The Depressive Episode in Children
In most of the cases, it is triggered by stressful life events, including a devastating event in the child s family ( such as experiencing the death of one or both parents or the loss of a close relative, followed by bereavement which has a strong emotional impact on the child), by the alienation from one or both parents, often due to separation or divorce of the child s parents or by constantly changing homes and schools ( moving to a new neighborhood, city or country). The depressive episode settles progressively and the behavior of the child changes according to the previous situation. Below are some of the signs of the depressive episode in children.
- psychomotor slowness or sluggishness to the point of retardation or inhibition of the motor and sensory function (paraplegia);
- a less expressive general appearance, the child does not smile or laugh like he/she used to;
- most commonly, the child exhibits a state of agitation, especially when the child is asked to perform certain tasks or to pay attention;
- the state of agitation is frequently and suddenly interrupted by a state of motionlessness, stupor and fixity ( the child sits on the couch in front of the TV but seems/looks absent, almost indifferent to any action surrounding him/her;
- the emotional instability is transformed into persistent anger ( the parents notice that the child is constantly angry with no particular reason, he gets easily upset, always disagrees and refuses everything);
- lack of interest in previously pleasurable activities;
- low self-esteem ( the child doubts or undervalues his/her abilities to perform certain tasks, often claiming “I cannot do it”);
- the conscious expression of the pervading feeling of culpability ( the child often states “I m bad, I am not nice to my parents”, “it is my fault”);
- poor memory, poor or lack of focus and attention;
- appetite disturbances, usually anorexia in smaller children and bulimia in older children;
- abnormal sleeping patterns, phobias and nightmares often accompany his/her sleep;
- ideas involving death or suicide ( the child states that he is not loved and he will die to kill himself).
Taken separately, these signs are not significant to characterize a depressive episode. However, their association ( five to six of these signs simultaneously), their constancy and the behavioural changes of the child point towards a possible diagnosis of a depressive episode.
Parents should not ignore this symptomatology, because failure to recognize these signs, alongside the persistent suffering of the child, could lead to a gradual inadequacy within the school and social environment, which confirms the self-deprecation of the child and accentuates the mutual misunderstanding between the child and the parent. These signs may also complicate with anxiety disorders, behavioral disturbances and conduct disorders ( theft or running away from home).
The Depressive Disorder in Children
Only a medical specialist can diagnose this clinical depression whose symptoms include the persistent feeling of guilt which gets worst with time, the need for (self-)punishment, self-aggressive conduct and self-destructive behaviour (cutting himself for the purpose of inflicting pain upon himself, engaging into dangerous, life-threatening activities), violence towards his peers, delinquency, drug and alcohol abuse, suicidal intent/attempt as well as clinical signs such as obesity, anorexia, asthma and eczema.
The main risk factors for depression in children include hereditary factors ( a family history of depression, especially in the case of the mother who suffered herself from depression as a child), parental deficiencies ( maternal deficiencies in particular, because since the child identifies with his mother, insufficient or lack of emotional support from his mother may cause depression in childhood) and also child abuse.