Most Children are cheerful, energetic souls who navigate life’s seas with only occasional difficulty. True, they have their stormy times, but they work through the ups and downs of life without taking on too much water.
Those who experience childhood depression are not so fortunate. Their storms are accompanied by a prolonged rainy season of frustration and despair, often punctuated by sharp and dramatic bursts of lightning and thunder. Such children frequently lash out at others or find their energy (and for some, their will to live) depleted.
Until the early 80’s, little attention was paid to depression in children. Indeed, it was commonly believed that children lacked the psychological wherewithal to experience depressive disorders. Yet recent research suggests that anywhere between five and ten percent of children under the age of 13 suffer from depression. Moreover, while the rates for boys and girls are essentially identical up to age 14, thereafter the rates increase dramatically for girls.
A family history of depression increases a child’s likelihood of experiencing a depressive episode two to three times, and one recent study suggests that children with a parent who suffered from childhood depression are fourteen times more likely to suffer from the illness themselves before the age of thirteen!
The combination of two factors: that depression is often triggered by a stressful event, and that people who have a genetic predisposition for depression often struggle to cope with stress – puts children prone to such circumstances at high risk for developing depressive symptoms.
Their ability to ward off a dysphoric condition may depend largely on secondary factors that serve as buffers from stress. Factors such as the child’s personality, the quality of family life, the support network available to the child, and his/her ability to apply healthy coping skills can, to some degree, serve as insulation against depression. In some cases, however the child’s biological makeup is such that the development of depression may be unavoidable even with such buffers.
In spite of the increased attention given to childhood depression within professional circles, it remains largely undiagnosed (or misdiagnosed) within the community. One reason this occurs is because childhood depression does not always mimic the depressive symptoms commonly seen in adults.
For instance, while children may experience some of the classic signs of depression, they are equally liable to ‘speak a language all their own.’ This language consists of both internalizing and externalizing behaviors.
The former include irritability, somatic complaints (most commonly, headaches and stomachaches), complaints of boredom, withdrawal, and low self-esteem.
Children who externalize their distress are often said to be ‘acting out,” exhibiting excessive anger or aggression, extreme mood swings, and drug or alcohol use. Such children have never met an argument they didn’t like, and tantrums are second nature to them.
Because they lack both the knowledge of and insight into their condition, children are unlikely to complain of depression…if they admit to personal struggles at all. More common will be the telltale signs of withdrawal or complaints of fatigue, of chronic grumpiness and poor frustration tolerance, or of episodes of which they ‘fly off the handle,’ or are constantly hurting others.
Understandably, parents often miss and dismiss such symptoms, and are only cued in to the gravity of the situation when their child starts making negative self-statements (e.g., “I hate myself!”) or suicidal references (e.g., “I’d be better off dead.”) Less obvious cues can be seen as an adolescent son or daughter begins ‘medicating’ dysphoric feelings with drugs or alcohol.
While it is normal for children to experience transient periods of sadness, the depressed child has a hard time shaking (as one child put it) “my lousy feelings.” Many parents, believing their child’s depression to be volitional trouble making, may become only more frustrated as they do their best to solve the problem.
It is true that comparatively few children will need professional help to deal with ‘the blues,’ but when the blues begin turning a darker shade of grey, then to black, and hope for change begins to fade away, it may be time to do more than simply row further into the stream.