What is MDD?
Major depressive disorder is a confronting and serious psychiatric illness which can severely impact the psycho social development of the child, however it remains largely misunderstood, misdiagnosed and undertreated. Parents struggling with this disorder in their children will first seek help from the local GP who is often ill-equipped to diagnose and treat the condition.
My intention in this post is to help parents recognize the symptoms and manifestations of MDD in their children and to equip them to seek answers from qualified practitioners.
[I am not a practitioner but have researched the topic and would encourage anyone who is concerned to do the same. This post is to share some of what I have learned in lay language]
These children are generally in the age range of 5 to 12 so pre-adolescent. It is more common than people would like to believe and early intervention will achieve the best outcome in treating a child displaying symptoms of MDD. Therefore, it is important for concerned parents to seek help early and follow up. It is also important to note that the younger a child presents with severe depression or MDD the more difficult it is to overcome and those very young children are more than likely to become adults who will continue to suffer serious depressive illness. Research has demonstrated that many adult disorders have their origins in childhood and conversely most childhood mental illness will continue into adulthood.
It is Difficult for GP’s and Parents to Acknowledge
Children are generally thought of as happy fun-loving and carefree young people who when they display symptoms of MDD they are thought of as spoiled or just extremely badly behaved children. Parents who bring a severely depressed child to the local doctor for answers are often confronted with disbelief or cynicism and leave frustrated. Doctors need to be informed of and aware of the illness and know the best course of action for further treatment so the child can be referred to a specialist physician working in the area of child mental health issues.
Risk Factors For Children With MDD
Previous to as recent as 1980 it was not agreed that children can suffer a severe depressive disorder. But in the years since there has been further study and acknowledgment that some children do meet the diagnostic evidence which confirms MDD. according to the American Psychiatric Association’s Diagnostic and statistical manual of mental disorders .
They have noted an increase among young children in
- the number and severity of depressive illness
- tendencies to attempt or suicide at a younger age.
- need for medical and psychiatric help
They have also noted a decrease in the social, educational and general quality of life for children suffering MDD. If the illness is allowed to continue into the teenage years and beyond it can have serious implications for the sufferer and those around them.
Most children who present with MDD will have experienced intense stress over a prolonged period
Some of these might be:
Consistent disharmony within the family.
Marriage breakup and divorce
Violence within the home
Physical and sexual abuse
Bullying at school
Constant moving between foster families
Refugee trauma ad anxiety
A severe traumatic event such as bush fire where lives are at risk.
A genetic disposition to depressive illness.
Symptoms of Major Depressive Disorder
- Constant depressed moods
- Extreme temper or outbursts of anger beyond normal
- Lack of interest in social activities
- poor sleeping patterns
- lack of or very poor levels of concentration
- physical symptoms such as aching or pain in various parts of the body
- thoughts of or talking about suicide and death
- blaming themselves for all the bad things happening around them
- poor appetite and failing to thrive
- social withdrawal and not wanting to attend school or other social connections.
- inability to relate to others around them.
- self injury or self mutilation
When To See the Doctor
If you observe several of the above indicators it would be prudent to talk to a doctor. It would also be wise to eliminate any physical underlying illness which might be contributing to the depressive behavior in the child. Unless all other contributing factors are addressed the chance of an accurate diagnosis will be severely impeded and may never be conclusively reached.
Some children showing signs of depression may not be picked up in the home but by family friends of school teachers. For the concern to be followed up the teacher should voice his/her concerns to an appropriate advocate for the child. If abuse is suspected then it may be time to contact the police or family services.
It is important to note that not all depression in children can be clinically diagnosed as MMD. There are other depressive illnesses which may be present and may display similar symptoms.
However, it does not matter if it is one kind or another the important factor is to have it treated effectively as early as possible so that it does not progress beyond the childhood years teenage years and then to adulthood. Depression at any age can be very debilitating and severely impact the quality of life for the sufferer as well as all those around them. Early intervention and treatment will deliver the best outcome.
- Begin by addressing general physical health issues such as diet, exercise and ensuring they are getting adequate sleep.
- Try as much as possible to encourage the child to express how they are feeling and actively seek ways to address those feelings if they indicate a malfunctioning such as feelings of extreme sadness or wanting to self harm. They may require professional counseling and support from concerned adults around them such as teachers and grandparents.
- Encourage pleasurable activities with other children and engage them in activities which will draw out a positive response. Ensure them that they are loved and valued.
- Seek further professional help if there is no evidence of improvement after a couple of months of working together with a team of people concerned for the welfare of the child.
- Work with the child ‘s siblings through all the above strategies so that they are in the loop as to what you are trying to achieve and that they understand that one child is ill and needs some extra help at this time.
A helpful site for understanding depression in children can be seen here: Health Direct
The Following Ted Talk by Nadine Burke Harris, who is a pediatrician states : and I quote from her Ted Talk summary Childhood trauma isn’t something you just get over as you grow up. Nadine explains that the repeated stress of abuse, neglect and parents struggling with mental health or substance abuse issues has real, tangible effects on the development of the brain. This unfolds across a lifetime, to the point where those who’ve experienced high levels of trauma are at triple the risk for heart disease and lung cancer. An impassioned plea for paediatric medicine to confront the prevention and treatment of trauma, head-on.