Childhood Stress and Depression

It is a common misconception that childhood is a time of innocence and "immunity" from stress and depression.

However, children have many stressors in their lives. They live in a world in which single parenting is common, economic security is fragile, television violence is pervasive, and accessibility to an extended family is limited. Add this to the stresses of normal development a child\'s coping skills are challenged.

The normal developmental milestones of growing physically, emotionally, socially, and intellectually cause stress in children. Certain temperamental characteristics make everyday events more stressful for some. For example, it's important to recognize that the child who is sensitive to sound, touch, or sight may have a difficult time in large groups. In addition, handicaps, illness, fears, developmental delay, and even giftedness can create stress in the young child.

Many external factors stress children, as well. Some of these occur within families and may include poverty, separation and divorce, the birth of a sibling, abuse, lack of positive relationships, inappropriate expectations and death. Others are present in society at large. Through the media, children become aware of substance abuse, witness violence and are enticed by material possessions and life styles often beyond their reach.

It\'s not always easy to recognize when your child is "stressed out." But here are some indicators that your child might be overly stressed:

Physical symptoms

• headache, upset stomach or vague stomach pain
  
• sleep disturbances, nightmares
  
• new or recurrent bedwetting
  
• decreased appetite, changes in eating habits
  
• other physical symptoms (with no physical illness)
  

Emotional or behavioral symptoms

• anxiety, seems worried or unable to relax
  
• new or recurring fears (fear of the dark, fear of being alone, fear of strangers)
  
• clinging, unwilling to let you out of sight (may or may not ask questions)
  
• anger, crying, whining, inability to control emotions, aggressive behavior, stubborn behavior
  
• regression to behaviors that are typical of an earlier developmental stage
  
• unwilling to participate in family activities
  
• unwilling to participate in school activities
  

Symptoms of stress are usually short in duration and the child "bounces back" quickly. However, you need to be aware that the symptoms for depression are the same as the ones for stress. To help determine if you child is depressed or "merely" stressed you need to ask yourself or your child these important questions:

1. How long has this been going on? Usually stressors change on a regular basis, (e.g., a final exam, a fight with a friend) and these changes will reflect in your child's mood. Your child may be stressing over his fight with his girlfriend, but then may rebound after a good day out with his male friends. If the symptoms of stress have been long term (more than two weeks) your child may be battling depression.
   
2. Changes in diet or long time habits are another indication that there is depression in the picture. If you fix your child's favorite meal to cheer her up after a low exam grade and she pushes it away, chances are she is stressed. However, if she continues to prevaricate on it and continues to push away her recently favorite things, a serious discussion about depression is in order.
   
3. Anytime a child says anything about killing/harming himself or others you need to respond quickly. Despite the prevalent terms floating around in society's language, it is important to take any comments like this seriously. Your child may insist that he or she was "just joking" or insist that "everyone says it", but it is imperative that you seek outside help if this is combined with stressors or depression.

   If you feel your child is battling depression it is essential that you obtain outside help and information. Contact your child's teachers. Express your concerns about your child and obtain any information about her schooling that maybe affecting her. Request that her teachers give you a written summary of what has been observed and also be sure to ask if they have any suggestions on what can be done to help your child. Find out if there is a counselor at the school that could talk with your child and give you some suggestions.

   Another important step is to have him checked by his physician. This will rule out any physical cause for the changes. When making an appointment with his doctor, be sure to explain the reason for it and express your concern for your child\'s mental health as well. Be sure to give the doctor the information you have obtained from the school as this will help in obtaining a possible diagnosis.

   If the physician wishes to place your child on medication, do not be afraid to ask about side affects, long-term use, addiction, withdrawal and especially alternatives. It is very important to be informed and often it is best to obtain a second opinion prior to starting your child on depression medication. Let the doctor know that unless otherwise indicated, medication therapy will be a short-term treatment.

   Medication can work very well at increasing emotional coping during depression. However, depression medication should not be viewed as a long term or lifetime alternative to developing coping skills. It is important that your child receive counseling in addition to drug therapy to help her self esteem and to help her build the skills needed to deal with these issues.

   The combination of psychological and medical treatments can be highly effective in reducing or eliminating depression and restoring your child's mental health once again.

   There are many good and reliable agencies that offer counseling on a sliding scale based fee and some insurance plans will cover family therapy.

   Please remember that this is not your child's "problem" it is necessary for the entire family to be involved in treatment!

   Above all, reassure your child that you are doing everything possible to help him through this and be sure to keep the lines of communication open with all of the people in his life.