Childhood Depression or Dysthymic Disorder

Dysthymic disorder is a more chronic, less severe form of depression.  The child needs to have at least 2 symptoms for most of the day, nearly everyday for at least a year.  A child’s symptoms can be such a part of who the child is that people may not notice much difference in a child’s functioning.  A parent, teacher or even the child may say, “She’s always been this way” or “That’s just who she is”.  A big red flag is that the child may have a very hard time feeling pleasure or may not remember what it’s like to feel happy.  

 

The symptoms of dysthymic disorder are mostly the same as depression.  In a child with dysthymic disorder their may be a change in weight or appetite and a change in sleeping habits.  The child may seem sad and hopeless but in some children their mood may be more irritable or cranky.  They may feel very angry and not know why.  They may be tired all the time, not wanting to do anything.  They may not be interested in anyone or anything, not wanting to play or spend time with anyone.  They may have a hard time concentrating. 

 

Children with dysthymic disorder may have a hard time remembering things.  They can have a hard time making decisions.  They tend to blame themselves and may think others blame them too.  They may brood or ruminate about past mistakes and bad experiences.  They may think their life will always be bad and that nothing good will ever happen to them. 

 

 

Children with dysthymic disorder may think they don’t deserve to have good things happen to them because they may think there is nothing good about them or that they’ll never be able to do anything.  They can have low self-esteem and no self-confidence.  They may have very poor social skills and may be socially withdrawn.  In my first few posts in Sept. and Oct. I wrote about the symptoms of depression in more detail.

 

When I worked with kids in community mental health some of them were diagnosed with dysthymic disorder.  Since I worked in community mental health a lot of the children I worked with lived below the poverty line.  Not all children who live below the poverty line have dysthymic disorder but poverty may be a contributing factor for some children. 

 

Poor children may not have as much to eat and what they do have may be less nutritious.  Poor children may experience more of the bad in life and that can cloud their view of the world, other people and themselves.  Poor children see the things that other kids have and hear about the places other kids go and may not understand why they don’t have the same things.  Being poor can be painful and frustrating for a child but not only poor children suffer from dysthymic disorder. 

 

A child living a very middle class or even upper class life can suffer from dysthymic disorder because of their biology, environment, trauma or relationship problems with their primary caregiver.  Like with depression and anxiety some children may be predisposed to having dysthymic disorder. 

 

If you see a child you think may be depressed but he doesn’t’ meet a lot of the criteria for depression, he may have dysthymic disorder.  Anytime you think a child has any emotional issues it is a good idea to get the child assessed.  Just remember that dysthymic disorder is a more chronic, less sever form of depression.  The child may have fewer symptoms but they may last a lot longer.  I hope my posts have helped you in some way.                

What Does Childhood Depression Look Like?

Childhood depression is finally emerging from the shadows.  More research is being done now than at any other time.  People are realizing that children can hurt and suffer too.  Many children are benefitting from therapy everyday but other children are still suffering.

 

You may ask, what does childhood depression look like or how can you tell a child is depressed.  Childhood depression can look different with each child because each child is different.  You may see depression in some children but not in others because some children can become very good at hiding their pain.  You may not be able to tell a child is depressed just by looking at them.  A child’s pain can come out in many different ways.

 

Anyone who has worked in community mental health or a psychiatric hospital will notice that many children receiving therapy have behavioral problems.  Their depression can come out as anger, aggression, irritability, yelling, talking back, throwing things, being mean or hurting others.  I’ve said it before, these children often get help right away. 

 

The prognosis of depressed children with behavioral problems can depend on how involved their parents are, family stressors and even socio-economic status.  Children who live below the poverty line may have a harder time because of the stress of poverty. 

 

Therapists in community mental health have started going to schools to provide therapy for children who can’t get to sessions any other way.  I have worked with both children and adolescents at their schools.  Children with behavior problems are identified quickly but that’s one of the problems.  Everyone focuses so much on children with behavior problems that they overlook the children who are good.

 

The pain of good children is often hidden because they are good.  They do well in school.  They make good grades and they never get into trouble.  They often sit with their heads down, doing everything thing they are supposed to.  If they show negative emotions, they are often ignored or even punished.  They learn that showing negative emotions is bad.  The often learn that crying or being sad is frowned upon so they hide their pain.  They learn to smile when they’re not happy and to hold their tears till they are alone. 

 

Good children tend to be more sensitive and they feel emotions more deeply but they may not know how to deal with or cope with their sensitivity and deep emotions so they turn their pain inwards, toward themselves; blaming and internalizing all the sadness, fear, guilt, anger and shame. 

 

Sometimes adults may get a glimpse of the pain a good child feels.  The child may look sad, lonely or tearful but a child who hides their pain can come up with an excuse.  It can be very hard identifying good children who suffer from depression.  Sometimes they are not identified till it’s almost too late.  That’s why it’s a good idea to have a child assessed for depression once a year. 

 

Children get a physical exam once a year so why not a psychological exam once a year?  A yearly assessment can identify children who need help.  Once a counselor or therapist breaks through the façade of a good, depressed child their emotions can flow like a raging flood.  The feeling a child gets when someone finally sees their pain is hard to describe.  Just knowing someone sees their pain is enough to give a child hope. 

 

Again I’ll ask, what does childhood depression look like.  The truest answer is that it depends on the child and some depressed children are hard to identify but a yearly assessment can help.  Thanks so much for reading.              

Childhood Depression and Generalized Anxiety

I’ve written about the struggles of children with social anxiety and separation anxiety but some depressed children can be anxious about many different situations and experiences.  Children with generalized anxiety may be afraid of many things. 

 

Children with generalized anxiety often have an intense fear of rejection.  They are constantly trying to please everybody.  They may be afraid if they don’t please everyone all the time no one will love them and losing a parent’s love can be one of their main concerns.

 

Children who are anxious about many situations often put a lot of pressure on themselves to be perfect.  They may do things like homework or other tasks over and over because if it’s not perfect it’s not good enough.  That’s another big fear; that they’re not good enough to be loved, liked or accepted.  They may think they don’t deserve love, family or friendship.  These children may need constant reassurance that they are good and that they are loved because they can have very low self-esteem and be lacking in self-confidence. 

 

These children are often very hard on themselves.  They can be their own worst enemy, their own worse critic.  They may think if they’re not a straight A student then they’re not smart enough, if they make mistakes then they have no value.  All the stress and pressure they put on themselves can lead to very negative views of the world, the future and themselves.  They may feel like they’ll never be happy, they’ll never be like anyone else, they’ll never be normal. 

 

Children with generalized anxiety worry about a lot of different things.  They may be worried that they’ll mess up and look foolish.  They may worry about natural or man made disasters like floods, tornadoes or terrorist attacks.  They may worry about getting an illness.  They seem to be worried about something all the time because they can’t control their worry.

 

Children with generalized anxiety can have a hard time concentrating or focusing on school work and other tasks but then again they may focus too much on the little details of school work and tasks to make sure they’re perfect.    

 

These children can be very forgetful.  Sometimes they are so anxious that their mind freezes up or goes blank. 

 

Children with generalized anxiety are often restless and on guard all the time because they are so afraid something bad will happen.  They play a lot of “what if” scenarios in their head, “What if I mess up? What if I look stupid?  What if everybody hates me and makes fun of me?  What if I get hurt?” 

 

These children can be very jumpy.  They can startle easily.  They may be clumsy.  They can be very uptight.  They may overreact to any accidents they have or mistakes they make, thinking it’s the worst thing in the world. 

 

Children with generalized anxiety can be irritable at times.  They may have trouble sleeping.  They may always be tight and tense.  This can cause muscle aches or soreness and may cause the child to clench their teeth which can cause jaw pain and earaches.  They have a tendency to tire easily.  Fear, anxiety and tension can be exhausting. 

 

These children may show physical signs of anxiety like a red, sweaty face or trembling hands or nausea and vomiting.  Being anxious all the time about everything and nothing is someone’s own personal hell but with help children can learn how to shut down their negative thoughts and live a relatively normal life.

 

Thank you so much for reading my posts.  I hope they are helpful in some way.  I welcome any comments.  I just ask that you be respectful.             

  never be normal.yone else, they'very negative views of the world, the future and themnselves  iences      

A Brief Post on How to Help a Child Who's Afraid of a Terrorist Attack

In this brief post I ‘d like to address how to help your child when they see there was a terrorist attack.  First assure them that they are safe.  Talk to them about the police, government agencies and the military and how they protect us all.  Then allow your child to express their fears through drawings or storytelling.  Ask them about what is going on in their pictures or what is happening in the story and why.  This helps them talk about how they feel. 

 

Then normalize their feelings.  Let them know that it’s OK to be afraid sometimes and that everyone is afraid sometimes.  Address their fears, again letting them know they are safe and that people are working to keep us all safe.    

 

Then tell your children how much you love them and let them know if they need to talk about their fears that you are always there for them to talk about anything that bothers or scares them. 

 

If your child is more anxious than others and continues to talk about their fears of a terrorist attack for more than a month or so, it might be a good idea to have them talk to a counselor or other mental health professional.  Unless of course their was another terrorist attack.  These seem to be trying times for everyone.  It's hard for parents and teachers to understand why this happens so imagine how hard it is for children.     

 

It’s terrible that we have to talk to our children about the bad things people do.  In a perfect world, children would always feel safe but the world is not perfect and it never will be.  It’s up to us to teach our children that there are bad people in the world but we can’t let those bad people rule our lives.  It’s also up to us to teach our children how to deal with the fear bad people can bring.  I hope this post has been helpful in some way.  Thanks for reading.

Childhood Depression and Separation Anxiety

I said it before, childhood depression and anxiety often go hand in hand.  Shy children are more likely to turn their depression inward toward themselves creating a fear that can be hard for the child or anyone to understand.  Because of their fear shy children tend to be more attached to their primary caregiver and can experience separation anxiety. 

The biggest fear a child with separation anxiety has is of losing their caregiver and being alone.  At home with their caregiver is the place they feel safest and most secure. 

There are different levels of fear and anxiety; mild, moderate and severe but it’s important to understand that these children feel a terrible dread when they are away from their caregiver.  The child is afraid something bad will happen to their caregiver or something bad might happen to them but from my experience the fear seems to be more about losing the person they love most. 

When a child with separation anxiety is away from their caregiver they can have physical symptoms like headaches, stomachaches and nausea to the point of throwing up.  They may need to stay in touch with their caregiver constantly phoning or texting; asking, “Where are you? What are you doing? Are you OK? Can I come home?” 

A child with separation anxiety may not want to go to school or anywhere without their caregiver.  The child may have a hard time concentrating when they are at school because they are focused so much on their fear and worry.  The child may cry because they want to go home and can be very difficult to soothe.  Just remember they are not being difficult on purpose.  They feel an anguish that is hard for them to control.  To them their fear is very real.      

 

When these children are with their caregiver they may cling to their parent’s legs or follow them around constantly.  In more severe cases the child may not want to go to a different room without their caregiver.    

 

Some children with separation anxiety may not even want to go to bed without their parent or caregiver.  When the child does go to bed he may need his caregiver to stay with him till he falls asleep.  Then if the child wakes up in the night he will often try to get into bed with his caregiver.  If the bedroom door is locked the child may sleep outside the caregiver’s door on the floor to try and be close to them. 

 

A child with separation anxiety may have recurrent nightmares of being lost or separated from his caregiver.  The child may dream about their caregiver getting hurt or killed in an accident or disaster.  He may dream about being kidnapped or taken away from home.     

Life is very difficult for an anxious child.  They carry the weight of all their fears on their tiny shoulders and can break from the stress and strain. 

Sometimes the world is a very scary place for children, especially children who have been hurt in some way.  I’m not saying all shy, anxious children have been hurt or abused but many have.  If you have or know a shy, anxious child please take notice.       

Many children, especially shy children, are overlooked and suffer in silence.  My greatest wish is that every child who needs help will be identified so they can get that help.  Thank you so much for reading my posts.  I hope they help.  I welcome any comments.  I just ask that you be respectful.   

Childhood Depression and Social Anxiety

Childhood depression and anxiety often go hand in hand.  Shy children who feel the pain of depression are much more likely to have problems with anxiety, especially social anxiety.

 

Many depressed children can have a hard time making friends or having normal friendships because of their social anxiety.  First I want to make clear the difference between social anxiety and autism. 

 

Children with social anxiety have the capacity to interact normally with other children and adults.  They want to interact and have friends but they can’t because they can be so afraid of rejection.  They’re afraid they may say or do something weird or stupid.  They’re afraid they’ll be made fun of.  They’re afraid of embarrassing themselves in some way. 

 

When a child feels this fear and anxiety her heart may race.  Her face can become flushed red and sweaty.  She may tremble.  Her voice may sound shaky and nervous.  These physical symptoms of anxiety can cause even more embarrassment which can cause more anxiety to the point where the child may have trouble breathing or moving.  It’s the fear response gone haywire. 

 

Most people have heard of the fight or flight response.  When a person experiences danger they need to prepare to fight that danger or run away but some people, including children with anxiety may be overly sensitive to fear and they may feel threatened in situations that aren’t physically dangerous but seem dangerous emotionally.  The fear of rejection from the world is a powerful and emotionally dangerous fear.   

 

When a child with social anxiety is put in a social situation she may try to hide anywhere she can like behind a parent or in a corner or behind furniture.  She may become so anxious she freezes up and doesn’t know what to do.  She may cry, struggle to get away or have a tantrum. 

 

These children may try to avoid social situations anyway they can, saying they are sick or have to go to the bathroom and because of this, children with social anxiety may have trouble attending school.  I know I missed more days than the average child because of my anxiety. 

 

A child may be anxious in certain social situations like public speaking or they may be anxious in most all social situations.  Social anxiety can cause a lot of problems with a child’s age appropriate social development.  They may seem younger or more immature than other children their age.  Anxiety often contributes to depression in children and vice versa.  Many times depression and anxiety are co-occurring and both may be diagnosed.    

 

I have said before that I began suffering from depression when I was 5 years old but I also suffered from anxiety.  When I was a child I was painfully shy.  I didn’t want to talk too or interact with people I didn’t know well.  I was afraid people would laugh at me.  I had very low self-esteem and no self-confidence.  I thought I was weird and ugly.  I thought no one could really like me because I was too different. 

 

Symptoms of depression like low self-esteem and low self-confidence can cause a lot of fear about how the child thinks the world sees her.  It’s a powerful fear of a world where she thinks she doesn’t belong.  I know from experience it’s a very painful fear and anxiety no child should have to suffer but shy, depressed children do suffer.  With help they can overcome their pain.  They just need to be identified so they can get help.

 

Do you think schools should assess children for anxiety?  I welcome any comments.  I just ask that you be respectful.  My next post will be about separation anxiety.         

Trauma

Childhood depression often begins after a trauma.  This post will be about the signs of trauma in a child.  Children, especially young children; can have a hard time identifying, explaining or understanding their emotions.  It’s very important for parents and anyone who knows or works with children to understand some of the signs of childhood trauma because children may not be able to express their fear and pain without help.  

 

A child who is having emotional issues related to a trauma may have recurring bad dreams about the trauma or can have bad dreams about monsters in general; under the bed, in the closet or chasing them.  Children may dream about a threat to themselves or others.  They may dream about rescuing someone they love from a threat or a monster.  Not every dream about monsters is a sign of trauma but if your child dreams about monsters often you may want to take notice.

 

Children who have experienced a trauma may become more high strung and jumpy.  They may startle more easily.  They may seem worried.  They may feel constantly afraid and constantly on guard so nothing can hurt them.    

 

Traumatized children may become more agitated or irritable than they were before.  They can feel guilt, anxiety, shame, anger, hopelessness and depression.  They may feel like they are bad or damaged and like they’ll never be normal.  They may feel like they are different and will always be different. 

 

After experiencing a trauma, a child can become socially or emotionally withdrawn.  They may not want to play with or interact with other children or family.  They may not want to talk much or give hugs and kisses.  They can become distant and may isolate themselves from others.

 

Children who’ve suffered a trauma may become more impulsive and irresponsible.  They may take more risks and do things that are dangerous or can cause them harm.  After a trauma a child may not care about consequences. 

 

A child may avoid situations or people who remind them of the trauma.  A child may avoid thinking about the trauma.  This can include having amnesia of part of the trauma.   

 

Children who are having emotional problems because of a trauma may re-live the trauma during play.  They may crash their cars together and talk about getting killed.  If they play with dolls, they may have one doll hurt or touch the other doll.  They may set up their toys then knock them all down, saying there was a tornado or flood.  If you are concerned, watch them play and have them tell you what their toys are doing or saying.

 

Traumatized children may have more physical health problems.  They may complain of stomachaches, headaches, nausea or other physical illnesses.  Like I said when I wrote about the symptoms of depression, a child may have more jaw pain or earaches.    

 

Children who’ve experienced a trauma may have a harder time making new friends.  The friendships and family relationships they already have may suffer because the child doesn’t want to interact with anyone.

 

Traumatized children may think they’ll never have a normal life.  They may think they will never grow up.  If a child has experienced several traumas, they may think life will always be bad or that their traumas are somehow normal. 

 

Some traumatized children may want to hide their trauma from their parents but with help from a therapist a child can come to terms with their fear and pain.             

 

How do you talk to your children about the bad things that can happen without scaring them? 

Do you think schools should assess children for traumatic experiences?  I welcome any comments.  I just ask that you be respectful.