Healthy Conversations: Childhood Depression—What it is & what it isn’t

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Depression can be an intimidating diagnosis, especially when the person struggling with the medical condition is young. For the child’s family, it’s also a daunting diagnosis.

“When someone in the family is depressed, it affects the entire family,” says Susan Cosgrove, PMHNP-BC, Psychiatric Nurse Practitioner at Dignity Health, Yavapai Regional Medical Group, Pediatrics (formerly Ponderosa Pediatrics).

Approximately 2.7 million children in the United States ages three to 17 suffer from depression. The positive news is that 80 to 90 percent respond to treatment and nearly everyone experiences some symptom relief.

During this episode of Healthy Conversations, Cosgrove highlights the misconceptions and symptoms associated with childhood depression. She also discusses risk factors, treatments and supporting someone who is depressed.

Is my child depressed?
Before delving into the signs of depression, let’s clear up some misconceptions about the condition.

“Depression is not a changeable behavior,” Cosgrove explains. “Someone who is depressed isn’t being lazy. It’s also not a character flaw or a way to get attention.”

  • A young person who is depressed may exhibit some of the following:
  • Anger or irritability
  • Appetite changes
  • Body aches
  • Changes in the pace of speaking
  • Difficulty making decisions
  • Feelings of worthlessness or guilt
  • Lack of focus, loss of interest in activities
  • Sadness
  • Self-harm and suicidal thoughts
  • Sleep issues, low energy

“Young children and adolescents will often present as angry, frustrated or irritable,” says Cosgrove. “It can be difficult for them to identify the sadness piece of depression. They don’t know how to deal with, or understand what’s happening to them.”

Is my child at risk for depression?
This gets to the age-old question of nature versus nurture. Nature refers to the hereditary genes that influence who we are, from hair color to personality traits. Nurture is about the environmental factors that shape us, including how we were raised and our social relationships.

“Is it genetic or is it the family you were raised in? The answer to that question is always going to be: Yes, it’s both,” Cosgrove says.

How can my child’s depression be treated?
The team at YRMG, Pediatrics practices “integrated” physical and mental healthcare. This means a child’s provider – pediatrician or pediatric nurse practitioner – may identify depression and refer the family to Cosgrove or the psychiatrist, both whom are part of the YRMG, Pediatrics team.

Treatment plans are individualized and typically based on a physical exam, blood work, a diagnostic evaluation and interview. Therapy, however, is part of every plan.

“Today, there are very specific types of therapies that are time limited,” explains Cosgrove.

Cognitive behavioral therapy, for example, helps children develop useful tools. They learn to identify negative thoughts, challenge them and change those thoughts into true statements.

Medication may also be part of the treatment. Cosgrove emphasizes that anti-depressants are not “forever medications.”

“Depression may go into remission after a year to 18 months of treatment,” she says. “At that time, the child’s provider would gradually stop the medication and I would monitor the patient’s progress.”

What else can I do to help my child?
Cosgrove advises parents to encourage a child who is clinically depressed.

“That means being present, listening to your child and asking what they need from you as a parent,” she says.

Recommended resources
Cosgrove emphasizes the importance of turning to reputable, research-based sources for information about depression. She recommends:

How to reach YRMG, Pediatrics
To schedule an appointment with Susan Cosgrove or another YRMG, Pediatrics provider, call (928) 778-4581.

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