For children, depression treatment may include psychotherapy either alone or in combination with antidepressant medication. Research indicates that the best approach for most children is a combination of both. Treatment can be provided by a psychiatrist. In more severe cases hospital care may be required.

There are a number of different types of psychotherapy available and treatment will vary between different children and different types of depression.

Causes of Childhood Depression

It is important when treating depression in children not to forget the cause and only treat the symptoms. Depression will often have an underlying social and psychological cause that cannot be address through the use of medication alone.

These can include a family breakup with two parents splitting up, a friendship break up or problems such as abuse or bullying at school. Temporary episodes of depression can be brought on by exam fears. Some children are less resilient, more sensitive, and less able to cope. As a result they can become depressed more easily.

Treatment usually consists of counselling or psychotherapy and antidepressants. Simply having them talk about their problems to family and friends is often a major step towards recovery

Antidepressant medication

Antidepressant medications are often an effective way to treat depression in children and adolescents. However, antidepressants can produce harmful side effects. The Food and Drug Administration (FDA) says that an extensive analysis of clinical trials showed that antidepressants may cause or worsen suicidal thinking or behaviour in children and adolescents.

However leaving depression untreated can itself lead to a higher risk of suicide.

Cognitive behaviour therapy.

Cognitive behaviour therapy has been shown to have a better success rate then antidepressants at beating depression for good and preventing a relapse into depression once treatment has stopped.

This is because the objective is to change the way something thinks and behaves. Therefore unlike drugs which treat the symptoms, cognitive behaviour therapy attempts to address the cause.

Often depression is caused by a faulty thinking process caused by a situation. This situation results in negative thoughts, emotions, physical feelings and actions.

Learning to change the way you think and behave to a situation can in turn change someone’s feeling. Cognitive behaviour therapy attempts to change the way you behave and think about yourself, the world and other people.

Conclusion

Remember, early detection and treatment of depression is important at any age — and family support is essential. If you suspect that your child is depressed, contact your child’s doctor or a mental health provider.

Antidepressant medications are often an effective way to treat depression in children and adolescents particularly in conjunction with psychotherapy. However, it is important to be aware of the possible side effects of antidepressants and the alternatives to antidepressant medication.

Which antidepressants are approved for use in children?

Prozac (fluoxetine) is approved for use in children and adolescents for the treatment of major depressive disorder. Prozac (fluoxetine), Zoloft (sertraline), and Luvox (fluvoxamine) are approved for use in children and adolescents for the treatment of obsessive compulsive disorder.

Other antidepressants for adults that are not approved for use in children include Paxil (paroxetine), Celexa (citalopram), Lexapro (escitalopram), Wellbutrin (bupropion), Effexor (venlafaxine), Serzone (nefazodone), and Remeron (mirtazapine).

However a doctor can use their medical judgment to prescribe other antidepressants for children.

What are the risks associated with Antidepressants?

Antidepressants can produce harmful side effects and complications. Antidepressants carry warnings about their possible link to suicidal behaviour.

The Food and Drug Administration (FDA) has required that black box warnings be placed on all antidepressant medications warning that they may result in increased risk of suicidal tendencies in children and adolescents. A black box warning is a safety warning that the FDA issues for some prescription medication.

You can find this warning on the package insert. It usually contains a black border that surrounds the text of the warning. [See Image]

The Food and Drug Administration (FDA) says that an extensive analysis of clinical trials showed that antidepressants may cause or worsen suicidal thinking or behaviour in children and adolescents.

The analysis showed that children taking antidepressants had about a 4 percent chance of developing suicidal thoughts or behaviour, compared with only a 2 percent chance in children taking a sugar pill (placebo).

The FDA in October 2004 issued a public health advisory and began requiring manufacturers to label antidepressants with strong warnings about the link to suicide in children.

However, not all mental health researchers believe these warnings are necessary. Some studies have reported opposite results — that suicide rates in children decrease when they take antidepressants.

Should any antidepressants be approved for use in children?

Just because there is a warning about a possible link between antidepressants and suicidal thoughts does not mean that antidepressants should not be used to treat depression.

The warnings that come with antidepressants should just be used to weigh up the pros and cons before using these medications.

Antidepressants can be an effective way of treating depression and often work well with psychotherapy. They are not used to just treat depression but other disorders including obsessive-compulsive disorder.

Depression and other disorders can prevent your child leading a happy and fulfilled life or engage in everyday activities. Depression can in some cases lead to suicide if it is not treated.

Should I take my child or adolescent off anti-depressants?

You should consult with your doctor responsible for your Childs medication to discuss the best course of action if you observe worsening depression or the emergence of suicidal thinking.

Do not halt the antidepressant medication without first consulting with the prescribing doctor as this can cause discontinuation symptoms if stopped abruptly. If your doctor advices that your child should stop then follow his advice carefully on how to do this.

What groups benefit the most from antidepressant drugs?

Antidepressants may be particularly helpful for children who:

• Suffer from severe, chronic or recurring depression
• Suffer from psychosis or Bipolar disorder
• Do not often have access to therapy
• Suffer from Dysthymia depression

Are there alternatives to antidepressants?

Huge improvements to mood and overall health can be gained by what you eat. What you eat affects brain chemistry.

Making changes to your children eating habits can dramatically effect their mood. The following changes have been recommended:

Give them a balanced diet and a rich nutritional supplement. Low levels of serotonin levels in the brain are known to have a significant impact on mood and many factors that contribute to low serotonin production are created by nutritional deficiencies.

Limiting consumption of carbohydrates. While you should not eliminate all complex carbohydrates limiting carbohydrates can reduce depression.

Limit food and drink containing colourings and preservatives.

Exercise releases endorphins which creates a natural euphoria and reduces stress.

Sunlight contributes to mood and there is a real connection between vitamin D deficiency and depression. It’s commonly known that natural sunlight stimulates vitamin D production in the body.

According to a number of studies including the Journal of the American Academy of Child and Adolescent Psychiatry up to 2.5 percent of children and up to 8.3 percent of adolescents in the U.S. suffer from depression.

If you believe your child is suffering from depression, talk to your doctor or mental health provider. A test for depression will usually involve a question and answer session with your child. A Diagnosis is usually based on their medical history and symptoms, so your doctor will need to talk to the child first.

Psychiatric Depression Tests

There is no clinical test for depression, but there are a number of psychiatric tests and questionnaires to measure depression. The two main methods used in psychiatry come from guidelines published by the American Psychiatric association and the international guidelines provided by the World Health Organization.

1. Diagnostic and Statistical Manual of Mental Disorders.

Published by the American Psychiatric Association it is a classification system based on all the known recorded symptoms associated with a particular mental condition. Your doctor will ask your child if they have certain symptoms, depending on their answers, they should be able to identify what the condition is.

2. International Classification of Diseases.

Developed by the World Health Organization and used for a whole range of illnesses including mental illness this method is based on the known symptoms associated with a particular mental illness.

Diagnosing Depression in Children

A test for depression is more difficult with children then with adults. Children are usually less capable of expressing their feelings and will express their moods in a more physical way. Some may be withdrawn and tearful, others may become irritated and hyperactive.

Secondly depression can go unrecognized by families and physicians as signs of depressive disorders in young people are often viewed as normal mood swings typical of adolescence. Also health care professionals can be slow to ‘label’ a child with a mental illness diagnosis.

However early diagnosis and treatment of depressive disorders are critical to healthy emotional, social, and behavioural development.

A test for depression usually involves asking the child if they suffer from certain symptoms which are commonly associated with depression. These may include

• Tiredness, headaches, stomach aches or vague physical complaints which appear not to have a tangible cause.
• Insomnia, sleeping irregularly, too often or not enough
• Changes in weight
• Irritable, sulky, being quite and introverted
• Loosing interest in favourite activities or hobbies
• Decline in school performance and exams
• Poor self esteem or regular feelings of worthlessness
• simply appearing unhappy much of the time
• major changes in weight
• contemplating suicide

If depression is diagnosed then it is important to find out what form of depression your child is suffering from.

Depressive disorders include a number of different types. These include major depressive disorder (unipolar depression), dysthymic disorder (chronic, mild depression), and bipolar disorder (manic-depression).