Depression in the child

Depression is a disorder characterized by a classic triad: a decrease in mood (hypothyroidism), motor and ideator inhibition. Symptoms of depression are close to those disorders that are observed in adulthood, but have a significant difference. In childhood, the somatovegetative symptoms of depression come to the fore, whereas the affective component is represented by a feeling of depression, depression, boredom, less often the experience of affective depression.

[1], [2], [3], [4]

Epidemiology

There are no accurate and comparable data on the incidence of depression in children, since they often occur atypically and are not diagnosed.

[5], [6]

Causes of the depression in a child

The causes and mechanisms of the development of endogenous depressions are unknown, although a number of factors are involved in the development of the disease. The main importance is attached to the constitutionally hereditary factor.

Depression in children is able to develop due to such factors:

• The pathology that occurred in the early neonatal period due to chronic hypoxia of the fetus inside the uterus, intrauterine infections, encephalopathy in the newborn;
• Problems and conflict situations in the family, incomplete family, lack of parental care;
• Teenage problems - surrounded by leaders appear, dictating the model of behavior in the company. Those who do not comply with this model, are out of public life. Because of this, alienation of the child arises, which leads him to depressive thoughts;
• Frequent travel from place to place - under such conditions, it will be difficult for the child to have a permanent social circle and find true friends.

The causes of depression in a child can also be acute stresses - such as a serious illness or the death of relatives, quarrels with relatives or peers, the breakdown of the family. Although depression can begin without binding to some clear reasons - externally, both physically and socially, everything can be good. In this case, it is a matter of violations of the normal functioning of biochemical activity in the brain.

There are also seasonal depression, manifested due to the special sensitivity of the child's organism to different climatic conditions (mainly observed in children who were injured during childbirth or underwent hypoxia).

[7], [8]

Pathogenesis

Modern research allows us to conclude that depressive disorders have a multifactorial pathogenesis - it includes biochemical, psychological, social factors, as well as genetics and hormones.

Often, depression in children is a reaction to a complex life situation - this form of depression is called reactive.

If we focus solely on the biological cause of depression, then this is a deficit of monoamines and a decrease in receptor sensitivity, because of which the monoamine cycle is accelerated (compensating for the loss of sensitivity), leading to depletion of neuronal depots. The differentiation of neurotransmitter monoamine systems according to a functional feature is done in this way:

• Dopamine, which regulates the motor circuit, answering the process of development of the psychostimulating effect;
• Norepinephrine, providing support for the level of wakefulness and the general activating effect, as well as the forming cognitive reactions necessary for adaptation;
• Serotonin, controlling the index of aggression, regulation of appetite, impulses, cycles of wakefulness and sleep, and also having antinociceptive and timoanaleptic effect.

[9], [10], [11], [12], [13]

Symptoms of the depression in a child

Psychotic forms of depression practically do not occur in children under 10 years old. Depressive disorders are observed in the form of episodes of recurrent or bipolar affective disorder in the form of phases, separated by light intervals.

Sick slackers complain of physical weakness, they say that they want to lie down, that they are tired, they are all fed up, do not like anything, they do not want to do anything and in general "eyes would not look at the white light". They have a disturbed sleep (difficulties of falling asleep, restless sleep with dreams and awakening), appetite is reduced. Cognitive productivity falls due to the slowing down of associative processes. Children stop coping with school load, refuse to attend school. They consider themselves foolish, useless, bad. With pronounced depression, rudiments of ideas of self-blame and guilt appear. For example, the 5-year-old P. Motivated his refusal to eat by saying that "he is the worst boy in the world and he does not need to be fed."

The periods of heavier depression are manifested in the characteristic states of agitation or inhibition. The states of agitation in the form of motor anxiety and fussiness are accompanied by externally unmotivated long inconsolable crying, lamentation of the type "oh, bad, bad to me", hysterical reactions or aggression to the persistent attempts of relatives to reassure them.

It should be noted that parents often do not understand the state of their child, take his behavior for whimsy, promiscuity, and therefore use inadequate measures of influence, which leads to increased agitation of the child and even suicidal attempts. Children of preschool and primary school age often can not explain their condition during crying, they say: "I do not remember, I do not know." The periods of agitation can be replaced by a state of inhibition, when they spend hours sitting in one place with a sorrowful expression of the eyes.

In childhood, with depression in the recurrent disorder, one can note a special daily rhythm of depression with worsening of the condition in the evening, in contrast to the typical daily and daily fluctuations in the adolescence and adulthood, with the greatest severity of depression in the first half of the day.

It should be noted that there is no direct dependence of suicidal risk on the severity of depression. The most suicidally dangerous are delusional depressions, which are rarely observed in childhood. Perhaps this is related to the relative rarity of suicide attempts in childhood, especially the younger. However, this does not exclude a possible suicide attempt with a relatively mild depression. The decision to commit suicide is facilitated by additional conditions in the form of quarrels, grievances, undeserved accusations, etc. In adolescents, the risk of suicide multiplies many times, which is due to the predominant structure of depression at this age (resonating depression) and the sensitivity, sensitivity to external influences that is characteristic of patients age.

Depression can occur atypically, masking other psychopathological and somatopsychic disorders. A special type of masked depression is somatized forms. Children with a moderate change in affect develop a variety of somatovegetative disorders that mimic various physical illnesses. External manifestations of mood reduction are a drop in energy potential and somatic tonus. Children complain of lethargy, weakness, boring mood. The surrounding note that the child is moody, tearful, not interested in toys, does not respond to gifts. These features of the behavior and affective response of the child doctors and parents associated with the alleged somatic discomfort of the child. As a rule, children in these cases are placed in a somatic hospital, where the results of the survey can not explain the persistent nature of the patient's somatic complaints. For a long period, in some cases up to several years, patients continue to be examined in pediatric and neurological clinics and sent to a psychiatrist often years after the onset of the disease.

The main typological variants of somatized depression are primarily associated with the nosological affiliation of depression. Depressive syndromes can be observed in various forms of schizophrenia, affective mood disorders, neurotic and stress-related disorders.

With recurrent depressions and depressive syndromes within the framework of periodically occurring schizophrenia, a variant with hyperthermia and latent depression is often observed. Peculiarities of thermoregulation disorders in patients - significant temperature fluctuations from subfebrile to high with a drop to hypothermic indices, specific daily fluctuations (morning peak with subsequent decrease during the day or evening peak and fall at night), seasonal periodic character. Along with hyperthermia, patients complain of headaches, dizziness, nausea and vomiting, which requires the elimination of not only somatic, but also neurological disease.

The most frequent manifestations of somatization in endogenous depression are the appearance of pain symptoms that can be localized in any part of the body, to be paroxysmal or permanent. As a rule, unpleasant bodily sensations and pains do not correspond to manifestations of known somatic diseases and can not be treated with symptomatic means.

In some cases, symptoms predominate from the gastrointestinal tract, in others - the cardiovascular system, in the third - respiratory organs, etc.

For young children with endogenous depression, changes in rhythm and quality of sleep, decreased appetite, temporary suspension in development and pseudo-progressive autonomic disorders are most characteristic. The latter are characterized by a partial loss of speech and motor skills, the appearance of enuresis and encopresis.

V.N. Mamtseva (1987) gives detailed descriptions of pseudo-neurological symptoms with latent endogenous depression in children, the so-called neurological masks. The main place in the clinical picture is occupied with complaints of headaches, which at the beginning of the disease are of a paroxysmal nature, but then become almost constant. Often complaints are pretentious, unusual in nature - "burns", "bubbles painfully burst", "it seems that the vessels in the water instead of blood", etc. Often complaints carry a shade of delusional or hallucinatory experiences of the patient. The patient S. Characterized his complaints about a headache as "bite." When asked who bites, he answered: "I do not know." Along with headaches, patients notice dizziness, which are not of a usual rotational nature. Patients complain that they are spinning inside the head, and there may be a sense of flight accompanied by depersonalization and derealization.

V.N. Mamtseva, within the framework of neurological masks, also describes seizures reminiscent of atypical epileptiform, proceeding with a feeling of sharp weakness, a violation of the gait, sometimes accompanied by a fall, but without loss of consciousness.

For teenage depression, a significant number of atypical phases that complicate the diagnosis are characteristic. For somatized depression is characterized by the presence of massive vegetative dysfunctions (sweating, chilliness, tachycardia, constipation, vascular dystonia, etc.).

Quite often in adolescence, there are relatively shallow depressions that are masked by behavioral disorders, which makes it difficult to diagnose them. In ICD-10, this variant of depression is highlighted in a separate rubric - mixed disorders of behavior and emotions.

Depression in children can manifest itself in different ways - everything depends on the child's living conditions, his age and other factors. The primary signs of the onset of depression are - mood swings, incomprehensible, unaccountable sadness, feelings of hopelessness. Other symptoms of depression in a child:

• Disorders of appetite - increase or vice versa of its loss;
• Drowsiness or insomnia;
• Irritability;
• Regular changes in mood;
• The child feels worthless, there is a feeling of hopelessness;
• Suicidal thoughts;
• Boredom and disinterest;
• Hysterical, capricious, tears;
• Constant fatigue;
• Memory impairment;
• Loss of concentration;
• Deterioration and awkwardness;
• Problems in study;
• Weakness, the appearance of causeless pain, nausea and dizziness;
• Adolescents have problems with various potent drugs or alcohol.

Also, in case of depression, the child can have high sensitivity and compassion, discontent with how people around him are affected, doubts about parental love.

Early school children, being in a state of depression, are afraid of answers at the blackboard, do not want to go to school, forget what they learned when asked about it by the teacher.

[14], [15]

First signs

The onset of depression in a child can occur gradually, but it can also appear suddenly. He becomes too irritable, he has a constant sense of boredom and helplessness. Others note that the child has become either overexcited or otherwise too slow. In sick children, too, there is excessive self-criticism or they begin to think that others give them unfair criticism.

The first signs of depression are usually barely noticeable to others, they are not given much importance. It is because of this that it is difficult to find a link between the symptoms that arise and understand that their cause is depression.

An important point is the timely detection of the child's symptoms of suicidal behavior - they usually differ depending on the age at which the patient is. Depression in children, as well as adolescents in this case is expressed in the form of stopping communication with friends and obsession with the idea of death.

Many children who suffer from depression show signs of excessive anxiety - too worried about any occasion or afraid to part with their parents. Such symptoms appear in some cases even before the depression itself was diagnosed.

[16]

Autumn depression in children

Many people think that adults suffer from autumn depression, but this disease has not bypassed the children either. At each age, such depression manifests itself in its own way, so it should be clarified for yourself what symptoms are characteristic of each group of children:

• Toddlers are capricious at the time of food intake, from the majority of foods refuse at all, they differ in inhibition in reactions, they gain weight very slowly;
• Depression in children of preschool age is manifested in a mild manifestation of facial expressions, an "old" gait. Also they become too quiet and sad;
• Symptoms of autumn depression in children of junior students are isolation, unreasonable longing, unwillingness to communicate with friends, indifference to learning and games;
• Senior students in a state of depression become excessively whiny or even aggressive. They lose interest in the surrounding life, memory deteriorates, the desire for active activity disappears, they react slowly to new information.

Seasonal depression should be recognized in a timely manner. Otherwise, it will develop into a chronic one, and in this situation, the child may even have suicidal thoughts. This, of course, is the worst deal, but it's better to be safe and identify the disease beforehand.

[17], [18], [19]

Depression in children under one year old

Depression is a mental disorder, expressed in a variety of forms and symptoms. Among them, loss of interest in active work, constant depression, slowness of thinking, physiological symptoms, such as loss of appetite or insomnia, the emergence of many unreasonable fears.

Depression in children and adults is very different in the severity of symptoms. For example, unlike adults who, during depression, enter the so-called "social retreat" stage, the child can become too rude and aggressive.

It should also be understood that symptoms such as learning disabilities and general withdrawal from it, absent-mindedness and lack of concentration may indicate not only depression - the reason for this behavior may also be the so-called attention deficit disorder. Consider also the fact that for each age there are signs of depression, although some common manifestations also exist.

Depression in children up to a year or two is poorly understood, there is very little information about it. Small children, if they do not have the opportunity to form their affection, as mother caress and care are absent, show signs that are similar to the appearance of a depressive disorder: alienation, apathy, weight loss, sleeping problems.

[20], [21], [22], [23]

Depression in preschool children

Most parents are hard at coping with depression in preschool children. Many children have a vulnerability to the development of mental disorders, but at the same time, if they have not yet been diagnosed with depression, they can be treated as overly disobedient, lazy, detached, excessively shy, which is fundamentally wrong, but only aggravates the situation.

Now, depression in children is often explained by such factors as attention deficit disorder, a temporary reaction to a stressful situation, a violation of an oppositional-defiant type. When children have similar diseases, you need to understand that they can go along with depression or misdiagnose instead.

Age from birth to 3 years: during this period, a sign of the disorder may be a delay in development, which has no apparent physical cause, difficulties with feeding, frequent hysterics and moods.

3-5 years: the child appears hyperbolized fears and phobias, there may be inhibition or regress in development (at important stages - for example, when he is accustomed to the toilet). Children can constantly and exaggeratedly apologize for minor errors, such as uncleared toys or scattered food.

6-8 years: in vague formulations complaining about problems with the physical condition, at times behaving aggressively. Also very clings to his parents and does not want to perceive strangers.

[24], [25], [26]

Depression in school-age children

Depression in school-age children has a stupid form - with the most obvious symptom being mental retardation. It manifests itself in the form of a sharp drop in academic performance, as the child loses the ability to perceive new information, he has memory problems, it is difficult to concentrate and reproduce new, newly mastered material.

If the stupid depression in children becomes protracted, depressive pseudo-delicacy develops against it, which creates self-deprecating ideas in adolescents about their own insolvency in all spheres, both in school and in relationships with peers. In addition, children may have aggressive or hysterical reactions to others. If the child is experiencing such depression, you need to turn to a psychiatrist to establish an indicator of his intelligence - this will eliminate the possibility of mental retardation.

Depression in any form is a serious problem and it must be treated. In doing so, you should take the help of a qualified doctor - a psychiatrist or a psychotherapist. Only a professional will be able to find for many different behavioral disorders the symptoms of depression and choose the optimal treatment that will help the patient.

[27], [28], [29], [30]

Forms

There is no common classification of depressive disorders in children. Classification of affective disorders, including depression, is presented below.

• F31 Bipolar affective disorder.
• F31.3-F31.5 The current depressive episode of varying severity within the bipolar affective disorder.
• F32 Depressive episode.
  • F32.0 An easy depressive episode.
  • F32.00 An easy depressive episode without somatic symptoms.
  • F32.01 An easy depressive episode with somatic symptoms.
  • F32.1 Moderate depressive episode.
  • F32.10 Moderate depressive episode without somatic symptoms.
  • F32.01 Moderate depressive episode with somatic symptoms.
  • F32.3 Severe depressive episode with psychotic symptoms.
  • F32.8 Other depressive episodes.
  • F32.9 Depressive episodes, unspecified.
• F33 Recurrent depressive disorder.
• F34 Chronic (affective) disorders.
• F38 Other (affective) mood disorders.

[31], [32]

Complications and consequences

Depression is a very serious psychological disorder that develops mainly against a background of various stresses or long-term traumatic situations. Sometimes depression in children can be disguised as a bad mood or explained by individual characteristics of the character. Therefore, in order not to have serious consequences and complications, it is necessary to identify depression in a timely manner and to find out what became its cause.

Emotional manifestations during depression are very diverse. Among them there is a low self-esteem, a sense of desperation and anxiety. A person who has a depressive disorder, constantly feels fatigue, is in a sad and sad state. In this case his behavior also changes. The presence of depression is also indicated by the loss of a person's ability to perform purposeful actions. Sometimes it comes to the fact that a patient with depression is attached to drugs or alcohol to ease bouts of anxiety and anguish.

In general, depression often leads to the development of drug or alcohol dependence, as they are able to help detachment and the appearance of a false sense of good mood. The consequence of depression can be a variety of social phobias.

[33], [34], [35], [36],

Diagnostics of the depression in a child

Practitioners believe that the use of special questionnaires, as well as rating ratings, will be very useful for diagnosing depression in a child. Among them: a rating of children's depressions from the Center for Epidemiological Research, a questionnaire of children's depressions and a self-rating depression rating. But the most popular and most effective method of diagnosis is conducting a clinical interview with the child himself, his relatives, as well as other adults who are familiar with him and are aware of his condition and problem.

Depression in children is not diagnosed by specific biological tests, although there are some biological markers that are being examined for whether they are suitable as a diagnostic method.

For example, in some patients at a severe depressive stage hypoxecretion of the hormone responsible for growth is manifested. This reaction is a response to insulin-induced hypoglycemia. There are also cases in which the secretion of growth hormone is at an excessive peak during sleep.

But for the time being, truly sensitive methods of specific diagnostics that can be of great importance in the process of detecting a depressed state have not yet been developed, but diagnostic criteria can be singled out:

• Decrease in mood with a gloomy pessimistic vision of the future (meaninglessness of existence at the so-called resonant depression).
• Ideal inhibition (not always) with a decrease in the ability to concentrate and attention.
• Motor retardation (lethargy, a feeling of unexplained fatigue).
• Ideas of self-abasement and guilt (in light cases - low self-esteem, lack of faith in one's own strengths).
• Somatovegetative disorders, characteristic of depression, - sleep disturbances, decreased appetite, constipation.

Read also: 8 things you need to know about antidepressants

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Differential diagnosis

For the pediatrician, differential diagnosis is most relevant between somatized depression and somatic disease with a depressive reaction to the disease. Differential diagnosis in the first place requires the elimination of somatic disorder. This is assessed by the totality of the results of laboratory and instrumental research methods, medical supervision. The presence of signs of a depressive disorder requires additional consultation of a psychiatrist, on the conclusion of which they decide the place and methods of treatment.

Differential diagnosis of depression is carried out with other affective disorders, for example, dysthymia, as well as bipolar affective disorder. The latter disease is especially important to differentiate in young patients.

Diagnosis is also carried out with mental illnesses such as schizophrenia, schizoactive disorder, dementia. In addition, it is necessary to distinguish between depression and dependence on various psychotropic drugs (which were taken both illegally and according to the doctor's prescription) and conditions that manifested as a result of neurological or somatic diseases.

If depression in children has psychotic symptoms, in addition to antidepressants prescribe ECT or antipsychotics. If a patient exhibits such atypical symptoms as an increase in appetite with a great craving for sweets and carbohydrate-rich foods, as well as feelings of anxiety, mood swings, drowsiness and unwillingness to accept refusal, one should prescribe either drugs that increase serotonergic activity or monoamine oxidase inhibitors .

Depression, which has psychotic signs (hallucinations, delirium), can by content both coincide with depressive motives, and do not coincide. At the catatonic manifestations there are such signs as negativism, psychomotor problems, echopraxia and echolalia.

Treatment of the depression in a child

To treat depression, the child uses modern antidepressants of the next group - selective inhibitors that act with reverse serotonin capture. This group includes such drugs: paroxetine, fluoxetine drugs, citalopram, sertraline drug, escitalopram. They have a calming and anesthetic effect on the body, helping to overcome obsessive fears and cope with panic attacks.

The effectiveness of these drugs is not worse than that of other drugs, and the risk of adverse reactions due to their intake is much lower when compared with tricyclic antidepressants.

Depression in children and adolescents is also treated with cognitive-behavioral therapy. It helps the child cope with the psychological problems and negative emotions that arise in him, making it much easier to adapt in society.

Among the tasks of individual psychotherapy is the schoolchild's training to correctly express one's own emotions, to talk about any traumatic moments and to overcome these difficulties.

If the family has any problems in the relationship between relatives, and parents can not find a common language with their child, family psychotherapy can help.

Medications

In the treatment of depression, fluoxetine antidepressants may be very effective. But it should be understood that it can take 1-3 weeks until the child is better. In some cases, it takes even 6-8 weeks for improvement to occur.

It is necessary to monitor the fact that the child takes the medication exactly as prescribed by the doctor. If there are any doubts or questions about taking medications, or 3 weeks after the beginning of their admission, there was no change for the better, you need to discuss this with your doctor.

Depression in children is treated with vitamins (especially effective in vitamin C), often using substances of group B, vitamin E and folic acid.

A good antidepressant effect is magnesium (in the form of magnetite and Magne B6).

Among the drugs that help with depression, they note BAD "5-HTP Power", "Sirenity", as well as "Vita-Tryptophan". They contain 5 hydroxytryptophan, which improves the synthesis of serotonin in the body. The drug is a mediator of good mood and works as a non-drug antidepressant.

Another antidepressant is St. John's wort, in which there is hypericin, which improves the production in the body of hormones of good mood.

Children aged after 12 years can take the medicine "Negrustin".

Vitamins

Depression in children can also be treated with various vitamins. Should be considered in more detail, what is the need for vitamins in adolescents:

• It is necessary to take up to 2 g of vitamin C daily. And it should not be ascorbic acid, but a natural product, in which, in addition to the vitamin, bioflavonoids will be contained. Without this addition, the assimilation of a useful substance will not be so effective;
• Group B-6 - vitamins in the form of pyridoxal phosphate or pyridoxine (the dose must be separated, gradually increasing the size);
• Vitamin complex, which contains manganese and zinc;
• Calcium complex, inside which, along with calcium, there are elements such as zinc, boron, magnesium, chromium and chelate form of vitamin D-3, since in it this vitamin is better absorbed by the body;
• Tablets containing compressed sea kale, iodized salt, or kelp.

In addition, you should take a multivitamin complex, in which, among other things, there is iron, which prevents the development of anemia. Also there is a very useful vitamin Molybdenum, which helps to normalize the balance with the growth of bones during puberty.

Also, teens are advised to drink herbal tea with the addition of a spoonful of honey - it has a calming effect - and eat for a night an extract of valerian (2 tablets).

Alternative treatment

Depression is a depressed, depressed mood that accompanies almost every mental disorder.

Basically, depression in children occurs in cases where the brain has to face a serious psychological problem that occupies it so much that it can not cope with other matters that need to be paid attention. In this situation, the problem begins to absorb all the available mental resources, because of which after a while a person will no longer be able to think sensibly and do adequate deeds. As a result - because of nervous overstrain cognitive, emotional, etc. Begin. Problems that demonstrate a malfunction in brain activity.

To strengthen the nervous system, you can turn to alternative treatment:

• Baths with tincture of poplar leaves;
• Morning wiping with salted water;
• Use of tincture from the root of ginseng;
• The use of eleutherococcus extract;
• Decoction made from leaves of mint (in a glass with boiling water is added 1 tablespoon tincture). You need to drink half a glass from the morning and before bed. You can also add mint leaves to tea;
• Tincture from the roots of chicory (in a glass with boiling water is added 1 tablespoon chicory). Acceptance: 1 tbsp. 6 times / day.

[38], [39], [40]

Herbal Treatment

Depression in children can also be treated with various herbs. Herbal treatment can be done using the recipes described below.

The root of the lure is poured 70% with alcohol (proportions 1k10) and insist. The intake is carried out at a dosage of 30-40 drops before meals twice / thrice daily.

3 tablespoons Chopped straw pour 2 cups of boiling water and insist. The resulting broth should be drunk a day. Tincture has a restorative and tonic effect on the body.

1 tbsp. Flowers of chamomile asters are poured with 1 glass of boiling water, after which they are cooled and filtered. Tincture it is necessary to drink 1 tbsp. 3-4 times / day. The broth helps to strengthen the nervous system and add to it a tonus.

Dried leaves or roots of ginseng need to pour boiling water (proportion 1k10), then insist. Reception is carried out at a dosage of 1 tsp. Daily.

Sliced leaves / roots of ginseng are poured 50-60% with alcohol in proportions on leaves 1,5k10, on roots 1k10. Tincture is drunk twice / thrice daily for 15-20 drops.

1 tsp The roots of the descending angelica are filled with a glass of boiling water and insist. You need to use half a glass 3-4 times a day. Tincture helps with nervous exhaustion, strengthening and toning the nervous system.

Homeopathy

When there is depression in children, homeopathic remedies can be used for treatment.

When depression is combined with insomnia, you should take Arnica 3, 6 and 12 dilutions. Depression is well treated and Acidum Phosphoricum (the so-called phosphoric acid) 3x, 3, 6 and 12 dilutions.

Mountain arnica helps when the patient demonstrates indifference, can not act independently, sullen. Also aspires to loneliness, crying and hypersensitive. Still absent-mindedness, nervous-mental arousal, irritability, self-will. Day can look drowsy, it can not fall asleep to him.

Sepia treats with severe memory problems, inability to mental activity, irritability and resentment. It also helps if the child begins to fear loneliness, becomes sad and anxious. He has weakness and mental exhaustion. Being in the company, experiences overexcitation, but the rest of the time is very gloomy. In the afternoon he is very drawn to sleep, but at night it can be difficult to fall asleep.

Zinc valerian acid acts well in cases of severe insomnia and headaches, as well as hysteria and hypochondria.

Phosphoric acid helps with nervous exhaustion, memory impairment, inability to think. The child is very irritable and uncommunicative, concentrating on his own inner world. He becomes apathetic and indifferent to the world around him. It is difficult for him to pick up the right words and gather his thoughts. There is a strong drowsiness, it is hard for him to wake up, dreams are disturbing.

Homeopathy copes well with psychological problems and helps with depression.

Prevention

Prevention, as well as treatment of childhood depressions, are directly dependent on the microsocial environment in which such children live. The most important thing is the situation in the team (kindergarten, school class, extracurricular sections) and family. In severe cases it is necessary to contact specialist psychiatrists, but with mild depression it can be cured due to the tolerant and attentive attitude of the parents.

This is the main thing - the correct attitude towards the child on the part of his adult relatives. It is necessary to show to it participation, to demonstrate one's love, to be interested in his deeds and experiences, to take his character traits and desires, that is, to appreciate him as he is.

This behavior will be the most effective medicine, due to which depression in children does not appear - they will not feel unnecessary and lonely. It is necessary to distract children from sad thoughts, take an active part in their lives, develop their talents and skills.

To prevent the development of depression, you need to learn to cope with stress. This contributes to a healthy lifestyle, constant charging, the correct mode, both in work and leisure. All this helps to cope with stress and maintain a mental balance.

[41], [42], [43], [44]

Forecast

Depression in children, manifested in severe form, can cause problems with learning, as well as abuse of prohibited psychotropic drugs. At many teenagers on a background of depression there are suicidal ideas.

If treatment is not available, after six months / year, a remission is possible, but after it often recurrences occur. In addition, during the depressed period, children are severely behind in their studies, lose contact with their friends and fall into a high-risk group for the possible abuse of psychotropic drugs.

According to the forecast, the probability of the return of depression in a teenager after the first episode is quite high:

• 25% of adolescents become depressed after a year;
• 40% - after 2 years;
• 70% experience a new depression after 5 years.

In 20-40% of children due to depression develops bipolar disorder. In most such cases, during treatment, weighed down heredity, ie, a mental disorder was / is in some relative.

Children and adolescents who have fallen into a depressed state need care, compassion and attention from relatives and friends. Do not overload their psyche, so as not to worsen the situation.

[45], [46], [47], [48]