If your child or teen has been struggling with depression, you may be understandably worried. I mention “child” because it is not uncommon for a child to be depressed. While it does not happen as often in children as it does in adolescents and teenagers, I have seen children has young as 5 or 6 with some form of depression.
I’d like to clarify that there is a difference between reactive and endogenous (or biologically-based) depression. Reactive depression arises in response to upsetting life events, whereas endogenous depression occurs more naturally, with or without a catalyst. It is not unusual for children with endogenous depression to have troubles explaining why they are sad, irritable, or cry so easily. Reactive depression is usually more short-lived, whereas endogenous depression poses longer-term difficulties, even if there are periods of relief. Moreover, there are different severities of depressive symptoms, from persistent unhappiness to major depression, in which functioning is much more severely impaired. All forms of depression can benefit from professional counseling from a psychologist or other mental health professional.
The warning signs of depression can include social withdrawal, a loss of interest in activities your child typically enjoys, voicing lack of confidence or being self-critical, a drop in self-care, and seeming “off” from their normal behavior. Parents know their children the best and will often mention that their child just doesn’t seem like himself. I will suggest parents look back at the last year and think about what their child was doing a year ago versus what he is doing now. Is there a big difference? This could potentially be a warning sign.
So if you think your child might be depressed, what can you do about it? In addition to speaking with your child’s doctor about it, there are things that parents can do at home to help their children and teens fight back against depression.
Help them see the things they do well. This goes beyond simply telling children they’re smart. Help them to see the things that they do well and try to avoid superficial praise. Give specific examples, such as “I read your book report and I was really impressed by your understanding of Mark Twain.” In that example, you could target specific phrases to make the feedback more tangible and “real.”
Encourage problem solving. It’s important for children to struggle and figure things out on their own so that they can feel proud of their accomplishments. Such struggles provide opportunities for a greater sense of competence and mastery.
Challenge their pessimistic views. Your child might feel like the world has ended because she received a C in English when she’s never earned anything less than an A. Try to shift her view by asking, “What’s the worst that can result from this? Is that likely to happen?” Explain that sometimes a C is okay when she’s worked hard and done the best that she can, and to see it in the context of other successes.
Provide incentives where necessary. Some children who are depressed are just not internally motivated, and may resist doing things that will help them feel better. Actively participating in life is important for mood. With such kids I will often recommend that parents provide a small incentive to accomplish the things they need to do. Consider what their interests are and create rewards around them. A putt-putt outing for completing a big school project is one example.
Offer constructive criticism. You can help your child to build thick skin and become more resilient by giving him feedback in a constructive way, that way when he does hear criticism, he’ll be better able to handle it. Saying things like, I see that you tried really hard to write this sentence. To be grammatically correct, you’ll need to change this.”
Parents often wonder when they should seek professional help for their children. I recommend having an initial conversation with your child’s primary care provider about it. If your child has been depressed for longer than 3-6 months, your child’s doctor might recommend counseling with a psychologist or other mental health professional.
I like to mention to parents during counseling sessions how important family involvement is to the success of their child’s recovery. Recovering from depression is a collaborative process and children whose families actively participate tend to do much better. We all have the same goals for the child, and while the therapist offers objectivity and expertise to guide movement, parents are in the best position to help their child practice the strategies she is learning to battle depression.