depression in young people
by Claire Laurent
For many years it was thought that children did not experience depression or anxiety, and that those who appeared quiet or moody, angry or sullen were merely going through 'a phase'.
© www.johnbirdsall.co.uk
It's now accepted that depression can occur in children and for some it affects their ability to get on with their lives. However, it is important to make a difference between 'feeling depressed' and 'having a depressive illness'.
Just as adults can feel low or upset over a loss of a loved one or disappointed by a particular event such as failing an interview or exam, so can children. But they can grow from these experiences and get on with their lives. Occasionally some are more overwhelmed by their experience and they may feel depressed for a longer time. This is not the same as having a depressive illness or clinical depression.
Clinical depression is more long lasting and may recur. Feelings of hopelessness and worthlessness come to dominate a person's life to such an extent that they find it hard to function normally. It may develop from long periods of feeling depressed; or it may exist within the person as a part of their individual genetic and biochemical makeup.
Clinical depression is treatable and the sooner it is identified and treated the quicker the episode will pass. Early treatment in children is particularly important as it can prevent depression becoming a feature of their adult life.
who develops depression?
About 2% of children under the age of 12 are depressed to the extent they would benefit from seeing a child psychiatrist, while around 4-5% of children in this age group are thought to show significant distress, bordering on depression. The rate goes up with age, with about 5% of teenagers being significantly distressed.
Social issues such as broken homes, poor community support and raised neighbourhood crime rates are all contributory factors to depression, and in areas where these factors are common the rates of depression amongst young people may be significantly higher, says Young Minds, a charity concerned with the mental health of young people (see help and info). For more, see what causes depression?
A study by the Office of National Statistics (2000) of more than 10,000 children and young people looked at the prevalence of a range of mental disorders among 5- to 15-year-olds in Great Britain. It found that the proportion of children and young people with any mental disorder was greater among boys than girls: 11% compared with 8%. However, other studies have shown that depression on its own is twice as common among teenage girls than boys.
recognising depression
'I couldn't concentrate on my work. I was always daydreaming, and wanted to sleep a lot. I couldn't be bothered to do anything. Sometimes when I felt really low it was scary, and I'd start messing about at school, getting into trouble. Anything not to feel like that ...'
Depression affects people differently but there are many symptoms which are common to all, whether they are children, teenagers or adults. These are:
- persistent feelings of sadness and irritability
- feelings of worthlessness, hopelessness or inappropriate guilt
- loss of interest in activities once enjoyed
- difficulty concentrating and remembering
- difficulty sleeping or excessive sleeping
- loss of energy or increased agitation and restlessness
- significant change in appetite or body weight
- feeling isolated from other people, even those who are close
- thoughts of suicide or death.
Five or more of these symptoms persisting over a period of two weeks might suggest a depressive illness. Recent research among more than 1,000 15- to 21-year-olds, commissioned by the Department of Health, found that 86% knew of someone who had experienced a mental health problem and that 76% knew someone who had been depressed.
There are also signs that are more particularly associated with depression in teenagers and children. These are:
- frequent vague complaints of physical illness such as headaches, stomach aches, muscle aches or tiredness
- frequent absences from school or poor performance in school
- talk of or attempts to run away from home
- outbursts of shouting, complaining, unexplained irritability or crying
- being bored, loss of interest in usual hobbies and activities
- loss of interest in playing with friends
- extreme sensitivity to rejection or failure
- reckless behaviour
- alcohol or substance abuses
- fear of death.
Of course young people are often moody and uncommunicative and children may complain of stomach aches or being bored at any time. But if the signs persist and seem worse than usual it's worth spending time with the child to encourage them to talk about how they feel.
Read the Signs is a new government campaign aimed at 14-21 year olds to encourage them to understand mental health issues and to try and tackle the stigma that still exists around mental illness. For more information on this campaign and for more about mental health problems see help and info.
other forms of depression
bipolar disorder
Although rare, bipolar disorder – also known as manic depression – can appear in both children and young people. It's characterised by swings in mood, energy and functions and may begin with manic, depressive or mixed manic and depressive symptoms. A young person may demonstrate manic symptoms by being extremely irritable or overly silly and elated. He of she may have a decreased need for sleep, and talk at an increased rate. Depressive symptoms may be any of the above. It is more likely to affect the children of parents who have the disorder.
what causes depression?
As with adults, there isn't always an obvious reason why children and young people become depressed. It may seem to appear out of the blue. However, there are likely to be a combination of causes ranging from the severe such as bereavement or experiencing physical, sexual or emotional abuse, through to bullying, parental divorce and changing schools, as well as worrying about growing up.
Having a parent who is depressed or always anxious also increases a child's risk of experiencing depression. The ONS study found that children with parents who screened positive for mental disorder were three times more likely to have a mental disorder than those who scored zero on the questionnaire. The greater the level of household income, family employment and parental education the less likely it was for the children to experience a mental disorder.
Children in two-children households had the lowest rate of mental disorder compared with those who were part of four- and five-children households. Children of lone parents were about twice as likely to have a mental health problem than those living with married or cohabiting couples. This is largely due to the circumstances in which many lone parents have to bring up their children, such as low income and a lack of family and social support.
getting help
'After I felt depressed a few times I knew I'd always come out of it and just tried to do things to distract myself till it passed. That helped a bit. It was horrible thinking it might come back though. In the end I went for counselling, which helped me feel more in control of my life.'
Children and young people need a caring adult to support them and understand them when they are feeling depressed. Family members can help by encouraging them to talk about their worries, listening and making suggestions to solve some of the issues.
If you think that their unhappiness is more than a passing phase, do contact your GP. Some GPs are good at teasing out what may lie behind persistent stomach aches and emotional outbursts and, if there are problems at home, children may feel happier to talk to someone who they don't perceive as part of the problem. GPs can also outline the different kinds of help available and perhaps refer you to a specialist if necessary.
A school counsellor, teacher, pastoral head or special needs co-ordinator are all people who might be helpful and interested to discuss your child's difficulties and support him or her.
Waiting lists for access to child and adolescent mental health services (CAMHS) can be lengthy in some places but many GPs now have practice counsellors who may help a young person address some of the issues troubling them. In addition, GPs, health visitors and social workers are increasingly receiving basic training in dealing with some of the more common mental health problems people face.
treatment
Treatment for depression in children and young people may involve short-term psychotherapy, medication or a combination of the two, together with target interventions at home or school.
psychotherapy
Research has shown that certain types of short-term psychotherapy, particularly cognitive behavioural therapy (CBT) can help alleviate depression in children and adolescents. CBT aims to help people understand and change negative attitudes they may hold and think more positively.
For more on CBT, see cognitive behavioural therapy in the mind section.
The dynamics within a family may be part of the problem for a young person with depression. Family therapy involves the whole family looking at how it deals with issues and if changes can ease some of the pressures within.
Individual psychotherapy can be helpful for some adolescents who are feeling very depressed.
medication
Antidepressant medications have been shown to be effective in adults, particularly when combined with psychotherapy. There has been less research done on their effect on children, but work in recent years has shown that some of the newer antidepressant medications, in particular the selective serotonin reuptake inhibitors (SSRIs) have been shown to be safe and effective in young people.
For more information see the feature on antidepressants and tranquillisers in this section.
For more on treatment see other websites listed under help and info.
You might also like to check out our feature on bereavement as well as other features on depression and manic depression and suicide in this section.
Thanks are due to YoungMinds for permission to use quotations from their publications in this feature.
help and info
Channel 4 is not responsible for the content of third party sites.
organisations
The Anna Freud Centre
21 Maresfield Gardens
London NW3 5SD
Tel: 020 7794 2313 (Mon-Fri 9am-5pm, answerphone available)
E-mail: info@annafreud.org
Website: www.annafreudcentre.org
Helps children and families with behavioural and emotional problems.
British Association for Counselling and Psychotherapy
35-37 Albert Street
Rugby CV31 2SG
Tel: 0870 443 5252 (Mon-Fri 8.45am-5pm)
E-mail: bacp@bacp.co.uk
Website: www.bacp.co.uk
BACP can provide you with a list of private counsellors in your area, plus information on counselling and choosing a counsellor.
CALM: Campaign against living miserably
Freephone: 0800 58 58 58 (Every day 5pm-3am)
Website: www.thecalmzone.net
Confidential, anonymous freephone helpline aimed at young men aged 15-35 living in Manchester, Merseyside, Cumbria and Bedfordshire who may be feeling low or depressed. Offers telephone counselling and information about other sources of help locally.
ChildLine
45 Folgate Street
London E1 6GL
Helpline: 0800 11 11 (Freephone 24 hours)
Textphone: 0800 400 222
The Line: a special helpline for any young person living away from home. This is the helpline for you if you live in a foster home or a children's home, if you're at boarding school or you've been in hospital for a long time. You can call The Line on 0800 88 44 44 from 3.30pm to 9.30pm on weekdays and 2pm to 8pm at weekends.
Website: www.childline.org.uk
UK's free, 24-hour helpline for children and young people. Trained volunteer counsellors provide comfort, advice and protection. Lines can be busy so please try again if you don't get through the first time. Young people can write to the following freepost address: ChildLine, Freepost 1111, London N1 0BR.
Depression Alliance
35 Westminster Bridge Road
London SE1 7JB
Telephone: 0845 123 23 20
E-mail: information@depressionalliance.org
Website: www.depressionalliance.org
National network of self-help groups for people experiencing depression. Offers a quarterly newsletter, national pen friend scheme and correspondence service with advice, guidance, support and fellowship to people experiencing depression, and their carers. Produces booklets and leaflets on various aspects of depression.
Samaritans
c/o Chris
PO Box 90 90
Stirling FK8 2SA
Helpline: 08457 90 90 90 (24 hours)
E-mail: jo@samaritans.org
Website: www.samaritans.org.uk
The Samaritans exists to provide confidential emotional support to any person, irrespective of race, creed, age or status who is in emotional distress or at risk of suicide; 24 hours a day. Can be contacted by e-mail, telephone, writing, or by visiting one of over 200 local branches (details are on the website).
YoungMinds
102-108 Clerkenwell Road
London EC1M 5SA
Tel: 020 7336 8445 (Just for info and publications)
Parents Information Service: 0800 018 2138 (Mon & Fri 10am-1pm; Tue-Thur 1-4pm)
E-mail: enquiries@youngminds.org.uk
Website: www.youngminds.org.uk
National charity committed to improving the mental health of all children and young people. Campaigns for better provision of child and adolescent mental health services. Provides information to anyone with concerns about the mental health or emotional well-being of a child or young person. Can give information on mental health issues, and details of local and national advice services. Leaflets for young people, and other helpful information are available on their award-winning mental health site.
Youth Access
1-2 Taylors Yard
67 Alderbrook Road
London SW12 8AD
Helpline: 020 8772 9900 (Mon-Fri 9am-1pm, 2-5pm)
E-mail: admin@youthaccess.org.uk
Website: www.youthaccess.org.uk
A national membership organisation for youth information, advice and counselling agencies. Provide details of and referrals to local youth agencies and counselling services for young people aged between 14 and 25, but do not offer direct advice.
websites
@ease
www.rethink.org/at-ease
Mental health resource for young people under stress or worried about their thoughts and feelings. Features information on causes of stress and practical advice on how to feel better.
British Confederation of Psychotherapists
www.bcp.org.uk
National body linking mostly long-standing training and professional organisations in the field of psychoanalysis, analytical psychology, psychoanalytic psychotherapy and child psychotherapy.
Change Our Minds
www.changeourminds.com
Produced by The Samaritans, the aim of this website is to prompt people to reconsider their attitudes towards emotional health. Includes information on stress, self-harm and teenage depression.
Children And Young People With Mental Health Problems
www.mhf.org.uk/html/content/children.cfm#
Information from the Mental Health Foundation on mental health problems in children and young people, such as depression.
Depression in Children and Young People
www.rcpsych.ac.uk/.../childrenandyoungpeople.aspx
Factsheet from the Royal College of Psychiatrists. Part of the Mental Health and Growing Up series of factsheets available on the website.
Depression
www.youngminds.org.uk/publications/booklets/depressed.php
This online booklet produced by YoungMinds explains the reasons why, and the ways in which, young people may get depressed. Discusses the various signs depression and suggests a range of activities which young people may find helpful to combat it.
The Mental Health of Children and Adolescents in Great Britain:
http://www.statistics.gov.uk/statbase/Product.asp?vlnk=3983
The summary findings of a survey of mental health among children and adolescents, aged 5-15, in England and Wales. The survey was last updated in July 2004. It was commissioned by the Department of Health, the Scottish Health Executive and the National Assembly for Wales.
Read the Signs
www.readthesigns.org
Aimed at young people, this website provides information about mental health, including depression, and has real life stories, and details of further help.
TheSite
www.thesite.org
Provides information and advice on a range of issues affecting young adults aged 16-25. Areas covered include sex, relationships, money, legal, health, mental health, drugs, careers, housing.
SpeakUp!
www.speak-up.org.uk
This interactive website will enable people aged 16-25 to share their experiences of mental health services with each other as well as professionals, carers and people involved in community projects. Participants will be able to express their views openly, ask questions and exchange ideas online. It is hoped that this site will help to improve mental health provision across the UK.
STEADY
www.steady.org.uk
A self management training programme for young people with the mental health diagnosis of bipolar disorder (manic depression) or extreme mood swings. The Steady training course is open to residents of the British Isles aged 18-25.
Understanding Childhood Distress
www.mind.org.uk/Information/Booklets/Understanding/Understanding+childhood+distress.htm
Produced by Mind, this booklet is for anyone wanting to know more about childhood distress. It describes how to tell if something is wrong with a child or young person, what sort of help to give and who to contact for further support or advice.
reading
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Childhood Depression Sourcebook by Jeffrey Miller (Contemporary Books Inc, 1999) |
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Counselling and Supporting Children in Distress by Sonia Sharp and Helen Cowie (Sage Publications, 1998) |
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Growing Up Sad: Childhood Depression and Its Treatment by
Leon Cytryn and Donald H. McKnew (W W Norton and Company Ltd, 1998) |
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'Help Me, I'm Sad': Recognising, treating and preventing childhood and adolescent depression by David Fassler and Lynne Dumas (Penguin Books, 1998) |
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Stress and Depression in Children and Teenagers: Overcoming common problems by Vicky Maud (Sheldon Press, 2002) |
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Unhappy Children: Reasons and remedies by Heather Smith (Free Association Books, 1995) |
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(February 2003, resources updated June 2005)
