How Do You Correctly Diagnose Depression in Children?
How Depressed is Your Child?
Diagnosing childhood depression is complicated but not difficult by a medical professional. There are 4 basic stages of depression that you can be aware of before meeting with your child's medical professional.
A severe form of depression in children that may involve disturbed sleep, appetite, suicidal thinking or self-harming behavior, loss of interest, problems thinking or concentrating, fatigue or loss of energy, restlessness or lethargy, and lowered self-esteem.
A less severe form of major depression in which symptoms are less evident and may appear chronic and last more than 2 years.
Depressive symptoms that are clearly associated with a child's separation from those to whom he or she is attached.
Depressive symptoms that come up due to a stressful life event. Childhood behaviour is unusual and the child finds it difficult to adapt.
A large number of treatment strategies have been developed for the treatment of depression in children. These strategies can be done with the child alone or along with the family or in a group with other children.
There is tons of evidence to suggest that treatment for depression in children involving the whole family is most effective. This only makes sense as a child's family needs to learn how to love and support each other during a difficult time. Peer group counseling has been found to be effective for children. Play child counseling is sometimes appropriate with younger children.
Depressed children are trained to recognize the relationship between their thoughts, feelings, and behavior; to watch out for their negative thoughts; to challenge their negative thoughts with evidence; to substitute more reality-based interpretations for their usual interpretations; and to focus on new positive behaviors.
Techniques designed to increase pleasant behaviour patterns such as self-monitoring of activities and mood, identifying positively reinforcing activities that are associated with happy feelings, increasing good activities, and decreasing negative activities.
Teaching children social skills such as how to interact positively with others. (Initiating conversations, responding to others, refusing requests, making requests, etc.) Children are provided with instructions, modeling by an individual or peer group, opportunities for role playing and feedback. The object of this approach is to provide the child with an ability to obtain reinforcement from others.
(*Please note: children learn best by watching. Often parents need to learn positive social skills in order to model appropriate behaviour to their children. You may find this very humbling as a parent to discover that your child is learning bad habits from you. If so, don't get down. Here's your chance to improve your life skills for your own health as well as the health of your child!)
Self-control approaches are designed to provide the self-control strategies including self-monitoring, self-evaluation, and self- reinforcement. Depression in children often happens when a child focuses on negative events, sets unreasonable and unrealistic expectations of personal performance, provides insufficient back up to their conclusions, and too much beating themselves up.
Interpersonal methods focus on the child's relationships, social adjustment and mastery of social roles. Treatment usually includes non-judgmental exploring of their feelings, active questioning on the part of the therapist, reflective listening, development of insight, exploring and discussion of emotional issues, and direct advice.
Very little is known about the safe use of antidepressants with children. The risks and side effects of medications and the findings that competent child counseling and counseling interventions may be more effective. It's best to restrict the use of medications with children. Always talk with your doctor about options and request to meet with a pediatrician or child mental health specialist.
Child Counseling can be helpful in cases of normal depression and can help insure the condition does not become chronic.
Child Counseling is almost always the first treatment of choice except in cases where depressive symptoms are so severe or critical that immediate relief is necessary to restore functioning and to prevent immediate and severe consequences.
Child counseling, or the psychotherapist, can generally be considered ineffective if a trial of 3 months has not produced a measurable and noticeable improvement. A decision to change therapists or to start a medication may be necessary at this point. Several trials of child counseling may be necessary to successfully treat depressive disorders.
Antidepressant medications require a substantial period of time before they take effect and several trials of different medications may be necessary to find a medication that actually works.
Medications alone appear to be helpful in only approximately 50% of the cases.
However, the use of medications requires a substantial commitment for period of time up to 9 months. In some cases, a child can stop taking their medications after 6 to 9 months without a risk of relapse. Unfortunately there is no way to know if a child will relapse of not.
Side effects are the primary reason why children stop taking their medications. The side effects of antidepressant medications can vary greatly and can have a significant or even traumatic impact on self-esteem and quality of life.
Medication is usually the second choice after a comprehensive and competent trial of child counseling. It is harder in a combined medication and child counseling approach to tell which approach is or is not helping and how much it is helping.
Child counseling can be a very effective alternative to the use of medications. However, research has found that combined child counseling and medication is often necessary and beneficial. Several trials of medications may also be necessary to successfully treat childhood depression.
Positive treatment is dependent on a correct diagnosis, correct understanding of the cause of the childhood depression, and implementing an appropriate plan of action.
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