Three hundred million individuals are affected by depression worldwide, and this mental health disorder can become serious and can lead to suicide. Children and adolescents are not immune to depression. Depression among children and adolescents is common but frequently unrecognized. It affects 2 percent of prepubertal children and 5 to 8 percent of adolescents. More than 10 percent of children will be diagnosed with depression before the age of 18. Childhood depression is under-diagnosed in children and teenagers because parents often believe that their son or daughter is just moody and that this moodiness is transient. The clinical spectrum of the disease can range from simple sadness to a major depressive or bipolar disorder. Children and teenagers often exhibit depressive symptoms differently than adults do. For example, a child or teenager who is depressed might refuse to go to school, isolate himself or herself, exhibit aggressive behavior, sleep more than usual or become involved with alcohol or drugs. Parents and teachers have a huge impact on their child’s outcome. Although it may be impossible to prevent your child from becoming depressed, it is possible to prevent further complications associated with depression by screening for depression regularly and seeking treatment promptly.
What should you do for childhood depression?
If you suspect that your child has depression, it is essential to talk to your child, teacher, and pediatrician for advice and recommendations. Start with talking to your child. Ask him/her if they have been feeling overly sad about something lately and explain that depression is a medical illness such as diabetes. Therefore, it is essential to talk about it so the doctor can help treat it. It is vital that you do not allow your child to see depression (or any form of mental illness) in a stigmatizing light. Talking to your child’s teacher can give you a bigger picture of how your child is acting at school. Is your child withdrawn? Does your child have friends? Is your child getting bullied? Is your child’s academic performance declining? Setting up a meeting with your child’s teacher can help you gather more information before you visit your child’s doctor. Once you have talked with your child and his/her teacher, talk to your child’s physician about his/her symptoms, as some medical illnesses can mimic depression. If your child has symptoms of depression, it is important for the doctor to either rule out or rule in depression and either treat or refer to a specialist accordingly.
Screening versus diagnostic testing
Screening refers to testing for a disorder in the absence of symptoms. For example, mammograms, colonoscopies, and pap smears are considered screening tests that are done on a routine basis to detect early (or advanced) signs of cancer. Diagnostic testing refers to testing when the individual presents with symptoms and/or signs that warrant that test. Screening for depression is a set of routine questions the physician presents to the patient regularly, even if the individual does not have symptoms. When an individual presents with symptoms for depression, the questions the physician asks may be the same as the screening questions, but the physician will also administer other diagnostic tests to rule out medical disorders that mimic depression. In 2018, new guidelines were released that recommended your child’s doctor screen for depression every year from ages 12 through 21, with suicide now a leading cause of death among adolescents. The United States Preventative Task Force concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening for major depressive disorder in children aged 11 years or younger.
Encouraging your child to be screened for depression
If your child is 12 years or older, it is important that they are screened for depression on an annual basis. By talking to your child about mental health and stressing the importance of keeping a healthy mind and body, you can prevent your child from stigmatizing depression. Instead, they can see this as a disorder that is similar to diabetes. Stigma is a significant barrier to getting help for depression (and other mental health disorders). With these new screening guidelines in place, the hope is that parents and caregivers become more comfortable having conversations about mental help with their sons and daughter at home and, when necessary, work with physicians and therapists to develop the best treatment plan for their child.
Kristen Fuller, M.D., is a clinical content writer and enjoys writing about evidence-based topics in the cutting-edge world of mental health and addiction medicine. She is a family medicine physician and author, who also teaches and contributes to medicine board education. Her passion lies within educating the public on preventable diseases, including mental health disorders and the stigma associated with them. She is also an outdoor activist and spends most of her free time empowering other women to get outside into the backcountry.