Depression
What is Depression?
Depression is more than just feeling down or sad, it is characterised by persistent feelings of sadness, hopelessness, or irritability, that significantly affect emotional well-being, behaviour, and overall functioning.
Depression causes more burden than any other illness either physical or mental in young Australians aged 12-25 years. Around 1 in 6 young people will experience depression during adolescence, it is more common in young people than children and the rates are higher among young females than males.
It is important to note that depression in children and young people can differ from depression in adults in terms of how it presents and manifests.
What are the signs and symptoms of depression?
Some key aspects or symptoms of depression in children and young people are:
Emotional Symptoms:
They may exhibit persistent feelings of sadness, irritability, or hopelessness. They may also experience a loss of interest or pleasure in activities they once enjoyed. Some may have difficulty experiencing positive emotions.
Behavioural Symptoms:
Depression can impact a child's or young person’s behavior. They may withdraw from social interactions, friends, or family. Some may show signs of restlessness or agitation, while others may become more socially isolated or exhibit changes in their academic performance.
Physical Symptoms:
They may complain of physical symptoms that don't have a clear medical cause, such as headaches, stomachaches, or general fatigue. These physical complaints can be expressions of their emotional distress.
Cognitive Symptoms:
Depression can affect their thinking and cognitive processes. They may have difficulty concentrating, making decisions, or remembering information. Negative thoughts about themselves, the world, or their future may also be common.
Sleep and Appetite Changes:
They may experience changes in their sleep patterns, such as difficulty falling asleep, staying asleep, or excessive sleeping. They may also show changes in appetite or weight, with some experiencing increased or decreased appetite.
It's essential to recognize that depression in children and young people can be influenced by various factors, including genetic predisposition, family history, environmental stressors, traumatic events, academic pressures, and social challenges
What are the most common depressive disorders?
Major Depressive Disorder (MDD):
MDD can occur in children, adolescents and young adults, the symptoms are similar to those experienced by adults. These include persistent sadness, irritability, loss of interest or pleasure in activities, changes in appetite or weight, sleep disturbances, fatigue, difficulty concentrating, feelings of worthlessness, and recurrent thoughts of death or suicide.
Disruptive Mood Dysregulation Disorder (DMDD):
DMDD is a condition characterized by severe and recurrent temper outbursts that are inconsistent with the young person’s developmental level. Young people with DMDD also exhibit a persistently irritable or angry mood most of the day, nearly every day. These symptoms must be present for at least 12 months, with symptoms being observed in multiple settings.
Persistent Depressive Disorder (PDD):
PDD, previously known as dysthymia, is a chronic form of depression characterized by a persistent depressed mood that lasts for at least one year (or two years for adults). Children and young people with PDD may experience symptoms of low mood, irritability, low self-esteem, fatigue, poor concentration, and changes in appetite or sleep.
Premenstrual Dysphoric Disorder (PMDD):
PMDD can also occur in adolescent girls. Symptoms include mood swings, irritability, depression, anxiety, and physical symptoms in the week preceding menstruation. These symptoms significantly impact daily functioning.
Bipolar Disorder:
Bipolar disorder can manifest in children and young people as well. It involves episodes of depression alternating with episodes of elevated or irritable mood, known as manic or hypomanic episodes. Symptoms during depressive episodes are similar to those in adults with MDD.
Clinicians at The Younger Years can conduct a thorough assessment to determine the appropriate diagnosis and treatment plan. Early intervention and appropriate support are crucial for children and young people experiencing depressive disorders.
How can depression be treated?
The treatment of depression in children and young people often involves a combination of approaches, including psychotherapy (also known as talk therapy or counselling), support from family and educators, and, in some cases, medication. Early intervention and appropriate treatment can significantly improve outcomes and help the child or young person navigate their emotions, develop coping skills, and build resilience.
Here are some common treatment options:
Psychotherapy:
Such as Cognitive-Behavioural Therapy (CBT) or Interpersonal Therapy (IPT), is often the first-line treatment for childhood and adolescent depression. It helps young individuals identify and modify negative thought patterns, develop coping skills, and improve interpersonal relationships.
Family Therapy:
Involving family members in therapy can be beneficial, as it addresses family dynamics, communication patterns, and support systems. Family therapy can help improve family relationships, educate family members about depression, and provide a supportive environment for the child or young person.
Supportive School Environment:
Collaboration between mental health professionals and educators is essential to create a supportive school environment. Teachers can be educated about depression, signs to watch for, and strategies to support students in the classroom.
Medication:
In severe cases of depression, or when other treatments have not been effective, medication may be considered. Antidepressant medications, such as selective serotonin reuptake inhibitors (SSRIs), are sometimes prescribed for children and young people. However, medication should always be carefully monitored and used in conjunction with psychotherapy.
Lifestyle Changes:
Encouraging healthy lifestyle habits can be beneficial for managing depression. This includes promoting regular exercise, a balanced diet, sufficient sleep, and minimizing stressors in the child's life.
Supportive Environment:
Creating a nurturing and supportive environment at home is crucial. This involves fostering open communication, providing emotional support, and encouraging the child or young person to express their feelings.
Peer Support and Social Activities:
Encouraging participation in social activities, such as clubs, sports teams, or support groups, can help children and young people with depression feel connected, reduce isolation, and build a supportive network of peers.
Continuity of Care:
Regular follow-up with mental health professionals is important to monitor progress, adjust treatment plans if necessary, and provide ongoing support to the child or young person.
Clinicians at The Younger Years will work collaboratively with GP’s, psychiatrists, or paediatricians experienced in treating depression in children and young people and tailor the treatment plan to match the individual's specific needs.
Is there a link between Depression and Suicide?
Depression is linked to a higher risk of suicide and self-harm in young people. When young individuals experience persistent feelings of sadness, hopelessness, and despair, coupled with a lack of effective coping strategies, they may develop suicidal thoughts or behaviours. Some warning signs that may indicate an increased risk of suicide in children and young people can include expressing thoughts of death or suicide, talking about feeling hopeless or trapped, withdrawing from social activities, exhibiting changes in behaviour or mood, giving away possessions, or displaying a sudden improvement in mood after a period of depression (which could indicate they have made a decision to attempt suicide).
If you are worried about a young person feeling particularly low or hopeless it is important to ask them directly whether they have ever had thoughts that life is not worth living, or if they have had thoughts of hurting themselves. Talking to a young person about suicidal thoughts is not harmful (1) and is the only way of assessing risk (2). Whilst many young people who have suicidal thoughts do not go on to end their lives, if suicidal thoughts have been expressed it should be taken seriously, as a sign of a mental health problem that warrants professional assessment.
With the right support and treatment suicidal thoughts tend to resolve or improve, early intervention is crucial in preventing suicide. In urgent situations, contact emergency services, attend your local Emergency Department, phone the Mental Health Access Line on 1800 011 511 or Lifeline 13 11 14.
Please reach out to us and book an appointment with our experienced psychologists for further help.