Depression in Children, Research Paper Example

This paper describes the primary issues that encompass childhood depression as it investigates the illness itself, the methods of treating it, and the current scientific thoughts that frame its modern debate. The result shows three main targets that are associated with childhood depression: 1. Childhood depression is difficult to diagnose; 2. There is not a consensus from among experts as to the efficacy of child self-reporting; and, 3. Treatments of this mental illness vary in intensity and in mode.

Depression is a terrible mental state that robs people of relationships and experiences that contribute to contented lives. Every person feels down or sad for short intervals. This is a part of life; however, clinical depression can linger for days, weeks, or months at a time, causing the sufferer to lose interest in family, work, and recreation. We are accustomed to adults who have bouts with depression, but when this illness comes down on the life of a child, it causes us to step back and react with disbelief. We question whether a child can be persistently sad or apathetic, or disengaged. After all, we reason, childhood is a happy time.

All children experience swings in mood and behavior. For most, this works out logically, as they grow and mature emotionally and physically. However, for some children, sad feelings are not fleeting –they persist to a degree that they interfere with normal childhood activities such as play and socialization. When depression presents itself in children, parents need to know that, as terrible as it is, it is usually treatable. Often, depression in childhood is a thing that is untreated, because adults pass it off as a passing phase. At other times, a depressed child withdraws of acts out in ways that can make the illness harder to diagnose, and, therefore, treat.

Significant changes occur in a child’s appearance, school performance, or social activities, are signs that point toward depression. Older children may begin to experiment with alcohol or drugs as a way of dealing with their feelings of worthlessness or guilt. In extreme cases, children will contemplate, or actually commit, suicide. Girls tend to attempt suicide more often than do boys do, but when boys attempt it, they are more likely to be successful.

As pleas for help, some will cut themselves with razor blades. Others will sit in their desks at school and stare blankly for extended periods. A few will try to run away from home to get away from something that is bothering them –real or imagined. Other depressed children or adolescents will become sexually promiscuous or begin experimenting with alcohol or drugs as escapes from their tormented lives.

One estimation claims that 2.5% of children in the United States. The most common group is males under the age of 10. We know that by the age of 16, girls have greater incidents of diagnoses of depression. Adolescents are more prone to have bipolar disorders than younger children are. An alarming fact reported by National Association of Mental Health is that between 20-40% of adolescent children with major bouts of depression develop a bipolar diagnosis within five years.

Perhaps doctors are loathe to label a child as being depressed, since people still tend to speak in whispers about people who have mental diagnoses. Maybe parents themselves steer medial professionals way from labeling a child with depression for the same reason. Boys and girls who live with the diagnosis of Attention Deficit Disorder or Hyperactivity hold the deeper problem of depression behind those commonly defined. This makes for a tough situation, because children are much less likely to discuss how they feel with an adult doctor. Children require much more time from doctors than they are accustomed to giving to their patients. If children with chronic depression are going to receive proper evaluation, it will take a great amount of time from a physician over extended visits and observations.

There is also the issue of medical competition. Psychologists possibly could have the fear that if they refer children to psychiatrists, then they will become medicated and their parents will think that they no longer require therapeutic sessions. It is possible that major drug companies devote little research time or money into testing whether their drugs are effective in small children. Given the fact that children are young and in a rapid state of maturation, it is possible that it is hard to tell if counseling helps them to a significant degree.

Depression in older adolescents receives more attention because of increased suicides by teens over similar incidents from younger children. If younger children could get quicker diagnoses and effective treatments, then it is plausible to think that teen suicide rates might drop drastically. It is possible that when elementary and middle school age children begin to have trouble at school, their parents and teachers will not even consider depression as a possible cause. This is another example of how this illness, at this age, moves into a shadowy place an ignored.

Depression stems from complicated places as children react to things that happen to them physically or personally. Genetic and biochemical factors also contribute to a child’s propensity toward depressive feelings. Children who have family histories that exhibit depression are at higher risk for episodes of depression. Children from families in conflict and families where of substance abuse, sex abuse, and neglect are present are prone to depression and more likely to experience it earlier than are others. This assertion jives with recent research (Harkness, Lumley, et al, 2008) who found that initial manifestations of depression exacerbated histories of maltreatment and stressful life situations. Further, their measurements showed that depression onset typically occurred within a three-month period following major episodes of abuse or turmoil.

Depression is different from stress, stress is different from anxiety, and anxiety is different from grief, yet each of these words work interchangeably when most people speak of this issue. Frustration and anger contribute to a child’s feelings of stress. A minimal amount of stress is good for us. We accomplish more when we push ourselves to meet deadlines or to exercise motivation in our activities. Anxiety is the result of a child’s feelings of fear, apprehension, and uneasiness. Grief is a natural emotional dealing with an important loss of love or life. These are completely different issues from clinical depression and need not be confused with it.

Children need reassurance that their depression is not unique to themselves and that lots of other children hurt as they do. Having facts will aid children in learning coping skills that they will possibly use for the balance of their lives. Hearing the journeys of other children and parents helps some children to feel more at ease about their difficulties. Making connections with other people who have experienced similar problems is not a shameful thing. Some children report finding hope and motivation through such encounters. Psychologists can recommend this kind of therapy when they feel the time is right, and when they feel the mix of people is right for mutual benefit.

One concern that doctors have is the prescription of medication to combat the effects of depression in childhood. Jureidini (2009), in comparing the pros and cons of medicating children for depression, concludes that it is better, on the whole, to wait and see how a child progresses through a reasonable amount of time before jumping in with medicine regimens. This point of view, based on studies that deal with issues such as general quality of life, hospitalization, and morality, is Jureidini’s way of joining a wave of physicians who fear that numerous patients take too much medicine and take them too early in hopes of alleviating their depressive traits. Physical and emotional rehabilitation could possibly be all many young patients require in order to feel better about themselves and their lives. At present, Fluoxetine is the only Food and Drug Administration-approved drug for depression in young children (Merriman, 2009).

Childhood depression is a serious disorder and is taken seriously by caring, practicing clinicians. Anagnostropoulos (2008) observed that childhood depression is not only a devastating thing for children, but that it takes its toll on their families and how they function. Changes in anxiety, learning, and conduct are key factors. Children with this disorder usually have low self-esteem and high self-criticism. These researchers find that newer drugs show more promising results than their predecessors do. Until about thirty years ago, depression in early adolescence forewent as a normal part of the maturation process. Medicines usually delayed administration, therefore, until young adulthood. In order to treat depression in young people effectively, specific cognitive, behavioral, psychoanalytic, and systematic routines, with and without medicines, show use for years and have witnessed contradictory results. These researchers urge for more work in the areas of diagnoses and treatments.

Science has determined that anxiety and depression share certain genetic predispositions. The work of Eley, Gregory, Lau, McGuffin, Napolitano, Rijsdik, Fruhling, and Clark (2008) points out the indistinctness of these maladies. Their study was massive as they worked with 300 pairs of 8-year old twins. The results showed almost identical findings from that of previous studies performed by other scientists. Home environment and genetic factors surface as the most predictable course from which children experience depression.

The usual practice of dealing with young children relied heavily on receiving information from adults about their symptoms of depression. Sullivan and Spitznagel (2007) believe that methods to help preschoolers to describe and show their anxiety levels would help health care professionals with prescribing treatments. They used an instrument called The Berkley Puppet Show for their research with more than 100 preschool children. Accompanying this was a variety of reports that parents filled out concerning child behaviors, feelings, and anxieties. The child participants in the study also reported their feelings through another measure, designed especially for them. Sullivan and Spitznagel found that the children self reported about the same information as their parents, causing them to feel that children are more reliable self-reporters than had previously been believed. As a follow up, parents complete more surveys six months following the study, and their conclusions at that time were still in keeping with the defined information from the original work. This caused the researchers to determine that age appropriate approaches are reliable to use with young children screened for anxiety disorders and depression. They add, however, that serious cases and complicated issues fall outside of the domain of their work and need avoidance with children under severe stress.

Schools are full of children who have social, behavioral, and emotional issues. Social workers who frequent schools are vital in identifying, assessing, and referring students who show signs of deep depression (Wooley & Curtis, 2007). School social workers can use a variety of appropriate instruments on which children, primarily ages six to 12, can self report their feelings. Some of these are better suited for school social worker assessment than are others.

Doctors feel inadequate to treat depressed children. A recent survey (Spittler, 2008) reported that 54% of primary care physicians did not feel confident in diagnosing depression in children. The same survey revealed that 85% of the same doctors did not feel confident in their ability to diagnose and treat children with anxiety. As a result, a majority of these doctors say that they feel inadequate in treating such patients. Parents who insist on counseling sessions for their depressed children need to understand how records will be kept of the sessions and ask numerous questions before beginning that kind of treatment program. Complications with insurance benefits also require understanding prior to the outset of clinical therapy, or, as the researchers in this area call it, “talk therapy.”

Conclusions

Maybe it is because of some chemical imbalance in the brain. Maybe it is inherited. Maybe it is the result of a chaotic domestic life. For whatever reason, childhood depression is real and is recognized as a powerful detriment to a child’s wellbeing. The literature reflects are growing trend toward therapies that rely on drugs and counseling, in tandem, as more effective. Most researchers agree that difficulty in diagnosis is the major mitigating factor for starting treatment programs.

References

Anagnostopoulos, D. (2008). Depression in children and adolescents. General Psychiatry, 7(2), 1-2.

Eley, T., Gregory, A., Lau, J., McGuffin, P., Napolitano, M., Rijdijk, F., & Clark, D. (2008). In the face of uncertainty: A twin study of ambiguous information, anxiety, and depression in children. Journal of Abnormal Child Psychology, 36(1), 55-65.

Harkness, K., Lumley, M., & Truss, A. (2008). Stress generation in adolescent depression: The moderating role of child abuse and neglect. Journal of Abnormal Child Psychology, 36(3), 421-432.

Jureidini, J. (2009). How do we safely treat depression in children, adolescents, and young adults? Drug Safety, 32(4), 275-282.

Luby, J., Belden, A., Sullivan, J., & Spitznagel, E. (2007). Preschoolers’ contribution to their diagnosis of depression and anxiety: Uses and limitations of young child    self-report of symptoms. Child Psychiatry & Human Development, 38(4), 321- 328.

Merriman, J. (2009). Treating pediatric depression: What is the efficacy of psychopharmacology? Neuropsychiatry Reviews, 10(2), 6-7.

Spittler, K. (2008). Most primary care clinicians lack confidence in managing pediatric anxiety and depression. Neuropsychiatry Reviews, 9(12), 20.

Sullivan, J,, & Spitznagel, E. (2007). Preschoolers’ contribution to their diagnosis of depression and anxiety: Uses and Limitations of young child self report of symptoms. Psychiatry & Human Development, 38(4), 321-338.

Wooley, M., & Curtis, H. (2007). Assessing depression in latency-age children: A guide for school social workers. Children & Schools, 29(4), 209-218.