Depression affects millions of people in the United States every year. As many as 1 in every 33 children may have depression and that number goes up as children enter their teen years. Knowing the warning signs and getting help early on are key to successfully managing depression.
Dr. Danielle Katz Squires, a pediatrician in Miami, Florida, shares her insights and advice on identifying and managing pediatric depression.
Q: Tell us about depression. What is the difference between depression vs. just having a sad day? A: All children and teens experience a sad day or the blues from time to time. Depression is a medical illness. It is a disturbance in mood for over two weeks that also interferes with daily functioning such as school, work or other daily activities.
Q: Are there more cases of depression now than before, and if so, why? A: We are definitely more aware of depression. Clinicians and the public have become much more cognizant of it through education and awareness. Fifty years ago, depression was often regarded as a symptom of another illness, now it is diagnosed as its own entity that often coincides with others illnesses or conditions. We are getting better at diagnosing it and talking about it openly with others.
Q: What are the societal or cultural triggers? A: People with chronic medical illnesses have higher instances of depressions. For example, children with ADHD, anxiety or learning disabilities may be more likely to experience depression. Of course there are risk factors such as genetics and family history, which also need to be considered.
Tumultuous life events such as the loss of a parent or sibling, divorce, abuse or neglect in the home may trigger depression in some children. If children see parents struggle with substance abuse or if children are bullied or are experiencing sexual identity issues, they are at a higher risk of suffering from depression.
Q: Is there any age group when depression is most likely to develop? A: It’s much more common to see signs of depression in teenagers or in children as they enter puberty.
Q: Are boys or girls more likely to suffer from depression? A: The distribution is fairly even in younger children, but depression rates are at least double in teenage girls compared to boys.
Q: What are the recommended steps for family members who think their loved one may have depression? A: I encourage parents to establish open communication with their children. It is important to be involved in a child’s life and to talk to them about their concerns before it makes them distressed. Encouraging positive connections with peers, school activities and school friends is a great way to establish a positive, supportive environment.
Q: How do you talk to someone about depression? A: The best way to talk about depression is with simple and concrete terms. Depression is a medical problem. We can address it and take care of it with treatment. Children are often open to therapy and addressing it. Most children know they are suffering and they are relieved to know there is a way to end their suffering through treatment.
Q: What might surprise us about depression? A: Depression is not a life sentence. Children do really well with treatment. When children receive early and adequate treatment through therapy and sometimes medications, depressive symptoms can resolve quickly. Treatment can be tapered off after 9 to 12 months of symptom remission and children generally do quite well.
Danielle Katz Squires, MD is a pediatrician at Kings Bay Pediatrics in Palmetto Bay, FL.