Depression can hit with the force of a tornado, tearing down lives and wrecking stability, but treatment is effective in four out of five cases.
It’s almost as prevalent these days as the common cold. Nearly everyone claims to have suffered it at some point in life. Children as young as 2 may develop it, as may mothers with newborns or men in the midst of life.
You guessed it: I’m talking about depression, the No. 1 mental health problem in America.
At any one time, more than 10 percent of the population is being treated for some form of depression. That means about 22 million people are spending millions of hours on therapists’ couches and popping millions of antidepressants daily. Little wonder that Elizabeth Wurtzel — beautiful, clever and for many years depressed — titled her best-selling treatment memoir Prozac Nation.
What Defines Depression?
Depression takes three main forms. The most severe is major depression, where the largest number of symptoms comes into play. Dysthymic depression is similarly chronic, but often the only symptom is an almost daily depressed mood that can last for years. Bipolar disorder is the third form, characterized by behavior that cycles between mania and depression. Mania may not look like depression to the untrained eye, but its high-energy symptoms are a kind of parody of happiness. Manics have delusions of grandeur, are excitable and voluble, never tire, seldom sleep, and have little need for food.
The curious thing about depression is that it can surface at any time in life. In recent years, physicians and therapists have been coming to terms with the fact that the threshold for depression has been getting lower and lower, in some instances starting in infancy. Childhood depression often begins with another disorder or emotional problem, such as Attention Deficit Disorder or hyperactivity, and then it literally evolves.
According to the National Institute of Mental Health, around 2.5 percent of children and 8 percent of adolescents in America suffer from some form of clinical depression.
Dr. David Fassler, chairman of the Council on Children, Adolescence and their Families at the American Psychiatric Association, is the first to admit that his field has seen a revolution.
“When I was at medical school,” he says, “we were taught that children weren’t emotionally mature enough to experience depression. Now we know that at any time something like 5 percent of children in America are depressed and that over half of depressed adults seeking treatment report being depressed in childhood or adolescence.”
Depression in children can have the same effects as in adults: The child will seem sad, will cry and mope, lose his appetite and sleep badly. Often, however, depression manifests itself as agitation or irritability, and the child will get into trouble at school, play truant, get involved in drugs or become sexually promiscuous. In either case, it is important for teachers to recognize whether such symptoms represent a change in the child, and to determine whether the symptoms are lasting. Children who are identified as depressed tend to respond well to treatment.
Avoiding Placing Blame
“Parents, too, need to realize that it’s not their fault if their child is depressed and that their child cannot simply snap out of it,” says Fassler.
It’s helpful for parents to learn which factors can reduce the risk of depression, especially in children who’ve already had an episode, and ways they can advocate for them during hard times, says Fassler.
“These include establishing a secure environment, so making the world relatively predictable; fostering open and honest communication, so your kids know they can talk to you about anything; adopting a constructive approach to discipline; and encouraging your kids to take up activities that will enhance their self-esteem.”
Parents with children suffering from bipolar disorder tend to have the most difficult experiences. (In 2013, the American Psychiatric Association reclassified bipolar disorder in children as disruptive mood dysregulation disorder.
In children with this disorder, every day their moods may swing through the gamut of human emotion. It’s exhausting for them — many are filled with rage and flip between hyperactivity and seemingly endless tantrums — and for their parents. One parent, a single mother with a 9-year-old son, said, “Hearing your child tell you that they want to die is crushing. It’s just not what you expect to hear.”