June 17, 2020
Stacey Winters, DO
Pediatrician
Willamette Valley Pediatrics
& Adolescent Medicine
As a group of humans, we all know the signs of depression: sadness, lack of motivation, lack of joy, fatigue, feeling worthless, lack of concentration, and changes to sleep and appetite. But, how does this manifest in children? Your 8-year-old is not going to come to you and say, “Mom, I am feeling worthless today.” That concept is not part of the thought process at their developmental stage. Children developmentally must first learn to name their emotions, then they can start to express them and eventually understand them. Think of how we feel as adults during this time of chaos in our country. How do we process? Are we doing a good job?
Just as we struggle with the changes faced - our children are struggling as well. They have their own stressors, such as being homeschooled with parents who are not teachers, not getting to go out and exercise, and not seeing their friends. These are in addition to living with parents or a parent who may be out of work, feeling isolated and alone, or stressed about finances. As a parent, it is our job to look out for signs of depression in our kids. They may need help to get through the chaos.
Children may express feelings of depression as:
- Going to bed early or very, very late
- Sleeping all day and not knowing why - they are just tired
- Refusing to eat their favorite foods, eating everything in the house, or hoarding food in the bedroom
Watch for:
- Wrappers in strange places
- Not engaging in favorite games or at reading time
- Only playing video games
- Not wanting to do any other activities
- Increased arguing and fighting with siblings
- Saying negative things about themselves
- Cuts on skin or damage to hands - Self-harm with cutting and punching walls is also common.
- Watch their taste in art - What are they drawing or painting? Are they listening to different music than they did previously?
There is a difference between depression and demoralization. The behaviors can be similar, but depression is a serotonin mediated change in mental state causing the symptoms listed above. Demoralization is more of a behavioral state where the circumstances surrounding you have created a state of sadness and frustration. Demoralization is not typically tied to a serotonin issue. If not addressed, however, demoralization can lead to depression. If you have concerns that your child is feeling sad or may be depressed, talk with them. Talk about concrete, tangible emotions and events. Use examples.
To assist your child who seems sad or is acting out, try to stick with a schedule (which we all know is very challenging right now). Kids thrive in a structured environment.
Incorporate outdoor activities. Anything is valuable, a barefoot walk in the grass at the house counts.
Limit screen time as much as possible. With video games, it is important to take breaks every 30 minutes or so. This mitigates the zoning out/addiction state.
Keep art in their lives on a daily basis.
Put activities in a schedule. The schedule can be a project to do together. Make it bright and fun. Everyone can participate and then post it in a central location for all to see.
Introduce self-awareness activities such as yoga and meditation. There are many age-appropriate examples out there. Investigate with your child then try some to see what interests them.
These ideas can help greatly with symptoms of demoralization. Depression can also respond to behavioral interventions, but more often will need more professional help through a counselor and/or a physician. Reach out to your pediatrician if you have any questions about depressive symptoms in your child.
If you are seeing signs of self-harm or suicidal ideation, make an appointment with your provider as soon as possible. If your child is suicidal, call your pediatrician and go directly to the emergency department.
Suicide Prevention Hotline: 1.800.273.8255