Helping the Depressed Child

The first step in helping the depressed child is to recognize that the child is, in fact, depressed. This can be challenging. For one thing, its difficult for adults to accept that young children- even infants-can suffer from depression. Childhood is supposed to be a happy, carefree time life. Only in recent years has scientific evidence convinced most mental health specialists that childhood depression exists.

Recognizing the symptoms of childhood depression can be difficult While some children display the classic symptoms-sadness, anxiety, restlessness, eating and sleeping problems-others express their depression through physical problems-various aches and pains that do not respond to treatment. Still others hide their feelings of hopelessness and worthlessness under a cover of irritability, aggression, hyperactivity, and misbehavior.

Complicating the recognition of depression are the developmental stages that children pass through on the way to adulthood. Negativism, clinginess, or rebellion may be normal and temporary expressions of a particular stage. In addition, children go through temporary depressed moods just as adults do.

Careful observation of a child for several weeks may be required to determine if there is a problem. When symptoms of possible depression seem severe or continue for more than a few weeks, an evaluation by the child’s pediatrician to rule out physical illness would be a good first step. A next step, if deemed necessary, would be consultation with a mental health professional who specializes in treating children.

While parents typically assume prime responsibility for getting treatment for their depressed child, other people-relatives, teachers or friends-can play a role. In the following case, school personnel were instrumental in getting help for a child.

Scott

Scott was not doing at all well in school. He was alternately disruptive and unresponsive in class. His third-grade teacher sought help from the school counselor, who observed Scott on and off for several weeks. She soon shared his teacher’s concern. Scott was not learning. He seemed unable to follow instructions. Withdrawn for the most part, he also regularly lashed out at the other children either physically or verbally.

The counselor’s efforts to win Scoffs confidence failed and her invitations to his mother brought no response. She therefore turned to Scott’s sixth-grade brother for help. He explained that his parents were divorced and that all three children lived with their mother, who worked long hours outside the home. He commented that his mother seemed tired and stressed most of the time and that Scott was a special problem, causing her a great deal more trouble than did the other children.

The counselor reported the situation to a team of school officials-psychologist, principal caseworker, teacher-who regularly met to address problems such as Scott’s. They recommended followup by the school caseworker, who met with Scott’s father and arranged for Scott to receive psychological and physical evaluations. The evaluations indicated that Scott was physically all right, but quite depressed, angry, and emotionally confused. He missed his father very much, but was angry with him for leaving. He loved his mother, but blamed her for his fathers absence. Deep down he blamed himself for his parents’ divorce.

The clinician who evaluated Scott recommended that he receive treatment for depression. It was also clear that Scott wanted and needed more contact with his father. His mother also needed some relief from the burdens she had been shouldering. Scots parents worked out an agreement to increase his father’s visits with his children and to cover the cost of Scott’s treatment with his father’s health insurance.

While Scott was helped through the intervention of school staff, the important role played by his parents cannot be emphasized enough. Parents not only procure their child’s treatment, it often is necessary for them to participate in it. Sometimes a parent may reap some personal benefit from a child’ s treatment. Scott’s mother, for instance, improved her own abilities to handle stress while she was learning how to help her son.

The major objectives of treatment, however, are to alleviate the child’s depression and strengthen the child’s coping and adaptive skills, possibly preventing future psychological problems. This is not to say that early treatment is the total answer. Some problems are not readily resolved and some reemerge later in life.