Major Depressive Disorder is defined by sad or irritable mood or loss of pleasure in things one used to find interesting, accompanied by a number of the following symptoms: inability to focus, thoughts of worthlessness, withdrawal, thoughts of death, poor sleep (too little or too much) and poor diet (over or under eating). These symptoms must be observable and cause clinically significant distress that impacts functioning.
What are Depression?
The current Diagnostic and Statistical Manual (DSM-5) classifies Major Depressive Disorder under the category of Depressive Disorders, and Bipolar Mood Disorders are classified in a separate section.
In children, depression may often be marked by irritability. Children may be less able to define their own symptoms. They may have trouble talking about their feelings or may deny them entirely. In children, depression can be defined by irritable mood, loss of interest in activities and by considering parent and teacher reports of these and other depressive symptoms. Glaring symptoms include frequent thoughts of death and suicidal ideation. Large meltdowns that seem way more intense than you would expect may be related to depression.
What are the signs and symptoms of Depression?
Sad. Feelings of sadness. OR
Irritable Mood. May seem angry, frustrated, have a short temper, and cry easily.
Loss of Pleasure. Less interest or participation in activities the child used to enjoy.
Inability to focus. Seeming unable to focus on anything. May seem lethargic or spacey.
Thoughts of worthlessness. Your child may make a lot of negative self-statements. “I’m not good enough.” “Everyone else can do that but I can’t.” “I never do anything right.”
Withdrawal. Your child may stop spending time with friends or family and may spend all his or her time quietly in a bedroom. Playdates and interest in others may decrease.
Thoughts of death/ suicidal. May report wishing he or she had not been born, may discuss life without him or her, and may try to give away treasured possessions. May express a desire to hurt him or herself and may share a plan. Be open to listening to your child, and hear his or her feelings instead of saying not to feel that way. Seek support immediately, and make sure no weapons or other dangerous opportunities are available. Keep close supervision of your child.
Poor eating. May not be interested in eating or may eat excessively with a focus on carbohydrates.
Poor sleep. May not be able to sleep or may sleep all the time, generally a disruption in typical sleep patterns.
How is Depression treated?
Cognitive Behavioral Therapy (CBT). Cognitive Behavioral Therapy is a modality with considerable research to support its effectiveness. With depression, often strategies can be taught and practiced in a setting that may be time limited. Eight to 10 sessions may be sufficient in building some of these skills. This therapy is often individual but may also be delivered in a group setting. Some goals of CBT include the following:
Increase Emotional Awareness. Activities to help your child recognize emotions may include drawing emotion faces, role playing and acting out different emotions, and recognizing them in the therapist. If CBT is offered in a group setting, practice recognizing emotions occurs through engagement with group members. Practice recognizing emotions at home, starting with positive ones and moving to sadness, worry, and other negative emotions. Journaling and completing homework assignments related to the emotional awareness goals can help some children remember and practice their skills at home
Improve Coping Skills. CBT often teaches and helps kids identify and practice coping skills, such as deep breathing, relaxation, reading, listening to music, taking a walk, jumping on the trampoline, or talking to a friend. Children learn to stop and identify their feelings and to take a break instead of yelling or hitting. They work with a therapist to recognize the antecedents, behaviors, and consequences associated with their thoughts and feelings.
Work to improve self-confidence. CBT focuses on identifying thoughts that lead to certain behaviors and determining whether those thoughts are valid or whether they are cognitive distortions. Children learn to combat negative thoughts and to see actions and experiences not as global and uncontrollable but as singular instances and under a child’s control.
Mindfulness. Mindfulness involves recognizing and accepting feelings and allowing them to just be. This practice involves scanning the body to notice any tension and working to let that tension go. Awareness of the present time and accepting thoughts and feelings are important in Mindfulness.
Relaxation and Meditation. Breathing and relaxation are encouraged in mindfulness and can make a big difference in reducing anxiety and the presence of negative, distorted thoughts.
Accepting Thoughts. Mindfulness focuses on acceptance and not on the immediate push to change and criticize ourselves.
Play Therapy. For young children, play therapy utilizes toys and art to allow a child a safe setting to act out their feelings and experiences. Guided play therapy can introduce coping skills and emotional awareness into the play themes.
Depression is a common diagnosis and can be treated. Taken together, it is valuable to obtain a diagnosis and to engage in the appropriate therapies as early as is feasible. With these supports in place, it is possible to see improvement in depressive symptoms, better coping skills and emotional awareness, and the potential to live a happy life.
How can Clear Child Psychology help with Depression?
If your child is struggling with this symptom to the point that it is getting in the way of his learning, relationships, or happiness, it’s time to seek professional help.
We Help You, Immediately
Our Free Discovery Session is a 20-minute consultation where we can talk one-one-one about the concerns and questions you have about your child.
We Help Determine Next Steps
Our Initial Consultation allows us to get a deeper understanding of your child’s needs and determine if an assessment is appropriate.
We Build a Customized Plan
Our Assessments allow us to determine your child’s specific strengths and challenges. We can use this information to develop a customized support plan which includes: referrals
We Connect you with the Right Professionals
Once we understand your child’s needs, we will help families get connected to the right specialists. No more guesswork, no more wasted time and resources.
We Provide Ongoing Coaching and Support
Our Coaching Packages allow us to continually support families as they continue their journeys. Parental coaching, clinical referrals and school advocacy are just a few examples of ways we help.