CHILDREN AND DEPRESSION

STATISTICS

Historically, children were not thought to suffer from mental or emotional illnesses, in part because they do not face the stresses adults face. Since the 1960’s, however, research has shown that children do suffer from depression, bi-polar, and anxiety disorders. From 3 to 6 million children suffer from depression and are at risk for suicide, the third leading cause of death among young people. Every hour 57 children try to kill themselves; every day 18 succeed (American Psychiatric Association, 1992).

DEPRESSION

Like adults, children experience normal mood swings, including deep sadness. Many of us refer to this feeling of sadness as "depression." We experience these feelings when we’re frustrated, disappointed, or sad over a loss in our lives. These feelings are normal and fade in a relatively short period of time. Studies of children ages six through twelve, however, have shown that as many as one in ten suffer from clinical depression, which is a specific illness with diagnostic criteria. These children cannot escape their feelings of sadness for long periods of time.

Like depression in adults, the illness has the following symptoms in a child:

Unlike adults, children do not always have the vocabulary to accurately describe how they feel. At the younger ages they do not understand certain abstract concepts, such as "guilt," "concentration," or "worthlessness." When they do not understand the concepts, they do not verbally report these feelings in a way grown-ups can easily recognize. As a result, children may show their problems in behavior. Some key behaviors – in addition to changes in sleep and eating patterns – that may be signs of depression are:

• A sudden drop in school performance
• Inability to sit still; fidgeting; pacing; wringing hands; pulling or rubbing the hair, skin, clothing, or other objects; or slowed body movements, monotonous speech, or muteness
• Outbursts of shouting, complaining, or unexplained irritability
• Crying
• Expression of fear or anxiety
• Aggression, refusal to cooperate, antisocial behavior
• Use of alcohol or other drugs
• Complaints of aches or illness when no cause can be found

CAUSES

Each child suffering from depression is unique, and any depression can be caused by a single factor or, more frequently, a combination of variables.

Often, biochemistry plays a role in depression. Two neurotransmitters that tend to be out of balance in depressive people are serontonin and norepinephrine. An imbalance in serontonin may cause the sleep problems, irritability, and anxiety characteristic of depression. Imbalance of norepinephrine, which regulates alertness and arousal, may contribute to the fatigue and depressed mood of the illness. Research has also found that depressed people have imbalances of cortisol, a biochemical the body produces in response to extreme cold, anger, or fear, and that cortisol levels will increase in anyone who has to live with long-term stress. It is not clear, however, whether the imbalances cause depression or whether depression causes the imbalances.

Family history is important. Studies indicate that depression is three times more common in children whose biological parents suffer from depression, even if no members of the adoptive family have the illness. Studies of identical twins have shown that there is a 70% chance that if one twin has depression, so will the other. These studies suggest that some people inherit a susceptibility to the illness.

Family and social environment are also important. A home where a family member is abusing drugs or alcohol is inherently inconsistent and unstable. The loss of a parent through divorce or death can be traumatic, as can enduring the long-term illness of a parent, sibling, or the child himself. A child living with an adult who is psychologically, physically, or sexually abusive must cope with incredible stress. In addition, in abuse situations, children often blame themselves for the abuse or assume they must "deserve" it due to some flaw in themselves. All of these can contribute to depression.