Monday, May 12, 2003
THURSDAY, May 8 (HealthScoutNews) -- The divorce had been hard on the 6-year-old, an only child.
"He was living with his mother and missed his father terribly," recalls Constance Wood, a Houston psychologist who specializes in the treatment of children and families. In school, his teacher noticed he wasn't playing with other children and was becoming withdrawn. He wasn't able to concentrate on his schoolwork, although he had been a good student.
"At home, he wasn't eating well and kept saying negative things about himself," Wood adds.
His mother was concerned, but had no idea how bad things were until the day she found him with a rope around his neck. He looked up and told her he was going to kill himself.
The case history, a true one, is extreme, but it depicts the very real problem of childhood depression, says Wood, who treated the little boy and reports he is now doing well.
Depression may be considered a grown-up disorder, but actually it affects up to 2.5 percent of children and up to 8.3 percent of teens in the United States, according to the National Institutes of Mental Health.
Yet, therapists say, many parents remain unaware that children can be depressed. To bridge that awareness gap, May 4-10 has been designated Children's Mental Health Week.
If the depression is recognized early, treatment can usually get a youngster on the road to recovery quickly. Most therapists use talk therapy, sometimes combined with medication.
"At least in the beginning, parents will blame it on something else," Wood says. Or they often excuse the symptoms as a phase.
Usually, it takes something dramatic -- from failing grades to the horrific rope incident -- to bring parents in to see a therapist with their child, Wood says.
Parents should be aware of the typical warning signs, adds Carl L. Tishler, an adjunct associate professor of psychology at Ohio State University. Among the signs that might spell trouble, he says: a return to bedwetting, or sleep disturbances such as getting up in the middle of the night and roaming around the house.
"With older kids, you might see more risk-taking in their behavior," he says.
"Most times parents are looking in another direction," Tishler says. "They are looking at school performance and saying, 'Why didn't you get a better grade?' They are focused on day-to-day behavior."
Depression can seem to spring from nowhere, but be especially alert, Tishler says, if your child has had a trauma, such as death of a grandparent or a parental divorce. Not that a divorce always leads to a depressed child, as Tishler's research shows.
His team found that the impact of divorce on a child's mental health was worse if the parents had a "World War III"-type divorce, he says.
Some symptoms are common to both childhood and adult depression, according to the National Institute of Mental Health, including a persistent sadness or irritable mood, loss of interest in activities that used to be enjoyed, a change in appetite or sleep habits, loss of energy, feelings of worthlessness, difficulty concentrating and other problems. If five or more of these persist for two weeks or longer, a diagnosis of clinical depression can be made.
Children may complain, too, of tummy aches or headaches or they may discuss running away from home.
If parents suspect depression, a referral or visit to a therapist is advised. "Treatment depends on the age of the child," Wood says. In young children, she often uses play therapy, inviting them to play with dolls or other toys to help them open up.
When kids are older and more verbal, she uses talk therapy to draw them out.
How long a child needs therapy depends on a number of factors, including the extent of the depression. If it is an adjustment disorder coupled with depression -- the result of a parent divorcing, or a grandparent dying -- "that will heal relatively quickly," Wood says, perhaps within three to six months of weekly sessions.
If needed, a therapist will prescribe an antidepressant, or, if he or she is not legally able to, refer the child to a health-care professional who can.
For facts on childhood depression, visit the National Mental Health Association, or read this report from the U.S. Surgeon General.
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