Depressive disorders in children and adolescents are becoming more and more frequent, which is caused by a wide variety of problems. Depression in the youngest is slightly different than in adults, so it is worth knowing its symptoms in order to provide the young patient with the necessary help as soon as possible.

Depression in children and adolescentsit is most common, what's more - its prevalence is much greater than one might imagine. Unfortunately, you can still often come across opinions that mental disorders in children are fiction. Many adults are convinced that such problems simply do not occur in the youngest. This kind of thinking is absolutely harmful and means that some of the patients in need of help do not receive it or receive it, but definitely too late.

In fact, a variety of mental disorders - including depression, anxiety disorders, as well as schizophrenia and eating disorders - are increasingly found in children and adolescents. In addition, some problems in the field of psychiatry, such as ADHD or autism spectrum disorders, are simply typical of childhood or adolescence.

Depression in children and adolescents: statistics

Statistics on the prevalence of depressive disorders are not optimistic. It is estimated thatdepression affects 2% of children and 8% of adolescents . These numbers are simply large, but it is worth noting that the statistics are very likely to be underestimated.

There is a shortage of child psychiatrists in Poland, in addition, many parents are still afraid of visiting such specialists, so that ultimately many cases of childhood depression may not be recognized at all.

Causes of depression in children and adolescents

In the case of many mental disorders and diseases, their pathogenesis has not been clearly defined, as is the case with depressive disorders. However, it is believed thatis significantly influenced by three groups of factors :

  • biological,
  • psychological
  • and environmental.

About the role of biological factors in the pathogenesis of various mental disorders, inthis depression is mentioned for a long time.genetics .

It is noticeable that those children in whose families someone struggled with depressive disorders often struggle with this type of problems themselves.

For years, depression has also been associated with abnormalities in the concentrations of various neurotransmitters, including serotonin and noradrenaline - in the central nervous system.

Psychological factors are nothing more than a specific construct of a child's psyche. Some children are less and others more vulnerable. Ultimately, in the case of the latter, various difficult events - e.g. the death of a loved one, change of school or experiencing bullying - can lead to depression in a short time.

Above, the environmental factors that are important in the pathogenesis of depression in children and adolescents have already been mentioned a bit. Depression can be fostered bysignificant life changes :

  • moving,
  • loss of job by a parent,
  • and experiencing violence (both mental, physical and sexual).

It is worth mentioning here thatdepressive disorders in children often have a strong relationship with school . Today, more and more children and teenagers cannot cope with the pressure. In addition, many young patients become victims of violence by their peers.

Recently, there has been another, previously unknown, possible cause of depression in children and adolescents -remote learning . It happened in 2022, when the COVID-19 pandemic hit the world.

The need to stay at home all the time, being isolated from peers and spending many hours in front of a computer screen resulted in some students developing depressive symptoms, and others developing full-blown depression.

Symptoms of depression in children and teenagers

Depression in children and adolescents is different from depression found in adults. Commonly associated with depression are problems such as low mood, sleep disturbances or the feeling of constant fatigue.

Symptoms of depression in children and adolescentscan be slightly different and may be:

  • mood swings (the child may be in both depressed mood and become very irritable),
  • self-harming behavior (such as self-harm or choking),
  • psychomotor agitation (it is usually caused by a young patient feeling anxious or tense),
  • memory and concentration disorders,
  • difficulty sleeping(such as problems with falling asleep, waking up at night or getting up very early),
  • changes in appetite,
  • tearfulness,
  • indifference,
  • loss of previous interests,
  • tendency to take impulsive actions,
  • withdrawal from social relations,
  • resignation thoughts (such as "life is meaningless").

Depression in children, as in adults, may take different forms and it is possible that, apart from the symptoms typical for mood disorders in a young patient,psychotic symptomswill appear. They can be:

  • delusions of guilt,
  • delusions about the impending end of the world
  • and hallucinations (usually auditory, where the patient may, for example, declare that he hears voices that condemn his behavior or that they speak very negatively about him).

In the youngest patients, depression may run in a masked form, which means that other than typical depression symptoms will come to the fore. Such can be, among othersailments of a somatic nature .

It happens that a small patient complains of frequent headaches or abdominal pain, as a result of which he has a number of different tests, and none of them allows finding the causes of the ailments he reports.

In such a situation, the parent should definitely watch their child carefully and consider visiting a psychologist or child psychiatrist.

The most serious problems associated with depressive disorders aresuicidal thoughts and intentions .

A young patient - contrary to appearances - can really be convinced that his life is completely meaningless and try to take his life. It is also not the case that those people who openly talk about the fact that they have suicidal thoughts will not attempt suicide - most often it is a desperate cry for help.

A parent who hears from his child that he would like to end his life should not delay, and urgently report to the appropriate specialists.

Depression in children and adolescents: recognizing

A parent suspecting his child's depression should consult a psychologist or psychiatrist. The possible symptoms of depression in children and adolescents described above, as well as other, less obvious problems, should lead to it.

Depression can be evidenced by, for example, a sudden change in the behavior of the child, as well as a deterioration of their learning results (especially when the child was an exemplary student before).

The diagnosis of depression is madeis based on a psychiatric examination and interviewing both the parent and the patient.

It is worth noting here, however, that depressive symptoms may appear not only in depression, but also in connection with completely different individuals. An example of this is hypothyroidism.

In addition, low mood and other symptoms suggesting depression may occur if you are taking certain medications (such as glucocorticosteroids).

For this reason, the psychiatrist not only collects a detailed interview, but also, if necessary, informs the patient's parents about what tests they should perform on him.

Treating depression in children and teenagers

There are two basic methods of treating depression in children and adolescents:

  • psychotherapy
  • and pharmacotherapy.

The first one in this age group is actually the preferred method. In Poland, however, the problem is that access to psychotherapy is simply limited. Various therapeutic interactions can be helpful in combating the problem. Quite often, however, systemic therapy is recommended, in which not only the depressed patient is involved, but also members of his immediate family.

Pharmacological treatment of depression is a concern of many parents. However, sometimes drug therapy is just essential. This may be the case, for example, in patients with very severe symptoms of depression. In addition, sometimes a patient without medication may not be able to participate effectively in psychotherapy.

Parents' concerns about psychotropic medications vary widely. Usually, however, they are worried that by taking them, the child will become addicted to them or become completely unable to function normally. There is really no such risk in the case of antidepressants.

Most often, young patients are recommended agents from the group of serotonin reuptake inhibitors, such as sertraline or fluoxetine.

These preparations are usually well tolerated. Side effects (such as headaches, drowsiness or gastrointestinal disorders), if at all, appear for a maximum of several days after the implementation of these drugs, and then disappear spontaneously.

Another parent concern is that when they start giving their child antidepressants, they will have to take them for the rest of their lives. This is definitely not true -the recommended treatment time for a single depressive episode is 6 to 12 months .

Antidepressants for children and teenagersmay bring the expected results, but it must be emphasized here that they must be taken strictly in accordance with medical recommendations. Some parents decide to stop taking them after they notice the effects of the treatment. Doing so is very dangerous because your symptoms may come back quickly.

Other caregivers give their children antidepressants and after a short time - due to the lack of improvement - they give up their use. Here it is important to note that antidepressants do not work right away. You should simply be patient, asthe first effects may take 2-4 weeks to appear , and the final effects even 12 weeks after starting treatment.

It's worth mentioning here that antidepressants aren't the only ones used to treat depression in children and teenagers. For example, in the case of psychotic depression, the use of psychotic medications may also be recommended. Sometimes, mood stabilizers (mood stabilizing) are also used.

An important aspect of treating depression is where the young patient should be treated. There are at least a few options and most children benefit from mental he alth clinics. Outpatient treatment is generally appropriate for those patients who are rather stable.

In a situation where the patient is threatening his life, e.g. due to intense suicide intentions - he should be hospitalized in an appropriatepsychiatric hospital for children and adolescents .

Another option is a stay in the day psychiatric ward, where patients attend therapy classes Monday through Friday and spend their afternoons and weekends at home.

It is worth mentioning here that Polish child psychiatry has been going through a specific crisis for many years. There are many children in need of help, while psychiatrists and psychiatric wards for children and adolescents are far too few. It is for this reason that reports of various tragedies, such as suicides committed by very young people, often appear in the media.

Currently, not all children who need it have a chance of finding a place in the hospital. This is one of the reasons why parents should be really alert and react as soon as possible when they notice a change in their child's behavior. Early assistance may delay the need for the child to go to hospital.

Depression in children and adolescents: prognosis

The prognosis of children who develop depression depends on many, in factfactors. They are better when the problem arises in connection with a specific situation, e.g. parental divorce, death of a loved one or change of school.

Worse prognosis, in turn, occurs when depression appeared for no apparent reason.

Generally, when symptoms of depression appear in childhood or adolescence, the patient has an increased risk of developing depression in adulthood.

Category: