Ask Dr. Marla: Depression in children

Question

Our seven-year-old son is showing signs of depression, I think because my husband and I used to fight in front of him. He is seeing a therapist but we feel that we can do more. He feels bad in school and is not doing so well. How can we help him more?

Answer

I’m glad that you have recognized your child has symptoms of depression and confirmed the diagnosis. You also have pursued appropriate support and therapy. Often, depression in children eight and younger goes unrecognized because this age group has difficulty putting words to their feelings. Sometimes as parents we see behaviours that may make us think they are anxious. Depression can present as a phobia or not wanting to leave a parent. There can be physical complaints such as tummy aches and headaches.

Often depressed children may seem unhappy or be prone to tantrums. They may withdraw from playing with their friends and of course, as you have noted, they can do poorly in school.

As many as two percent of elementary schoolage children experience depression, so you are not alone. The rates in this age group are about the same for boys and girls.

It’s terrific that a therapist is involved as, untreated, depression can last nine months or so. These are critical years. We do know that depression can not only affect how they do at school, but also affect social interaction with friends and self-esteem. It can actually affect how your child develops.

You suggest that a potential cause is your marital fighting and you are right that this certainly can be a stressor for your child. Other factors can include:

• family history of depression
• poor communication with a father
• mother’s mental health
• poor living conditions
• physical or sexual abuse
• loss of a parent through death or separation or divorce, or even the fear that a child might have about this.

You have already recognized the role of fighting and addressed that. Interpersonal psychotherapy, which he is getting from a therapist, is critical. On occasion, medication should be used. But in this age group we mostly focus on what we call psychosocial interventions such as family counselling and addressing the environment that your child is in. If it is clear that the depression centres on your relationship with your spouse, treatment for you both is important. It will address your relationship and offer you both support.

A particular kind of therapy that can be helpful for children is cognitive behavioural therapy, which teaches them how to recognize and change some of the thoughts they are having. Sometimes just having support from a therapist can help a child deal with his fears and sadness. It might be that your child is too young to benefit from cognitive behavioural therapy.

It is important to show continued support and love for your child, as well as reassurance. I am glad to see the ‘we’ in your letter which means you are both committed to working together to best support your child.

Originally published in ParentsCanada magazine, May 2011.