Anand is 8 years old and is a quiet, obedient 3rd grader. Lately, his teacher has noticed that he is having trouble concentrating in class. His mind wanders during classroom tasks, he has trouble remembering oral instructions from his teacher. His teacher thinks he might have ADHD and recommended having Anand tested.
Bahar is a 10 year old girl and is in the 5th grade and is having trouble keeping up with the schoolwork. When she reads her textbook, she retains very little information, having to read the same paragraph 4 or 5 times. It takes her three times longer than most of her classmates to complete her homework, regardless of the subject. Her parents think she might have a learning disorder and are worried she is not functioning at her age level.
Sarasi is a 9 year old girl who is having trouble sleeping. While she goes to bed at her regular bedtime of 9:00, she can’t fall asleep until almost 11:30pm and is tired during school the next day. She seems generally fatigued and complains of exhaustion even on the weekends. Her doctor says it’s just insomnia and is recommending sleeping pills.
Jay is a 5 year old boy who just began kindergarten. He has trouble sitting still in class, always walking or running around the classroom as if he has had too much sugar. For his age, his impulse-control is limited and he tends to hit other children, take their crayons without asking or turns in tasks without completing the assignment. He talks very quickly and seems hyper. His parents read up on ADHD and think he might fit the diagnosis.
Priyam and Pratish are 9 months old twins. Priyam seems more lethargic and less energetic than what is typical at 9 months of age. She seems to show little interest in her toys and is not very engaged in play with her parents. Pratish is highly irritable and is difficult to soothe. He cries often for no apparent reason. They both have trouble going to sleep and staying asleep during naptime and at night. Their parents think teething, switching to solid food and moving from their old house are to blame for the disruption in their children’s lives.
All five of the above snippets describe five entirely different scenarios but have the same underlying issue: all of the abovementioned children are depressed.
One of the most common misconceptions about depression is that it is reserved as an adult experience. We tend to believe, inaccurately, that childhood is a happy, blissful time without any stressors or problems. However, a much higher percentage of South Asian children are depressed than we would like to believe. Last year, a study published results identifying the under 14 year old age group to comprise of 2% of India’s suicides each year. The sharp increase in suicidal tendencies in most of the South Asian countries is evidence for the rising rates of depression and other emotional health issues in children and adolescents.
What makes a child depressed?
Childhood is marked by a time of life when the body and mind are growing rapidly. A child’s brain acts like a sponge and soaks up absolutely everything around him. Here are some common reasons for why South Asian children become depressed:
· Maternal depression – If the mother is depressed or is experiencing post-partum depression, her child (whether it be a newborn or a teenager) is much more likely to become depressed as well. This would explain why both Priyam and Pratish are exhibiting signs of depression at such an early age.
· Pressure to perform academically – Most South Asians place a high value on academic achievement. This stress can become debilitating and can result in depression in children.
· Bullying – Children who are bullied experience low self-esteem and can internalize their problems, eventually developing depression.
· Marital Stress, Separation or Divorce – No matter how much we try to protect children, they pick up on the stress that exists within a family, especially if the stress is between their parents. Witnessing marital fights or going through a divorce are all risk factors for developing depression.
· Child abuse – Experiencing or witnessing any type of abuse can increase the risk of developing depression.
· Physical Ailments/Medical Illnesses – Depression is a common side effect for many illness or medical issues in children. E.g. broken bone, asthma, or allergies. It is also a common side effect of some standard medications.
· Isolation – Not having many friends, extracurricular activities or a strong support system is a risk factor for developing depression.
· Significant life changes – E.g. beginning school, birth of a sibling, moving to a new city
· Other emotional health issues – Anxiety, learning disorders, autism, ADHD, and many other mental health issues are often seen co-existing with depression in children.
· Poor balance of work and play – Children learn not just by studying but also by playing and without having the opportunity to play creatively, depression can develop.
· Poor nutrition – A healthy diet is necessary for a healthy mind in children as well.
What are some common symptoms of childhood depression?
Diagnosing depression in children is difficult because the symptoms can be so varied. In addition, children rarely tell their friends, parents or teachers how they feel. Instead, their symptoms present themselves through their behavior and their body.
Here are some common symptoms for infants, toddlers, children and adolescents:
· Fatigue/Exhaustion
· Crying more than normal for the age or without explanation of cause
· Irritability
· Sleep problems (e.g. difficulty falling or staying asleep)
· Stomach aches
· Fear of school
· Mood changes
· Change in appetite
· Anxiety
· Fear of being separated from parents
· Temper tantrums (e.g. beyond what is normal for the age, more often than the child normally has them, etc.)
· Expressing hopelessness
· Not interested in activities previously excited about
· Suicidal thoughts or attempts (can begin as early as 7 or 8 years old)
If you notice a change in your child’s behavior or mood, it is important that you make an appointment with a pediatrician or a child mental health professional as soon as possible for an evaluation. Depression is one of the most easily treatable mental health issues in children and adults and with early intervention, your child can live a healthy life.
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