Although everyone feels sad sometimes, persistent sadness, irritability, or lack of interest may reflect a more serious problem. Symptoms of depression include sadness, irritability, loss of interest in fun activities, withdrawal, low energy, poor concentration, sleep problems, appetite problems, hopelessness, low self-esteem, and thoughts of death or suicide. The National Institute of Mental Health and the Society for Clinical Child and Adolescent Psychology both provide information about treatment options for depression.
Depression can be hard to identify in young children, as they may never directly express feeling sad or hopeless. In older children and teens, depression can easily be mistaken for lack of motivation, attitude problems, attention problems, or typical teenage withdrawal and behavior change.
Although a formal diagnosis of depression only requires symptoms to last for two weeks, childhood episodes of depression can last for months or years. Because depression can be both a cause and consequence of other problems, it is no surprise that depression often overlaps with anxiety, poor school performance, loneliness, defiant behavior, delinquent behavior, and substance use. Children may feel trapped in a downward spiral, in which depression and lack of energy make it hard to make friends, complete homework, and get along with parents, and those problems in turn increase their feelings of depression and hopelessness.
Depression can also take a toll on friends and family, who miss spending time with an enthusiastic, positive child, and feel worn down by the grumpy, critical behavior depression can bring. Depression can increase arguments and conflicts between family members and cause friends to drift away.
Although depressed children often feel that things will never get better, there are many effective treatment options. Research shows that even though depression can be rooted in biological factors, talk therapy can be a useful alternative or addition to medication. One of my first goals in therapy is to help generate a sense of hope and optimism about the real potential for change.
At this point, research most strongly supports a cognitive-behavioral approach to treating depression in childhood. I work with children and families to tailor a cognitive-behavioral approach to fit the unique strengths and needs of each child. Common elements of my approach to depression include helping children to:
- Understand the causes of depression
- Develop more effective problem-solving skills, so they do not feel hopeless or overwhelmed
- Engage in activities, and overcome lethargy and lack of interest
- Build strong social skills, and develop a strong network of supportive friends and adults
- Relax in stressful situations and regulate unpleasant emotions
- Disengage from their negative thoughts, and realize that they are often not accurate
- Think in positive, optimistic ways
- Recognize their many strengths and talents
- Persist in the face of setbacks
- Identify and pursue their true values and interests
Please contact me if you are interested in learning more about how therapy may be helpful for your child. This page is intended as a brief overview of my usual approach to helping children overcome depression, not a comprehensive review of all possible approaches. If I begin working with your child or family, we will discuss treatment alternatives, and the likely risks and benefits associated with each option.