Depression Contributed by: Dr Atif Magbool. Speciality Registrar Child and Adolescent Psychiatrist.

What is Depression?

Depression is different from feeling a bit sad or down for a day or two. Feeling sad is a normal reaction to experiences that are stressful or upsetting. We all feel low sometimes. It’s when feeling low goes on for a long time and gets so bad it stops someone living a normal, active life, it can then be called ‘depression’.

Fast Facts!

  • Nearly 800,000 children and young people in the UK suffer from depression.
  • 0.2% of 5-10 year olds are depressed.
  • 1.4% of 11-16 year olds are depressed.

What causes it?

There is no specific cause for depression. It is commonly caused by mixture of things.

  • Depression may run in families. It can be triggered if  too many changes happen in your life too quickly. Other triggers include personal experiences can be a trigger such as family breakdown, the death or loss of someone you love, neglect, abuse, bullying and physical illness.
  • Depression seems to be linked with chemical changes in the part of brain that controls mood.

What are the symptoms?

Depression affects different people in different ways, but common symptoms include:

  • Feeling very low
  • Being moody and irritable – easily upset or tearful
  • Not enjoying anything
  • Becoming withdrawn – avoiding friends, family and regular activities
  • Feeling guilty or bad, being self-critical and self-blaming
  • Feeling unhappy, miserable and lonely a lot of the time
  • Finding it difficult to concentrate
  • Not looking after your personal appearance
  • Changes in sleep pattern: sleeping too little, too much or waking up earlier.
  • Feeling tired
  • Finding it difficult to concentrate
  • Not interested in eating, eating little or too much
  • Suffering aches and pains, such as headaches or stomach-aches
  • Feeling as if life is not worth living.
  • Feeling hopeless and wanting to die.
  • Feeling you are not good looking.

How is it diagnosed?

There is no medical test to identify depression, and the diagnosis is made by a doctor (usually a psychiatrist). The doctor will spend time with the patient, and will often talk to those who know them best, such as school, family and friends. They may arrange for some physical tests to rule our that the person is not physically unwell.

The type and number of feelings listed above that a child or young person has will help the professional decide whether they have mild depression, moderate or a more severe depression and what treatment would suit them.

How is it treated?

Most people have mild or moderate depressions. These depressions can be treated by increasing levels of physical activity, sleeping properly, eating healthy food, learning how to get better, trying to keep yourself occupied by doing activities, talk to someone whom you trust and can help and with a therapy called Cognitive Behavioural Therapy (CBT).

CBT teaches special exercises that help people to control their negative feelings and to change the way they think and behave.

Medicines for depression only really work for people who have severe depression or moderate depressions that go on for a very long time. Medications called ‘antidepressants’ are usually used for this condition. They need to be prescribed by specialist child and adolescent psychiatrists after a careful assessment. Medications are usually given for few months and sometimes may need to be taken for a longer time.

Case Study

Suzan is a 14 years old girl who has been feeling low for the last 4 months. Her mum took her to see the doctor because they noticed she was a bit down, becoming withdrawn, avoiding friends, family and usual regular activities and had started cutting herself. Suzan hadn’t noticed much, cutting made her feel better.

When Suzan and her family thought about it, they realised that she had not been sleeping very well, her appetite had reduced, and she was struggling to enjoy things she used to – like watching the TV and going to see her favourite band. She found her thoughts to be really negative, and struggled to see things in a positive light.

Suzan was treated with CBT, She found this really helpful, particularly as she can now think about things in a more rationale way, and has also noticed that she is more able to cope with difficult days. With time her sleep and appetite have also improved, and she has been trying to spend more time with her friends – which she is starting to enjoy again. She is no longer cutting, and has found more helpful ways to cope, like distracting herself with music.

Suzans family are happy she is more like her old self, and are now aware of the warning signs to pick up if Suzan is feeling down again.

Want to know more?

YoungMinds –www.youngminds.org.uk information about mental health and emotional wellbeing

NHS Choiceswww.nhs.uk – information on depression

ReThink – Young People – www.rethink.org/youngpeople – information and useful tips for young people on staying well and all about mental health problems.