Monday, 18 August 2014

Identifying Depression in Children

Identifying depression in children is not always easy. Children, especially younger children, may not yet have acquired the vocabulary, skills or even the comprehension to articulate their experiences. Some children withdraw and become sullen and others may become hyperactive or aggressive.

Children therefore manifest depression in very different ways, but some of the commonest features do tend to reflect those of adults, especially after the age of 8. Spending lots of time in bed but with poor sleep and early waking is common. Poor performance at school, getting into fights, losing interest in hobbies or friends and complaining of headaches, stomach aches, tiredness and other vague physical symptoms are also common.

Boys especially will deny feelings of sadness and may instead be moody, uncooperative and bored. Some young people may cut themselves and this can be interpreted by adults as manipulative behavior rather than an attempt at communication.

Like adults, it can take some time for children to recover from depression. Most episodes in children or adolescents last just under a year but clinical depression can recur in as many as 70 per cent of children within five years. Around 30 per cent of children who have a depressive illness will go on to develop bipolar affective disorder. On current estimates, roughly two per cent of children under the age of 12 suffer from depression. By the time children reach their teens the figure has risen to five per cent.

The children most at risk appear to come from backgrounds of family conflict, marriage breakdown, or situations where they experience physical and/or sexual abuse.

Approaches to the treatment of depression in children tend to reflect those used with adults but with particular focus on aspects of the child’s life. Treatment therefore is likely to have a psychological basis and will focus on social and emotional problems, difficulties at school, how to problem-solve and manage emotions, self-esteem and family relations.

Kevin Stark is just one psychologist to have developed an empirically evaluated treatment procedure. In one version of Stark’s programme he took 29 children aged 9-12 who scored highly on a self-reported measure of depression. Children were taught methods for setting realistic standards and goals for themselves and way of more accurately evaluating and interpreting the causes of both good and bad outcomes. After 12 sessions over a period of just five weeks, children showed significant improvements in their depression scores which were maintained over an 8-week follow-up.

The message here is that children don’t have to suffer depression but it is likely to come down to the vigilance of those around them to understand and identify behaviors that appear to suggest depression. Then, proper consultation with medical professionals should yield a more positive outcome.

Saturday, 16 August 2014

Depression or Despondency: Which is It?

If you’ve ever experienced flu you certainly know the difference between that and a head cold. So, is despondency to the head cold as depression is to flu?  Many people have all the symptoms of depression but they don’t realize it. They worry that their symptoms might be considered self-indulgent and that their doctor has better things to do than listen to them moaning on. So, are you a little despondent, or are you depressed? This checklist breaks down the typical signs of depression:

You feel weary, indifferent and you lack motivation. You no longer have an interest in doing things like hobbies. Your performance at work has dipped. You feel restless and irritable. You catch yourself staring into empty space. Getting up and dressed has become slower and labored.

Life is a gloomy, predictable and monotonous. Every day feels the same or worse than the days before. You feel like this most of the time. Mornings are nearly always the worst but by the afternoon or evening you feel slightly better.

There are changes to your diet. Maybe you are eating more and putting on the pounds or maybe you have gone the other way and you’re losing weight.

Sleep is disturbed or has become a place of refuge. Maybe you have problems getting to sleep then staying asleep. Maybe you sleep too easily and stay asleep much longer than you used to.

You move the way you feel – sluggishly, heavily, slowly. Maybe when you are sitting or lying you can’t properly relax because you feel agitated and irritated.

You feel tired nearly all the time. You feel spent both physically and emotionally. There’s nothing left in you to give to others. You feel it’s easier, perhaps even better, that you don’t bother contacting others.

You feel pessimistic about pretty much everything. You see things in black and white terms. When people point things out about your emotions or behavior you feel attacked, defensive, sensitive and suspicious.

It seems harder to make decisions about what to do. Reflecting on the decisions you’ve made previously you regret them. To others you may seem absent minded but you actually find that you can’t think straight. You find it hard to choose between simple alternatives. Everything is just so effortful.

You try to behave in a way that no-one can see the way you feel. Inside however you feel like you’ve been painted into a corner. Nothing you say or do will make the slightest difference. Thoughts of the pointlessness of it all have crept in.

If any one of these seems familiar the chances are that some or all of the others will too. If this is the case you are almost certainly depressed. Despondency is a characteristic of all forms of depression but in depression it feels deep and long lasting. Unlike flu, which can provide several days of misery, depression can last for months or longer and is ultimately far more debilitating. You take flu seriously and you wouldn’t think twice about treating it. Your mood state is of equal or greater importance, so don’t put off treating this most debilitating disease.