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Dealing with Childhood Depression

When we think of children and depression, the picture that most likely pops into mind is that of a lonely teenager, diary in hand, languishing in the isolation of her bedroom; or we envision a misfit adolescent, sulking in a corner with only his Game Boy and comic books for company. But depression isn't just a teenage or adolescent problem. The "blues" can strike as early as kindergarten and can progress into an extremely serious illness if left untreated.

According to Ellie Epstein, an employee assistance program counselor with Methodist Hospital in Omaha, Neb., childhood depression is more common than you would think. "There are many things that can contribute to a young child's bout with depression," says Epstein. "A stressful life event is usually found to be the trigger in children ages 6 through 9. Since depression has very little to do with biology at this age, the causes are usually found to be environmental; something that has occurred either inside or outside the family unit."

The Effects of Tragedy

Unpleasant family events - such as death, divorce, family conflict, illness or physical disability - can turn an otherwise happy-go-lucky youngster into a sad, withdrawn child.

When their 7-month-old daughter died, Michael and Kim Moore* were understandably devastated, but, through their grief, they realized their 6-year-old son, Timothy*, and 3-year-old daughter, Josie*, were suffering from depression. "The depression was a natural occurrence following the death of their sister," says Kim Moore. Both children exhibited classic signs, including sleeping problems, angry outbursts, voluntary isolation and fear of separation.

Childhood depression can also be attributed to ongoing familial situations that place the child in uncomfortable territory. When a parent suffers from alcohol or drug abuse, the child feels her parent cannot be trusted. A similar scenario occurs when a child is involved in physical, sexual or emotional abuse. Sometimes, depression stems from poor parenting skills. "Some people exhibit behaviors that are not conducive to great parenting," says Epstein. "Yelling, fighting, criticizing - all of these diminish a child's sense of self."

Depression Without Tragedy

Depression can also occur with a positive event, like the introduction of a new baby or a move to a new home. Although these events are seen as happy, the child can feel threatened and insecure. Even in the most loving families, financial problems, over-scheduling and lack of "down time" can also add to depression.

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Every child has ups and downs, good days and bad. A scrape with the neighbor kid, the loss of a championship game or the death of a beloved pet are all part of being a kid, but depression can sneak in when a parent least expects it. Warning signs that point to possible depression include:

• A noticeable personality change. A happy child is now combative and bitter; a child who is usually a loner is suddenly clingy.

  • Withdrawing or acting out. A child begins spending hours alone in her room; a child with no previous problems in school is suddenly fighting.
  • Any extremes in behavior. Over-eating or under-eating; sleeping all the time or not at all; a family history of eating disorders, alcohol or drug abuse.

"Any uncharacteristic behavior that is dramatic and long lasting is suspect," says Epstein. If the behavior continues for six weeks or longer, Epstein suggests seeing your child's pediatrician. "The most important thing for parents to avoid is the old 'It's just a stage' excuse," she adds. "It may be a stage, but it may be something more. If the child's ability to function deteriorates, it is time to get some help."

Resources for Parents

Fortunately there are many excellent resources available to parents with children experiencing depression. "All of the causes of depression can be negated if a child has positive role models to provide effective coping skills, safe support and trust," says Epstein. "Don't ignore your child's needs. Good communication, coping and problem solving skills will serve your child her entire life."

The Moore family, with the help of a psychologist, worked through their grief together. "We listened to what the children had to say, and we gave them time," Kim Moore says. "We let Tim and Josie have their space, but we reinforced how much they meant to us, which was hard because we were grieving as well." The Moores participated in a grief recovery class to learn to manage their grief and provide assistance and guidance for their children. "We went to special events where a bunch of grieving people gathered to remember their loved ones," she says. "This showed the kids that their sister will never be forgotten. We also picked a favorite color, yellow, to symbolize their sister. When we see yellow flowers while out on family outings, one of us makes a comment about how God let her stop by to spend some time with us."

Here are some additional ways you can help your child deal with depressive issues:

• Teach positive communication. Young children don't often have the vocabulary to effectively express feelings of anger and confusion. Give your child the words she needs to help her share her feelings.
• Get your child to talk about it. Provide your child with a safe adult to share his feelings with. Every child should have someone to go to for comfort and guidance, whether it's a parent, teacher, counselor or family friend.
• Keep your child active. Sports and physical activities are good outlets for pent up anger.
• Use art as communication. Acting, painting, drawing, dancing and other creative arts offer excellent opportunities to get feelings out and express grief.
• Read books. Many parents use bibliotherapy - the process of reading books to help a child identify with others - as a way to put the child in another's place. Epstein suggests The Dinosaur Series by Laurie Krasney Brown and similar books to help prepare for or deal with an unsettling event or situation.

Above all, be honest with your child. "Trust is the key to helping children get through a rough patch," says Epstein. "Children are excellent perceivers of environment. Whatever we withhold from our children in the name of protection, they will supplant with fantasies that are usually 10 times worse than what is really happening. If a child is old enough to ask a question, she is old enough to get an honest answer."

By being honest, parents are telling their children that they are worthy of the truth and are important enough to be trusted, thus sending the message that the parent is trustworthy as well. When a parent and child suffer a loss together, as in the Moores' case, the family bond grows tighter. "Cry with your children. Let your children see you cry. Model for them, and show them that it's OK to feel bad sometimes," adds Epstein.

Moore is very proud of the way her children have come through the crisis of losing a sibling. "By allowing my children to grieve, by allowing them to cry and feel angry, and by showing them our support no matter how crappy they felt or acted, we have shown them that it is OK to have bad days, and that, over time, bad days can turn into good days."

*Names have been changed to protect privacy.

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