Depression is defined as a condition affecting mood, thinking, and the body. It affects overall mental and physical health and is reflected in a person’s behavior toward themselves and others. It is one of the most widespread mental health conditions today. Many people experience temporary frustration and depression because of separation, death, illness, or a life crisis that causes sadness. This is a natural reaction to such events, and the person consequently regains their strength and returns to their usual state after a while. However, when feelings of frustration, sadness, loneliness, and low mood persist and affect the course of life, the person is experiencing a mood disorder known as depression. In this article, we will discuss depression in general and childhood depression in particular.

Depression may develop suddenly and without a reason, or it may arise because of psychological stressthat is particularly severe for the individual. It may also develop slowly and worsen over time. Depression affects males and females, children and adults alike, regardless of their educational, cultural, or financial level; everyone may experience it. Depression is considered a mental health disorder that can be treated when a person consistently follows the treatment plan prepared by theirpsychological consultant..

Causes of depression:

  • Biological causes: Changes in brain chemistry, most importantly serotonin and noradrenaline (a deficiency in these substances causes depression).
  • Genes (hereditary factors).
  • Personality traits:A sense of defeat and lack of willpower, dependence on others, moodiness, a pessimistic outlook, and difficulty adapting to external circumstances.
  • Environmental factors: Domestic violence, psychological or physical abuse, sexual harassment, separation, death (bereavement), and job loss.

Ways to treat depression:

Approaches to treating depression are divided into two categories:

  • Medication treatment: Using antidepressants.
  • Psychotherapy:Through psychotherapy sessions using cognitive behavioral therapy, psychoanalytic therapy, family therapy, or group therapy, depending on which type is most suitable for the patient after analyzing the causes of the condition.

Childhood depression:

Causes of childhood depression

  • Physical conditions such as epilepsy and diabetes.
  • Environmental influences such as parental separation or the death of one parent.
  • Hereditary factors, such as one parent having the condition.

Symptoms of depression in children:

  • Mood swings.
  • Imagining events that have not happened in ways that make the child sad, angry, or afraid.
  • Persistent feelings of anger, sadness, hopelessness, and frustration.
  • Changes in appetite.
  • Sleep disturbances (insomnia or excessive sleeping).
  • Isolation and withdrawal from friends and family.
  • Loss of pleasure.
  • Sensitivity to criticism from others.
  • Poor concentration.
  • Feeling tired and lacking energy.
  • Feelings of guilt.
  • Thinking about death or suicide.
  • Physical symptoms such as stomach pain, headaches, and abdominal cramps.

How depression is diagnosed in children:

  • Persistent mood swings,
  • feelings of sadness,
  • hopelessness, and guilt for two weeks.
  • A child can be diagnosed with depression and should be taken to a consultant or psychiatrist for treatment..

Depression and its relationship to different stages of childhood:

1. Between seven and thirty months of age (anaclitic depression):

  • Symptoms: A sad facial expression, difficulty understanding, and difficulty moving.
  • Cause: Separation of the mother from her child for more than a week, family problems, or maternal depression.
  • Treatment approaches: Reuniting the child with their mother and having the mother focus on her mental health.

2. The preschool stage:

  • Symptoms: Behavioral symptoms that include aggression and elevated activity and movement.
  • Causes: Separation of the child from their mother, family problems, loss through death or separation, moving home, and failure to help the child adapt.
  • Treatment approaches: Reuniting the child with their mother, making a positive change in the social environment, and psychotherapy.

3. The school-age stage:

  • Symptoms: The symptoms listed above under the symptoms of depression.
  • Causes: Loss of adequate care—that is, loss of the person who cares for the child psychologically and physically—bullying, family problems, loss or death, moving home, and failure to help the child adapt.
  • Treatment approaches: Restoring the presence of a person who can meet the child’s psychological and physical needs, creating a positive change in the social environment, and strengthening the child’s self-confidence, competence, and independence through therapeutic and counseling sessions with a specialist.

4. Adolescence:

(It affects females more than males due to hormonal imbalance and physical changes, which are greater among females than males, in addition to the need for admiration and social approval.)

  • Symptoms: The symptoms listed above for depressive disorder, especially mood swings and loss of pleasure.
  • Causes: Hormonal changes, the adolescent’s focus on how others view them, family problems, psychological or physical violence, loss through separation or death, changes in the home and family environment, problems with friends, difficulty adapting, and a negative view of oneself.
  • Treatment: Psychotherapy with a specialist that considers the adolescent’s personality and family, and the use of antidepressant medication.
  • Treatment approaches: Effective treatment for children combines medication, psychotherapy, and relaxation exercises. According to studies, this approach has proven effective and helps prevent relapse.

Medication treatment consists of selective serotonin reuptake inhibitors (SSRIS), especially in moderate and severe cases. However, these medications have side effects that include headaches, sleep disturbances, vomiting, nausea, diarrhea, and tension, particularly at the beginning of treatment. Medication treatment lasts no less than one year, and when it is stopped, it ((must)) be withdrawn gradually under the supervision of a specialist or psychotherapist, during a period without family conflict or psychological stress.

The child must also continue taking the medication for at least three months before the specialist or psychotherapist determines whether the child has responded to treatment. The medication may then be changed to another from the same inhibitor group, and if effectiveness is not demonstrated, two medications are given.

Selective serotonin reuptake inhibitors include: Fluoxetine, sertraline, and citalopram.

Psychotherapy aims to teach the child skills that enable them to monitor themselves, develop skills for adapting to their surroundings, communicate positively with themselves and others, and express themselves and their feelings.

It also helps the child acquire skills that enable them to control their patterns of thinking and replace negative thoughts with positive ones (cognitive therapy), as well as teaching the child skills that enable them to control their behavior (behavioral therapy).

Family therapy:

A specialist or psychotherapist may use family therapy for children with depression by strengthening communication, understanding the child and their world, and encouraging the child to understand and express their feelings. It also focuses on the causes and content of the depression and how to discuss it so that it can be treated.

How parents can interact with a child who has depression:

  1. Embrace and support the child’s thoughts, feelings, and behavior.
  2. Help the child express themselves and their feelings by listening to them well.
  3. Strengthen the parents’ communication skills with the child by building trust and respect between them.
  4. Listen to the child’s problems, do not underestimate their seriousness, and look for solutions together.
  5. Always surround the child with a supportive and encouraging family environment.
  6. Offer the child encouragement and positive reinforcement.
  7. Do not make the child feel afraid, so that their psychological state does not worsen.
  8. A psychiatrist must be consulted if it is not possible to improve the child’s psychological state.