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Depression in Children

It's estimated that up to 3.5 percent of children twelve years old and younger and 9 percent of adolescents also suffer from depression. In the very young, symptoms include crying for no reason and restlessness; while in preschoolers they may be manifested as irritability and aggression. As children mature they may experience a sense of apathy, low energy, and listlessness at school and at play. Once adolescence is reached, symptoms tend to resemble those in adults more closely.

Depressed kids aren't just "acting up."

In our culture children are considered the very symbols of hope and joy so the idea that they experience the hopelessness of depression seems counter-intuitive. As a result, parents and teachers may dismiss signs of distress as "kids just being kids." Yet a child who is "acting out" and showing anger and aggressiveness may be as depressed as an adult who is feeling sad and blue.

Aside from irritability, kids may seem to have little energy - even for activities that they used to love. They may have trouble focusing on class work and lose their appetite. Older children may attempt to change their appearance, dressing in ways they never did before and, like some adults, try to self-medicate by using alcohol or drugs.

There are no special tests to identify depression in youngsters.

If a child exhibits the systems of depression for two weeks or more, he or she should be taken to a doctor to make sure they're not suffering from a physical ailment requiring medication. Once physical causes have been ruled out, a mental health evaluation can be made based on interviews with the child and information from parents, teachers, friends, and classmates. Research indicates depression occurs along with, or perhaps because of, other maladies such as Attention Deficient Hyperactivity Disorder (ADHD), obsessive compulsive disorder (OCD), or bipolar disorder. Children with a family history of depression and those from dysfunctional families are at an increased risk of becoming depressed.

Traditional treatment options are psychotherapy and medication. Once depression is diagnosed, the patient's doctor will probably prescribe a regime incorporating psychotherapy and selective serotonin reuptake inhibitors (SSRIs). These medications have been used to great effect in treating children as well as adults. But in the last five years questions have been raised about the safety of these drugs for patients 18 years and younger. In 2004 the U.S Food and Drug Administration (FDA) warned that some antidepressants could increase suicidal thoughts and behavior in children. Later this warning was extended to cover everyone under the age of 25.

More recently, a study completed in 2006 indicates that the benefits of these medications may still outweigh the risks. Currently, the FDA has demanded that SSRIs carry a "black box" label warning that children and adolescents suffering from depression are at increased risk of having suicidal thoughts on these drugs. One SSRI - Fluoxetine (brand name Prozac) - has been approved by the FDA for use by children as young as 8 years old. Yet even Fluoxetine can lead to suicidal behavior among a small group of people. So all medication used by children should be carefully controlled and monitored constantly.

Psychotherapy for children

Cognitive Behavioral Therapy (CBT) has also been found to be effective in treating several childhood psychological disorders including depression. The goal is to reduce the patient's anxiety by altering their beliefs and behaviors. The treatment is based on the theory that our thoughts can trigger moods that impact on our actions. Replacing depressing or worrying thoughts allows the child to experience more appropriate feelings and exhibit more positive behaviors.

An alternative to medication - Neurofeedback

Neurofeedback is a form of biofeedback and has been used to treat ADD and ADHD in children for the last thirty years. During the last decade it has been gaining acceptance among the established medical community as a therapy for these disorders as well as depression in both adults and children.

Neurofeedback works directly on brain wave activity and can be equally effective in treating depression whether the condition is caused by an emotional trauma or physical injury. Patients suffering from depression, like those with ADD and ADHD, exhibit brain activity that is either slower or faster than normal. Using neurofeedback, patients learn to adjust their brain waves to calm down or concentrate more successfully. Since neurofeedback is non-evasive and doesn't change the body's chemistry, it can be an excellent alternative treatment to anti-depressants and other mind-altering drugs. It can also be used in combination with psychotherapy and/or prescription pharmaceuticals when appropriate.

Merln Hurd PhD; BCN, QEEGT

86 University Place, 8th Floor
New York, NY 10003
212-645-3076
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merlynh@nyneurofeedback.com
www.nyneurofeedback.com

PVKelsey, LICSW

328 Broadway
Cambridge, MA 02138
617-547-7537
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pvkelsey1@gmail.com
cambridgeneurofeedback.com

Center for Personal Growth

472 Kings Highway
Valley Cottage, NY 10989
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neeaack@mac.com