The tragic suicide of a 9-year-old Dallas boy who was found hanging in a school bathroom this week has sparked much commentary about depression in children.
Dr. Wendy Walsh: Depression is associated with the rising rate of child and teen suicides. The statistics are not new. Back in 2007, the Centers for Disease Control and Prevention's Annual Summary of Vital Statistics reported that the suicide rate rose more than 18 percent in children and adolescents ages 1 to 19 years old.
The reasons for this increase are unclear, but some experts suspect the inappropriate monitoring of children on antidepressant medications is one factor. The rise in the youth suicide rate occurred at the same time that the Food and Drug Administration mandated heightened warnings on the labels of selective serotonin reuptake inhibitors (SSRIs), a particular class of antidepressant medications that includes Prozac, Paxil, and Zoloft.
The theory is this: Antidepressants act as a brain stimulant. One symptom of depression is lethargy and inactivity. Some psychologists believe that depression is nature's way of keeping the body low while the mind is hurting. In many patients, the first thing an antidepressant does -- before elevating mood -- is elevate energy. Now the sad and angry child has the physical power to do something about his or her pain. Thus the suicide thought can more easily become a suicide action.
"At age nine, kids are just beginning to understand that death is final," says University of Texas' Dr. Betsy Kennard. Dr. Kennard, who specializes in the treatment of depression and suicide in adolescents, told the Dallas Morning News that "youths typically don't have the long-term view of the world that adults do. They may think their despair won't go away, so there's more hopelessness," she said. "Youths are also more impulsive, which puts them at higher risk."
About 5 percent of children and adolescents are suffering from depression at any given time. That's about one or two children in each classroom. According to the American Academy of Child and Adolescent Psychiatry, the behavior of depressed children and teenagers may differ from the behavior of depressed adults. Child and adolescent psychiatrists advise parents to be aware of signs of depression in their youngsters.
If one or more of these signs of depression persist, parents should seek help:
- Frequent sadness, tearfulness, crying
- Decreased interest in activities; or inability to enjoy previously favorite activities
- Persistent boredom; low energy
- Social isolation, poor communication
- Low self-esteem and guilt
- Extreme sensitivity to rejection or failure
- Increased irritability, anger, or hostility
- Difficulty with relationships
- Frequent complaints of physical illnesses such as headaches and stomachaches
- Frequent absences from school or poor performance in school
- Poor concentration
- A major change in eating and/or sleeping patterns
- Talk of or efforts to run away from home
- Thoughts or expressions of suicide or self-destructive behavior
A child who used to play often with friends may now spend most of the time alone and without interests. Things that were once fun now bring little joy to the depressed child. Children and adolescents who are depressed may say they want to be dead, or may talk about suicide. Depressed children and adolescents are at increased risk for committing suicide. Depressed adolescents may abuse alcohol or other drugs as a way of trying to feel better.
Children and adolescents who cause trouble at home or at school may also be suffering from depression. Because the youngster may not always seem sad, parents and teachers may not realize that troublesome behavior is a sign of depression. When asked directly, these children can sometimes state they are unhappy or sad.
The good news is that depression is treatable. Individual and family therapy and cognitive behavioral therapy and interpersonal therapy have been shown to be very effective. And for many people, antidepressants do work well, but they must be prescribed by a psychiatrist who can monitor mental health. All too often, pediatricians and gynecologists dole out pills without the psychotherapeutic follow-up. That's the danger.
|Dr. Wendy Walsh holds a Ph.D. in Clinical Psychology and her area of interest is Attachment Theory, a psychological, evolutionary and ethological theory that provides a descriptive and explanatory framework for understanding interpersonal relationships between human beings. As a psychological assistant registered with the California Board of Psychology, Dr. Walsh has treated individuals, couples and families for a variety of mental health concerns including personality disorders, anger management, eating and substance disorders, and depression. Connect with Dr. Walsh on Facebook.|