Children may not have the words to describe depression, let alone disclose it to a parent. They may exhibit visible symptoms of depression such as persistent low mood, social withdrawal, or changes in appetite or sleep.
The symptoms parents can’t necessarily see are stomaches and headaches, feelings of worthlessness or guilt, difficulty concentrating and thoughts of suicide.
The following 10 steps are a guide for parents of a child who is struggling with depression.
1) Find a counselor or psychiatrist.
Find someone who specializes in pediatric depression. A counselor can help the whole family establish good communication skills and lifestyle choices that promote optimal mental health.
If your child needs antidepressants or mood stabilizers, the counselor will refer you to a psychiatrist or psychiatric nurse practitioner who can prescribe them.
Make a habit of walks after dinner, weekends in the woods, walking in the mall, and backyard soccer games. Invest in snow shoes if weather is inhospitable, or find a used treadmill.
If your children like sports, keep them involved, but resist the temptation to overschedule. Overscheduled children are often highly stressed children at risk for depression, according to Psychology Today. Unstructured time for creative, outdoor play and time with family helps children de-stress.
When humans hug, oxytocin, the “love hormone,” is released in the brain. Hugging and affectionate touch can improve brain signals and regulate mood.
Dr. Kai MacDonald, assistant clinical professor of psychiatry at the University of California, San Diego School of Medicine, told Psychology Today, “Studies of blood levels and genetic factors in depressed patients point to the possibility that this natural hormone might play a part in helping clinical depression.”
4) Validate emotions.
- "I hear you."
- "Tell me more about that."
- "That sounds very difficult."
- "How can I help?"
If you have your own history of depression, share that experience. Share the feelings you had, and how you worked through them. If you currently struggle with depression, don't overshare with your children, but do let them know how you manage your illness.
Use phrases such as, “My brain is working against me today, so I’m going to take it easy”, “I’m feeling down, so let’s just have sandwiches for dinner,” or “Let’s go for a walk to chase away the blues." Modeling coping skills and good self-care will help your child for a lifetime.
Emotionally invalidating statements cause a depressed person to withdraw even more. Dismissing your child’s experience, no matter how well-intentioned you are, can push your child away. Try to avoid the following examples:
- "Toughen up."
- "Get over it."
- "How can you be depressed? We just bought you a laptop/puppy/iPhone."
- "You are overreacting."
5) If your child complains about medication side effects, listen.
Should you choose to medicate, know that every medication has side effects. It is a tightrope walk of finding the medication that both works for your child and has manageable side effects.
Common side effects include cognitive dulling, sleep changes and overheating while exercising or playing.
Listen to your child’s complaints and address them with your doctor. A medication a child can tolerate is a medication the child is more likely to take.
6) Affirm, affirm, affirm.
Children have radar for insincerity and empty praise. Telling a child he is a precious snowflake destined to be president isn’t helpful. Instead, let your child know how you feel.
- "You are important to me."
- "Your life is important to me."
- "I’m so happy you were born."
- "I’m proud of how you’re working through this."
7) If you child’s depression is affecting his or her school work, pursue a 504 plan.
A 504 plan is a legal document that requires modifications and accommodations be made for grade school and high school age students. Section 504 is a part of the Rehabilitation Act of 1973 that prohibits discrimination based upon disability.
Mental health falls under the purview of 504 plans. Children under the care of a doctor may qualify if you can document the illness. Contact the school’s administration.
Accommodations for depression might include extra time to complete assignments, permission to leave the classroom if emotions become overwhelming, and sitting in natural light. Help breaking down large assignments into smaller pieces, or a shortened school day, are other possible accommodations that may also be included.
8) Limit screen time.
Studies show screen time is a risk factor for anxiety and depression in children and teens. You will be met with apocalyptic resistance, but setting limits is essential.
Have a public charging area for phones and laptops. Remove televisions from bedrooms, period. Insist that all electronics have a curfew. It could be dinner time, or an hour before bed time.
See this EmpowHer Article for the how and why of limiting children's screen time.
9) Make gratitude lists together.
“You have so much to be grateful for!” or, “How can you be depressed when we are so blessed?” are not empathetic statements. However, snuggling on the sofa (oxytocin!) while coaching your children to create their own gratitude lists is beneficial.
According to Psychology Today, encourage positive interactions, especially those involving gratitude, increase dopamine, serotonin and oxytocin (the love hormone, remember?). Encourage your children to come up with their own gratitude list. Gratitude lists can be part of the bedtime routine or dinner conversation.
10) Have an emergency plan.
- Have the emergency contact number for your children’s doctor by the phone. If you are frightened, concerned for their well being, if they are experiencing severe reactions to medication or threatens suicide, then give yourself permission to call, no matter what the hour.
- If your child has meltdowns or extreme anxiety, ask the doctor if a prescription to treat anxiety and tension would be appropriate.
When a child is escalating emotionally but not a danger to him/herself or others, an appropriate, doctor-prescribed tranquilizer can mitigate the situation until you can get in to see the doctor.
NEVER give a child medication, tranquilizers or otherwise, prescribed for adults. Children metabolize medications differently than adults do, and giving a child someone else’s prescription is extremely dangerous.
- Take time NOW to establish which hospital your child will go to in a mental health emergency. Find the hospitals or clinics covered by your insurance before a crisis hits. Confirm with the hospital that they have pediatric psychiatry, and then keep the hospital’s number permanently by the phone.
Be brave and parent well.
About Oxytocin. PsychCentral. Retrieved October 5, 2015. http://psychcentral.com/lib/about-oxytocin
Teens & Young Adults. NAMI.org. Retrieved October 5, 2015. http://www.nami.org/Find-Support/Teens-and-Young-Adults
Screen time is associated with depression and anxiety in Canadian youth. NCBI.org. Retrieved October 5, 2015. http://www.ncbi.nlm.nih.gov/pubmed/25657166
The Overbooked Child. PsychologyToday.com. Retrieved October 5, 2015. https://www.psychologytoday.com/articles/200301/the-overbooked-child
Depression in Children. WebMd.com. Retrieved October 6, 2015. http://www.webmd.com/depression/guide/depression-children
How Gratitude Combats Depression. psychologytoday.com. Retrieved October 6, 2015. https://www.psychologytoday.com/blog/two-takes-depression/201211/how-gratitude-combats-depression
Reviewed October 7, 2015
by Michele Blacksberg RN
Edited by Jody Smith