| Childhood depression is a very real but | | | | set in stone. For example, a 12 year old boy |
| sometimes elusive illness that affects the | | | | may show signs of depression by aggressive |
| young today. We take a look at what it | | | | behaviour and phusical complaints."For Dr |
| actually means and how unity and support in | | | | Chan, "Depression before the age of six is |
| the family can help fight its hold over a | | | | very rare. In fact, I do not think that there |
| child.At the recently concluded Asia Pacific | | | | is general agreement that it exists. In a |
| Suicide Prevention Convention 2006, we learnt | | | | young child, the common emotional condition |
| a few startling facts about children and | | | | is anxiety, not so much depression. From six |
| suicide. For example, in a worldwide survey, | | | | years onwards, I would agree with the given |
| 7.3% to 38% of the children surveyed | | | | description."Children under stress, who |
| demonstrated suicide ideation, which is the | | | | experience loss , or who have attention , |
| idea of wanting to kill themselves. In | | | | learning , conduct or anxiety disorders are |
| Singapore, close to 4.7% of children | | | | at a higher risk for depression. Depression |
| entertain this morbid thought. While the | | | | also tends to run in families.Lena's |
| figure may be alarming, there is no need to | | | | experienceLena (not her real name) is a 17 |
| panic as it is actually not uncommon to think | | | | year-old student who recently suffered a |
| about suicide.Ask anyone in the street if he | | | | relapse and fell into depression once more. |
| had thought about suicide before and the | | | | Lena has been troubled by depression since |
| answer will most probably be a `yes'. | | | | the age of 12. Once again, she has no |
| Thinking about something as serious as | | | | appetite for food, is feeling listless and |
| killing oneself and actually doing it are two | | | | confused, lost alot of weight and is |
| different matters. Out of all childhood | | | | isolating herself from others.Lena's mother, |
| suicides, approximately 23.5% are associated | | | | 49 year old clerical staff Sonia (not her |
| with mental illness such as depression, | | | | real name), recounts her daughter's |
| schizophrenia and others. Seeing the numbers | | | | experience with depression, " It all started |
| and understanding that depression is one of | | | | after Lena's father passed away. At first , |
| the key causes that drive our young to | | | | nothing seemed wrong. SHe was very sad but |
| suicide. It is time we understand a little | | | | she did not shed a tear at his funeral. It |
| more about this elusive illness called | | | | was a year after that she started to miss him |
| "Childhood Depression".The Definition of | | | | badly. This was compounded by being bullied |
| Childhood DepressionIn a 2004 article | | | | in school and stressed by schoolwork. Always |
| published by the American Academy of Child | | | | a quiet child, Lena became even more |
| and Adolescent Psychiatry , childhood | | | | withdrawn. She had trouble sleeping, would |
| depression is defined as "an illness when the | | | | cry for no reason, refused to eat and talked |
| feelings of depression persist and interfere | | | | about hurting herself."Seeing her daughter's |
| with a child or adolescent's ability to | | | | condition, Sonia brought Lena to a Polyclinic |
| function."Feelings of depression are | | | | which referred them to a psychiatrist at a |
| represented in the forms of mood, physical, | | | | hospital. Lena was given antidepressants and |
| mental and behavioural changes in a child. Dr | | | | started having regular therapy sessions with |
| Ken Ung, Senior Consultant Child, Adolescent | | | | psychiatrists and counsellors. She tried to |
| & Adult Psychiatrist & Psychotherapist at | | | | follow their advice of not thinking |
| Adam Road Hospital describes the signs of | | | | negatively, to focus on developing her |
| childhood depression as persistent | | | | interests and to make a timetable for each |
| "irritability or loss of interest, loss of | | | | day. Everyday was a struggle but she managed |
| appetite and weight, poor sleep , lethargy, | | | | to recover with time."She said she liked the |
| headache, stomach pain, loss of | | | | counselling sessions where she could talk to |
| concentration, preoccupation with self-harm | | | | someone about her feelings and problems." say |
| or suicide, refusal to go to school, | | | | Sonia of Lena's reaction to treatment. |
| increased temper tantrums and antisocial | | | | "Slowly, she got better to the point that she |
| behaviours such as smoking, drinking and | | | | was more cheerful and could laugh and giggle |
| running away from home. Any combination of | | | | like a normal young girl. She even enrolled |
| these changes that lasts for more than two | | | | in yoga classes that helped her gained |
| weeks could spell a child falling into | | | | fitness and to relax."For Sonia, being |
| depression and warrants a closer look.Many of | | | | supportive of Lena through the down times and |
| the symtoms listed are actually applicable to | | | | being sensitive to her needs are her |
| both adults and children but there are | | | | priorities. "I told her that her health is |
| telling differences. Age, in a | | | | more important than studies. When I'm at |
| non-categorical way, does make a difference | | | | work, I try to call her and talk to her |
| in the presentation of depressive behaviour. | | | | whenever I can. She will tell me things like, |
| "We don't tend to categorize (childhood | | | | " Mummy, I'm useless and I don't know what to |
| depression) in terms of age groups," says Dr | | | | do," and I will try to encourage her to look |
| Ung, " but we can generally say that | | | | on the bright side, not to think too |
| adolescent depression tends to look more like | | | | much..etc.. I have to try to give her lots of |
| adult type depression , whereas, childhood | | | | love, my full support and |
| depression can be more `a typical' perhaps | | | | attention."TreatmentWhat most doctors agree |
| manifesting in bodily pains and behaviour | | | | on is that medication should not be used |
| changes. The closer the age of a child to | | | | unnecessarily on children and that when used, |
| adulthood - the more we can expect to see an | | | | it should be accompanied with the right |
| adult-type depression.Types of childhood | | | | counselling and therapy. " It's interesting |
| depressionThere is no clear categorization of | | | | that recent studies have not been able to |
| childhood depression. According to Dr Ung, | | | | prove that antidepressants work in children. |
| "Typing depression is notoriously difficult | | | | This could be because children are not mini |
| and fashions come and go. We now tend to type | | | | adults and what works for adults may not work |
| it according to severity i.e. mild, moderate | | | | for kids," says Dr Ung.There is also little |
| and severe. Sometimes, we use the term | | | | research of how antidepressants work on |
| `reactive' depression to denote the type that | | | | children and prescription drugs may increase |
| is due to a reaction to some stress (such as | | | | the risk of self-harm for some vulnerable |
| the sudden passing of a loved one). Although | | | | ones. However, Dr Ung adds, "To keep a |
| very rare in children, `psychotic' depression | | | | perspective on things, the increase of |
| refers to the presence of psychotic symptoms, | | | | antidepressants prescriptions is small, |
| which are symptoms that show that the person | | | | probably around 2% in affected children given |
| has lost touch with reality, i.e. hearing | | | | inactive medications (placebos) to about 4% |
| voices, believing irrational, bizarre or | | | | of those on active medication."Counselling, |
| incredible thoughts."Another childhood | | | | it seems , plays the key role in helping |
| psychiatry expert, Dr Sharon Chan of Sharon | | | | children recover from depression. "A good |
| Chan Child Guidance Clinic, who has been | | | | counsellor will try to get information from |
| practicing child psychiatry since 1988 | | | | parents, child and school and will try his or |
| concurs, "I am not sure that there is such a | | | | her best to co-ordinate the counselling to |
| categorization (of childhood depression).. | | | | incorporate all these parties. |
| because the entity is still controversial, it | | | | Cognitive-behavioural therapy is one of the |
| follows adult depression patterns (sic) - | | | | commonest forms of counselling techniques |
| chronic, single episode or recurrent, | | | | used nowadays - it seeks to change the |
| adjustment disorder, bipolar etc."Bipolar | | | | negative thoughts of the child to more |
| disorder, also known as manic-depression, is | | | | realistic and positive ones and also t help |
| a type of mood disorder marked by extreme | | | | the child make action/behavioural changes |
| changes in mood, energy levels and behaviour. | | | | that will help lift the mood," adds the |
| Symptoms can begin in early childhood but | | | | psychiatrist.Cyber Help |
| more typically emerge in adolescence or | | | | |
| adulthood. Children with bipolar disorder | | | | With the computer-savvy generation of today, |
| usually alternate rapidly between extremely | | | | some children or teens may choose to express |
| high moods (mania) and low moods | | | | their thoughts and feelings in cyber space. |
| (depression). These rapid mood shifts can | | | | is a community website launced in March to |
| produce irritability with periods of wellness | | | | provide information and counselling services |
| between episodes, or the young person may | | | | for depression. A `diary' services allows |
| feel both extremes at the same time. Parents | | | | members to post daily updates on their mental |
| who have children with the disorder often | | | | and emotional experiences while a `letterbox' |
| describe them as unpredictable, alternating | | | | service provides them with an opportunity to |
| between aggressive or silly and | | | | ask questions to a panel of experts. Most |
| withdrawn.Stages of childhood | | | | importantly, a service like this seeks to |
| depressionAccording to a Harvard Medical | | | | educate the public on the existence of |
| School Publication, " The picture changes | | | | depression and encourage those who are |
| with age. Up to age three, the signs (of | | | | depressed to seek help. Following examples, |
| childhood depression) may include feeding | | | | depressed children may be inspired by a |
| problems, tantrums, and lack of playfulness | | | | strong sense of community to step out of a |
| and emotional expressiveness. AT ages 3-5, | | | | possible state of isolation. Adults too, can |
| depressed children may be accident-prone and | | | | visit to gather more information and advice |
| subject to phobias. Even before age 5, they | | | | before deciding how best to seek |
| may show signs of self-reproach by | | | | help.Understanding is Key."Sometimes, |
| apologizing unnecessarily for minor mistakes | | | | depressed children are mistakenly labelled as |
| and transgressions like spilling food or | | | | lazy, stubborn or difficult," says Dr Chan. |
| forgetting to put clothes away. Children of | | | | This is largely due to a lack of knowledge |
| early school age (6-8) sometimes show | | | | and understanding on the adults' part. |
| depression with vague physical complaints and | | | | Children, unlike adults are dependent on |
| aggressive behavior. They may cling to their | | | | their families and guardians to identify |
| parents and avoid new people and challenges. | | | | their troubles and seek help.Dr Ung adds," |
| At ages 9-12, some common symptoms are morbid | | | | One common misconception is that the child is |
| thoughts and lying awake worrying about | | | | mad. This is totally not so. Another is that |
| schoolwork. By then, children have enough | | | | the child is `weak'. Some famous people who |
| intellectual capacity and social | | | | are strong of character and have suffered |
| understanding to think about reasons for | | | | depression include Abraham Lincoln. Another |
| their depression , and they may blame | | | | misconception is that it is incurable or that |
| themselves for disappointing their | | | | the child is `bad'. Depression is a very |
| parents."When asked for his opinion on this | | | | treatable condition and the change of |
| analysis, Dr Ung says, " I think that this is | | | | behaviour from depression should not be |
| a good guide by and large. Nevertheless, this | | | | mistaken for `badness'. |
| is merely a guide and should not ne taken as | | | | |