Areas of Specialization - Children and Adolescents
Depression in Children
Case examples
Jack, a 6 year old boy, lives with his mother and stepfather. Since his father's death 3 years ago from cancer, Jack has become increasingly irritable. His teacher reports that he is doing poorly in school, seldom turns in his homework, and seems lethargic and "in a world of his own." Jack frequently complains to his mother that his classmates are smarter and play baseball better than him. Jack used to enjoy little league, but more recently he protests when it is time to leave for practice and complains that his stomach hurts and he feels nauseous. Jack's coach has informed his mother that he often argues with his teammates. Consequently Jack's popularity with his peers has declined and he avoids previously enjoyed playdates. Jack has been eating less over the past two months, even refusing his favorite snacks, and has lost a few of pounds.
Lily is a ninth grader who has become increasingly sullen and moody since beginning high school. Her parents have always had a argumentative relationship, but they have recently begun to talk about divorce. Lily's principal has become concerned when one of her teachers found a poem that she had written glamorizing suicide. Lily's teachers also reported that she has failed several tests this quarter and she frequently falls asleep during class. Lily has also been caught cutting class to hang out in the parking lot to smoke cigarettes. On the weekends Lily prefers to sleep and watch television rather than go to the movies or shopping with her friends. Her mother became very concerned last week when she smelled marijuana on Lily's sweatshirt while doing the laundry. When she confronted Lily, her response was that she could not do anything right, her parents were nagging her to be more social and when she finally goes out with friends she is blamed for having a good time. Lily stated that she hates her life, nobody understands her and she wishes she were dead. |
These two examples illustrate how
depression may present in children
and adolescents. A depressed child
may pretend to be sick, refuse to
attend school, and cling to a parent.
Adolescents may sulk, have problems
at school, be grouchy and self-destructive,
and feel misunderstood. Since normal
behavior varies from one developmental
stage to another, it can be challenging
to determine whether a child is
suffering from depression or simply
passing through a phase. However
when a sad or irritable mood endures,
the possibility of a depressive
disorder should be evaluated. Jack's
stomachaches, irritability, and
impaired school and social functioning
are typical depressive symptoms
experienced by younger children
that may not be identified as a
mood disorder. As a teenager, Lily
exhibits sadness, social isolation,
risk for substance abuse and overall
moodiness. Lily's academic performance
has deteriorated due to her inability
to concentrate and excessive fatigue.
Of particular concern are Lily's
suicidal thoughts and hopelessness
about her future as adolescent impulsivity
is a risk factor for suicide. As
a young child, it is particularly
important that Jack receive prompt
treatment to decrease interference
with his development. In Lily's
case, female gender places her at
increased risk for depression in
adulthood, emphasizing the importance
of identifying and managing her
symptoms as preventive against future
depression, substance abuse, and
suicide.
Describe
treatment >> |
