Depression impacts as many as 15-20% of kids at some point during their childhood, and the signs are often missed by parents. But if parents don’t notice there’s a problem, that their “difficult,” clingy, bored child might be depressed, these untreated symptoms can lead to problems later in life, or even suicide.
Fortunately, treatment options continue to advance. UCLA’s Youth Stress & Mood program works – via grants from the National Institute of Mental Health and the CDC – to better understand depression in children and teens. They’ve been involved in clinical trials examining the benefits of various approaches to treating depression. Joan Asarnow, Ph.D., director of the program, recently answered a few questions about kids and depression, and what parents can do to help.
How often does depression in children go undiagnosed? Untreated?
Unfortunately, many youngsters dealing with depression do not receive treatment. One recent study suggested that less than 50% of children with depression receive professional help. The good news is that we now have a number of treatments with scientific evidence that show that they work. There have been major advances in the past few decades and parents whose children are suffering from depression now have evidence-based psychotherapies (talk therapies) that have been shown to be beneficial in scientific studies.
While medications are still somewhat controversial for the treatment of depression in children and adolescents, there are medicines that are approved by the Federal Drug Administration (FDA) for depression treatment. In our recent studies completed at UCLA we have had success in improving depressive symptoms in a wide variety of samples, with between 50% to 60% of youths benefiting substantially from treatment within about 12 weeks. Researchers are constantly working on developing better treatments and improving access to treatments, however, we need parents, caregivers, and teachers to reach out to kids in trouble and bring them in for treatment.
Are the signs of depression the same for children as for adults?
Many of the signs of depression are the same in children as in adults. These include sadness, not enjoying things as much as one used to, appetite or weight changes, changes in sleep patterns (particularly trouble sleeping or sleeping too much), feeling really tired, feeling down about oneself, having trouble concentrating, having difficulty making decisions about little every day things, and thinking a lot about death or suicide. In children, we also see sadness coming across as irritability, general crankiness, and a tendency to be “bored” and find things “boring.”
Do depressed children go untreated because they are undiagnosed? Because their parents don’t want to admit there is a problem? Because their parents can’t afford treatment? Because services are not available?
There are many reasons why children may not receive needed treatment. Sometimes symptoms of depression are mistaken as other problems (for example, irritability can be misinterpreted as a child who is “just difficult”), or adults may not realize that a child is going through a difficult time. We find that parents are generally very concerned about how their children are feeling and acting, and that once they recognize there is a problem they want their child to feel better.
While there are limited services and costs associated with treatments, there are also many services available that are not being fully utilized. We encourage parents to speak with a mental health professional or their child’s primary care doctor or nurse if they are concerned about their child’s mental health. At our clinic, the UCLA Youth Stress and Mood Clinic, we offer many treatments, some of them at no cost when they are part of our ongoing research efforts.
What types of problems can follow children with depression into adulthood? Are these problems more difficult to treat in adults than in children?
Almost all children with depression will get better at some point, but children and adolescents who have been depressed are at a significantly higher risk of becoming depressed again in adulthood – sometimes with more severe symptoms than people who become depressed for the first time as adults. Children who have been depressed are also at greater risk for substance use, school problems, and work problems, in addition to other mental health problems such as suicide and suicide attempts. We hope that treating depression in children early will also help prevent more severe episodes in the future, which is why we are so focused on spreading awareness of childhood depression.
What types of treatments are now available for children with depression? How have options changed over the past decade?
Fortunately, there are a number of promising treatment options for children with depression. Many children will benefit from cognitive-behavioral therapy, which helps children develop more adaptive patterns of thinking and behavior. Another promising approach is family-centered therapy, which can help all family members develop more positive ways of interacting with each other and solving problems together.
Treatment may also include the use of antidepressant medication. Over the last decade, these approaches and others have continued to be tested rigorously, providing clinicians and families with more information about what works best, and helping to refine the approaches to make them even more effective.
At the UCLA Youth Stress and Mood Clinic we provide the newest and most state-of-the-art treatments in a research setting, so that families can get help and be part of shaping new treatments for other kids in the future.
Reach the UCLA Youth Stress and Mood Clinic at 310-794-4941 or visit: www.semel.ucla.edu/mood/youth-stress.