Episode Transcript
Depression appears to be on the rise in kids these days. Children younger and younger are being brought in by their parents for it. What does depression look like in children, and how can you, as a parent, help if your child has depression?
According to the National Institute of Mental Health, a reported 3.2 million kids aged 12 to 17 years old have had at least one major depressive episode in the last 12 months. This is as of April 2019. I know that, in my clinic, I personally see kids eight and up struggling with depression at least four to five times per week. That is a staggering number when you think about it.
There are several theories about why depression is on the rise in kids, starting with social media. Kids are constantly connected these days. And while it's always been the case, especially with teens, that they compare themselves to their peers, they are now having more and more pressure to keep up. Teens turn to social media apps to see what the current trends are, and they measure their self-worth by how many likes they get on their posts. It's a great way to get instant validation, and if they don't get enough likes, or if something isn't liked by a friend they thought would like it, then that reinforces, in their developing brains, that they aren't good enough, or that their friend really doesn't like them.
Kids also see a lot of negativity in the world in the media. Online, on TV, they see the violence in the schools, movie theaters, terrorist attacks, and they can feel like they have no sense of security.
Finally, the pressure to be perfect, to be successful, to be the absolute best at everything they do, that's a lot for a kid. That's a lot for an adult. The bar is held so high sometimes it feels impossible to reach.
Also, with teens and their out of whack hormone levels, it was thought that that was the main reason for their moodiness. Then, in the 1980s, mental health providers started realizing this wasn't completely the case. Kids can have true depression, and it started becoming okay to diagnose them more appropriately. So while it seems like there is a huge increase in depression cases, it might also be that depression has always been there, and we are just now open to seeing it and diagnosing it.
So what are the signs of depression in kids? A lot of people expect depressed kids to be sad, but that's not really how it presents in kids and teens especially. It can present as fatigue, as anger, or ADHD-like symptoms. It can be a change in how they're eating, too much or too little compared to what they normally do. It can present as your teen completely stopping doing things they once loved, like sports or hanging out with friends, instead choosing to be alone.
Finally, it can present as self-injury. This is one of the most common ways it presents in girls. Cutting with sharp objects or using erasers to burn their skin are two methods I see often in clinic. Rarely does depression first present with attempted suicide. But when attempts are made, boys choose the more lethal method than girls.
If you think your child might have depression, try to talk to them. It can be scary for them to admit if they are. They may not want to disappoint you by having those feelings. Make sure that they know that you are there because you care about them and you want to make sure that if they are depressed, you are there to help them out.
Next, make an appointment with them to be seen by their pediatrician. We have several screening tools to get objective information from the teen and can take it from there to discuss their feelings and options for treatment, including medications or therapy, depending on the situation.
Please remember that your pediatrician is not a therapist though. We need to refer them to behavioral health specialists for long-term therapy and sometimes even for medication management, depending on how complex the situation is. I always tell my patients' parents, "You wouldn't want a psychiatrist managing your child's asthma. I'm much better at that. Similarly, a child psychotherapist or psychiatrist is much better at managing your child's mental health issues, because that's what their training is in."
Finally, if your child or anyone you know is in an immediate crisis and you need to speak to someone urgently about suicide prevention, call the National Suicide Prevention Hotline at 1-800-273-TALK. That's 1-800-273-8256.