and economic backgrounds.backgrounds.

• As many as 1 in every 33 children may As many as 1 in every 33 children may have depression; in teens, that number have depression; in teens, that number may be as high as 1 in 8.may be as high as 1 in 8.

Causes of DepressionCauses of Depression• According to Kids Health, there are many According to Kids Health, there are many

causes of depression. causes of depression. • Genetics is one cause. Research has Genetics is one cause. Research has

shown that depression can run in shown that depression can run in families; however, not everyone who has families; however, not everyone who has the genetic makeup for depression gets the genetic makeup for depression gets depressed. Many people who have no depressed. Many people who have no family history of depression have the family history of depression have the condition. So although genes are one condition. So although genes are one factor, they aren't the single cause of factor, they aren't the single cause of depression.depression.

• Life events is another cause of Life events is another cause of depression. The death of a family depression. The death of a family member, friend or pet can go beyond member, friend or pet can go beyond normal grief and sometimes lead to normal grief and sometimes lead to depression. Other difficult life events, depression. Other difficult life events, such as when parents divorce, separate such as when parents divorce, separate or remarry, can trigger depression. or remarry, can trigger depression. Even events like moving or changing Even events like moving or changing schools can be emotionally challenging schools can be emotionally challenging enough that a person becomes enough that a person becomes depressed.depressed.

• Family and social environment can also Family and social environment can also cause depression. Some teens may be cause depression. Some teens may be experiencing a negative, stressful or experiencing a negative, stressful or unhappy family atmosphere. This can unhappy family atmosphere. This can affect their self-esteem and lead to affect their self-esteem and lead to depression. High-stress living depression. High-stress living situations can also lead to depression. situations can also lead to depression. These include poverty, homelessness These include poverty, homelessness and violence in the family, relationships and violence in the family, relationships or community.or community.

• Substance use and abuse also can Substance use and abuse also can cause chemical changes in the brain cause chemical changes in the brain that affect mood. Alcohol and some that affect mood. Alcohol and some drugs are known to have depressant drugs are known to have depressant effects. The negative social and effects. The negative social and personal consequences of substance personal consequences of substance abuse also can lead to severe abuse also can lead to severe unhappiness and depression.unhappiness and depression.

• There are medical conditions which There are medical conditions which may also be a cause of depression. may also be a cause of depression. Some medical conditions can affect Some medical conditions can affect hormone balance, resulting in a change hormone balance, resulting in a change in mood. Some conditions, such as in mood. Some conditions, such as hypothyroidism, are known to cause a hypothyroidism, are known to cause a depressed mood in some people. depressed mood in some people. When these medical conditions are When these medical conditions are diagnosed and treated by a doctor, the diagnosed and treated by a doctor, the depression usually disappears.  depression usually disappears.  

• For some teens, undiagnosed learning For some teens, undiagnosed learning disabilities might block school disabilities might block school success, hormonal changes might success, hormonal changes might affect mood, or physical illness might affect mood, or physical illness might present challenges or setbacks.present challenges or setbacks.

If You Suspect Your Child Has If You Suspect Your Child Has DepressionDepression

• According to Kids Health, depression According to Kids Health, depression can be successfully treated in more can be successfully treated in more than 80% of people who have it; than 80% of people who have it; however, if depression goes untreated however, if depression goes untreated it can have deadly effects. It is the it can have deadly effects. It is the number one cause of suicide. number one cause of suicide.

• Depression can be treated with Depression can be treated with psychotherapy, medicine or a psychotherapy, medicine or a combination of therapy and combination of therapy and medicine. A psychiatrist can medicine. A psychiatrist can prescribe medicine, and although it prescribe medicine, and although it may take a few tries to find the right may take a few tries to find the right drug, most people who follow their drug, most people who follow their prescribed regimen eventually begin prescribed regimen eventually begin to feel better. to feel better.

The First StepThe First Step

• According to Kids Health, a parent’s According to Kids Health, a parent’s first consultation should be with their first consultation should be with their child's doctor. The doctor will probably child's doctor. The doctor will probably perform a complete examination to rule perform a complete examination to rule out physical illness. out physical illness.

• If depression is suspected, the doctor If depression is suspected, the doctor may make a referral to a psychiatrist (a may make a referral to a psychiatrist (a medical doctor who can make a medical doctor who can make a diagnosis, offer treatment and diagnosis, offer treatment and prescribe medicine), psychologist (a prescribe medicine), psychologist (a health professional who can diagnose health professional who can diagnose and treat depression, but is unable to and treat depression, but is unable to write prescriptions), or licensed clinical write prescriptions), or licensed clinical social worker (a person who has a social worker (a person who has a degree in social work and is qualified to degree in social work and is qualified to treat childhood depression).treat childhood depression).

More Tips for Parents and More Tips for Parents and CaregiversCaregivers

• According to the National Alliance on According to the National Alliance on Mental Illness (NAMI), there are many Mental Illness (NAMI), there are many things parents can do to help a child things parents can do to help a child who has depression. who has depression.

• Parents should be aware of the Parents should be aware of the behaviors that concern them and note behaviors that concern them and note how long the behaviors have been how long the behaviors have been going on, how often they occur, and going on, how often they occur, and how severe they seem. how severe they seem.

• Parents should take their child to see Parents should take their child to see a mental health professional or the a mental health professional or the child's doctor for evaluation and child's doctor for evaluation and diagnosis. diagnosis.

• Parents can get accurate information Parents can get accurate information from libraries, help lines and other from libraries, help lines and other sources. sources.

• Parents should ask questions about Parents should ask questions about treatments and services. treatments and services.

• They should talk to other families They should talk to other families with similar problems in the with similar problems in the community. community.

• Family support groups may be very Family support groups may be very important to a family experiencing important to a family experiencing depression. NAMI may have support depression. NAMI may have support groups in your area, or there may be groups in your area, or there may be other agencies who also offer other agencies who also offer support groups. support groups.

What Can Parents and What Can Parents and Caregivers Do to Help A Child Caregivers Do to Help A Child

with Depression?with Depression?• According to Kids Health, some parents According to Kids Health, some parents

may have some feelings of guilt. It may may have some feelings of guilt. It may be important for them to receive some be important for them to receive some counseling as well. counseling as well.

• Parents must make sure their child takes Parents must make sure their child takes any prescribed medicines. They must any prescribed medicines. They must encourage healthy eating too, as this may encourage healthy eating too, as this may help improve mood and outlook. help improve mood and outlook.

• Parents should make sure their child Parents should make sure their child stays active. Physical activity has been stays active. Physical activity has been shown to help alleviate the symptoms of shown to help alleviate the symptoms of depression. Physical activities, such as depression. Physical activities, such as bike rides or walks, can be incorporated bike rides or walks, can be incorporated into the family's routine. into the family's routine.

• Children must know their parents Children must know their parents care for them. Parents can tell their care for them. Parents can tell their children they are there, they love and children they are there, they love and care about their child and want to care about their child and want to hear what he or she has to say, even hear what he or she has to say, even if it isn't pleasant. Although these if it isn't pleasant. Although these things may be difficult for a child to things may be difficult for a child to believe, it is important for parents to believe, it is important for parents to say them. say them.

• Parents and caregivers should keep up Parents and caregivers should keep up treatment for children child and watch treatment for children child and watch for warning signs. for warning signs.

• Make sure the prescribed treatment is Make sure the prescribed treatment is followed, whether it's medication, followed, whether it's medication, therapy or both. therapy or both.

• Parents should call the doctor if they Parents should call the doctor if they see signs that their child may be see signs that their child may be thinking about suicide. Untreated thinking about suicide. Untreated depression is the number one cause of depression is the number one cause of suicide. If a child talks about suicide to suicide. If a child talks about suicide to their parents or anyone else, or shows their parents or anyone else, or shows warning signs such as giving warning signs such as giving belongings away and being belongings away and being preoccupied with death, call a doctor or preoccupied with death, call a doctor or a mental health professional a mental health professional immediately. immediately.

• Parents should accept the situation Parents should accept the situation and never tell their child to "snap out and never tell their child to "snap out of it." At times, parents may need to of it." At times, parents may need to remind themselves that it is not remind themselves that it is not laziness causing their child's inability laziness causing their child's inability to get out of bed, complete chores or to get out of bed, complete chores or do homework. He or she simply do homework. He or she simply doesn't have the desire or the doesn't have the desire or the energy. energy.

For More Information, Visit these For More Information, Visit these WebsitesWebsites

• National Alliance on Mental Illness, National Alliance on Mental Illness, http://www.nami.org/Content/ContentGroups/Helhttp://www.nami.org/Content/ContentGroups/Helpline1/Facts_About_Childhood_Depression.htmpline1/Facts_About_Childhood_Depression.htm

• National Institute of Mental Health, National Institute of Mental Health, http://www.nimh.nih.gov/health/topics/depressiohttp://www.nimh.nih.gov/health/topics/depression/depression-in-children-and-adolescents.shtmln/depression-in-children-and-adolescents.shtml

• Kids Health.org, Kids Health.org, http://kidshealth.org/parent/emotions/feelings/unhttp://kidshealth.org/parent/emotions/feelings/understanding_depression.htmlderstanding_depression.html

Missouri Department of Social Services Missouri Department of Social Services State Technical Assistance TeamState Technical Assistance Team

Address:Address:

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Telephone: Telephone: (573) 751-5980(573) 751-5980(800) 487-1626(800) 487-1626(8 a.m. to 5 p.m. CST, (8 a.m. to 5 p.m. CST, Monday – Friday) Monday – Friday)

Email:Email:

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