SIGNS AND SYMPTOMS OF DEPRESSION IN CHILDREN AND ADOLESCENTS; What parents should look for -Article by R.Manoj Clinical Psychologist, Child Psychologist and Counselor-Chennai

Depression in children is a reality. The early recognition, acceptance and addressing the situation proficiently, is the best way forward for parents to keep their own aspirations about their children alive. Otherwise they may only make their own life stress and make their children feel that they are nor worthy enough to live. Recognize clinical depression and accepting the fact will help your child in three ways. One, it will prevent you from blaming yourself or your child. Second, it would prevent you from making stupid emotional comments about your child’s behavior and third feel guilty for any extreme steps taking by your child when he or she starts feeling the pressure as unmanageable.

Listed below are few signs and symptoms which you should look for in your child which would be early warnings for you, of your child being prone to depression. But a word of caution- Don’t just read the symptoms and when you see a few of them in your child, brand the child as being depressed. The symptoms as be listed to just guide you to seek the help of a professional whenever you observe that there is some sudden or gradual change in your child. Only qualified professional clinical psychologist or a psychiatrist can conclude whether the symptoms exhibited are those or depression or whether its that of any behavioral problems or emotional distress.

To provide a better and easy recognition I have grouped the signs and symptoms under four major functional areas of everyone’s life.

Behavioral

• There may be sudden or gradual changes in activity levels. They may show lack of interest in the activities which were pleasurable to them or even their day to day responsibilities which they had been doing without ant push.  The child may either show lethargy in his activities or involve excessively in activities which the parents had been denying him from doing
• School, refusal and high resistance to academic related activities  are one of the  symptoms which is commonly seen
• Frequent expression of being tired and being bored about everything failure to involve in any of  his  activities Inspite of  consistent encouragement can also be witnessed
• There may be noticeable increase of Sluggishness in their actions, reactions and even play and entertainment related activities
• The children may withdrawal tendencies. They may suddenly or gradually move into isolation or keep themselves occupied in activities which are done in isolation such as playing video games. Places of isolation becomes their preferred and favorites ones and you can find them escaping to such places at the first opportunity.
• There may be a sodden or gradual loss of interest in family affairs or involvement with their favorite family member or even friends.
• In some children there may a dynamic opposite behavior. They make show an increased level of dependency and express exaggerated sense of insecurity in the form of fear of doing even very simple things such a short absence of parents.
• Sometimes the children may show  excessive interest in praying, repeating a few acts etc to ward of their fear
• In some cases they may involve in self injurious behavior  hitting or biting themselves and in other times they may involve in reckless or aggressive behavior for which they are sure to be punished physically. Sometimes it may even go the extend of attempting suicide
• Sometimes they may become over demanding and throw temper tantrums whenever their demands are not met
• In case of adolescents there are possibilities of the child involving in substance abuse which includes, tobacco,  alcohol and other dangerous psychotropic drugs

Emotional

• The child may look sad cry frequently for even simple issues or provocations which can be explicitly look as unreasonable. Some times the crying spells may for long spells even without any provocation
• The child may be show highly sensitive reactions such as being upset, disturbed, offended or disappointed even for simple criticisms or negative experience
• There may be significant increase in expressed anger, and even aggressive reactions even with out ant reasons. sometimes they may pick up fights with their friends parents or siblings without any provocation
• The child may become anxious, tensed and even panicky for no apparent reasons. they may show startled reactions even regular happens that happens abruptly such as noise of the horn etc
• Expression of fear about even simple things, known people and situations , environments they have been already exposed to. They even show excessive avoidance to everything they fear about
• They may be seen worried, brooding a lot, getting irritated and frustrated even for very simple happenings frequently. They may also have difficulty in making choices regarding simple things

Physical

• There may be significant change in appetite which may range from starving to overeating. This may even lead to significant weight loss or weight gain in a short period of time. Sometimes these children are found to be skipping regular meals and spending time munching junk foods excessively.
• They may also having sleeping problems which range from lack of sleep  to excessive sleep. in some cases the sleep is disturbed, the sleep cycle is disrupted  and they may also have nightmares because of which they feel drowsy most of the time.
• The children who are depressed may also fake illness. In some other cases they may complain of  pain in various parts of the body or even show symptoms of some specific illness which cannot be diagnosed by physical examinations.
• Enuresis (bed wetting) and encorpasis (inability to control their bowel movements) which develops after the control is already established also point towards depression

Cognitive signs

• There may be deterioration in attention and concentration which reflects in most of their activities. they may also been seen drifting in to their fantasy world irrespective of the task they are engaged in  They also have difficulty with their short term memory because of the same.
• They may have feelings or worthlessness and self depreciating thoughts which is expressed by self criticisms  and good for nothing mind-set even for simple failures.
• Poor self esteem and low self confidence which is expressed consistently through their inability to complete even simple tasks is one more important indicator.
• They may show pessimistic attitude towards everything, every event and even everybody they come across
• They have significant feelings of guilt and express the need to be punished even over their perceived faults. They blame themselves even for mistakes in which either they have limited role or no role at all.
• These children may express the belief that they are destined to suffer nad have to live their life the way it is which is a indication of strong feelings of hopelessness
• They have strong feelings of helplessness and they have strong feelings that nobody can help them and hence they  have difficulty in seeking help. They feel they are all alone in this world because they believe that there are nobody around whom they can trust, who would understand and help them
• Suicidal thoughts which are expressed as death wishes are the clear signs of depression and if these thoughts are witnessed,  then have no doubts, the child is suffering from depression.

Depression should be addressed just like any other physical illness. Children cannot not articulate their emotions or even identify that they are depressed. So it’s the responsibility of the adults specifically the parents and teachers to recognize it by observing the changes that happen in their behavior, emotions, physical health and habits and their cognitive process and take appropriate measures. It’s not necessary that the child should have all the symptoms mentioned above for the child to be diagnosed. If the child has even half of the symptoms mentioned above you need to become cautious because you child may be in depression or prone to depression. If your child is experiencing even half of the above said symptoms, it is a good to get an evaluation by a professional clinical psychologist with experience in handling childhood disorders. If their child is either found to be depressed or prone to depression then effective intervention measures and appropriate support can be provided to prevent the condition from escalating and also safe guard them from  social isolation, losing their self confidence, developing negative self-esteem and safety risks that result from persistent depression