Childhood & Adolescent Depression

By Dr. Michael Oberschneider, Ashburn Psychological & Psychiatric Services

According to the Centers for Disease Control and Prevention (CDC), depression affects one in every 10 Americans. And while the CDC’s data on depression currently shows that folks residing in the Commonwealth of Virginia fall slightly below the national average, many children, adolescents, and adults in our area suffer from depressive disorders.

In fact, childhood and adolescent depression are on the rise, and a 2014 survey conducted by the World Health Organization (WHO) found depression to be the number one disability and illness for adolescents worldwide. WHO’s survey also ranked suicide as the third leading cause of death worldwide for adolescents, following road/traffic injuries and HIV/AIDS, respectively. Moreover, research has shown that about half of those who suffer from mental health conditions later in life showed symptoms by 14-years-old.

While the exact cause(s) of childhood and adolescent depression is not entirely known, research has identified a number of factors that are believed to contribute to the development of formal depression, including genetics and biology, social anxiety and peer pressure, academic pressure, traumatic events, romantic relationship struggles, low self-esteem, feelings of hopelessness, separating or divorcing parents, family financial struggles, physical or emotional neglect, or abuse and other sorts of early life and family of origin struggles (e.g., moving, blended family dynamics, significant losses).

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Research studies have also shown that children and adolescents who suffer from depression are at a higher risk for experiencing other sorts of problems and conditions — anxiety, ADHD, oppositional defiant disorder, and substance use disorders, as well as social and conduct problems.

The 2013-2014 Fairfax County Youth Survey assessed 47,084 Fairfax County Public School Students in the 6th, 8th, 10th and 12th grades across several areas of functioning. Overall, youth in the 10th and 12th grades who participated in the survey endorsed higher rates of depression for themselves compared to their same-aged peers nationally. And females who participated reported higher rates of depression for all of the assessed grades than the male students. Interestingly, the trend for higher rates of depression for females was also consistent for all races. The percentage of students in the 10th and 12th grades in Fairfax who considered suicide was also higher than the US average.

Depression Signs & Symptoms
While depression can mean something different and may even look different for individuals of all ages, parents should keep a watchful eye out for the following signs and behaviors for their children and adolescents:

• Extreme personality changes
• Loss of interest in activities that used to be enjoyable
• Significant loss or gain in appetite
• Significant weight gain or loss
• Difficulty falling asleep or wanting to sleep all-day
• Fatigue or loss of energy
• Feelings of worthlessness or guilt
• Withdrawal from family and friends
• Neglect of personal appearance or hygiene
• Sadness, irritability, or indifference
• Extreme anxiety or panic
• Poor school performance
• Difficulty paying attention and concentrating or making decisions
• Thinking or talking about death and/or suicide
• Feelings of hopelessness
• Curiosity with or experimentation with drugs or alcohol

When to Consider Getting Help
It’s a good thing to trust your parental instincts or intuition if you feel that your child or adolescent may be depressed. I recommend meeting with a child psychiatrist or child psychologist if the problems are (1) impacting your child or teen across the important areas of his or her life and (2) if your efforts to provide support as a parent(s) have not improved things within a reasonable amount of time.

Research has shown that individual Cognitive-Behavior Therapy (CBT) and Interpersonal Therapy (IT) are considered to be the most effective therapies for treating depression. Depending on one’s circumstances and needs, family therapy may also prove to be helpful in reducing depressive symptomatology and bringing about improved personal well-being. Mental health research studies have also repeatedly shown that psychiatric medication to be very successful in the treatment of childhood and adolescent depression, especially for severe range depression. Several research studies have shown that a combination of medication and therapy together brings about the most meaningful and lasting changes for depression.

Prevention is the Best Medicine
There are many things that parents can do to prevent emotional and social problems from happening for their children in the first place. The research in this area supports the old adage that “an ounce of prevention is worth a pound of cure.” For example, studies have shown that children that spend too much time on screens are at a higher risk of developing problems, including depression. Thus, it is good for parents to limit gaming, social media, and other forms of electronic entertainment for their children. Moreover, children who do not eat healthily, do not exercise, and do not have a consistent sleep schedule are also at a greater risk of experiencing depressive symptoms. Family time is also important, for example, studies have shown that children who eat fewer than three family meals a week are at a greater risk of developing problems ranging from tobacco and alcohol use to depression and eating disorders.

Thus, as a psychologist, I frequently recommend the importance of balance for children and adolescents. Yes, Northern Virginia children and adolescents have so many resources and opportunities available to them. Yes, socioeconomically, Loudoun County currently ranks as the highest-income county by median household income in the US. And yes, our area’s public school system is one of the best in the country, and many of Virginia’s colleges and universities are top-notch. But with so many opportunities and resources available to our children comes increased pressure and competition, which can be difficult for some.

By spending time with your children, by being involved and available in their lives, and by modeling and encouraging balance across the important areas of their lives — academics, social, physical/athletic — your children will be better able to manage and overcome emotional problems when they occur.