Childhood depression is a phenomenon that often goes unnoticed. Parents often interpret a child’s bad mood, fearfulness, anxiety, and reluctance to do anything as whims or laziness. If a baby or teenager complains of blues, apathy, loss of strength, causeless sadness throughout the day, and noticeable changes in behavior persist for more than two weeks, we can assume the development of an affective disorder . Depression in childhood is associated with significant suffering and leads to social disorientation of the child.
To date, there are no accurate data on the prevalence of depression in children. It is estimated that symptoms meeting the criteria for a mood disorder are present in 1% of children under 10 years of age and 5% of adolescents. In recent years, post-Soviet countries have seen an increase in the number of cases in children and adolescents.
In preschool and early school age, the ratio of boys and girls suffering from depression is approximately the same. In adolescence, girls are more susceptible to emotional anomalies than boys. The pronounced severity of depressive symptoms in children aged 11 to 18 years is often due to hormonal changes in the body that are characteristic of the puberty period. However, changes associated with puberty are not the leading cause of mood disorders.
Causes of depression in childhood
Affective disorders are phenomena that run in families. Most children born to parents with a history of depression are 50% likely to have emotional problems. This trend is caused by mutations in the serotonin transporter gene (SERT-1), which can be traced in members of the same family. Also, rare variations in the NKPD1 gene, inherited from ancestors to descendants, are detected in children with high rates of depressive symptoms.
Depression in children and other neurotic disorders may be associated with developmental disorders in the embryonic and fetal periods . Chronic fetal hypoxia and intrauterine infections can lay the foundation. An unfavorable course of a mother's pregnancy, especially the first trimester, leads to defects in the basic vital systems of the future person. The basis for affective disorders can be perinatal or acquired encephalopathy, leading to a lack of supply of nutrients to the newborn’s brain.
The leading cause of depression in childhood is an unfavorable conflict atmosphere in the family . Frequent quarrels between parents are a serious test for the fragile psyche of a young person. Often, mood disorders are associated with the lack of a common view on the parenting style of mom and dad. Conflicting demands and thoughtless use of “carrots and sticks” undermine the child’s nervous system and inhibit the body’s adaptive capabilities.
A typical cause of childhood depression is growing up in a single-parent family . The divorce of parents and the subsequent departure of one of the ancestors is a difficult test for a child. Often in such situations, children blame themselves, believing that their behavior or, in general, existence provoked a break in the marriage.
The classic “culprit” of childhood depression is the lack of proper attention to the child from parents. Many adults are so busy creating their own careers that they do not find time to fully communicate with their offspring. They are not interested in the baby’s life, do not offer help in solving problems, do not share personal experiences and do not give constructive advice. The little personality suffers greatly from the lack of unconditional love and affection. However, the child is not able to objectively interpret the reasons for the detachment of his ancestors, and believes that due to some personal characteristics he causes a feeling of hostility. Thus, against this background, the baby’s ideas about his own worthlessness, uselessness, and uselessness are born and strengthened .
The cause of depression in adolescents is natural age-related problems . In children's groups there are always leaders who set their own rules and dictate a model of behavior. Those children who do not conform to the foundations and norms of a given team become objects of ridicule or are completely expelled from the company. The lack of normal contacts with peers, the feeling of being an outcast, forms an inferiority complex in an immature personality and leads to melancholic thoughts.
The trigger mechanism is often frequent moving, explained by the characteristics of the work of adults. A constant change of place of residence does not give the child the opportunity to “settle in” in a new environment, show his talents, or make friends. Lack of belonging to a permanent children's “group” deprives the child of communication with peers necessary for normal development. The baby does not receive the required experience of social interaction and is deprived of internal harmony.
Common causes of childhood depression are the effects of extreme stress factors , which the child and teenager interpret as dangerous and insurmountable. Affective disorders can start from :
- serious illness, disability, death of close relatives;
- an accident in which a loved one was injured;
- forced restriction of activities due to dangerous diseases, injuries or operations;
- separation from loved ones;
- physical violence from peers or parents;
- experiences of sexual harassment or abuse;
- moral pressure coming from adult family members, teachers, team members;
- experienced a car accident;
- violent restriction of freedom;
- biased attitude of teachers, inflated demands, unfair criticism.
During adolescence, issues related to appearance come to the fore. Boys and girls are painfully aware of the presence of real and imaginary defects. Teenagers find it unacceptable to think that they don't live up to fictitious standards of beauty. They suffer due to the lack of fashionable clothes and cool gadgets.
Teenage girl looking thoughtful about troubles in her life.
Often the manifestation of depression in adolescence is associated with worries about an unhappy first love. Lack of attention from a peer you like pushes you to think about inferiority. The teenager places himself among the ranks of unattractive and uninteresting people, significantly inflating the size of existing or imagined shortcomings. However, the teenager does not have the internal resources to correctly interpret the situation, and does not have useful skills for character correction and personality development. The teenager does not see options for changing the situation and focuses only on the negative aspects of life.
The iceberg is almost invisible
“We are noticing a sharp increase in borderline mental disorders in children,” said leading researcher at the Research Institute of Hygiene and Health Protection of Children and Adolescents of the Scientific Center for Children’s Health, Professor Vladimir Chubarovsky. — Problems in basic mental functions manifest themselves in behavioral abnormalities.
For a number of forms, the iceberg of mental disorders is 100%. That is, specialists simply do not see them, but they notice a sharp increase in aggressive behavior, they see a tendency towards extended suicidal forms, which are not found anywhere else in the world.
For example, “hooking” is riding on train or subway cars. Or extreme “selfies” in places dangerous to life and health. Early onset of sexual activity also indicates psychological distress. If previously these were exclusively girls with developmental disabilities, now they are the most ordinary girls who do not have a diagnosis.
As a rule, only suicides of children and adolescents attract public attention. Their statistics vary among different experts: Russia is listed either in 3rd place in the world or in first. But few people know that for every successful case there are 100 attempts, that is, unrealized suicides. And this makes the statistics of teenage suicide completely different.
Symptoms of depression in childhood
Depression in childhood manifests itself in many and varied symptoms. Signs of melancholy may be present constantly or occur periodically, for example: when the season changes. The intensity of depressive symptoms is variable and depends on the child’s temperament, age, social environment, and living conditions.
The primary symptoms of childhood depression are emotional instability . Parents notice that their offspring often changes mood for no reason. One moment the baby is having fun and laughing, the next moment he is sad and crying. As the disorder worsens, a depressed, gloomy mood becomes apparent. The young person stops enjoying life and perceives phenomena in black tones. He is overcome by boredom and apathy. The child is not interested in current events, does not want to communicate with friends, does not play games usual for his age, and does not enjoy gifts.
Symptoms of depression in children are nervousness and irritability . A child or teenager reacts very violently to messages addressed to him. He perceives all the words of other people as offensive, insulting, unfair phrases. Preschoolers and younger schoolchildren become capricious and throw tantrums, accompanied by a stream of tears. A depressed teenager acts hostile and aggressive, especially towards family members. He is dissatisfied with how others treat him and doubts the love of his parents.
With depression, a small person perceives himself as a worthless and incapable being. He is overcome by a feeling of hopelessness. He is confident that in the future he will not be able to achieve any significant results. The child stops making the effort necessary to master the educational material. Lack of motivation to study complements the deterioration of cognitive abilities, a phenomenon characteristic of affective disorders. With depression, a student is unable to concentrate on one task; he becomes inattentive and restless, which affects the quality of his knowledge.
A depressed patient looks sluggish and lethargic. A child overcome by depression complains of weakness and weakness. He points out that he gets tired quickly from typical workloads. A depressed student may refuse to go to school, saying that he does not understand the information given by teachers. He considers himself stupid, incapable, bad. With severe affective disorders, ideas of self-blame appear. The student reproaches himself for not being able to master the curriculum.
Often the baby is in a state of lethargy. A child can sit in one place for hours with a sad expression on his face. Motor and mental retardation is replaced by periods of agitation. The child becomes fussy and inconsistent in his actions. He cries inconsolably for a long time, laments, groans, and demands help from those around him.
Compared to adults, children are less likely to have appetite disturbances and sleep problems. However, in adolescence, due to depression, a boy or girl may refuse to eat or, conversely, experience an increased need for food. Young children complain of having frightening dreams.
Typical signs of childhood depression are symptoms of autonomic dysfunction:
- headache;
- dizziness;
- discomfort and pain in the abdominal area;
- increased sweat secretion;
- feeling of chilliness;
- change in heart rate;
- frequent urge to urinate.
Unpleasant bodily sensations during a medical examination do not meet the criteria for known somatic and neurological diseases.
Depression in early childhood is characterized by a low incidence of suicide attempts. However, in adolescents, the risk of committing suicide increases significantly. A teenager, as a rule, makes the decision to commit suicide in the presence of acute psychotraumatic factors: a strong quarrel, beating, rape.
Classification
Childhood depression has several types or classification options.
According to the nature of the course, adynamic and alarming forms are distinguished.
Based on duration, childhood depression is divided into depressive reaction, syndrome and disorder.
According to the international classification of diseases, childhood depression is divided into:
Phobic disorder of childhood (childhood fears, possibly even traumas)
Anxiety disorder caused by separation (the child was separated from his parents or very close people)
Mixed disorder of behavior and emotions (withdrawal, aggressiveness, abnormal attitude towards others).
Diagnostics
If depression is suspected, parents should seek help from a qualified professional. To clarify the diagnosis, you will have to undergo more than one examination:
- pediatrician: examination, questioning, tests - to exclude somatic diseases;
- narrow specialists (endocrinologists, gastroenterologists, dermatologists, cardiologists, etc.): clinical, laboratory, instrumental studies - to confirm the pediatrician’s conclusions;
- neurologist: ultrasound, EEG, MRI - to determine physiological factors;
- clinical psychologist or psychotherapist.
In psychotherapy, there are various methods for diagnosing childhood depression:
- methods “My Family”, “House-Tree-People”;
- Rosenzweig frustration test;
- Beck questionnaire;
- Zung test;
- Smulevich diagnostic criteria;
- Luscher color test;
- CDI - scale (questionnaire) Kovacs.
These diagnostic methods make it possible to find out not only the depth of the child’s depressive state, but also the possible causes.
“Sleep, work and rest mode”
Ideally, the transition to the school rhythm should be gradual - it is advisable to switch to the “correct mode” two weeks before the start of classes. If this does not happen in a timely manner and you see that the child is tired of school, first of all you should adjust the daily routine. Adequate sleep is an indispensable condition for school success. You need to learn how to relieve excessive excitement from the first days of school, for example, by walking before bed or taking longer than usual water treatments.
Remember: most often a student does not need to sit at home studying for eight hours. Sometimes it is just the parents’ desire to see their son or daughter fully involved in the process of acquiring knowledge. Know how to separate your desires from the realities of the educational process.
Sergey Kiselev/AGN "Moscow"
