Depression is one of the most common mental disorders we encounter. Depression is also called a depressive disorder, and its main symptoms are low motivation and depression, which causes mental and physical decline. According to the ‘Mental Health Survey’ by the Ministry of Health and Welfare in 2021, 7.7% of Koreans will suffer from depressive disorder at least once in their lifetime.
In recent years, the awareness of depressive disorder has widened, and the number of people who want to recognize and treat depressive disorder is increasing. However, the problem is that those who do not know their depression properly and cannot express it. For example, children and adolescents. Unlike adults, children who are emotionally immature and unable to express their emotions are difficult to recognize even if they have a depressive disorder.
For example, in the 2005 survey of depression among children and adolescents conducted by the Seoul Metropolitan Government, the prevalence of depression diagnosed through parental reports was only 0.86%, but the self-reported depression rate of children and adolescents was 7.37%, which is about a tenfold difference. That’s why it’s important to pay attention to and monitor children’s emotional changes.
◎ About, What is Depression in Children and Adolescents?
Depression in childhood and adolescence is by no means small compared to depression in adults, and even in children aged 3 or 4, the age at which they show depression is so young that cases of depression have been reported. Among Korean children, the proportion of children suffering from depression is 1~2%, and among them, the prevalence of depression in adolescence reaches 5%.
Parents often confuse childhood depression with puberty. However, unlike adolescence, depression is marked by a marked decline in mental and physical function. This is a case of a lack of concentration, making it difficult to perform tasks that would normally be possible, or a marked decrease in patience.
If depression in childhood and adolescence is left unattended, recovery and recurrence can lead to ‘depressive personality’ or ‘chronic depression’. Therefore, if a child’s depression is suspected, it is necessary to intervene as early as possible to improve it, and to observe it with constant interest even after recovery.
◎ About, Causes of Depression in Children and Adolescents
The causes of childhood and adolescent depression can be broadly divided into biological factors and psychosocial factors. Biological factors include genetic factors and biochemical factors such as hormones or neurotransmitters in the brain. Depression can occur due to an imbalance of hormones and neurotransmitters such as serotonin. Depression in a parent or close relative may also have a genetic risk factor.
Psychosocial factors include emotional deficiencies. If you don’t get enough support from your caregiver when you need care, your risk of developing depression is high. In addition, negative environmental factors surrounding children, such as separation from loved ones, conflicts between families, parental divorce, and abuse, are also considered as major causes of depression in childhood and adolescence.
◎ About, Depression Symptoms in Children and Adolescents
Symptoms commonly observed in childhood depression are sad appearance, anxious and anxious appearance, and separation anxiety. Afterwards, as adolescence progresses, a decrease in interest in activities or games that they normally enjoy, a feeling of helplessness, and a feeling of hopelessness appear. Masked depression, which is disguised as sensitive mood, increased irritability, and aggressive and impulsive behavior, is common without a clear feeling of depression or helplessness. Many people complain of physical symptoms, such as stomach ache or headache, without any specific cause.
If your child becomes irritable or exhibits aggressive behavior, if he/she speaks less and cries frequently or becomes anxious, if his/her sleep pattern changes and he/she eats less, if he/she becomes dazed with difficulty concentrating or if his/her grades drop sharply, if he/she refuses to go to school Depression in children and adolescents may be suspected if self-harm behaviors or references to suicide are made.
Depression in childhood and adolescence can have slightly different appearances depending on age and gender. In the case of girls, they tend to express their feelings of depression a lot, but boys do not express their feelings of depression and instead show a lot of aggressive behavior. They may fall into dangerous actions or flight deviations. Also, unlike adult depression, where there is no motivation for everything, there is a tendency to become immersed in and addicted to areas of interest and fun, such as games and mobile phones. On the other hand, I can’t stand anything that’s fun and boring.
◎ About, self-diagnosis of depression in children and adolescents
1 Unusually irritable or crying over trivial things.
2 Complains of physical pain without a specific cause.
3 Behaving erratically, throwing objects violently, or making extreme comments.
4 He has a depressed expression and doesn’t want to go out and wants to be alone.
5 I talk less and I don’t feel much interest in my usual daily life.
6 Contents such as death and loneliness are found in diaries or conversations with friends.
7 Talks about being tired or bothered a lot.
8 The process of thinking is slow, and the ability to learn is poor.
9 The amount of food changes, so they have no appetite or show binge eating.
10 Shows symptoms of insomnia or hypersomnia, feeling tired even after sleeping all day.
* If 2 or 3 or more of these apply, consultation with an expert is recommended.
◎ About, treatment of depression in children and adolescents
If depressive symptoms are suspected and this causes difficulties at home or at school, it is recommended to seek counseling from a psychiatrist.
In order to establish a treatment strategy for childhood and adolescence depression, a multifaceted approach is needed that includes various factors such as the child’s innate temperament, genetic vulnerability, cognitive and emotional development, and home environment.
For example, children can learn to express and control their emotions through play therapy because their verbal communication skills are immature. Cognitive behavioral therapy, interpersonal therapy, and family therapy are sometimes performed. In adolescence, school stress or academic burden can contribute to aggravation of depressive symptoms, so close cooperation with the school can help.
If the effect of non-pharmaceutical treatment alone is limited, drug treatment may be attempted. If safety is threatened due to repeated self-harm behavior or suicide risk, more aggressive treatment such as hospitalization should be considered.
◎ About, Prevention and Management of Depression in Children and Adolescents
Regular exercise and regular living are very important for preventing and managing depression. In particular, when you see enough sunlight during the day, hormones such as serotonin are secreted, which makes you feel better. In addition, vigorous physical activity, especially aerobic exercise, is also effective in evoking a positive mood and improving stress. It is helpful to train a healthy body and mind through appropriate outdoor exercise.
It is also important for parents to develop positive thinking skills in everyday conversations. If you have depression, you are prone to negatively biased thoughts. At this time, it is necessary to help people think positively by pointing out the positive side of the situation and thinking of alternatives.
