Depression and Anxiety Disorders in Kids


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Q: My 8-year-old son complains of frequent stomachaches and headaches and doesn’t seem to be his normal, happy self. He cries easily and wants to sleep more than usual. He stays in his room all the time, and if I try to get him involved in family activities he gets irritable and angry with everyone. Could he possibly be depressed?

A: Based on what you describe, it sounds as though your son is struggling now, and while depression is associated with teenagers and adults, children can also be affected by this illness. The Times of India had this to say in an August 2014 article on depression: “Pre-adolescent children as young as 5 years old are now suffering from anxiety disorders and depression.” Needless to say, this issue is not limited by age or culture.

In order to evaluate your son’s behavior, it is important to rule out any physical health problems. A visit to your pediatrician is a good place to start. Once cleared of physical issues, it is reasonable to look at emotional reasons for his change in behavior. It is common for elementary-school children to have difficulty expressing how they feel, and they may complain of physical symptoms such as headaches or stomachaches to let you know that something is hurting them emotionally.

If you decide that your son is likely suffering from emotional issues, you may want to consider these four main areas of stress that are common to children dealing with depression: school issues, relational conflicts, loss and trauma.

School issues. If a child is struggling academically, this can start a downward spiral of frustration, embarrassment and low self-esteem. The problem can be compounded by social pressures or bullying. If your son has been unwilling or unable to acknowledge any problems at school, you may want to contact his teachers to learn more about what might be going on there.

Relational conflicts. Family dynamics are often at the root, at least in part, of a child’s stress. If there is strain in the home such as fighting among parents, financial worries, parent-child issues or sibling conflict, children can quickly become overwhelmed. We may underestimate the impact these have on our children because we are often directly involved and busy finding ways to cope ourselves.

Loss. Loss can be significant. Ask your son if a special friend has moved away or consider the loss of a family member such as a grandparent or a favorite pet. Talking with your child about these things can often begin to alleviate his emotional pain and you may see some reduction in depressive symptoms.

Trauma. Exposure to trauma can create an emotional impact for months and even years after an event. Verbal abuse such as constant put-downs, screaming or bullying can cause a child to feel unprotected and vulnerable. Physical abuse, including inappropriate use of discipline or any form of physical mistreatment, creates emotional scars that continue to cause symptoms for the child after the physical trauma has stopped. The potential for sexual abuse also needs to be considered. Anytime a child’s behavior changes suddenly and dramatically, the possibility of trauma moves to the forefront of consideration.

A definitive diagnosis of depression is best made by a mental health doctor, who will in turn have the most experience in offering treatment options. Many children benefit from a team approach in which a psychologist or counselor offers counseling in a very structured way while a psychiatrist prescribes and monitors the effectiveness of medications. Severe depression can require a hospital stay if a child is a danger to himself or others. This is necessary to stabilize the child and keep him or her safe until well enough to be treated less aggressively. Mental health is a vital part of one’s life and requires good care from an early age.

Susan Michels works with children and adolescents at Cone Health Behavioral Health Hospital. Send questions to Sherri McMillen at sherri.mcmillen@conehealth.com.

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