Definition

Depression is a mood disorder that is defined as feelings of sadness, anxiety, or loss of passion that can interfere with daily activities. Nowadays, increasing awareness of mental health continues to be promoted, one of which is depression in adults. But in fact, not only adults can experience depression. It is known that depression can also occur in children.

A child who looks sad is not necessarily experiencing depression. However, if the feeling of sadness felt by a child occurs continuously and affects various aspects of his life, such as relationships in the environment and the family, hobbies, and activities at school, this could be because the child is experiencing depression.

Research shows that children who are depressed tend to experience depressive episodes again when the child grows up. Children with depression who are not treated well will have more serious mental health problems. Making a diagnosis and monitoring children with depression is a crucial thing that must be done.

As a parent, you may deny that your child is depressed. You may choose not to seek help for your child's problems because of the stigma against depression in society. However, depression in children can affect a child's development, so appropriate treatment is needed. Keep in mind that depression is not a condition that will go away without proper treatment. Proper treatment is important so your child can grow physically and emotionally well.

Causes

Similar to depression that occurs in adults, depression in children is also caused by various combinations of things related to physical health, life events, family history, environment, genetics, and hormonal and biochemical imbalances in the brain.

Risk factor

Several factors can increase a child's risk of depression, including:

• Children with a family history of depression are at higher risk of experiencing depression or other mental health disorders
• Children who have conflicted families
• Children and teenagers who abuse substances such as alcohol and drugs
• History of bullying, physical, emotional or sexual abuse.

Symptoms

The symptoms of depression that manifest in children may differ from one child to another. Depressive conditions in children tend to go undiagnosed and do not receive appropriate treatment because the symptoms are considered normal emotional and psychological changes that occur in children. Some symptoms in children with depression can include:

• Anger or irritable
• Feeling hopeless and sad that occurs continuously
•  More sensitive to rejection
• Withdrawal from society or the environment
• Changes in appetite can be an increase or decrease in appetite
• Changes in sleep patterns, including sleeping too much or not being able to sleep
• Crying or screaming
• Difficulty concentrating and thinking
• Feeling tired and less enthusiastic
• Complaining about problems with the body, such as stomach aches and headaches that don't go away even after being given medication
• Experiencing difficulty in carrying out activities at home or with friends at school while doing extracurricular activities, hobbies, and other things that the child previously considered interesting
• Feelings of worthlessness or guilt
• There are thoughts or ideas about ending life or committing suicide

Diagnosis

During the examination, the doctor will conduct a mental health evaluation through an interview with your child and you or the person who takes care of your child. The doctor can also conduct further examinations by conducting a series of psychological tests on your child. Information from teachers, playmates, and friends at your child's school can help doctors make a diagnosis.

Until now, there has been no medical examination or psychological test that can clearly show depression. However, examination tools, such as questionnaires filled out by the child and parents about personal information, are helpful to make a diagnosis. Not infrequently, therapy sessions and questionnaires can also help find other illnesses that contribute to depression in children, such as ADHD, adjustment disorders, and OCD.

Management

The options for treating depression in children are similar to those used in adults, such as psychotherapy or counseling and medication using drugs.

Apart from psychotherapy, your doctor may recommend CBT or cognitive behavioral therapy. CBT is a form of therapy used to treat depression, especially in older children. CBT helps children to change negative thoughts into more positive ones, changes the child's way of thinking to be more effective, and directs children to better behavior.

Doctors may recommend psychotherapy or CBT first and then consider administering antidepressant medication if there are no significant changes after psychotherapy or CBT. A combination of psychotherapy, CBT, and antidepressant medication is the most effective treatment.

It should be remembered that administration of antidepressant drugs must be carried out under the supervision of a doctor because the use of antidepressant drugs can cause an increase in suicidal thoughts.

Complications

Children who suffer from depression are more likely to experience depressive episodes again as they age. Furthermore, they tend to use illegal substances, abuse alcohol, and even want to commit suicide or attempt suicide.

Based on the latest research, it is known that suicide is the third leading cause of death in children aged 5 to 14 years.

Prevention

Children tend to express themselves through games and words. Spend more time with your child to know about their feelings. Talking to someone other than parents helps children feel supported. Grandmothers, grandfathers, uncles, aunts, teachers, or even counsellors can provide support by listening to their stories and complaints. 

Eating fruit, vegetables, and protein-rich foods, doing physical activity for at least 60 minutes every day, getting enough sleep, and implementing relaxation and mindfulness techniques are some examples of healthy lifestyles that can be done to prevent depression in children.

When to see a doctor?

If your child shows symptoms of depression that last for two weeks or more, it is important to take them to the doctor immediately to determine whether these symptoms are indeed signs of depression or not. It is crucial to pay attention to any symptoms that suggest suicidal thoughts, such as:

• Have many symptoms of depression (such as changes in eating patterns, sleeping patterns, and changes in daily activities)
• Socially isolated, including from family
• Talking about suicide, death, hopelessness, and helplessness
• Tends to do risky things
• Frequent accidents
• Using prohibited substances
• Frequent crying or decreased emotional expression

If you suspect that your child might be experiencing depression, it is essential to take them to the doctor immediately. It is crucial to maintain open communication with your child, even if they may seem withdrawn. Listen carefully to your child's story and avoid telling them what they should do. Instead, provide them with a supportive and safe environment where they can express their feelings.