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THERAPY corner: Tips for Counsellors – Identifying Depression in children

Depressed child

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Signs – at least two or three of the following developing in a short span of time, are warning signals that a child may be depressed:

Sadness, apathy, withdrawal from friends and social situations, showing signs of being rejected and unloved, sleep disturbances or nightmares, blaming oneself or developing guilt for small things, poor appetite and weight loss, thoughts of suicide, giving away valued possessions, unexplained physical complaints, falling grades.

Any of the above symptoms occurring for a short period (up to 1 or 2 weeks) can be ignored, but longer periods need to be taken seriously. Also keep in mind that even small children may have “masked depression,” particularly when they think that a significant adult will get effected or is already going through a bad time, and their depression will cause further pain to the adult.

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Situations that may be looked out for, which may cause depression:

  • Death in the family, serious illness.
  • Threat of separation of parents (temporary or permanent), being sent away.
  • Friend moving away, or unable to make new friends.
  • Difficulty in adjusting to school, friends, or academics.
  •  Facing failure, rejection or humiliation.

When trying to determine depression in a child, try and get the perspective not only of parents (because they may be too emotionally involved to be objective about what is happening to her), but also teacher, friend, neighbour, relative, etc.

Obviously the best and most significant remedy is to make the child talk. If the parent or teacher finds it difficult, a trusted adult, counsellor or elder should be given the task of gently making the child talk. When the child expresses loss of interest or involvement in activities that she earlier enjoys, the first warning signal is on. Then one can check with the list s given above, and subsequently use counselling or psycho-therapy to try and pull up the child.

In more severe or long-lasting cases, the child may require medication. The old tricyclic antidepressants are less effective in children and may have side effects, hence they are not used. Modern drugs like Fluoxetine (under strict medical supervision) can be effective, and not have much side effects. Lithium also continues to be an effective treatment.

Adolescents: Look out for wild mood swings, and feelings of injustice or frustration. Check out the child’s coping ability, adaptability to changing social circumstances, how he is relating to his parents or persons in authority. Check for addictions of any sort, possession of harmful objects like knives etc. Do not be alarmed by simple withdrawal and isolation – many adolescents like to be left alone. Evaluate him more when he is in different types of company, with his family, friends, at college, etc.

In rare and extreme cases, adolescents are also susceptible to bipolar depression which is a serious psychotic condition, requiring immediate medical intervention.

Suicide: Depressed children who are feeling suicidal inevitably give indicators well in advance (except a very few impulsive suicides, like when results come). It is up to the adults to be sensitive enough to pick up the signs. 28% of high school students have had suicidal thoughts some time or the others, and 8% have actually made at least a feeble attempt.

Do not take depression in children lightly, it is better to deal with it early.

Dr. Ali Khwaja

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