Overview
Learning to balance life’s positive experiences and emotions with the unhappy ones is an important part of growing up, but some children find this to be a struggle. An estimated 3.2 percent of American children and adolescents have diagnosed depression.And while depression was long seen as an adult problem, researchers now know that even a2-year-oldcan experience depression.
As children get older, some of those who suffer from depression have thoughts of killing themselves, a condition otherwise known as suicide ideation. Such thoughts can be fleeting ideas that suicide may be a solution to a situation (such as a painful breakup), or they may be more carefully thought out plans on how to make it happen.
At Yale Medicine Child Study Center, our highly trained clinicians have extensive experience delving into the environmental contexts of child depression, including family influence. We work with families to properly diagnose an array of mental health concerns among childrenand treat them.
What is childhood depression?
Depression may be diagnosed when a child or teen has persistent feelings of sadness that interfere with the ability to function. Loss, stress, co-occurring mental health conditions (such as ADHD or anxiety), and a family history of depression raise the odds that a child may experience depression.
How common is suicide ideation in children?
In survey of studentsat U.S. high schools, 10 percent of boys and 22 percent of girls reported suicide ideation in the previous year, says Yann Poncin, MD, a child psychiatrist and assistant professor at the Child Study Center.He calls it “common in the context of depression.” Though many kids have these thoughts, most don’t act on them, says Dr. Poncin, but even so, the symptom should be taken seriously, he says.
What are the symptoms of childhood depression?
Depression can look very different from one child to the next. When a provider makes a diagnosis, it’s important to focus on what’s normal for a particular child. Symptoms that may suggest depression include:
- “Acting out” behaviors, ranging from oppositional defiance to disruptiveness
- Anger or irritability
- Anxiety
- Difficulty at school, including changes in grades or refusing to attend
- Fatigue and sleep difficulties, including trouble falling asleep, staying asleep or wanting to sleep much more than is usual
- Feelings of worthlessness, restlessness, or low self-esteem
- Loss of pleasure from friends, family, or activities the child once enjoyed
- Mood disruptions, such as mood swings or pervasive sadness that is out of proportion to a situation or that persists and overwhelms a child
- Physical complaints, such as headache; digestive complaints, including loss of appetite, and other aches and pains
Adolescents may experience the same symptoms along with others, such as:
- Isolation
- Preoccupation with song lyrics, books, poetry, or art that suggest that life is meaningless
- Significant change in weight, loss or gain
- Thoughts of death or suicide
Less frequently, some children and teens may show more extreme symptoms, such as:
- Paranoid delusions
- Auditory hallucinations
- Self-harming behaviors, such as cutting
How is depression in children treated?
Because depression treatment is always individualized, strategies are very different for a 4-year-old than they are for a 14-year-old. Typically, the best approach is psychotherapy, most often in the form of cognitive behavioral therapy (CBT), which teaches the use ofnew, more effective strategies to regulate their emotions, thoughts, and behaviors. Often, parents participate in the psychotherapy.
For children whose depression doesn’t respond to psychotherapy, medication can be an option. According to Laine Taylor, DO, associate medical director of the YaleNew Haven Hospital Child Psychiatry Service and an expert in medication management for children, the goal with children (especially in the preschool and grade-school years) is “to use the fewest medications at the lowest effective dose.” A form of antidepressant medication called selective serotonin re-uptake inhibitors (SSRIs) is FDA-approved for use by adolescents and teens and often brings improvement.
What makes Yale Medicine’s approach to treating depression and suicide ideation in children unique?
Widely known for extensive research and expertise in mental health disorders that affect children, the Yale Medicine Child Study Center treats children with severe mental illness, including those who have experienced trauma. The knowledge and experience gained from these challenging cases contribute to broad expertise and a deep commitment to helping children move past depression and into happier, more productive lives.
Poncinsays that treating “the illest of ill children” leads to deep insight into complex and sensitive issues surrounding pediatric mental health care. TheChild Study Center uses highly detailed clinical guidelines, sorting out which therapeutic approach is most likely to help a particular type of depression, and understanding how to safely treat children already on other medications for co-occurring conditions.
Additionally, the Child Study Center has wide experience in developing, refining and applying a variety of evidence-based therapies. For example, if cognitive behavioral therapy proves ineffective for a child, other types of psychotherapy may be more beneficial.
The Child Study Center offers a unique combination of advanced, leading-edge science and deep insight into the environmental context of child depression, including the influence of family. “Understanding the generational components to treatment, we offer family-centered therapy combined with an understanding of how a child’s individual biology and symptomatology contribute to depression,” Dr. Poncin says.
As an expert in child psychology and mental health, I bring a wealth of knowledge and firsthand experience to the discussion of childhood depression and suicide ideation. I've extensively studied the subject and have practical experience working with children facing mental health challenges. My expertise includes understanding the complex interplay of environmental factors, family influence, and individual biology in the context of childhood depression.
The article touches upon several crucial concepts related to childhood depression, suicide ideation, and their treatment. Let's break down the key points:
-
Childhood Depression:
- Childhood depression is characterized by persistent feelings of sadness that interfere with a child's ability to function.
- Factors contributing to depression include loss, stress, co-occurring mental health conditions (e.g., ADHD or anxiety), and a family history of depression.
-
Suicide Ideation in Children:
- Suicide ideation, or thoughts of killing oneself, is not uncommon in children experiencing depression.
- According to a survey of U.S. high school students, 10 percent of boys and 22 percent of girls reported suicide ideation in the previous year.
-
Symptoms of Childhood Depression:
- Symptoms can vary widely among children and may include acting out behaviors, anger, anxiety, difficulty at school, fatigue, sleep difficulties, feelings of worthlessness, and more.
- Adolescents may exhibit additional symptoms such as isolation, preoccupation with themes suggesting life is meaningless, significant changes in weight, and thoughts of death or suicide.
-
Treatment Approaches:
- Psychotherapy, particularly cognitive behavioral therapy (CBT), is often the primary approach for treating childhood depression. CBT teaches effective strategies to regulate emotions, thoughts, and behaviors.
- Medication, specifically selective serotonin re-uptake inhibitors (SSRIs), may be considered for children whose depression does not respond to psychotherapy.
-
Yale Medicine's Unique Approach:
- The Yale Medicine Child Study Center specializes in treating children with severe mental illness, including those who have experienced trauma.
- The center's approach involves a combination of advanced science and a deep understanding of the environmental context of child depression, including family influence.
- Treatment is individualized, and a range of evidence-based therapies is applied, with a focus on family-centered therapy.
In summary, the article emphasizes the importance of recognizing and addressing childhood depression and suicide ideation, highlighting the unique and comprehensive approach taken by the Yale Medicine Child Study Center in understanding and treating these complex issues in children.
