Post on 26-Mar-2015
transcript
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Depression in children
Dr.Ksh. Chourjit SinghProf. of Pediatrics
Regional Institute of Medical Sciences, Imphal
National Chairperson, Growth & Development Chapter, IAPNational Executive Board Member
Advisor HIV/AIDS in Children Task Force, Manipur State.Past President, East Zone, IAP
President, NNF, Manipur State Branch
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Introduction
Depression in school-age children and adolescents remain a long-overlooked Health problemAs prevalent as in adultsCommon cold of mental illness – Clinical DepressionSpecially in childhood – is a major health problem
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Severity of Problem
5% children at any given time1% of Pre-school children 2% of school-age children 5% of adolescents are affected 25-50% of all children & adolescents in Psychiatric treatment are for depression & its related problems More common in boys than girls – 5:1 school-age childrenAdolescent girls than boys - 2:1
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Severity of Problem ….
Untreated Depression can be taken as important cause of suicide in
adolescents, even adults
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Why depression in young ?
A) Risk factors
Children referred to mental health providers for school problems
Children with medical problems
Asthma
Diabetes
Epilepsy
Many chronic childhood diseases
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Why depression in young ? …….
Law and order problems
Frequent bandh/ strikes
Frequent school closures
Ethnic group clashes
Insecure feelings
Conflict environment
Watching television a lot i.e. more than 6 hours a day
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Risk factors …..
Rural vrs Urban children
Sexually harassed children
Children with family history of depression
Genetically potential
What is happening in an individual child’s life
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B) Why depression runs in families
Genetics Even if a child never contacts with depressed parents,
child may also likely to be depressed
Marital difficulties Broken family/ marital problems Divorce plus depression in parents
Parenting problems Hard to be good parent when depressed Parenting problems whether from parents or from child
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C) Can experience depression at any age –
Presentation?
Shortly after birth & very youngFailure to thriveDisrupted attachments to othersDevelopmental delaysSocial withdrawalSeparation anxietySleeping and eating problems
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C) Chance of depression at any age…
Between 6-12 years of ageFatigueSadness Inability to feel pleasure Irritability & InsomniaLack of self esteemStomach ache and headache
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C) Chance of depression at any age…
HallucinationsAgitation & extreme fearsWeight changes Difficulty with school workApathyLack of MotivationSocial withdrawal
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C) Chance of depression at any age…
AdolescentOver-sleepingSocially isolatedActing out in self destructive waysSense of hopelessnessDespairing thoughtsWeight changes
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Future of depressed school-age children
If untreated in time – affects the children
School performance and learning
Social interaction and development of normal peer relationships
Self-esteem and life skill acquisition
Parent-child relationship & sense of bonding
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Future of depressed school-age children….
Lack of trust – can lead to Substance abuseDisruptive behaviourViolence and AggressionLegal troubles and even suicide
Depression thinking can become part of a
child’s developing personality, leaving long-term effects in place for the rest of
the child’s life.
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Behavioural changes – What?
Professional attention decreases
Classroom disruption
Expulsion from school
School failure
Injury to themselves or others
Symptoms ADHD
Truancy
Delinquency
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Stress in students leading to depression
Parental pressure to perform and to stand out among other children
If not come up to expectationsFrustrationPhysical stressAggressionUndesirable complexes
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Stress in students leading to depression…
Under-Performers
Negative traits
Shyness
Unfriendliness
Jealousy
World to loner
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Over-scheduling a student’s life
Non-availability of time for extra-curricular activities after schoolNo proper place for ventilation & breathing spaceUnwanted learning like music, painting or outstanding in sportsToo many crammed schedule & unmindful of the children’s choiceUnadjusted school systems and tremendous amount of homework – spending their evenings, weekends and vacations
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Over-scheduling a student’s life…
Loss of interest in studiesUnder-perform due to excess academic pressure
Students often carry enormous amount of anxiety and negative personal traits & massive attention problemsNon-effortless learningPhysio-Psychological transition of studentsMainly affected elementary to Junior High School
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Diagnostic Points
Transient depression or sadnessImpairment in child’s ability to functionTwo typesDysthymic disorderMajor depressions
Dysthymic disorder – less severe but lasts longerChronic depression/Irritability > 1 year
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Diagnostic Points ….
Onset about 7 years of age2-6 symptoms within 5 yearsLeads to major depression/ Double depressionUntreated Dysthymic disorder will experience Remission within 6 yearsPrevalence of depression increases with age – 5 percent of all teens
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What can be done
Diagnostic evaluation – success to treatmentAll disorders be discovered and addressed Medication Mood stabilisers Anti-anxiety Anti-depressants Stimulants
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What can be done…Individual therapy
Often beneficial for patients & specially help with issues
Family conflicts
Self-esteem
Relaxation strategies
Mood and anger control
Better communication
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School environment
Interaction
School Counsellor
Principal
Psychologist
Teachers and Parents
Psycho-educational treatment
Speech and occupational therapy
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School environment…
Counselling
Curriculum modification
Resource classes
Behavioural modification system
Self-contained classrooms
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Home/ Parental environment
Family and Home modification\
Homely life environment
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Family therapy
Defining Family members role and responsibility
Better communication & behavioural Reward systems
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Don’t overload your child with too many after-school activities and
responsibilities.
Let children learn to pace themselves.
Don’t enrol them in every class along and don’t expect them to be first in
everything.
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Thank you