Children Can Experience Depression, But It’s Misdiagnosed As The Growing-Up Blues
Depression In Children and Adolescents On The Rise
Childhood is a happy time for most children, but for increasingly many young children and adolescents, this is not the case.
According to an article published in 2022 in Jama Pediatrics, the Health Resources and Services Administration found that depression and anxiety among children ages 3 to 17 had increased between the years 2016 to 2020.
There are no specific statistics in Malaysia however, but according to Matilda Xavier, director and clinical psychologist of Mentem Psychological Services in Subang Jaya, she often sees children with depression at her practice.
For many depressed children, their depression is often mistaken as growing up blues.
“Everyone feels blue sometimes,” Matilda said. “Adolescents tend to be more sensitive at this stage in their lives because they are going through a lot of physical and psychological change – teenage angst. However, depression is more than just teenage angst. Depressed feelings last longer, for most of the day and affect most areas of their functioning. It is not normal any more.”
Among the symptoms of childhood depression are the continuous sense of hopelessness, sadness and emptiness, which sometimes involves crying.
Some children lose weight because of undereating, while others gain weight because of overeating in order to cope with the depression. Sometimes they oversleep. They also tend to lose interest and pleasure in activities they used to enjoy.
Adrianna, 25, a part-time diploma student in social work, recalled the depression she went through as an adolescent.
“I started to lose interest in everything that I did,” she said. “I skipped school just to stay at home and sleep. I was a bright student but due to this I flunked my studies.”
Adrianna felt suicidal and actually attempted suicide, but this only spurred her determination to find the solution. This is why she decided to see her school counsellor who wanted to refer her to her psychiatrist.
However, her parents refused to sign the consent form. Does she think things would have been better if her parents had agreed for her to see a psychiatrist?
Yes, Adrianna said. “Maybe I would have understood better about what I was going through and I might not have flunked my SPM.”
According to Matilda, it is not uncommon for depressed children to have their studies affected. “They have difficulty focusing, concentrating or making decisions,” she said.
According to Matilda further, if the depressive symptoms are obvious, parents may bring their children to therapy, but sometimes the symptoms are not obvious to parents.
“Children may present with behaviour problems that mask their depression,” she said. “This would cause the parents to seek out our services.”
Matilda added: “Sometimes school teachers or counsellors would have noticed the child displaying depressive symptoms or the child might have talked to their teacher or counsellor about their depression or suicidal thoughts so teachers or counsellors then inform the parents and suggest therapy. We have even had situations where children themselves asked their parents to send them for therapy because they are depressed.”
While childhood depression is becoming more and more common, it does have its solutions.
Matilda said: “At our practice, we do a thorough assessment to understand the child and their environment and to explore what is contributing to and maintaining the depression. With all the information we gather from our diagnostic interview, with both the child and their parents, and even from teachers, we come up with a plan to treat the depression.”
“Unless the depression is severe, or if there are severe behavioural issues that are really disruptive and they need medication to stabilise the symptoms, we prefer not to recommend medication as the first line of treatment, because children’s brains are still developing,” Matilda added.
At the end of the day, Matilda said, solving depression among children is a community issue.
“We work with both the child and the parents and if necessary, with the teachers as well,” Matilda said. “The best treatment or course of action will depend on the age of the child. For young children, expressive arts therapies will work well. With older children, other forms of talk therapy including cognitive behavioural therapy or also known as CBT would work. Sometimes older children also may benefit from expressive arts therapies.”
It all boils down to acknowledgement and awareness. “First, family members, teachers, and others have to understand and accept that children can be depressed,” Matilda said.
“Do not brush it away and say things that minimise the children’s distress. Take it seriously. Listen to the children without being judgmental or negative. Accept without criticism when a child says he or she is depressed. Acknowledge it and find ways to help the child. Being supportive will help the child recover better.”