When it is More than Just Sadness

When your child gets a physical injury, it is evident, and the healing process can be seen. Put a Band-Aid on a scratch, give a hug for a bruise, or get a cast for a broken bone.  But what happens when a child is suffering internally?  Unlike adults, children are still learning where they belong in the world and don’t always know the appropriate way to express themselves.  This can be challenging when it comes to understanding your child’s mental health.  How can they let you know how they are feeling when they aren’t even sure of how they are feeling themselves.

‍

Coming off the years of COVID, it is not a surprise that childhood depression is on the rise.  Children were isolated from peers, thrown into a new learning style with virtual learning, living with the unknown of COVID, and being stuck inside all while processing with the limited coping skills of a child.  So, what is childhood depression? Depression is a mood disorder that is not age exclusive.  Anyone, at any age, can experience depression, or the prolonged feeling of unhappiness. The difference of adult and child depression, however, is the way in which symptoms manifest. As an adult you more than likely can identify feeling down or sad when asked and can advocate for yourself when it comes to needs.  This isn’t always the case for children because they don’t always have the vocabulary to express feelings or may choose to internalize their feelings due to shame or fear of disappointing.  So as a parent it is important to read between the lines to identify the signs of depression in your child.

‍

Though there are tell-tale signs of depression such as lack of energy, trouble concentrating, unusual fatigue, long periods of sadness, and decrease in enthusiasm, a child may also develop different signs and symptoms based on their age.  It may be shocking to hear that even infants can experience depression and because they aren’t able to express themselves, it can be challenging to identify.  Common symptoms in infants include unresponsive facial expressions, limp body posture, slow physical mannerisms, irritable or fussy mannerisms, lack of eating and sleeping, and physical aches and pains.  Once a child starts to develop language and become toddler and preschool age their symptoms can include frequent complaining of physical aches, difficulty going to sleep and staying asleep or excessive sleeping, changes in appetite, lack of interest in peers, and irritability.  When children hit school age, 5-12 years old, common signs include sadness most of the time, tantrums and misbehavior, negative feelings or remarks about themselves, feelings of guilt, constant worry, complaining of aches, lack of energy, loss of interest in preferred activities, problems with sleeping or excessive sleeping, difficulty concentrating, decrease in academics, and strained peer relationships.  When a child becomes a teen, it is important to note that changes are occurring in many aspects of their life which can result in rapidly changing feelings of highs and lows. Concern should arise when a teen is experiencing more episodes of low feelings than high, along with crying for no apparent reason, feelings of frustration or anger, feeling hopeless, frequent irritability, loss of interest in activities, conflicts with others, low self-esteem, feeling worthless, fixation of past failures, trouble concentrating, thoughts of death, excessive sleeping or insomnia, heavy use of drugs or alcohol, social isolation, decrease in personal hygiene, angry outbursts, risky behavior, and self-harm.

‍

If you feel as if your child is experiencing some or all these symptoms the best place to start depends on your child’s age.  For young children a conversation with their primary care doctor about your concerns can be a helpful in ruling out medical issues while also having help in finding a professional who specializes in childhood depression.   As a child gets older it is still important to bring up concerns with their primary care doctor to rule out anything medical and get set up with a mental health professional, but it is also just as important to provide a safe space for your child to feel heard.   Childhood depression can be mistaken for laziness or being a “bad kid,” which can be frustrating as a parent and equally frustrating as a child.  Talking with your child using age-appropriate language is a great way to help them start to understand how they are feeling.  Always begin with letting your child know that they aren’t alone, and you are there to help support them in being their best possible self.  For younger children using language such as sadness or feeling blue is helpful for them to identify and grasp how they are feeling.  It can also be helpful to use the rain cloud analogy, which is explaining depression as rain cloud that follows them around even when everyone else is in the sunshine. As children start to mature, going through the depression symptoms list along with your child can be beneficial for both of you to understand what your child is experiencing.  If your child is apprehensive in sharing, don’t feel discouraged, as it is a difficult topic to discuss.  In this case, you can also reach out to your child’s teacher to discuss peer relationships, academics, and behaviors they are seeing at school to better understand if your child is experiencing symptoms of depression.

‍

Childhood depression is not something you or your child should feel ashamed or guilty for having but it is important to ask for help.  Depression is not something that goes away on its own and like a physical injury, it should not go untreated as it could result in serious consequences.  Knowing and recognizing the signs of childhood depression is a great start to getting your child the help they need.  Reaching out to your child’s primary care doctor or searching for a local mental health professional will get the process of diagnosis and treatment plan started. Even if you aren’t fully sure if your child is showing signs of depression, it is better to error on the safe side and have them evaluated.  Remember you are never alone in the process and there is no shame in asking for help for both you and your child!