Identifying depression in children is not always easy. Children, especially younger children, may not yet have acquired the vocabulary, skills or even the comprehension to articulate their experiences. Some children withdraw and become sullen and others may become hyperactive or aggressive.
Children therefore manifest depression in very different ways, but some of the commonest features do tend to reflect those of adults, especially after the age of 8. Spending lots of time in bed but with poor sleep and early waking is common. Poor performance at school, getting into fights, losing interest in hobbies or friends and complaining of headaches, stomach aches, tiredness and other vague physical symptoms are also common.
Boys especially will deny feelings of sadness and may instead be moody, uncooperative and bored. Some young people may cut themselves and this can be interpreted by adults as manipulative behavior rather than an attempt at communication.
Like adults, it can take some time for children to recover from depression. Most episodes in children or adolescents last just under a year but clinical depression can recur in as many as 70 per cent of children within five years. Around 30 per cent of children who have a depressive illness will go on to develop bipolar affective disorder. On current estimates, roughly two per cent of children under the age of 12 suffer from depression. By the time children reach their teens the figure has risen to five per cent.
The children most at risk appear to come from backgrounds of family conflict, marriage breakdown, or situations where they experience physical and/or sexual abuse.
Approaches to the treatment of depression in children tend to reflect those used with adults but with particular focus on aspects of the child’s life. Treatment therefore is likely to have a psychological basis and will focus on social and emotional problems, difficulties at school, how to problem-solve and manage emotions, self-esteem and family relations.
Kevin Stark is just one psychologist to have developed an empirically evaluated treatment procedure. In one version of Stark’s programme he took 29 children aged 9-12 who scored highly on a self-reported measure of depression. Children were taught methods for setting realistic standards and goals for themselves and way of more accurately evaluating and interpreting the causes of both good and bad outcomes. After 12 sessions over a period of just five weeks, children showed significant improvements in their depression scores which were maintained over an 8-week follow-up.
The message here is that children don’t have to suffer depression but it is likely to come down to the vigilance of those around them to understand and identify behaviors that appear to suggest depression. Then, proper consultation with medical professionals should yield a more positive outcome.