Preventing Depression In Children

Childhood and adolescence are life stages that produce a whirlwind of emotions. Happiness, sadness, anxiety, anticipation, confusion—all are expected emotional fluctuations. However, some children remain sad and hopeless for the majority of the time. These persistent “blues” begin to interfere with relationships, school, and day-to-day activities. Although both children and adults experience depression, depression has unique qualities in childhood. Recognizing the signs, risk factors, and treatments are important to prevent depression in children.

Preventing depression in children. Photo by Aa Dil from Pexels
Preventing depression in children. Photo by Aa Dil from Pexels

What is Childhood Depression?

Depression is a mood disorder that effects how someone thinks, feels, and acts. It is characterized by persistent sadness and feelings of hopelessness lasting longer than two weeks. Depression impacts the whole body from cognitive processes to physical ailments. It interferes with enjoyable day to day activities, relationships with family and friends, as well as school or work.

Childhood depression is depression that occurs in childhood. This includes ages 3 to 12 and the adolescent stage, too. Cases of childhood depression are steadily rising. According to the American Academy of Child and Adolescent Psychiatry, one in seven children and adolescents experience a depressive episode.

Symptoms of Depression

Aside from sadness, childhood depression is associated with a range of symptoms. Childhood depression is more than feeling sad. It impacts the whole body in ways one would not expect.

  • Frequent hopelessness—Frequent hopelessness accompanies sadness and is marked by crying.
  • Decreased energy—A child’s energy levels are low when experiencing depression. Fatigue arises from secondary sleeping disorders and chronic boredom.  
  • Irritability and/or aggression—Depression causes an alteration in mood. In childhood depression, the main mood changes are irritability and aggression towards others.  
  • Difficulty concentrating—If the child is in school, declining grades is a sign of childhood depression. Poor academic achievement results from difficulty focusing on tasks and decreased care for activities.
  • Isolation—Children who were once social tend to withdrawal from friends and family when they become depressed. They do not partake in games or outings and are reserved in sharing their feelings.
  • Changes in weight and/or eating habits—Weight, along with appetite, can increase or decrease with depressive episodes.
  • Irregular sleeping patterns—Insomnia is the inability to sleep during the night. Children with depression have difficulty falling and staying asleep.
  • Preoccupation with death and suicide—Talk death and thoughts of killing themselves is common in childhood depression. A major sign of high suicide risk is giving items away.  
  • “Dark” play—Depressed children express their mood through play. This includes drawing dark images or play games focused around death.
  • Sensitivity to rejection—Depressed children are perceived as overly sensitive. The slightest rejection upsets them. They often say derogatory remarks about themselves (i.e. “I am so stupid, ugly, friendless, etc.).
  • Physical complaints—The somatic complaints are stomach aches, migraines, and generalized body aches.

Childhood Depression Versus Depression In Adulthood

The basic symptoms of depression are the same regardless of age. However, the predominant symptoms do differ throughout various stages in life. For example, childhood depression is marked by irritability and anger rather than strictly sadness. Unlike adults, they do not isolate themselves from others as frequently and they experience distress if separated from close loved ones.

While sleep disturbance is a common symptom of depression, adults are more prone to insomnia whereas children alter their sleeping schedule to sleep at odd hours. Children also have increased somatic complaints such as stomach aches, body pain, and migraines.

Risk Factors

A definite cause of depression is not currently known. Experts document specific risk factors occurring in the lives of depressed children. These risk factors may occur before or after the diagnosis and include:

  • Gender—When depression manifests in childhood, it is more common in males than females.
  • Family history—Research shows there may be a genetic link to depression. 30-40 percent of depressed children will have a family member with the diagnosis.
  • Chronic illness—Suffering from a medical illness during childhood increases the chances of developing depression. This is due to how some illnesses impact the brain, as well as the diagnosis making the child feel different than their healthy peers.
  • Abuse or neglect—Abuse may take the form of emotional, physical, or sexual.
  • Poverty—Children growing up under the conditions of poverty is associated with higher rates of depression.
  • A loss of a parent—The death of a parent, friend, or close relative can lead to long periods of depression as the child grieves.
  • Trauma—Children who are depressed have typically experienced trauma, whether it be a divorce, excessive stress, or surviving a natural disaster.
  • Attention or conduct disorders—Depression occurs along with attention disorders like attention deficit disorder (ADD) or attention deficit hyperactivity disorder (ADHD).
  • Mental illness—Depression is a sign of an existing mood or anxiety disorder such as bipolar disorder, generalized anxiety, social anxiety, and more.
  • Learning disabilities—Poor academic performance is sometimes a consequence of depression, but it is also a risk factor. Children who struggle to learn as quickly as their peers due to learning disabilities impacting reading, writing, mathematics, and oral skills  (i.e. dyslexia, dyscalculia, processing disorders, etc.).
  • Substance abuse—Many depressed children and adolescents have a history of underage use of tobacco products and alcohol consumption.

Diagnosing Depression In Children

There is not a specific test to diagnose depression; therefore, childhood depression is a difficult disorder to diagnose. If unexplained sadness, feelings of hopelessness, and a loss of interest in once pleasurable activities continues longer than two weeks, the child must be evaluated by a medical doctor.

A thorough medical history, as well as family history, is taken. The doctor will likely order blood tests to rule out other conditions that mimic the signs and symptoms of depression. Conditions with similar symptoms are thyroid disorders, anemia, vitamin D deficiency, food intolerances, or blood sugar issues.

If there is no obvious medical explanation, the child is sent to a mental health professional where both the parent and child fill out questionnaires regarding the child’s behavior, mood, and history to access whether symptoms are related to childhood depression or another mental disorder such as anxiety, bipolar disorder, post-traumatic stress disorder, or attention deficit hyperactivity disorder.  

Psychotherapy to Prevent Depression In Children

Psychotherapy is a form of talk therapy designed to target a range of emotional difficulties and mental illnesses. In psychotherapy, the client shares their feelings with a trained counselor. They implement techniques to cope. Cognitive-behavioral therapy (CBT) is the main type of psychotherapy for depression treatment.

Cognitive-behavioral therapy (CBT) focuses on identifying unproductive beliefs and cognitive distortions that influence behavior. For children specifically, incorporating play into therapy is. Play therapy involves coloring, board games, acting, or another activity the child enjoys. During a study at Washington University, incidents of childhood depression decreased 44 percent when children were had play therapy as treatment. Therapy is most frequently recommended for existing depression. However, therapy as a preventative is productive for children with an increased risk for developing the disorder.

School Prevention Programs to Prevent Depression In Children

The majority of children spend more of the day at school than at home. Thus, schools share the responsibility of preventing depression in children. Experts have found that school prevention programs are effective. These programs center around interpersonal problems. The programs outline potential problems experienced by children at risk for depression and propose solutions. Experts recognize children face a unique set of challenges including but not limited to parental conflict, the stress of managing academics, bullying, peer pressure, and other adversities. Programs to prevent depression decrease the risks of those problems leading to depression because it teaches them relaxation techniques and coping mechanisms. The children learn to view setbacks as opportunities for growth.

Cognitive Skills Training

Cognitive skills are the skills necessary for the cognitive processes of acquiring knowledge. Without cognitive skills, we cannot learn or manipulate information to pay attention, reason, or remember. The basic cognitive skills are attention, long and short term memory, auditory and visual processing, processing speed, and cognitive flexibility. The cognitive skills of children advance as they mature. The more developed a child’s cognitive skills, the more effectively they think, learn, and make decisions.

Schools address cognitive skills in the curriculum. With the ability to make productive decisions, they are not as likely to become depressed. Even brain training games via the computer provides an entertaining method of training cognitive skills.

Technology To Prevent Depression In Children

There are pros and cons to any technology. Although researchers have had concerns on the impact technology and social media has on a child’s mental health, technology use in moderation can prevent depression in children. Parents, teachers, or guardians must first teach children how to stay safe online. This includes proper digital etiquette to avoid cyberbullying, checking in often, and not contacting strangers.

Technology can be used to deliver mental health services. Therapy is becoming increasingly accessible online. A child might be more comfortable speaking with a therapist via the internet prior to in-person appointments. Next, technology like cell phones and online messaging increases peer communication. Nurturing friendships by remaining in contact improves mood. Children are not as prone to withdrawing from others when there are frequent opportunities for communication.  

Preventing Depression In Children
Photo by Jessica Lewis from Pexels

Physical Activity To Prevent Depression In Children

In both children and adults, studies indicate that “patients assigned to exercise alone had equal improvement of their depressive symptoms compared to those assigned antidepressants alone” (2019). Exercise releases feel-good endorphins that have benefits on the body. Not only does it improve cardiovascular health, but physical activity promotes nerve cell growth in the hippocampus—the area of the brain that controls mood.

It also gives children fun activities to focus on. Even five minutes per day of physical activity can prevent depression in children. When choosing an exercise they enjoy, they are more apt to engage. For example, most children would prefer playing soccer to walking around the block.

Diet to Prevent Depression In Children

Just like eating vegetables is essential for proper physical growth, a well-balanced diet helps prevent depression in children. Research published in the American Journal of Public Health suggests that deficiencies in zinc, folate, and magnesium lead to depression. The brain further needs omega-3 fatty acids and to manage mood. Child friendly foods containing omega-3 include fish, as well as nuts and seeds. Incorporating flax or chia seeds into a smoothie is a tasty option for children to receive added nutrition. Processed candies, soda, and refined sugars should be eaten in moderation.

Sleep to Prevent Depression In Children

Not sleeping enough at night is associated with childhood depression. In a research study on sleeping habits, 73 percent of children who are unhappy reported a lack of sleep. The brain heals while the body is sleeping. To achieve seven to nine hours of sleep, ensure the child follows a regular bedtime. Keep a nightly routine. Allow the child to unwind an hour before bed without distracting electronics that stimulate the brain. On difficult nights, a thirty minute nap during the day increases alertness and improves mood.   

Parenting Techniques To Prevent Depression In Children

Parents and guardians are an integral component to preventing childhood depression. Children need to have a trusted source to share their feelings with. Along with counseling as a preventative therapy, assure them that they have a trusted source to share their feelings with by providing them with open, honest communication. Create a consistent and stable environment. While discipline has its place, praise their successes and positive decisions. Spend quality time and boost the child’s self-esteem by partaking in activities they excel at.

Resiliency To Prevent Depression In Children

Psychological resiliency is the ability to cope with challenging circumstances. Those who are resilient return to baseline quickly after a crisis. Children are not automatically born resilient. It is a skill they develop. Resilient children are less likely to suffer from severe depression. They are not as fearful to take healthy risks such as trying a new sport, forming friendships, or striving for academic achievements.  

Parents can help children become resilient by encouraging them to make decisions independently. Parents must recognize they cannot save children from every hardship. Although they lend assistance when possible, they trust the child to learn from their mistakes as they solve problems.

Setting Goals To Prevent Depression In Children

Depression causes decreased interest, care, and concern for life. Goal setting motivates the child in moving forward in their recovery from mental illness, as well as to prevent depression from occurring in the future. Set goals should be specific, measurable, and achievable.

To ensure success, it is recommended that each large goal into divided into smaller goals. If the child wants to earn an A+ in their science class, their initial goals may first be completing all of their homework, studying for their chapter test, and finally acing their final exam. Someone who is depressed believes they cannot accomplish their goals, but setting attainable goals enhances their confidence.

References

Carballo, J. J., Muñoz-Lorenzo, L., Blasco-Fontecilla, H., Lopez-Castroman, J., García-Nieto, R., Dervic, K., Oquendo, M. A., & Baca-García, E. (2011). Continuity of depressive disorders from childhood and adolescence to adulthood: a naturalistic study in community mental health centers. The primary care companion for CNS disorders, 13(5), PCC.11m01150. https://doi.org/10.4088/PCC.11m01150

Dryden, J. (2011). Parent-child play therapy relieves depression in preschoolers. Retrieved from https://source.wustl.edu/2011/01/parentchild-play-therapy-relieves-depression-in-preschoolers/#:~:text=Depression%20severity%20scores%20decreased%2044,received%20the%20investigational%20play%20therapy.

Long, S., Rogers, M. L., & Gjelsvik, A. (2019). The influence of depression status on weekly exercise in children ages 6 to 17 years. Preventive medicine reports13, 199–204. https://doi.org/10.1016/j.pmedr.2018.12.018

O’Neil, A., Quirk, S. E., Housden, S., Brennan, S. L., Williams, L. J., Pasco, J. A., Berk, M., & Jacka, F. N. (2014). Relationship between diet and mental health in children and adolescents: a systematic review. American journal of public health104(10), e31–e42. https://doi.org/10.2105/AJPH.2014.302110