Dr. Sumit Patil

Depression in children and young people affect people from ages 5 to 18. About one in four children in India suffer from childhood depression. Boys and girls up to the age of 10 and 16 respectively, are more prone to depression. As per the report released by WHO, among 10 South-East Asian countries, India has the highest suicide rate. An estimated rate of suicide per 1 lakh population of the age group of 15-29 is 35.5 percent.

Definition and Signs 
According to Thompson (1995), depression is an overall lowering of normal functions which is not specific to any one component of the mind. Clinically, the signs and symptoms of depression have the following components:

1. Mood Changes: sadness, irritability, sense of loss of interest even in cherished activities
2. Cognitive changes: inefficient thinking, poor self-esteem, a feeling of hopelessness, loss of concentration, poor attention span, indecisiveness. Rarely, suicidal tendencies, delusions, hallucinations.
3. Physical changes: low energy, apathy, tiredness, increase or decrease in appetite, disturbed sleep, low emotional responsiveness. Children in primary school stage may report of headaches and stomach aches, limb pain.
4. Impairment in personal and/or social functioning: Self-harm, deterioration in school work without any specific reason, sudden and persistent levels of aggression and irritability.

Causes:

1. Marital or family disharmony
2. Divorce and separation
3. Physical and sexual abuse
4. Domestic violence
5. Problems at school: bullying, social isolation, exam failure
6. Severe personal assault
7. Children with parents suffering from depression

Diagnosis of Childhood Depression
Any child suffering from symptoms of depression for at least 2 weeks, should be scheduled to visit his health care provider. Parents and guardians should eliminate any physical reasons for the symptoms before visiting a mental health professional. There are no specific medical or psychological tests that can clearly diagnose childhood depression. Following measures can help to make an accurate diagnosis:

1. Questionnaires for both the child and parents.
2. Interviews and study of the patient's history by a mental health professional.
3. Information from friends, teachers, and classmates can be useful to detect early symptoms of childhood depression.

Treatment

• To alleviate depressive disorder
• To reduce concurrent related conditions like ADHD (attention deficit hyperactive disorder) and learning disabilities
• To promote normal social and emotional development and school performance
• Relieve family distress
• To prevent or reduce the risk of relapse

Psychological therapy is the first line of treatment and includes:

1. Cognitive behavioural therapy in group and individual format
2. Interpersonal psychotherapy focuses on interpersonal issues like interpersonal conflicts, grief and loss and its effect on current feelings and problems
3. Psychodynamic child psychotherapy where children are given a way to express their issues through playing, drawing, talking
4. Family therapy deals with solving family-related issues and management of crisis
5. Art therapy is an approach to vent out your negative feelings using creative expression as an outlet.
6. Guided self-help helps you in understanding the core of the problems and finding ways to manage the same with the help of a professional.
7. Relaxation and self-modelling can go a long way in dealing with depression. Relaxation techniques like exercising, meditating and yoga help your mind soothe and reduce stress and anxiety which in turn elevates the mood and reduces depression.
8. Counselling has help people overcome loneliness and discuss the things that make them feel low openly. This helps in seeking a solution for that particular cause.

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