Magazine article Psychology Today

Why Kids' Depression Goes Unnoticed

Magazine article Psychology Today

Why Kids' Depression Goes Unnoticed

Article excerpt

IN AN IDEAL world, parents would recognize the first subtle signs of depression in a child and take immediate action-talk to a pediatrician, pursue therapy, secure the help the child needs. In reality, most children who struggle with depression do so unnoticed by those closest to them.

Parents are not mind readers, and many children-for a variety of reasons-work to minimize or conceal entirely their despair. But with depression and suicide on the rise in children, the recognition of the disorder has become a matter of urgency. According to a recent survey, one in four children in middle school or older knows a peer with depression; one in 10 knows one who has died by suicide.

In my clinical experience, while a small subset of parents bring their child in for help shortly after depression sets in, the vast majority wait far longer. Typically, by the time a child comes to see a pediatrician, like me, or a mental health professional for help, they've been experiencing significant symptoms of anxiety and depression for two or even three years.

In a recent poll, 90 percent of parents rated themselves at least "somewhat confident" that they would see the signs of depression in their child. But "somewhat" may be the operative word. In the same poll, conducted by C.S. Mott Children's Hospital in Ann Arbor, Michigan, two-thirds of parents revealed barriers that could keep them from recognizing their child's poor mood. Forty percent said it is difficult to distinguish depression from normal childhood ups and downs, while 30 percent acknowledged that children may excel at hiding their true feelings from prying adults.

Good parents want to do right by their children. When a child is struggling with a mental illness like depression, it's up to parents to break down communication barriers, make kids feel safe in speaking up, and do what's needed to facilitate recovery.

ASILENT SADNESS

Parent-child communication can be complicated under the best circumstances; depression makes it more so. Often kids really don't sound the alarm that they've been feeling down. Many kids and teens in my practice confide how bad things are for them emotionally, but they also reveal that they've never told their parents. Or they tried once and didn't bother to try again.

Why not? Most often, it's for one of the following reasons:

? Parents don't listen. Maybe the parents are busy when the child tries to confide, or they are online and don't pick up a cue to put down what they are doing and tune in. Even though parents tend to spend more time with their kids than ever before, evidence suggests that they are also more often distracted.

? Parents try to fix them. When most people have a problem, they want a loved one to listen-not fix. But most parents have been solving their children's problems and healing their booboos since they were little. With this dynamic firmly in place, it's perfectly routine for parents to tell a child how to feel or suggest "quick fixes" that don't address the true roots of the problem.

? Parents tell children that their feelings are temporary. Children can seem to change from day to day and week to week. Even when confronted with persistent evidence of a child's low mood, many parents continue to be convinced that he is simply going through a phase that won't last. "Don't worry," a wellmeaning mom might say. "It will pass."

? Parents don't check in again. Kids can look fine from the outside, so parents move on-often fearing that following up will itself trigger the depression they so desperately want gone-the way a threeyear-old says yes every time she's asked if something hurts.

Parents may think that their child is impressionable and will imagine that he is anxious or depressed if the idea is planted in his mind. …

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