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Concerned
about Child
and Adolescent Depression?
Azfar Malik MD. MBA
Jean Beck RN. MSN. ACNP. CS.
The following guidelines are an educational
baseline for evaluating depression in young children and adolescents. These are
clues to alert parents when further evaluation should be considered, and are used
in perspective to all else occurring with a child.
Children are a part of a family and cannot be
assessed without knowledge of how the child relates in the family, and how
family issues relate to the child.
Each child is an individual. These guidelines
are only references or clues to alert to possible potential problems. The
guidelines need to encompass the special circumstances of each child and their
family.
If after reading these guidelines, you are
concerned for a child's welfare, Please seek professional evaluation from a
pediatrician, primary care physician or a child/adolescent psychiatrist.
If you have specific questions related to
child/adolescent depression, send your questions. We are unable to
individually treat a specific situation, but can offer professional, educational
information that hopefully will guide you to help.
Suicide
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any expression of wishing to die should be
taken seriously
-
you will not push a child to hurt himself or
put a thought into their head by asking if they are feeling down, depressed
or suicidal.
-
often the child does not want to die.. only
to stop the pain, but they don't know how to cope with the hurt.
Warning Signs
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verbalized wish to die
-
comments like 'you won't be seeing me soon'.
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giving away prized possessions
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leaving depressed, suicidal notes
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essays of dark, death thoughts
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reckless, dangerous, risk-taking behaviors
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over-dosing of over-the-counter medications,
or those used by other family members, often without telling anyone
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cuts, burns and noted abuse of the body
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telling others how they would kill
themselves.. have a plan.
Generalized Depression
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isolation, withdrawal
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sadness, unhappiness, empty feelings, no
pleasure or fun from life
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excessive weight gain or loss
-
school problems, grades dropping, skipping
school, can't get out of bed to go to school.
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change in usual patterns, friends, activities
that appear to have a negative affect on behavior.
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mood swings. low depressed to high,
non-stop energy.. or feeling OK to sudden outbursts of anger, raging temper.
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unable to sleep or sleeping too much
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slow movements, lack of energy, tired all the
time, can't concentrate or make decisions.
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feels worthless, helpless, hopeless, low
self-esteem, blaming themselves
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thoughts of wanting to die, be at peach, have
no pain with no specific plan to harm themselves.
Anger and Depression
Anger is expressed through-out life, from young
children with temper tantrums, to teenage rebellion, to adult outbursts of
anger, on occasion. Anger is healthy, appropriate and essential to balance
value of self with boundaries toward people or events that erode that
worth. So, how does one distinguish between normal growth and development
of anger, versus anger that warrants concern? Again, each child's
situation must be individualized towards their specific circumstances,
individually and within their family.
Young Children (ages1 - 6yrs)
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excessively rough play, where others avoid
the child out of fear
-
overly aggressive
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impulsive, spontaneous rages, to the point
that they are out of control and it is hard to calm the child down.
-
destructive to property, toys or anything of
value.
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cruel to animals or people... hits, burns,
verbally mean
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self-abuse... head-banging, pinching, pulling
hair
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unpredictable, out of control, can't take
them out to the store or restaurant for fear of them throwing a temper
tantrum and making a scene... you get hurt trying to contain their out of
control behavior.
-
sets fires, overly fascinated with fire,
matches, etc. lasts a period of time and has not respond to parental
boundaries.
Adolescent and
Pre-Adolescent (ages 7 - 18yrs)
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excessive fighting, assaulting others.
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destroys property.. e.g.: holes in the wall
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do not follow rules or boundaries. walk
out on you when you try to discipline them, do as they please, making
comments like 'you can't make me'
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constantly test rules and boundaries
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provokes others, setting up a situation so
that they can vent their anger, so they have an excuse to vent.
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verbally cruel, demeaning to others
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defiant of any authority.. teachers, police,
parents, principal.
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dangerous, reckless, risk-taking behaviors..
e.g.: driving too fast.
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intrusive and intimidates
others. family is afraid to say anything for fear of setting him off.
walk on egg-shells when around him.
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takes pleasure in hurting others.
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no sense of remorse or guilt.
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stealing, feels entitled to take things as
long as he can get away with it.
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looks for excessive power and control of
others
Jean
Beck is an Advanced Clinical Nurse Practitioner with expertise in
working with psychiatric disorders in children and adolescents.
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