When Your Child Is Depressed
September 17, 2004, KidsHealth.org

If your child is depressed, you're probably frightened and frustrated because depression can be scary for your child and discouraging if you're a parent who's at a loss to help.

You want to put your protective arms around your child and make her whole again. Or instead of hugging her, maybe you want to tell her to get a grip, to snap out of it.

But depression isn't something a person can just snap out of and it's much more than a bad mood that will eventually go away. Although your child's condition may seem unshakable right now, her depression is a treatable illness with definite symptoms and effective treatments. Here's the good news: you can help your child by getting her the help she needs.

Getting Help for Your Child
Your first consultation should be with your child's doctor, who probably will perform a complete examination to rule out physical illness. If depression is suspected, he or she may refer you to a psychiatrist (a medical doctor who can make a diagnosis, offer treatment, and may prescribe medicine); psychologist (a health professional who can diagnose and treat depression but is unable to write prescriptions); or licensed clinical social worker (a person who has a degree in social work and is qualified to treat childhood depression).

When it comes to managing your child's depression, all of these health professionals can help. The important thing is that your child feels comfortable with the therapist. If it's not a good fit, find another.

Your child's teacher, guidance counselor, or school psychologist also may be able to help you. These individuals may be first to notice the change in your child, and they may be first to alert you to the problem. It's important to remember that these professionals have the welfare of your child at heart and that the information you and your child reveal to them during therapy is kept in strict confidence.

Treating Depression
Don't put off your child's treatment. Early detection and diagnosis are key in treating children with depression. A child or adolescent psychiatrist or psychologist can perform a complete diagnostic evaluation. Your child's treatment plan may include counseling, medicine, or a combination of both. Family intervention also may be helpful: the best outcome often is achieved when the entire family works together with the child in therapy sessions. Depending on your child's age and maturity, it also may be beneficial if your child is involved in treatment decisions and takes responsibility for her own wellness.

(Note: Depending on the age of your child and the severity of the depression, your doctor may prescribe antidepessant medications. Although there has been a lot of publicity recently about suicide risk with these medications in patients under age 18, there is little doubt that there are many appropriate times when medication can and should be prescribed -- caution should be used and the child should be monitored closely during the first 2 to 4 weeks after starting such medications. -- David Baxter)

Because depressed children often are critical of themselves and their worlds, cognitive therapy is especially effective in helping to change the way they think of themselves. Cognitive therapy teaches children to look for connections between thoughts and actions and to challenge negative thoughts. For example, if your child thinks to herself, "I'm a bad person," she would then ask herself for evidence. Most of the time, there is no evidence or proof to back up these negative thoughts; it's simply the way the child perceives herself. Once she realizes what she's doing, she may be able to think more positively.

Studies show that the average duration of a depressive disorder is 6 to 8 months, but statistics vary from child to child, and a full recovery may take years. Ignoring depression can be dangerous because the illness can affect your child's social skills, as well as her concentration, energy level, and relationships with family and friends. Because your child doesn't like herself, it can be hard for others to like her. This disruption in social development can have lifelong effects if untreated.

What Can I Do to Help?
Most parents think that it's their job to ensure the happiness of their child. When your child's depressed, you may feel guilty because you can't cheer her up. You also may think that your child's suffering because of something you did or didn't do. This isn't true. If you're struggling with guilt, frustration, or anger, you may want to consider counseling for yourself. In the long run, this can only help - both you and your child.

Other ways to help:[list][*]Become an expert on depression. This way, you'll know what to expect and how to cope. [*]Make sure your child takes her medicine and encourage her to eat right, too, as this may help her feel better physically as well as improve her mood and outlook. Physical activity also has been shown to help alleviate the symptoms of depression. (When the child is ready for this step,) incorporate physical activities, such as bike rides or walks, into your family's routine. [*]Let your child know that you're there for her, that you love and care about her, and that you want to hear what she has to say, even if it isn't pleasant. Although these things may be difficult for your child to believe, it's important to say them. Eventually, they'll be acknowledged. [*]Accept your child's behavior. Never tell your child to "snap out of it." Remind yourself that she's not being lazy because she can't get out of bed, won't clean her room, or do her homework. She simply doesn't have the desire or the energy. [*]Take care of yourself. Remember that even though it's your child who's suffering, it's OK to step away from the situation for a while. Have dinner with a friend or go to a movie. Do something for yourself.[/list:u]Ignoring depression can have deadly consequences: the number-one cause of suicide is untreated depression. If your child talks about suicide, to you or anyone else, or shows warning signs such as giving belongings away and being preoccupied with death, call your child's doctor or mental health professional immediately.