A Rough Patch, or Something More? Depression in Youth

Natalie Brei, PhD
Licensed Clinical Psychologist

Is it a phase? A stage? Teenage angst? Hormones? We all have periods down in the dumps. Working through these periods can build resiliency and increase our faith in God and ourselves. But what if the negative mood - sadness, loneliness, irritability, anger – lasts for weeks and you think this is more than the typical “ups and downs” in your child?

Depression can hit children of almost every age, with many factors contributing to risk. Yes, some children are just more withdrawn or melancholic… but – whether or not you know the reason - if you are noticing a difference from the norm for your particular child, further investigation is necessary.

Reading the Signs

A quick internet search can give you the basics depression in children. Depression is characterized by a two-week long period when one of these two things happens more than half of the time:

1. Down, depressed, or hopeless mood (**or persistent irritability in children)

OR

2. Loss of interest or pleasure in daily life and previously enjoyed activities

Other signs of depression within that period:

• Feeling worthless or guilty

• Loss of appetite or unusual weight gain

• Fatigue

• Difficulty concentrating

• Noticeable slowing of thought or physical activity

• Thoughts of death or suicidal thoughts

The following may be helpful to consider:

Activities: BUSY does not equal NOT DEPRESSED. Often we think of someone who is depressed sitting on the couch all day. Ask instead, “Is my child doing activities he enjoys during free time? Or is he withdrawing from people or activities?”

Thoughts and Feelings: Listen for words like guilty, worthless, sad, hopeless, irritable/angry, or numb.

Suicidal Ideation: Statements like, “I wonder what it would be like if I never woke up” or “I wish I weren’t here any more” are cause for immediate follow-up. How parents respond is important – you want your child to open up.

But how do I not freak out if I hear these things from my child?

• Try to stay calm. Engage in “Active listening” - put aside the “fix-it” mentality and just listen. Try repeating what you hear (“Sounds like you feel ... xxx)” or, “Tell me more about that.” Children often talk more if you talk less.

• Monitor your Reactions - (It’s HARD!) - Especially if your child mentions thoughts of death, avoid a huge reaction. Say you’re seriously concerned. Emphasize your love, and prioritize safety. Follow up with a professional therapist or an emergency room visit if concerns are more immediate. Show your child you are serious about safety.

• Don’t Discount It – Don’t minimize your child’s feelings, even if he or she has a bad attitude! You can work on changing perceptions later. For now, listen and give yourself a bit to process before responding.

What Can I Do RIGHT NOW?

If you think your child is indeed dealing with depression:

• Increase social support (time with family/friends/social activities) to combat loneliness. Speak with your child’s teacher, coach, or other adults who see your child in other settings. Find out if bullying is a factor.

• Snag one-on-one time with your child - even if there is no talking and even if it doesn’t end perfectly.

• Turning outward, toward others and toward God or other spiritual figures, is a great way to help a child “stuck” in a depressed mood. Volunteering or assisting a younger child with a project can build a child’s sense of purpose. Think about reserving time for prayer and thankfulness to avoid constant negativity.

• Sleep, exercise, and a proper diet can’t be emphasized enough. Start small to develop better habits.

• Gently help your child notice and then begin to challenge any faulty negative thoughts.

• “Behavioral activation” - intentionally plan pleasant activities into the schedule. Examples include walks, one-on-one time, music, drawing, games, and social activities.

When to seek more help

What if you’ve tried everything with little luck? Don’t put pressure on yourself as a parent to fix everything. Seeking outside help is important in these cases, and it ideally comes from a professional. If your child hesitates at the thought of a therapist, is there a trusted adult, priest, spiritual director, guidance counselor, or other mentor who shares your family values?

Most primary care doctors are trained to screen for depression and help you find resources as well as advise you about medication. (For clinical depression, a combination of therapy and medication predicts the best outcomes.)

The important thing is to get your child talking. If you encourage your child to start to discuss these feelings with someone who can help, this may eventually lead to more openness to formal counseling.