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Wednesday 2 June 2010

Kids can get depressed, too

This article is extremely good.


Many of us always take advantage that children do not understand what is going on around them, irregardless if its a negative or positive thing that is happening. However, you´d be totally surprised to find that it isn´t true. Children understand very well what is going on within the family, especially when their parents are having an arguementation.

Why I say this?


My daughter understood very well what is going on between me and my ex husband back then when we were constantly fighting, before my baby and I left my ex husband. She also knew we were separated, although in her own kiddy way, she didnt know how to say it. I remember how back then, when we still go back to my ex husband´s place every weekend to stay, how she´d try to pull both me and my ex husband together to play or to be in a hug.... which for us adults was very awkward - even if its just merely the slightest skin contact. But for a child, she´s innocent, all she wants is to see her daddy and mummy happy. I remember how she always insist that daddy and mummy must always do things together with her, be it taking her out for a day trip or a holiday or playing in the swiming pool and etc. She wants us both to be together, although for us we never fulfill, especially my ex husband - the playing together or hugging each other parts..... 

You might not agree with what I think.... then think bout this... My daughter havent seen her father for 1 year, before he started demanding to see her in March 2010. She practically nearly forgotten her father in a way as my family never speak about him nor do we talk about him (Mother to daughter talk). Then, in December, when I took her to the Dolphin Show in Sunway Pyramid (Her father used to work there in Starbucks), when we were driving up the slope to the carpark, My daughter asked me.... "Mummy, why does daddy don´t want us anymore?"......... And she´s only 2 years odd then. 


With my ex husband meeting her back lately, I know she is getting more and more confused as we both have moved on with our lives tremendously as we stopped getting in touch with my ex for more than a year now... we were separated for 2 years, but we (my daughter and I) only stopped seeing him completely for a year. I know she is depressed, in her kiddy way she is showing it differently. But... *sighs* there isn´t much I could do.

At least now, for us, the nightmare is partially ended. Though we have moved on completely, the ghostly figure of her father still lingers as he takes us out every weekend.


Anyways, parents out there...... Do read this and bear in mind :) *Cheers*


Kids can get depressed, too

By LIM WEY WEN

EVERY now and then, I catch myself when I’m about to utter to my younger friends this line that annoys me most when I was a child: “What have you got to worry about?

You don’t have to think about work or demanding bosses or making ends meet. It should be the happiest time of your life!”

As much as I could relate to the passing remark now, I also realise that when I saw the world through the eyes of a 10-year-old, I did not feel the same way.

Life was definitely not easy when I had to stay up late every night to finish homework that never seemed to end, cope with the hurtful remarks thrown at me by friends at school, and live up to the expectations of people around me.

However, this is a reality that many of us had to live with when we were children – the assumption that when we are young and impressionable, no matter what happens, it could not be that bad. This applies to childhood depression as well.

“In most families, children are least suspected to be unhappy,” says child developmentalist Ruth Liew.

Most parents think that their children are unaware of the family’s problems and the signs from their children’s behaviour are often brushed aside as being naughty or difficult to manage, she adds.

This is a problem that consultant psychiatrist Dr Aw Tui Iar (or Dr T. I. Wong) often sees as well. “The idea that children (below 18 years old) cannot get depression is a common misconception,” she says. “Some of them do have depression. However, it is not easily diagnosed.

“It can occur when they go through puberty and their teenage years, when they go through difficult times. But for young children, especially those below five, it is usually difficult to be sure that it is depression unless there are life-changing events that makes it more likely to happen.”

Blue’s clues

The factors that put children at higher risk for depression are similar to adults, and they can be grouped into three big categories: family history (genetic factors), stress factors, and personality types, Dr Wong explains.

Dr Adnan Omar ... Parents and caretakers should know the symptoms of childhood depression and seek help promptly.

“When you group them under these three categories, you can see the bigger picture,” she says.

If a child has a family member – a parent, grandparent, or relative – with a history of mental illness like depression, he has a higher chance of having it.

If a child finds it difficult to cope with stressful events – events where he needs to adjust to changes in life – it may also be easier for him to develop depression.

And since our response to the stressors in life are largely influenced by our personality types, children whose personality traits tend towards worry and anxiety are more likely to get depression or anxiety disorders.

For children, the stress can usually be traced back to their school or home. “Sometimes people do not understand that stress does not always equate to unhappy things that happen in life. But stress can be anything, including happy events,” Dr Aw says.

“For instance, moving to a bigger house should be a happy event – the child has their own room and things like that – but there are a lot of things, like the new environment, new neighbours and new friends, to adapt to,” she explains.

However, this does not mean that when you have any of these three factors, you would definitely get depression, Dr Aw notes. There are other factors involved, such as coping skills and the presence of social and family support. “Sometimes, children can also get depression although they come from happy environments and families,” she adds.
 
Dr Aw Tui Iar ... Children can help themselves, but they cannot do so by willpower alone. They need support

Like any condition, early detection of childhood depression is always best. However, it is difficult in childhood depression as the signs of depression in children are usually vague, and some of them are quite different from adults. (see table.)

When contacted to speak about his experience as a school counsellor, Supian, who is also a secondary school teacher, says although he has not experienced referring a student to a psychiatrist or professional counsellor, the problem with most of the students who come to him could be traced back to significant events in their lives.

“Usually it is due to a divorce, arguments, or rifts between parents, an occasion where they have been cheated or lied to, or a break up,” he says. “When these problems are not resolved, they start to show changes in their behaviour – they start to lose interest in their studies, do not finish their homework, and start playing truant.”

Suicidologist and college counsellor Dr Adnan Omar says, “The most common symptom of depression among children is irritability or anger. Adults, however, are more likely to be reserved and withdrawn.”

Other symptoms in children that are different from adults also include increased sensitivity to rejection, vocal outbursts or crying, and physical complaints (headaches, stomach aches) that doctors find have no real physical causes.

“Usually, a headache will go away after a while. But if the headache does not go away, and when you bring your child to see a doctor, he can’t find anything that causes it, it could be a sign of depression.

However, when a child shows some of these signs, parents do not need to suspect depression right away. “Like adults, the symptoms must be there for at least 14 days,” says Dr Adnan.

“Of course some children will respond with anger if they do not get what they want on the playground, but that is not depression because it is situational. If you see that anger consistently, it is not situational anymore.

“The symptoms have to be persistent – it does not just come and go,” he explains.

Seeking help

When a parent notices worrying signs in a child, what should they do?

“It depends on the condition,” says Dr Aw. Usually, parents will still go to see general practitioners and paediatricians anyway to get the physical symptoms checked first, but they can always see a psychiatrist, psychologist, or counsellor if they are concerned, she notes.

“If your child’s condition is less urgent, like when he is just feeling a little down, miserable, or behaving badly, you can see a psychologist or a counsellor for it,” she says.

“But if it is something more severe (or more likely to need medications) – like when your child is expressing suicidal feelings, it may be better for you to see a psychiatrist,’ she adds.

Many parents may ask, “Since my child is still growing up, will it get better with time?”

In response to the question, the US National Institute of Mental Health answered in their handbook on the treatment of children with mental illness, “While some children get better with time, other children need ongoing professional help.

Talk to your child’s doctor or specialist about problems that are severe, continuous, and affect daily activities. Also, don’t delay seeking help. Treatment may produce better results if started early.”

While general treatment includes medications to improve the child’s mood, it is usually more complex than adult depression because it also needs to include efforts to change the child’s environment (so it is more conducive to his mental health) and therapy usually also involves the family or caregivers.

The type of treatment depends on the age and developmental stage of the child, and on the stage and type of depression a child has.

For instance, if the depression is obviously associated with environmental factors such as abuse or stress factors, treatment will focus more on educating the parents or caregivers on how to help the child change his environment or teach the child ways to cope with the stress he is experiencing through psychotherapy (which includes counselling for older children and play or creative therapy for younger children).

Says consultant child and adolescent psychiatrist Dr Aili Hanim Hashim, “The symptoms maybe the same but treatment is definitely different (in adults and children).”

In children, psychiatrists do a lot more intervention work, which includes individual work with the children (especially if they are mature and of age to understand and follow the individual work), and working with parents (especially if the parents have insight to their difficulties and are willing to make changes).

“Very often, we do not need to use medication on these children. But there is a wrong perception from the public that we psychiatrists ‘simply use medications’ on the children, and this makes adults afraid to use such facilities,” she adds.

“As doctors and therapists, we are aware and very cautious of using medication on children and I know my colleagues (child psychiatrists in Malaysia) are very well informed of when, how, and adverse effects of using medication in children.”

“Sometimes, children are emotionally stuck. Their problems can be hidden in their unconscious mind,” says play and sandtray therapist of Agape Counselling Centre Lisa Sum. And as children, they may not have the experience with such emotions to comprehend and express them.

Helping children express their emotions in their own way (through play, creative or other psychotherapy techniques) will help reduce their anxiety and make them happier, calmer, and more focused.

“When they feel angry or hurt, sometimes they will withdraw within. That is why as therapists, we help the child explore their emotions,” Sum explains.

“We teach them to be more in tune with their bodies and we help them focus on themselves so their feelings will come out eventually.”

Taking action

To prevent, or overcome childhood depression, there are a few things parents could do, says Dr Adnan. For starters, parents and caretakers should know the symptoms of childhood depression and seek help promptly. Parents should also take the time to talk to their children. “Talk to your kids, especially when they are 10 years or older. Show that you care,” he says.

In most cases, Dr Adnan says most children do inform their parents early in their disease. “They do say something. However, after a while they stop talking because they think their parents don’t care.”

As parents today are often busy with work commitments, teachers, who often spend more time with the children, could also spend more time to talk to them.

Another way to help such children is to keep them active, says Dr Adnan. “Just do something, especially on the weekends. It’s just like us adults.

When we are feeling down we just need to do something – go out for drinks with friends, go for a walk, or go shopping. So, plan something to make your children active. Take your kids out somewhere.”

Last but not least, Dr Adnan emphasises the importance of teaching children basic coping mechanisms. It could be cognitive coping mechanisms (think positive, don’t take rejections too seriously), behavioural (express your emotions constructively by sharing it with someone or doing activities such as running) or social ones (basic social skills such as how to make friends and how to get along with them).

“The problem with children these days is they have low self-esteem,” he says. “They tell themselves things like ‘I’m stupid and I’m not as good as the next person’. When you keep saying these negative self-thoughts frequently, you will believe in those statements. So we need to teach them how to think positively and how to handle failure and rejection.”

Can parents expect their children to handle their problems on their own?

“When you talk about depression as an illness, it is unfair to expect children to ‘just snap out of it’ on their own,” says Dr Aw. “This is an example of common advice that is well intentioned but misguided. Because if it is so easy for them to ‘snap out of it’, they wouldn’t be in this situation.

“Children can help themselves, but they cannot do so just by willpower alone. They need people around them to help them go through the process.”

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