BYLINE: Alan J Flisher and Astrid Berg
When Sam's parents were asked to come to the school, they were surprised. Their 12-year-old son had never been in any trouble and now there was this unexpected call.
His teachers had noted a recent fall-off in his school performance; he seemed to be distracted, was often staring out of the window and generally looked subdued and even sad. On the playground, he was easily angered; he had aggressive outbursts and was picking fights.
What prompted the call to his parents was the fact that he had been caught smoking alone.
What was happening? Was this a phase or a change due to puberty? Was he being negatively influenced by friends or by TV programmes?
The teacher reassured the parents that their son was still friends with the same children, none of whom displayed this behaviour. However, she noted that Sam was "not himself", and that something seemed to be going on inside him. She suggested that he see a doctor.
The doctor clarified that Sam was suffering from depression. He had not been eating with his usual gusto. He seemed tired when woken up in the morning, and complained that he had not slept well.
His parents were astonished - how could a child, their child, become depressed? They had showered him with love and made sure he had everything he needed. His three older siblings had never been like this. Are children not always happy?
Slowly a picture emerged, and they began to understand what could have been an influence. His father had recently been retrenched, leaving his mother as the only breadwinner. This caused strain in the marriage. There were financial worries and his father suffered from feelings of worthlessness and anger.
The couple had kept their late-night conversations and arguments separate from their children. But Sam overheard them. Even if he did not comprehend the details, he could sense the stress. Was he to blame?
Children know more than their parents think. If they are not given the facts, they blame themselves - a normal childhood response.
Once the parents realised what had been happening, they started to talk openly to Sam and his siblings. This helped the children ask questions and receive reassurance. Sam's symptoms improved and no further intervention was necessary.
However, some children need more intensive intervention. This is more likely if there are other family members with depression, if the child is exposed to ongoing stress or does not have good emotional connections with family, school or peers. Such children may need to be seen by a professional who provides mental health services for children and adolescents. Psychotherapy for the child, …