By Dr Himani Khanna
Depression is a mental illness characterised by persistent feelings of sadness, irritability, loss of interest in activities, feeling of hopelessness, worthlessness and even thoughts of suicide. Often, these symptoms can affect a child’s sleeping and eating habits and they may have trouble concentrating on school work, family life, social activities. A diagnosis of depression is given only when these symptoms persist for two weeks or longer and interfere with the child’s ability to function.
Childhood depression is when these emotional blues persist and interfere in the child’s interest, school work and family life. Many times, depression is missed in children as normal emotional and psychological changes that occur during growth.
Certain symptoms which may be alarming
Extreme irritability, persistent feeling of sadness, hopelessness, withdrawal from the previously enjoyable activities, or from family or friends, increased sensitivity to criticism, change in appetite and sleep like eating too much or too little or sleeping too much or too little, throwing a frequent temper tantrum, difficulty in focusing, sometimes complains of stomach pain, headache that does not respond to treatment, talking about death or suicide.
Children with chronic physical illness like diabetes, epilepsy, stressful life events, environment full of family problems, family history of depression, alcohol or drug use, history of violence are at greater risk of depression.
It is important for parents to know that if they observe symptoms of depression in a child persisting for more than two weeks then they may consult their paediatrician or a developmental paediatrician to help manage these concerns.
The counsellor must look into a detailed family history, home environment, parenting style, medical history and conduct a physical examination to rule out any features of physical abuse. A detailed history and physical examination help the professional to be able to reach to the core reason for symptoms of depression. The first and most important intervention in toddlers is tender, loving care, play therapy and cognitive behaviour therapy, family therapy and lastly, medical therapy.
Family therapy is where the whole family needs to be involved in taking care of the child, be sensitised to the needs of a child. Working with parents and grandparents on parenting styles can help them better understand their child and manage the difficult behaviours. Play releases anxiety and can act as a means to bond with the child and also help let the child’s emotions out in the play.
Art Therapy can also be used as a means to interpret a child’s hidden unexpressed emotions and can also be used to heal them.
Cognitive Behaviour Therapy where a psychologist can work at counselling not just the child but also help the parents in their abilities to handle difficult behaviour and situations.
Medical Therapy cannot be disregarded because when the symptoms are severe and a child doesn’t seem to respond to the other methods, then medication that balances the neurotransmitters in the brain help us to tide away the crisis, while other therapies gradually take over.
Hence, one has to be aware of identifying the red flags and intervening at an early stage to manage it in time and prevent the severity.
(The writer is a developmental paediatrician & Co-Founder of Continua Kids)
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