My daughter got in the car after school recently and promptly dissolved into tears. She said “Amy” had given her a hard time at school the past couple of days. By the end of the week, she wondered if she and Amy could go to the movies together.
Any child can come home from school in tears or have a tough day. But when a bad day stretches over weeks, it’s time to be concerned about depression. Those who work with depressed and suicidal children and teens say parents should watch for the signs.
“Any child can have some symptoms of depression on a particular day,” says Mary Herbert Daly, a licensed clinical social worker. “You need to observe behavior over several days or even a week or two.â€
Children may cry without an obvious reason, Daly says. Their grades may drop, and they may start skipping school. Older children and teens may turn to alcohol, drugs and promiscuity.
Depressed children may start sleeping and eating more or less than usual. They may start wetting the bed, says Richardean Benjamin-Coleman, a clinical specialist in psychiatric and mental health nursing.
“There could be acting out,” Benjamin-Coleman says. But on the other hand, the child may withdraw.
“More often than not, the kids who act out get more attention than the ones who are withdrawn and quiet,” she says. “Busy parents sometimes may overlook quiet and withdrawn kids and may just see this as a relief that they’re not being bothered by the child. Certainly, parents need to be in touch with the behavior patterns of the kids and particularly look at some changes.â€
Children and teens may cut themselves, not as a suicide attempt, but because they just want to feel pain, Daly and Benjamin-Coleman say.
“Many more children are doing this,” Daly says. “They say when they bleed they feel a sense of relief.â€
“The bad part about something like that,” says Benjamin-Coleman, “is while they may not have intentions of killing themselves, they may do so accidentally.â€
Depressed children may complain of pains with no physical cause, Daly says.
“We had a 7-year-old in the emergency department,” Daly says. “She frequently complained of a stomach ache. Her primary care provider couldn’t find anything wrong. It even got the point where she had exploratory surgery. It was nothing at all. It was her way of showing her unhappiness. Another child complained of her legs hurting so much she couldn’t bear her weight.â€
Children and teenagers may deny they have a problem, but parents should insist on talking about it.
“Don’t be afraid to say, â€˜Are you thinking of hurting yourself?’ If you bring it up, you’re not putting it in their minds because it’s already in their minds,” Daly says. “Let the child know you’re there, that you care for him and that you’re working this out. If the teenager says â€˜Leave me alone. I don’t want to talk.’ You need to say â€˜That’s not an option.’â€
Once you realize your child has a problem, the next step is to go to the child’s primary care physician to rule out physical causes and to get a referral for counseling if that’s warranted.
When it Gets Serious
Cause for more serious concern comes if a child starts giving away prized possessions, reading or writing stories and poems about death, or making plans for her funeral.
Daly says that nationwide, every two hours and seven minutes a child dies from suicide. Girls attempt suicide three times more than boys, but boys succeed three to five times more often than girls. That’s because boys usually choose more lethal, irreversible means such as gunshots and jumping off buildings while girls often take an overdose of pills.
“Seventy-five percent of children who attempt suicide have talked about it recently and given really obvious signs,” she says.
Just because you catch a child’s suicide attempt before he completes it doesn’t mean you can relax either. “The likelihood of the child attempting suicide again within 30 days is very high,” says Daly.
If you feel your child is suicidal, take him immediately, any time of the day or night, to a psychiatric hospital or to be evaluated in the emergency room. The child will be evaluated by someone on call and, if she is found to be a danger to herself or others, she’ll be admitted.
“It’s a reality that the world is changing,” Daly says. “Children have more choices and much more information available to them. There’s a lot more pressure on them. The family is under a great deal of pressure. It’s harder to make ends meet. Both parents need to spend more time away from home working. Life is just more challenging.â€
The good news according to Daly is that 80 – 90 percent of depressed children can be helped with therapy, medication or a combination of the two. And more children are being treated. But too many children with problems still aren’t being treated, Daly says.
Some families choose holistic approaches such as massage, light therapy, aromatherapy and herbs along with or instead of counseling and drugs. Light therapy can be helpful to those suffering from seasonal affective disorder – depression in response to winter’s shorter days. Check with a physician before giving a child herbal remedies because herbs could interact negatively with medication prescribed by a doctor, Daly says. The best defense is to know your child and keep an open line of communication. If depression hits, don’t hesitate to get help fast.
Karen Haywood Queen is a freelance writer.
what to look for
Not every depressed child will experience every symptom – some will experience a few symptoms, some many; and the severity of symptoms will vary from child to child. Depression can be very serious, but it is treatable. Talk with your child’s pediatrician if your child shows any of these signs and symptoms.
Signs of Depression That May Be Present in Children and Adolescents
- Loss of interest in activities once enjoyed
- Significant change in appetite or body weight
- Difficulty sleeping or oversleeping
- Loss of energy
- Feelings of worthlessness or inappropriate guilt
- Difficulty concentrating
- Recurrent thoughts of death or suicide
- Frequent vague, nonspecific physical complaints such as headaches, muscle aches, stomach aches or tiredness
- Frequent absences from school or poor performance in school
- Talk of or efforts to run away from home
- Outbursts of shouting, complaining, unexplained irritability, or crying
- Lack of interest in playing with friends
- Alcohol or substance abuse
- Social isolation or poor communication
- Fear of death
- Extreme sensitivity to rejection or failure
- Increased irritability, anger or hostility
- Reckless behavior
- Difficulty with relationships
Resources: National Institute of Mental Health, www.nimh.nih.gov.