Depressed child. Depression in children. Children and the reasons for their development of depression

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Depression in a child in a diagnostic sense means a mental illness, the main criterion of which is emotional disturbances. Depression is often perceived by both the child and parents as a manifestation of laziness, bad character, selfishness, and natural pessimism. Parents should remember that depression is not just a bad mood, it is a disease that requires treatment by specialists. The earlier a child is diagnosed and appropriate appropriate treatment is started, the much higher the likelihood of a quick recovery. Today, doctors have a wide range of different methods of psychotherapy, herbal medicine, and physiotherapy, which help relieve depression.

For a long time, psychiatrists argued: is a child capable of experiencing depressive symptoms? After all, a feeling of melancholy, sadness, a decrease in general tone, a weakening of interests, lethargy and withdrawal from contacts are signs characteristic of adult depression. In children, it is difficult to identify such manifestations because of their vagueness, as well as the child’s inability to talk in detail about his emotional experiences.

Depression in children and adolescents is often masked and includes anxiety, school failure, concerns about health, and disturbances in relationships with peers and loved ones.

Causes of depression in children

The following factors contribute to the development of depression:

Family climate: conflicts in the family, single-parent families, overprotective mothers, complete lack of parental care, lack of sex education on the part of parents. Often in single-parent families, children cannot tell their parents about personal problems; this applies to families where, for example, a father is raising a daughter. Frequent conflicts in the family make the child think that he is a burden and life would be easier without him. The presence of maternal overprotection does not give the baby the opportunity to adapt to society and the environment, and without the lack of proper support, children become helpless. Lack of sex education can have a negative impact on a teenager, leading to withdrawal;

Pathology in the early neonatal period: intrauterine fetal hypoxia, the presence of neonatal encephalopathy, birth of children with asphyxia, intrauterine infections leading to brain damage;

Structural and hormonal changes in the body during adolescence (the appearance of menstruation in girls, nocturnal emissions in boys); change in body shape, appearance of youthful acne. An excess of hormones makes children more aggressive, and leaders emerge among teenagers who dictate their lifestyle. If he does not correspond to this certain image, the teenager falls out of this group of communication, which leads him to alienation, as well as the emergence of thoughts that he is not like everyone else;

Frequent changes of place of residence do not allow the child to have time to make friends with whom he would spend all his free time and share secrets;

Problems with learning, as well as falling behind in the school curriculum, alienate you from your peers, making you mentally vulnerable;

Advances in technology - computerization and the Internet - have united the whole world, narrowing it to a computer monitor, which has had a very bad effect on the ability to communicate.

Depression can also develop due to exposure to chronic or acute stress (serious illness or death of loved ones, family breakdown, conflicts with peers, quarrels with loved ones, etc.), and can occur against the background of complete social and physical well-being, which, associated with disturbances in biochemical processes in the brain. Such depressions include, for example -.

Other reasons for the development of depression include the collapse of ideals and illusions, a feeling of powerlessness and helplessness in the face of insurmountable difficulties.

The causes of depression can be severe mental trauma, overexertion, impaired brain metabolism, headaches, inadequate consumption of sugars, allergies, diseases of the stomach, thyroid gland, eating disorders, and mononucleosis. Almost 50% of depressed children had both or one parent having recurrent episodes of depression.

Symptoms of depression in a child

Adolescence is the most susceptible to depression. Psychologists distinguish early depression (12-13 years), middle depression (13-16 years), late depression (over 16 years).

A depressive state manifests itself with a classic triad of symptoms: decreased mobility, decreased mood, decreased thinking.

During the day, the decrease in mood occurs unevenly. Often in the morning the mood is high, children are quite willing to go to school. Then the mood gradually decreases and the peak of low mood occurs in the evening. The children are not happy about anything, they are not interested, they have headaches, and occasionally their body temperature rises. They complain about constant problems at school, conflicts with students and teachers. Even in good things they see only negative aspects. Children also have flashes of a very good mood, when they are having fun and joking, however, such a mood does not last long - no more than an hour and then again gives way to a decrease in mood.

A decrease in mobility is noticed by a reluctance to move: children either constantly sit in one position or lie down. Physical labor does not arouse any interest. Speech is quiet and the thought process is slow. It is difficult for children to find the necessary words, it is problematic to answer questions immediately, and they often answer with only one nod of the head. Children tend to fixate on one thought with a negative connotation: everything is bad with me or no one loves me. Children lose their appetite, they refuse food, sometimes they don’t eat for several days. They sleep little because they are worried about insomnia due to fixation on one thought, which interferes with the process of falling asleep. The sleep itself is restless, superficial, and does not allow the body to fully rest.

Thoughts about suicide do not appear immediately; they often require a long period of illness (more than a year) to arise. Children do not limit themselves to the thought of suicide; they come up with a plan of action and think through various options. This course of depression is the most dangerous because it can lead to death. All of these experiences represent the nature of excruciating suffering, causing disturbances in interpersonal relationships and leading to a decrease in social activity. The symptoms of the disease are revealed mainly in behavior: the child’s activity changes, interest in friends, games, studies disappears, misunderstandings and whims begin. Often, a difficult situation can be a trigger for the onset of depression. Despite the rather specific picture of this condition, it can be very difficult for parents and doctors to understand the essence of the child’s problems and understand his illness. This is due to the fact that, due to their age, children cannot give a clear description of their condition.

So, symptoms of depression include:

Depressed mood for most of the day, feeling of emptiness, melancholy, depression;

Loss of interest and complete indifference to all previous activities, studies, hobbies;

Gain or decrease in the child’s body weight;

Sleep disturbance (the child either does not fall asleep for a long time in the evening, or falls asleep, but often wakes up during the night);

Psychomotor inhibition or agitation;

Long-term loss of appetite;

State of powerlessness, daily fatigue;

Feelings of shame, concern, guilt;

Decreased ability to concentrate and think (the child is often distracted and finds it difficult to concentrate);

Changes in behavior (not wanting to communicate).

Signs of depression in a child

From a psychoanalytic point of view, a sign of depression is dysregulation. Depression often develops in children with unstable personalities. The basis for development is the lack of acceptance, as well as emotional understanding on the maternal side.

A sign of depression is a decrease in thinking and an inability to complete schoolwork at home. Schoolchildren experience a feeling of rustiness and slowness of mental processes.

Doctors unsuccessfully made repeated attempts to find out which component of the symptom complex: intellectual delay or psychomotor retardation is primary and underlies the disease. A constant component of a depressive mood is anxiety of varying intensity: from mild anxiety to uncertainty and intense agitation.

Depressive mood is a complex formation: the patient experiences helplessness, depression, hopelessness, obvious or hidden anxiety, despair, internal tension, uncertainty, loss of interests, and insensibility.

When the mood is normal, it consists of several, and sometimes multidirectional, emotions. In a healthy person, mood is the result of many influences, as well as causes: a feeling of vigor and fatigue, physical health or illness, pleasant and sad events. In healthy people, the mood is, to one degree or another, subject to external influences: it improves with good news and deteriorates with unpleasant events, and a painfully altered depressive mood is determined by intense, prolonged periods.

Today, being a serious health problem, it often remains without parental and medical attention. This disease causes suffering and pain not only to those who are sick, but also to parents. Unfortunately, most parents still view depression in children and adolescents as a sign of weakness.

Depression in a child - how to help? Clarification of the diagnosis necessarily includes a consultation with a psychiatrist. Psychologists work in schools and, if necessary, you can turn to them for advice. A school psychologist will help avoid the development of severe symptoms and give the student the opportunity to talk about painful issues.

First of all, you should talk to the child, take an interest in his life, problems at school;

It is necessary to be interested in what their child does after school, what kind of friends he has;

You need to pay attention to how long the child does not do anything. For some children, this is laziness, but a lazy child can be bribed with gifts and forced to do something, but a child with depression is not happy or interested in anything: no encouragement, no gifts.

Treatment of depression in a child

The child himself is not able to get out of a depressed state, so the task of adults is to seek medical help in a timely manner. Severe cases with expression of suicidal thoughts, as well as the presence of a specific plan for death, are indications for treatment in a hospital: in the department of borderline conditions.

Mild forms of the disease can be treated at home. Throughout the course of treatment, the child can live a normal life: do housework, go to school, and go shopping.

Among medications, Adaptol has proven itself well in pediatric practice. This medicine is well tolerated, does not cause drowsiness, and has no side effects. Adaptol improves mood, normalizes sleep, develops resistance to psycho-emotional stress, relieves somatic manifestations - pain, normalizes temperature.

What to do if your child is depressed? In the treatment of mild forms of depression, you can use a homeopathic drug - Tenoten, which reduces anxiety, improves sleep, normalizes appetite, helps normalize memory, and improve concentration. In severe cases, antidepressants are prescribed, which are used under the supervision of a doctor.

However, no treatment for depression will be effective without positive changes in the family. Parents need to accept the child: his aspirations and needs, as well as help, develop the ability to express feelings, teach him step by step to cope with difficulties, problems and constructively influence the current situation. For preventive purposes, the child should be in the fresh air as often as possible, not overtired and rest in a timely manner.

Doctor of the Medical and Psychological Center "PsychoMed"

The information presented in this article is intended for informational purposes only and cannot replace professional advice and qualified medical care. If you have the slightest suspicion that your child has depression, be sure to consult a doctor!

– a mental affective disorder characterized by low mood, inability to experience joy, motor retardation, and negative thinking. The disease is manifested by anxiety, fears, phobias, obsessive actions, disorders of social adaptation, somatic symptoms (headache, malaise, digestive disorders). Diagnosis is carried out using the method of clinical conversation, interviewing parents, and projective psychological tests. Treatment includes psychotherapy, social rehabilitation, and medication.

General information

The word “depression” is of Latin origin, meaning “to crush”, “to suppress”. Pathology occupies a significant place in the structure of childhood mental disorders. Prevalence ranges from 0.5% to 5%. There is a tendency for morbidity to increase and the average age of patients to decrease. The frequency of affective disorders in the age group under three years is 0.6-0.9%. Primary manifestations of emotional instability in children are harbingers of depression in preschoolers, schoolchildren, and adults. There is a seasonality of exacerbations, with the peak incidence occurring in the autumn-winter period.

Causes of depression in children

The causes of depression are determined by age. For children under 3 years of age they are divided into:

CNS lesions. Affective disorder develops as a result of damage to brain cells during intrauterine fetal hypoxia, intrauterine infections, birth asphyxia, neonatal encephalopathy, severe illnesses, and neuroinfections.
Hereditary predisposition. Children whose close relatives suffer from mental and neurological illnesses are more susceptible to depression.
Pathological family relationships. The cause of the depressive state is a break in contact with the mother: physical separation (orphanage, hospital), emotional alienation (mother's alcoholism, involvement in other areas of life). A difficult family situation is a provoking factor. Frequent scandals, manifestations of aggression, violence, alcoholism, drug addiction of parents create a feeling of depression and oppression.

In preschool age, the child experiences the first experience of socialization - he begins to attend kindergarten, sections, creative studios, and establishes contacts with peers. Depression can develop due to biological reasons or complex interpersonal relationships. Emotional disturbance forms:

Parenting style. The cause of childhood depression is often the attitude of parents: the use of violence, hypercontrol, overprotection, indifference, lack of interest in the child’s life. The level of neuroticism, manifested by a depressive state, increases.
Social relations. Increasingly complex interpersonal contacts become a source of stress. Rejection from peers and the requirement to obey the instructions of teachers negatively affect the emotional state of a preschooler.

In children of primary school age, the reasons listed above remain and new ones are added. They are represented by the complication of social relationships, an increase in academic workload, and characteristics of mental development. The condition becomes more serious with the inability to cope with the demands of adults, the inability to achieve set goals, and the assessment of oneself as weak, stupid among peers.

Pathogenesis

Depression in children is a multifactorial disease caused by biological, genetic, and psychosocial reasons. Biological pathogenetic factors include deficiency of serotonin, norepinephrine, increased levels of cortisol at night, and an imbalance in melatonin synthesis. There is a catecholamine theory, according to which depression develops due to disturbances in hypothalamic-pituitary interactions and a deficiency of central nervous system neurotransmitters responsible for reverse signal transmission.

There are psychophysiological and personality characteristics that contribute to the occurrence of depression. Emotional disorder develops against a background of increased nervousness, adaptation disorders, fear, introversion, and anxiety. Exposure to negative environmental factors - pathological relationships, bad experiences - increases the risk of developing the disease. The child becomes vulnerable to negative events, withdraws, and adapts less well to external conditions. Sometimes the pathogenetic mechanism of depression is sensitivity to climatic conditions (seasonality), changes in biochemical processes in the brain.

Classification

There are several options for classifying depression in children. Based on duration and completeness of manifestations, the disease is divided into depressive reaction, depressive syndrome, and depressive disorder. According to the nature of the course, there is an adynamic form of the disease, which is characterized by lethargy, slowness, monotony, and an anxious form, characterized by motor restlessness, phobias, fears, tearfulness, sleep disturbances, and nightmares. Russian psychiatry guidelines recommend using the following ICD-10 categories to classify childhood depression:

Separation anxiety disorder. The key diagnostic criterion is the separation of the child from loved ones, manifested by emotional and somatic disorders.
Phobic disorder of childhood. Diagnosed in the presence of fears specific to a certain age period.
Social anxiety disorder. Anxiety and depression develop when interacting with unfamiliar people and new social situations.
Mixed behavioral and emotional disorders. Anxiety, fearfulness, obsessions, compulsions, hypochondria are complemented by behavioral disorders - aggressiveness, isolation, disregard for social norms.

Symptoms of depression in children

A characteristic feature of the disease is camouflage. The young patient does not yet evaluate emotions, is not aware of them, and does not make complaints. In early childhood, somatic symptoms and anxiety occupy a central place. Sleep disturbances, loss of appetite, low body weight, diarrhea, constipation, pain of various locations (headache, abdominal, joint, muscle), and rapid heartbeat are often observed. Preschool children talk about fatigue: “legs don’t want to walk,” “I want to lie down.” At primary school age, the idea of having an illness, increased attention to one’s own condition, and anxiety even with minor illness may be added to physical ailment. Diagnostic tests (laboratory tests, ultrasound, MRI) were unchanged.

The emotional state is characterized by anxiety. Tension and fears intensify in the evening, reaching their peak at night. Anxiety is pointless, causeless, and as it grows, it transforms into formalized fear. The kids are screaming and crying. Panic is caused by the departure of the mother, a new environment, unfamiliar people (doctor, family friend). Children adapt poorly to kindergarten and worry that their mother will forget to take them home. The older a child gets, the more terrible pictures his imagination draws. There is a fear of the death of parents, an accident, or war. In severe cases, anxiety is generalized, all events look threatening. Phobias are formed - fear of closed spaces, sudden death, darkness, heights. Panic attacks develop - attacks of rapid heartbeat, dizziness, suffocation.

In younger schoolchildren, depression manifests itself in behavioral changes: isolation and indifference increase, interest in games, lessons, and communication decreases. Complaints of boredom appear: “I’m bored,” “I want to cry,” “I don’t want anything.” Decreased interest in life is a clear sign of depression. Children become tearful, emotional regression is noticeable: the child cries without his mother, calms down when rocked. Depression is expressed by dysthymia - gloominess, gloominess, embitterment, uttering reproaches, blaming. Decreased interest in learning and general malaise lead to school maladjustment: academic failure increases, and there is no desire to attend school.

Complications

In 20-50% of cases, depression in children is aggravated over time by other mood and behavior disorders. 30-80% of patients have an anxiety disorder, 10-80% have behavioral disorders, 20-80% have dysthymia, 18-30% have substance dependence. The most dangerous outcome of depression is suicide. Approximately 60% of sick children have thoughts of suicide, 30% make attempts, some of them result in death. Timely diagnosis and periodic monitoring by a doctor reduce the likelihood of complications.

Diagnostics

Diagnosis of depression in children includes a comprehensive examination by a pediatrician, child neurologist, and psychiatrist. Before the age of four, the disease is detected by exclusion and identification of risk factors (pre- and postnatal damage to the central nervous system, heredity). At an older age, it becomes possible to identify emotional changes and social causes that provoke the disorder. The diagnosis process includes the following activities:

Consultation with a pediatrician. The specialist examines the child, interviews the parents, and issues a referral for standard tests to exclude somatic diseases.
Consultations of narrow specialists. Specialized doctors (gastroenterologists, dermatologists, surgeons) use the necessary clinical, laboratory, and instrumental techniques to completely exclude somatic pathology.
Consultation with a neurologist. The doctor conducts an examination and refers for instrumental studies: ultrasound, EEG, MRI of the brain. The result allows us to determine the presence of a biological basis for the development of depression.
Consultation with a psychiatrist. When somatic diseases are excluded, the patient is referred to a psychiatrist. The specialist evaluates emotional reactions, behavioral characteristics, determines the presence of psychological causes of depression, analyzes data from examinations by a neurologist and clinical psychologist, and establishes a diagnosis.
Clinical Psychologist. Determination of depression after 3-4 years is carried out using special psychodiagnostic techniques - drawing tests, methods that involve the interpretation of figurative material. The emotional sphere and features of social interactions are assessed based on the results of a drawing of a person, a non-existent animal, the “house-tree-person” technique, “my family”, and the Rosenzweig test.

Treatment of depression in children

Recognized methods of treatment include drug therapy. At the same time, social rehabilitation measures are being carried out. An integrated approach involves:

Taking antidepressants. The most common use of selective serotonin reuptake inhibitors. They relieve pain, calm, smooth out panic and phobias. The likelihood of side effects is low. The therapeutic effect is observed after a few weeks.
Cognitive behavioral therapy. The most effective are cognitive behavioral methods: the child learns to recognize, express and experience emotions, talk about traumatic experiences, receive support, change behavior and mood using various techniques. The basis of the work is relaxation methods - breathing exercises, body-oriented therapy. Projective techniques (drawings, modeling, fairy tale therapy) help to experience and realize negative feelings. develops effective behavioral skills.
Family psychotherapy. Meetings between parents, child and psychotherapist are aimed at restoring harmonious family relationships and finding a “common language” between family members. Parents learn to help their child overcome difficulties and create conditions for a speedy recovery.

Treatment is carried out on an outpatient basis; in severe cases of the disease (psychotic episodes, suicide attempts), inpatient treatment is required. Once severe symptoms have resolved, the patient is discharged. Parents are advised to inform teachers about the disease and emphasize the importance of a tolerant attitude, help, and support during the recovery period. They should be warned about the confidentiality of information about the disease. At home, constant emotional support, adherence to a sleep-wake schedule, nutrition, and feasible physical activity (regular walks) are important.

Prognosis and prevention

There is a high risk of developing a repeated episode of depression: 25% of children have a relapse of the disease after a year, 40% after two years, 70% after five years. 15-40% are diagnosed with bipolar personality disorder in adulthood. Prevention of depression in children can reduce the likelihood of developing the first episode, and if the diagnosis is established, reduce the risk of relapse. The main preventive measure is the creation of a favorable family environment, maintaining trusting close relationships, support, and participation in the child’s affairs. Periodic medical monitoring, systematic use of prescribed medications, and attendance at psychotherapeutic classes are important. Self-cancellation of treatment is unacceptable, even if the patient appears healthy.

is associated with adults as if they are the only ones entitled to mood disorders. Unfortunately, depressive disorders also affect children and adolescents.

Depression in a child manifests itself somewhat differently than depressive states in adults, so it is more difficult to diagnose in younger patients.

Symptoms of childhood depression are nonspecific and can be masked by the clinical pictures of other diseases.

Symptoms of depression in children

Depression can even occur in infants. This form is called anaclitic depression. As a rule, mood disorders develop after the sixth month of a baby’s life, most often in children who were sent to educational institutions or an orphanage, or were hospitalized for a long time after childbirth. The lack of emotional and physical closeness with the mother leads to the appearance of symptoms of childhood depression in the form of severe crying and screaming, lethargy and a “waxy” face of the baby.

From year to year...

Depression can also be recognized in children aged 6-7 years. How does depression manifest itself in early school age? Various types of fears may arise, problems at school, behavior that differs from developmental standards, significant mood swings - from extreme crying to complete calmness, indifference to one’s needs and desires, reluctance to play.

Depression in children can also be psychosomatic in nature and manifest itself in the form of various diseases, for example, abdominal pain, dizziness, shortness of breath, nausea, constipation, diarrhea. The child may suddenly stop growing or begin to lose weight or gain weight. Does not understand the meaning of life, avoids contact with peers and even thinks about death. Suicide attempts often occur.

Depression in children manifests itself in the silhouette and appearance of the child - neglect of personal hygiene, indifference to clothing, hunched back, circles under the eyes, sad expression, anxiety, muscle tension.

The baby may lock himself in his room, avoid movement, and have difficulty sleeping. Loses contact with the environment, parents, brothers and sisters, classmates. He becomes apathetic, lethargic, and constantly feels unwell.

What are the most commonly observed symptoms of childhood depression?

Inability to feel joy, sadness, depression.
Lack of smile.
Loss of previous interests.
Giving up your favorite games.
Apathy, psychosomatic slowdown, decreased vital activity.
Chronic fatigue, lack of energy.
Feeling of inner anxiety and restlessness.
Physical illnesses such as palpitations, abdominal pain and headache.
Extremely low self-esteem, feelings of inferiority and hopelessness.
Sleep disturbances, insomnia or excessive sleepiness during the day.
Decreased appetite and body weight, refusal of favorite foods.
Problems with concentration and memory, difficulties in school, worsening grades.

Depression in teenagers

The term “depression” has become entrenched in the consciousness of society exclusively as a condition of an adult; however, both children and adolescents experience depressive states.

In adolescence, it very often leads to suicide attempts. Quarrel with parents or blackmail is not a demonstration of force, but a manifestation of duality of feelings. Ignoring a child’s words about the meaninglessness of life, a bad mood or unwillingness to act leads to serious consequences - the death of the child, which could have been avoided.

Why do children suffer from depression?

There are many reasons. Experts usually identify genetic, biological, social, psychological and neural factors. Children can become depressed after the loss of a loved one - father, mother, brother, sister, friend, beloved animal.

Depression can occur as a result of a change in place of residence, parental divorce, poverty, unmet emotional needs of the child, etc. There are frequent cases of depression of a non-reactive nature, i.e. not a consequence of a traumatic event.

Most young patients suffer from endogenous depression, which is caused by biological factors, for example, disorders at the level of neurotransmitters. Sometimes children inherit their parents' affective disorders when the mother or father complains of depression, creating with their behavior an image of a negative attitude towards life and the world.

How does depression occur in children?

Until recently, doctors believed that preschoolers were too mentally underdeveloped to experience symptoms of depression. Unfortunately, it turns out that they still can.

Depressive disorders In their case, they are determined genetically, and for their appearance, often no traumatic event is even required. Because symptoms can differ significantly from the generally accepted characteristics of depression in adults, making a diagnosis is challenging and vital to effective coping.

Dr. Joan Clube, a professor of psychiatry at the University of Washington, DC, has been researching depression for 20 years. Already in the mid-80s of the 20th century, doctors found that some children going to school already had clinical symptoms of depression.

Over the past 10 years, researchers have concluded that symptoms of depression may be much younger than previously thought. Fortunately, this phenomenon is not common. From the analysis it follows that the problem may affect 1-2% of preschool children.

What causes symptoms to appear at such a young age? Scientists believe that this is not necessarily associated with stress in the child's life. Depression in children is most often a hereditary disease that develops independently of traumatic or unpleasant events.

By nature, children are prone to frequent mood swings and therefore, identifying symptoms requires closer observation. Symptoms may come and go, however, if the process lasts longer than two weeks or becomes significantly worse, you should contact a specialist.

Treatment of childhood depression

How to cope with depression in a child

When you see something worrying happening to your baby, sit down and calmly talk about his troubles. Spend more time with him than usual, observe and find out why he is so sad and depressed. What's bothering him? What can't he handle?

When your child blames himself for something that is not his fault, reassure him that he is not responsible for it. Don't yell at your child because of bad grades at school or difficulty concentrating. Do not underestimate a child's long-term poor health. When you don’t know how to cope with a problem on your own, seek help from a psychologist or psychiatrist. You can talk about this topic with a psychologist or school teacher.

If the baby suffers from clinical forms of depression treatment must be started. As a rule, it is based on pharmacotherapy in the form of antidepressants and psychotherapy. Only severe forms of depression with suicide attempts require hospitalization. However, sometimes children are admitted to a psychiatric hospital when there is a lack of understanding of the disease and lack of support for the child from the parents.

Psychological intervention, as a rule, gives fairly quickly visible results and, above all, reduces the likelihood of “complications” of depression in the form of feelings of inferiority, decreased immunity or suicidal thoughts. It is worth noting that the effects of psychotherapy largely depend on the attitude of the parents towards the sick child.

Recently, reports of suicides among teenagers have increasingly appeared in the press. The most common causes of suicide are depression. Such conditions do not develop in an hour or a day. Depression is a long-term condition. The duration of depression is most often more than two years, however, shorter-term conditions can also occur (from 2 weeks to 2 years).

Causes of depression in children

The following factors contribute to the development of depression:

1. Pathology of the early neonatal period: chronic intrauterine fetal hypoxia, birth of children with asphyxia, the presence of neonatal encephalopathy, intrauterine infections. All of these conditions lead to brain damage.

2. Family climate: single-parent family, conflicts in the family, “overprotection” by mothers, lack of care on the part of parents, lack of proper sex education on the part of parents. Very often, in single-parent families, children cannot tell their parents about all their problems, especially for families where the daughter is raised only by the father. In such families, children withdraw into themselves, the whole burden of problems falls only on their shoulders, and sometimes they cannot cope with this burden. Frequent conflicts in the family lead to ideas in the child that he is a burden for his parents, that without him their life would be much easier. In the presence of “overprotection” on the part of the mother, children are not able to adapt to the environment and society; without the lack of support from the mother, they become completely helpless. Adolescence is a period of experimentation, especially sexually. In the absence of sexual experience, very often problems and failures may arise during the first sexual contact. If the child is sufficiently informed sexually, this circumstance will not cause a negative reaction in the teenager, however, in the absence of sex education, this situation can negatively affect the teenager, which will lead to his isolation.

3. Adolescence. As mentioned above, adolescence is a period of experimentation. In addition to the previously described problems, hormonal and structural changes in the body occur during this period. Girls get their first periods, boys have nocturnal emissions (night ejaculation), body shape changes, and juvenile acne appears. Due to an excess of hormones, children become more aggressive, and leaders appear in their environment who dictate this or that way of life. If you do not correspond to this image, you cannot get into the social group, which means you find yourself left out of social life. All this can lead to the child’s alienation from society and the emergence of thoughts that he is not like everyone else.

4. Frequent change of place of residence. A child should have a social circle and friends. With frequent changes of place of residence, a child cannot make full-fledged friends with whom he could spend his free time and share secrets.

5. Problems in learning. The modern educational process is too overloaded with subjects; not every child is able to cope with the school load. Falling behind in the school curriculum isolates the child from his classmates, making him very vulnerable mentally.

6. Availability of a computer and the Internet. Advances in technology have made it possible to unite the entire world, narrowing it down to a computer monitor, however, this has had a negative impact on the ability of young people to communicate. Children's range of interests is narrowing, they are unable to discuss anything with their peers, except how much he "pumped up" his hero or how many "bots" he "killed" yesterday. Children become shy when meeting in person; it is difficult for them to find words, because on the computer it is so easy to hide behind a couple of emoticons. At the same time, their only form of communication is chatting.

Depression in a child can develop as a result of exposure to acute or chronic stress (death or serious illness of loved ones, family breakdown, quarrel with loved ones, conflicts with peers, etc.), but it can begin without any apparent reason against the background of complete physical and social well-being, which is usually associated with disturbances in the normal course of biochemical processes in the brain. There are so-called seasonal depressions, the occurrence of which is associated with the body’s special sensitivity to climatic conditions (often manifests itself in children who have suffered hypoxia or received various injuries during childbirth).

Symptoms of depression in a child

Adolescence is the most susceptible to depression. There are early (12-13 years), middle (13-16 years) and late (over 16 years) depression.

Depression presents with the classic triad of symptoms: low mood, decreased mobility, and decreased thinking.

The decrease in mood throughout the day with depression is uneven. Most often, in the morning the mood is more upbeat, and children are quite willing to go to school. During the day, mood gradually decreases, with the peak of low mood occurring in the evening. Children are not interested in anything, they may have a headache, and in rare cases, an increase in body temperature. Children complain that everything is bad for them, that they have constant problems at school, conflicts with teachers and students. No success makes them happy; they constantly see only the negative sides even in the best things.

In addition to low mood, so-called outbursts of very good mood occur. Children joke and have fun, however, such an elevated mood does not last long (from several minutes to an hour), and then is replaced again by a depressed mood.

Decreased mobility manifests itself in a reluctance to move; children either constantly lie down or sit in the same position, most often hunched over. Physical labor does not arouse any interest in them.

The thought process in children is slow, speech is quiet, slow. Children find it difficult to select the necessary words; it becomes problematic for them to build an associative series (for example, wedding-bride-white dress-veil). Children answer questions after a pause, most often with only one word or simply a nod of the head. There is a fixation on one thought, most often with a negative connotation: no one loves me, everything is bad for me, nothing works out for me, everyone is trying to do something bad to me.

Children's appetite decreases, they refuse to eat, and sometimes they may not eat for several days. They sleep little and are troubled by insomnia, as fixation on one thought interferes with the process of falling asleep. Children's sleep is superficial, restless, and does not allow the body to fully rest.

Thoughts of suicide do not arise immediately; most often, their occurrence requires a long period of illness (from a year or more). The thought of suicide is not limited to one. Children come up with a plan of action, think through options for leaving life. This variant of the course of the disease is the most dangerous, as it can easily lead to death.

In addition to psychological disorders, somatic symptoms very often occur. Such children often seek medical help with complaints of general malaise, weakness, pain in the chest, heart, abdomen, headache, and possibly increased body temperature, which is often regarded as a persistent (circulating) infection in the body.

Due to the presence of psycho-emotional disorders, children begin to fall behind in school, they lose interest in any entertainment, children stop engaging in hobbies, even if they previously devoted all their time to it.

As mentioned earlier, the course of the disease is long and can last for years. Therefore, if a child lives in a family with his parents, it is quite easy to notice the symptoms. It’s another matter if the child lives in a dormitory. During the day, fellow students see him as usual, without changes, since the deterioration of his condition usually occurs in the evening, and in the evening the child is most often alone in the dorm room, where no one sees him. For the administration, such a child is of no interest, since he does not violate the order.

What should parents pay attention to?

First of all, it is necessary to talk with the child, take an interest in his life, problems at school. It is necessary to pay attention to intonation, plans for the future, and optimistic views on the future. Pay attention to whether your child has friends and be interested in what he does after school. It is necessary to pay attention to how much time the child spends not doing anything. For some children, this is laziness, but even the laziest child can be made to do something by bribing him, but a child with depression is not interested in anything, neither gifts nor encouragement.

Closedness and lack of friends can sometimes also be observed during masturbation, when children try to be alone and avoid prying eyes. Frequent mood swings can occur when a child takes drugs. In this case, other signs of drug addiction are also noticed: preference for wearing clothes with long sleeves, photophobia, increased irritability, inability to concentrate on one activity (restlessness), detection of syringes, needles, and strange bags.

Screening a child with depression

Treatment of children with depression

In severe cases, when a child expresses suicidal thoughts, especially when he has a specific plan for ending his life, treatment should be carried out only in a hospital, in the department of borderline conditions.

For milder forms of the disease, treatment can be carried out at home. Throughout the course of treatment, the child must live a normal life: go to school, do housework, and go shopping.

In pediatric practice, the drug Adaptol has proven itself very well. This drug is very well tolerated, has no side effects, and does not cause drowsiness. The drug normalizes sleep, improves mood, and increases the body's resistance to psycho-emotional stress. It is necessary to take the drug in a dosage of 300 mg, 1 tablet 3 times a day. The duration of treatment is from 2 weeks to a month. In case of severe symptoms, adaptol should be taken at a dosage of 500 mg 2-3 times a day for 3 weeks, and then switch to a dosage of 300 mg and continue taking it for another 1 month. This drug, in addition to psycho-emotional symptoms, also relieves somatic manifestations of depression: pain goes away, temperature normalizes. The use of adaptol for frequent headaches, heart pain, and frequent increases in body temperature is one of the ways to accurately establish a diagnosis and identify patients with depression from a group of children.

You can also use a drug such as tenoten on an outpatient basis. Tenoten is a homeopathic medicine that blocks certain proteins in the brain. It reduces anxiety, improves sleep, and normalizes appetite. The drug helps improve concentration and normalize memory.

In severe cases, antidepressants are used: amitriptyline, pyrazidol, azafen. These drugs should be used only under the supervision of a doctor, and preferably only in a hospital.

But no treatment for depression in children will be complete without positive changes in his family; parents must accept the “real child”, his needs and aspirations instead of their own expectations, instead of the “dream child”. When conducting psychotherapy, they work to strengthen the child’s self-esteem, develop his ability to express his feelings, share them, cope with problems step by step and constructively influence the current situation.

Prevention of depression in children

To prevent the development of depression in children, it is necessary to organize psychological assistance in schools and colleges; children need to be explained the need to visit a psychologist if problems arise. It is necessary to improve the climate in the family, try to do some activities with the whole family (picnics, hikes in the forest, sports games). Be interested in your child’s life, show how interesting what he is interested in is for you. Try to know your child's friends, however, it is necessary that this be unobtrusive, everything should happen in the form of a conversation, when the child himself tells you everything. Pay attention to your child’s behavior, notice any new addictions your child has.

The child will not be able to get out of depression on his own. Therefore, the task of parents is to pay attention to changes in the child’s personality in a timely manner and seek medical help.

The child should be outdoors more often, be active in daylight and rest in complete darkness. This has a beneficial effect on the entire body and normalizes biorhythms.

Pediatrician Litashov M.V.