Depression is a mood disorder (mood) that cause children and adolescents to feel sad or irritable to be a long time. A young person who is depressed, no longer enjoys school, and play with friends and may be lacking in energy or have other symptoms. As adults, symptoms range from mild depression to severe and one person to another. Depression can last a long time and may have a cyclic evolution, with periods of illness followed by periods without symptoms. Chronic depression, dysthymia and mild form called, occurs when a child feels defeated most of the time period of one year or more. Both the mild form and severe form of depression can be treated with efficiency.
Until recently it was believed that only adults suffer from depression, while children and teens do not. We now know that even young children can have serious forms of depression that require treatment for healing. However, symptoms of depression in children and adolescents are difficult to recognize. Symptoms range from abdominal pain and boredom can be confused with symptoms of other diseases. Many children and teenagers with depression do not receive proper treatment for the symptoms is not known. Variations of mood and emotional changes caused by depression can go unnoticed, considered unimportant or assigned normal growth.
Children and adolescents with depression and other disorders and often have anxiety, hyperexcitability similar behavior (hyperactivity) with attention deficit disorder, eating disorders and the serious process of learning and behavior problems (disorderly conduct). These symptoms may occur before being diagnosed with depression in children.
In the past, consider that depression is "all in the mind" and that a depressed person is able to recover by itself. Today we know that depression is an illness that requires treatment and is not a flaw or weakness. Childhood and adolescence can be difficult for children with depression and family members, especially when the disease is not treated. If untreated, severe depression may last a year or more. Severe or prolonged depression can cause problems such as difficulty in making friends with others and maintaining friendships, difficulties in school, drug abuse, suicidal behavior and other problems that may extend into adulthood. Have turned to professional help if your parents found this behavior in childhood depression.
Depression is considered to be an imbalance of certain chemicals called neurotransmitters that transmit messages between brain nerve cells. Some of these chemicals, like serotonin helps regulate mood. If these chemicals that regulate mood, cause imbalance in the brain nerve cells, resulting depression or other mood disorders. Experts do not currently have set up the neurotransmitter imbalance that occurs. They believe that this change can occur as a consequence of stress or disease, but it can occur without clear cause.
Depression in family members: children and adolescents who have a parent with depression are three times higher risk of depression than do those whose parents do not have depression. Experts believe that both inherited family traits (genetic) and living with a parent who has depression may increase risk to the child's depression.
Depression in children and adolescents may be due to stress, unresolved social problems and family conflicts. It may also be associated with trauma such as violence, abuse or neglect.
Children and adolescents who have serious medical conditions prolonged learning problems or behavior problems may be more easily depressed.
Some medications can trigger depression, such as steroids or narcotics for pain relief administered. Once the drugs are discontinued, symptoms usually disappear.
Factors that increase risk of depression in young
Several factors increase the risk of depression in young people:
- If a parent or an immediate family member has depression: it is the most important risk factor for depression (children or adolescents who have a parent with depression are three times more likely to be depressed)
- If they had a depressive episode, especially if the first depressive episode occurred at a young age
- If you have chronic medical conditions such as diabetes or epilepsy
- The presence of other psychiatric disorders, such as disorderly conduct or anxiety (anxiety, fear)
- Death of a family member or close friend
- Physical or sexual abuse
- Abuse of alcohol or drugs.
Other risk factors and situations that lead to depression are:
- Girls in early puberty (girls and boys before puberty have the same risk for depression but after puberty and adulthood, women are 2 times more prone to depression than men do)
- Domestic violence
- Lack of social relations with persons of the same age
- The victim of aggression or aggression.
Depression in childhood or adolescence is to develop gradually or suddenly. The child may seem irritable rather than sad or feeling tired or hopeless. Entourage child in the child with apparent slowness in movements depression, insomnia or agitation. The child may be self-critical or have a feeling that others are too critical of him.
The symptoms of depression are often subtle at first. At this stage it is difficult symptoms associated with depression and it's hard to believe that it is depression in children.
Children with depression may have these symptoms:
- Violent temper
- Unexplained pain such as headaches or stomach
- Difficulty in thinking and decision making
- Drowsiness sauinsomnie
- Changes in eating habits that can lead to growth, absence of weight loss or weight gain, expected to increase child
- Loss of self-esteem (low self confidence)
- Feelings of guilt or hopelessness
- Lack of energy or constant fatigue
- Withdrawal from social life, such as lack of interest in friends
- The thought of death and suicidal thoughts.
Untreated depression can lead to suicide. Carefully for signs of suicide change with age. Signs of attention to child and adolescent suicide include preoccupation with death or suicide or the recent termination of the relations of friendship.
Many children with depression have symptoms of anxiety (anxiety) such as permanent and unfounded concerns and fears of separation from a parent. Sometimes these symptoms appear before depression is diagnosed.
Other less common symptoms can occur in children with severe depression and hearing voices that are not there (auditory hallucinations) or blind belief in a false idea (illusion, anger). Hallucinations are common in childhood, while delusions are more common in adolescence.
Differentiate between various normal mood and symptoms of depression is often difficult. Occasional feelings of sadness or irritability are normal. They allow the child to understand the grief and cope with obstacles in life. For example, deep sorrow (heavy loss) is a normal response to a loss such as death of family pet, the loss of a friend or divorce of parents. After a tough loss, the child may stay sad for a long time. However, if these emotions do not disappear after a while and begin to interfere with the private life of the young child can develop symptoms of mood disorder like depression or dysthymic disorder (depression during long nonsevere) requiring treatment.
Approximately 15% of children and adolescents diagnosed with depression develop bipolar disorder (this contradictory symptoms: alternating between depression and mood exaggerated). Children and adolescents with bipolar disorder have extreme events which alternates between bouts of manic depression (children are energetic, restless or irritable). The common symptoms of depression may be common to other diseases.
It is sometimes difficult to differentiate bipolar disorder from depression. It is common for a child diagnosed with bipolar disorder to be diagnosed with depression for the first time that after his first manic episode is diagnosed with bipolar disorder. Although depression is part of bipolar disorder, they require different treatment from that of depression. Like depression, bipolar disorder may be familial, hence the need to inform the family doctor about a family that there are other cases of bipolar disorders .
Depression in childhood and adolescence may be manifested first by irritability, sadness by crying or sudden unexplained. Children may lose interest in activities that they once used to enjoy, can not feel loved or they may feel hopeless. They may have problems at school, may become careless or rude.
Often children may have depression and other disorders associated with depression and other manifestations of anxiety (anxiety), behavioral disorders similar to hyperexcitability (hyperactivity) with attention deficit disorder, eating disorders and the process of learning, and serious behavior problems (conduct disordered). These disorders can occur before a young person to become depressed. Some children with depression develop serious behavior problems (disorderly conduct), usually after they became depressed. If your child has this disorder should be instituted when necessary treatment for depression.
The child or teen with depression is more prone to drug abuse, alcohol, smoking than those who do not have depression. About 30% of young people with depression will have problems with alcohol or drugs. They are much more difficult to treat depression, increase the treatment time required to become efficient and increase the risk of suicide. An early diagnosis and treatment accompanied by good communication with your child can help prevent substance abuse.
Emergency services must be announced if:
- The child is in a position to automutila, if you threaten other people or signs announcing a suicide attempt
- Missing child hears voices (auditory hallucinations).
The child will be advised to notify emergency services if you can not refrain from self-harm or injury to others.
Listen Read phonetically Watchful waiting Approach "wait and see", also called "watchful waiting" may be appropriate if the child has feelings of grief, sadness and melancholy.
However, parents must tell the doctor when symptoms last more than two weeks or if symptoms interfere with daily activities.
Untreated depression can lead to suicide. Signs that announce a suicide attempt change with age. Signs that announce a suicide attempt include a child or adolescent preoccupation with death and suicide or break a friendship recent. Specialists doctors recommend Treatment for depression involves expert consultation, specific medication, family education, or a combination thereof. It is also important that your child be involved in your treatment plan by setting long-term sustainable relationships with the specialists involved in treatment.
Specilistii involved in treating children with depression are:
- Resident doctor
- Health care specialist.
Specialized counseling (psychotherapy) may be given by:
- Social worker
- Licensee in mental health
- Psychiatric nurse. Investigations Doctor or other health professional will evaluate and diagnose depression in children, it chestionandu about medical history and performing tests to determine if symptoms are not due to other causes besides depression. The child may undergo a general physical exam, followed by performing blood tests to determine if they have associated diseases such as hypothyroidism (low thyroid function) or anemia (low red blood cells). The child may be subjected to mental health assessment tests, tests that analyze the capacity of thinking, reasoning and memory.
Father can be asked to complete a questionnaire on the child's pediatric symptoms, it is a short screening test to help diagnose depression or other psychological problems of children. The child will also give a written or oral test for diagnosing depression.
Sometimes more laborious tests are needed that can fully assess the child's condition. The interview is conducted preferably in the presence of a parent or a person who knows the child well. Other important information can be obtained from your child's teachers or social workers. Treatment Treatment - General
Treatment of depression in young adults is similar to including psychiatric counseling and medication. Although antidepressant medication may be effective in treating depression, safety and long-term effects of these drugs in children are not yet fully understood. However experts believe that the benefits of antidepressants outweigh the risks in most children with depression.
Less than one third of children and adolescents with depression receive treatment. This is partly due to the youth of prejudice are not due to depression or feelings of depression are normal in their age. Also, children do not seek help if you suffer from depression, because they think it's normal to feel depressed, they invinovatii else or someone else their symptoms or they did not know where to turn for help. Children should be advised to seek help if they feel depressed, you must learn where and who to go to seek help if they are depressed.
Treatment options are:
- Selective serotonin receptor inhibitors (SSRIs) such as fluoxetine (eg Prozac), usually one of the SSRI fluoxetine is used to treat depression in children and adolescents, however, like other SSRIs citaprolam ( Celexa) or sertraline (Zoloft) may be effective in depression and sometimes they are prescribed
- Atypical antidepressant medication such as bupropion (Wellbutrin, for example) or venlafaxine (Effexor)
- Monoamine oxidase inhibitors (MAOI) such as tranylcypromine (Parnate) or phenelzine (Nardil)
- Tricyclic antidepressants such as amitriptyline (Elavil) or dezipramina (such as Norpramin). Tricyclic antidepressants have been used previously to treat depression occurs in childhood, but recent studies have shown limited effects of these drugs. Tricyclic antidepressants have a risk of overdose and other serious side effects such as cardiac side effects.
The type of treatment your child needs depends on the first episode of depression, severity of depression, leading to depression (family problems or problems at school). If your child has thoughts of suicide, severe depression or is disconnected from reality (psychosis) or can not perform any activity where hospitalization is necessary.
Treating depression in children and adolescents generally consists of counseling, medication and family education.
Advice for depression may include:
- Cognitive behavioral therapy, which focuses on modifying certain ideas and behavior model (how to behave)
- Group therapy that focuses on social and personal relationships and related issues
- Problem-solving therapy, which is a type of cognitive therapy to help find practical solutions to these problems
- Family therapy to help educate and comfort the family
- Play therapy for very young children
- Educating family members can be made both by informing medical personnel and family therapy. Some of the most important things you need to teach family members are:
- Know how to check if your child closely follow the therapeutic plan, such as administering medication and proper counseling sessions scheduled
- To learn ways to reduce stress that occurs in a person living with depression
- Know the signs of recurrence (return) to prevent this disease for recurrent depression
- Know the signs of suicidal behavior, to assess its severity and can take a correct attitude in their presence
- Learn to recognize signs of a manic episode (a sign of bipolar disorder) is a fit of excessive energy or irritability
- Setting up treatment from a parent who has depression.
Treatment depends on how established the child's symptoms are severe and if the symptoms interfere with daily activities affect the quality of life. Treatment includes advice from experts and long-term drug therapy.
Some children do not respond to first drug testing and requires multiple medications to relieve symptoms. Both medication and professional counseling may be the most effective therapy, especially in children with chronic depression that lasts for at least a year.
An important part of treatment is ongoing follow-up drug administration in children with depression. Often people who feel better after a while antidepressants are considered "cured" and I do not need further treatment. However, when medication is discontinued, symptoms usually recur, so it's very important that the patient follow the treatment plan exactly.
The child must meet to continue the program of counseling and lifestyle changes such as healthy eating and regular exercise.
If your child has a disorder associated with depression, you should still follow the treatment for that disease. Medical personnel must be notified about radiotherapy treatment plan and associated disease.
Treatment if the condition gets worse
If the child's condition worsens during treatment for depression (which includes specialized counseling, medication and lifestyle changes) needed additional treatment.
If the disease worsens into account the following:
- Parents need to ensure that treatment is administered under medical prescription, as is the recommended doctor about therapy, such as this child to scheduled counseling sessions
- Appeared to follow if symptoms are not caused by another disorder (disorder such as attention deficit hyperactivity disorder, anxiety or substance abuse) and to treat the condition if necessary
- Identify and reduce stress to prevent aggravation of symptoms
- Changing the dosage or changing the child receives medicine
- To monitor compliance with medical recommendations regarding therapy used at home (balanced diet and regular exercise).
It requires a short hospital stay, especially if the child shows warning signs for suicide (aggressive or hostile behavior, excessive thoughts for death or detachment from reality) or if that is so depressed that they lose touch with reality (psychotic) or has hallucinations or delusions. Warning signs of suicide change with age. Warning signs for suicide in children and adolescents may be excessive preoccupation with death or suicide or a recent break a friendship.
If this young man is depressed, the parent should have to hide guns and drugs with potentially lethal in the house, especially if the young know they exist, and have warning signs for suicide. Although drug overdose is the method most often attempted by young people in their suicide attempt, a very high risk at home may present existence of a firearm, especially if it is in an accessible and is loaded with ammunition.
Father should try to convince the young to the utility of a plan for safety in case of his thoughts of suicide, also called written or oral contract against suicide. Young agrees to not to cause any harm to himself and tell a parent if they have suicidal thoughts. Evidence of effectiveness of contract against suicide, attempted suicide or to prevent the act itself is being evaluated. It is not clear whether these agreements help and how much help, but some doctors believe they are useful.
For older children with severe depression with electroshock therapy may be used for the transformation. In this procedure, a short electrical stimulus is sent to the brain through electrodes placed on the head. This is considered to relieve depression by altering chemical in the brain called neurotransmitters.
Although some experts believe that the benefits outweigh the risks of treatment for most children with depression, research on antidepressant drugs are limited. Long-term effects and safety regarding the use of drugs to treat depression in children and adolescents are unknown. Recently, specialists from the National Agency for Medicines (NAM) have warned about the possibility of increased risk of suicide in people who are taking antidepressant medications.
Family involvement is very important to treat depression especially in children and adolescents. Sometimes parents of children or adolescents with depression may be or may become depressed and needing her therapy. If parent remains untreated depression may prevent recovery of the child.
The treatment instituted as soon against depression in children, with both its recovery is faster. If the treatment is delayed longer child's recovery more difficult.
Sometimes they are necessary for several weeks to become effective drugs, even if symptoms improve more quickly. This delay in the amelioration of symptoms can be difficult for family and child. At first they may try different drugs until they found the best for the child.
It is common for children and teens to defend a new episode of depression (relapse) during the first 2-5 years after the first episode.
Outpatient treatment (at home)
Creating a pleasant home environment is necessary in children with depression, it has needed the support and understanding. Love, understanding and continuous communication are some of the most important things you can do to help you handle a child with depression.
In addition, having a good family life, attending meetings of Solace (counseling), taking medication prescribed by a doctor, with good lifestyle habits, symptoms of depression can be reduced to a child.
Usually do exercises, like to swim, to walk, play every day.
Avoid alcohol and illegal drugs, the drugs not prescribed by a physician, natural therapy and medicines that have not been advised by a doctor (because they can interfere with medications used to treat depression).
Enough sleep. If your child has trouble sleeping (resting) to:
- Goes to bed at the same time every night
- Keep your bedroom quiet and dark
- Not to do exercises after 17 hours.
Balanced eating. If your child has a poor appetite or reduced, it is recommended to eat frequent snacks rather than hearty meals.
To be confident that he will be fine. Positive thinking is very important in treating depression. It is difficult to think positively when you are sad but good to remind the child with depression is that progress is gradual and takes time.
If any signs of suicide (eg aggressive or hostile behavior, excessive thoughts about death, or detachment from reality) is seeking help from health professionals or child care at the doctor, a counselor experienced psychiatrist or emergency services. Should call 911 immediately if your child is in danger.
Medications used to treat depression in children and adults have been introduced in studies observing the effects of reliability and long lasting. Following these studies, there was a consensus about the connection between antidepressant drugs and suicidal behavior. National Association of Drug Administration has reviewed these results. Thus, especially in the first weeks of treatment with antidepressants may appear suicidal feelings or behavior. When a child begins with depression antidepressant treatment should be closely monitored. However, children with untreated depression are also at risk of suicide, so that should be taken into account all the risks and benefits of antidepressant therapy.
Treatment with antidepressants such as fluoxetine (Prozac) is an effective therapy in treating depression, especially if it is taken consistently as prescribed, but sometimes it takes a week to go for treatment to begin to act.
SSRIs (selective serotonin receptor inhibitors) are effective in treating other diseases, such as in anxiety.
A child with depression should receive treatment with each medication recommended for depression, until the discovery of a new effective treatment for depression. Once the proper medication is recommended, children with depression should continue to take medication for several months or more symptoms of depression soon after decreased to prevent recurrence again.
Some children who were first diagnosed with depression are later diagnosed with bipolar affective disorder, the disease cycle are found in both symptoms of mania and depression (feeling very energetic, often with euphoria, agitation, irritability or risky behavior impulsivity). If a child or teenager has bipolar disorder, first episode of mania can occur spontaneously, but may result from drugs such as stimulants or antidepressants drugs. It is therefore very important to inform the doctor about the diseases present in the child care family, if there is bipolar disorder and one of the parents is necessary to follow closely the characteristic signs of manic behavior. For additional information about bipolar disorder in young people read the article "Bipolar disorder in childhood and adolescents."
Advice Drug Administration Association. National Association of Drug Administration recommend that patients, their families and physicians who care for patients to monitor, to watch closely for adults and children taking antidepressants for signs of suicide. Supervision is recommended especially at the beginning of treatment or when doses are changed.
Also, the recommendation of the Medicines Management Association is to follow any person who takes antidepressant therapy to see increased anxiety, panic attacks, agitation, irritability, insomnia, impulsivity, hostility and anger.
It is very important to observe these behaviors in children, the impulsiveness they may be less controlled than in adults, with an increased risk of suicide impulses.
While the drugs used for depression are effective sick child, the Association of Drug Administration requires drug companies to include in the package leaflet special hazard warnings or thoughts of suicide during the action of antidepressants used. Medicines Management Association encourages anyone recommend antidepressants, considering that antidepressant use in children or adolescents achieved a balance between increased risk of side effects and drug delivery need. If the child is treated with an antidepressant is recommended halting its sudden. It is required to consult the doctor who cares about children and tracking any changes observed closely for signs of suicide.
Out of surgical treatment for depression at this time.
Counseling by trained personnel is an important treatment for depression. Lifestyle changes, such as performing regular exercise and adequate rest can help your child recover faster and more particularly to improve their lifestyle. Family therapy can contribute to unifying the family, especially when it is preoccupied with child depression.
The presence of a child suffering from depression in the family requires changing attitudes, understanding and patience. It is necessary to train parents regarding childhood depression and what they can do as well as other family members to help in treating depression. Family therapy is an effective way to learn the best thoughts and deeds, to help treat depression.
Shock therapy (electroconvulsive therapy), although it is an effective treatment for adolescents and older than children who have severe depression or who do not respond to other treatments, it is rarely used in children or adolescents. Even if this therapy is effective in adults with severe forms of depression are currently no studies to show effectiveness of ECT in children and adolescents or adults.
The types of behavioral therapy (counseling) most often used to treat depression in children and adolescents are:
- Cognitive behavioral therapy, which helps reduce blurring negative thoughts and encourage positive behavior
- Relationship therapy, it focuses on the initiation of relationships between children
- Problem-solving therapy, in which children are helped to deal with, to understand current issues
- Family therapy, which encourages the whole family to express their fears and help them find new ways to remove them
- Play therapy, which is involved in a small child or a child with mental retardation, aiming to help them overcome their fears and fears (however not proven that this type of treatment reduces symptoms of depression)
- Shock therapy (ECT), often used in children, may be helpful if they do not respond to other treatments, or their depression is severe.
Complementary therapy: complementary medication has been used to treat depression in adults but its efficacy in children and adolescents has not yet been proven, there is no evidence that this therapy would be safe for use in children or adolescents, medication may interact with complementary other drugs, such as with antidepressants.
Some symptoms of depression in children and adolescents may persist in spite of drugs or other therapies. Depression is common in young people remains a problem and requires long-term therapy involving specialized counseling professionals (psychologists), medication, education about the disorder or a combination thereof. Treatment started early can bring the best results for sick children with depression. Prophylaxis Preventing the first episode of depression is difficult, but it is possible to prevent or reduce the severity of future episodes of depression (relapse).
There is some evidence that cognitive behavioral therapy (CBT) performed in a group of children, may prevent or delay the appearance of the first episode of depression in children and adolescents whose parents had depression (condition in which children are exposed to an increased risk of become depressed).
Children with depression need to take medication prescribed by a doctor, to attend the meetings of Solace, to follow a balanced diet and also do exercises regularly.
In a child with depression, there must be a good social support, both in the family home and at school, with teachers, other family members and friends who surround him, they must have the capacity to understand and sustain.
You have to know how to recognize symptoms of depression and a diagnosis to begin appropriate treatment immediately if symptoms appear.
In some schools to distribute educational material and also there is the possibility to participate in group therapy, especially those who have an increased risk to depression, such as those who have family problems or conflict with others.