Depression in a child

Depression is a disorder characterized by the classic triad: decreased mood (hypothymia), motor and ideational inhibition. The symptoms of depression are similar to those observed in adulthood, but have a significant difference. In childhood, somatovegetative symptoms of depression come to the fore, while the affective component is represented by a feeling of oppression, depression, boredom, and, less often, an experience of the affect of melancholy.

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Epidemiology

There are no accurate and comparable data on the frequency of depression in children, since it often occurs atypically and is not diagnosed.

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Causes child depression

The causes and mechanisms of endogenous depressions are unknown, although a number of factors involved in the development of the disease have been identified. The constitutional-hereditary factor is of primary importance.

Depression in children can develop due to the following factors:

• A pathology that occurs in the early neonatal period due to chronic hypoxia of the fetus inside the uterus, intrauterine infections, and encephalopathy in the newborn;
• Problems and conflict situations in the family, single-parent family, lack of parental care;
• Teenage problems – leaders appear in the environment, dictating the behavior model in the company. Those who do not correspond to this model find themselves outside of social life. Because of this, the child becomes alienated, which leads him to depressive thoughts;
• Frequent moving from place to place – under such conditions it will be difficult for a child to establish a permanent social circle and find real friends.

Causes of depression in a child can also be acute stress - such as a serious illness or death of relatives, quarrels with relatives or peers, family breakdown. Although depression can begin without being tied to any clear reasons - outwardly, both physically and socially, everything can be fine. In this case, the matter is in the disruption of the normal functioning of biochemical activity in the brain.

There are also seasonal depressions, which occur due to the child’s body’s particular sensitivity to different climatic conditions (mainly observed in children who were injured during childbirth or suffered hypoxia).

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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 difficult life situation – this form of depression is called reactive.

If we focus exclusively on the biological cause of depression, it is the deficiency of monoamines and the decrease in receptor sensitivity, due to which the circulation of monoamines accelerates (compensating for the loss of sensitivity), leading to the depletion of neuronal depots. Differentiation of neurotransmitter monoamine systems by functional feature is carried out in the following way:

• Dopamine, which regulates the motor circuit, responsible for the process of developing a psychostimulating effect;
• Norepinephrine, which provides support for the level of wakefulness and a general activating effect, and also forms the cognitive reactions necessary for adaptation;
• Serotonin, which controls the aggression index, appetite regulation, impulses, sleep-wake cycles, and also has an antinociceptive and thymoanaleptic effect.

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Symptoms child depression

Psychotic forms of depression are almost never seen in children under 10. Depressive disorders are observed in the form of episodes of recurrent or bipolar affective disorder in the form of phases separated by light intervals.

Patients are lethargic, complain of physical weakness, say that they want to lie down, that they are tired, that everything is boring, that nothing brings them joy, that they do not want to do anything, and in general, “they would rather not look at the world.” Their sleep is disturbed (difficulty falling asleep, restless sleep with dreams and awakening), appetite is reduced. Cognitive productivity decreases due to the slowing down of associative processes. Children stop coping with the school workload, refuse to attend school. They consider themselves stupid, worthless, bad. In severe depressions, rudiments of ideas of self-accusation and guilt appear. For example, 5-year-old P. motivated his refusal to eat by the fact that “he is the worst boy in the world and he does not need to be fed.”

Periods of worsening depression are manifested in characteristic states of agitation or inhibition. States of agitation in the form of motor restlessness and fussiness are accompanied by outwardly unmotivated long inconsolable crying, lamentations such as "oh, I feel bad, I feel bad", hysterical reactions or aggression to persistent attempts by relatives to calm them down.

It should be noted that parents often do not understand their child's condition, take his behavior for a whim, licentiousness, 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 cannot explain their condition during crying, saying: "I don't remember, I don't know." Periods of agitation can be replaced by a state of inhibition, when they sit in one place for hours with a mournful expression in their eyes.

In childhood, with depression within the framework of a recurrent disorder, a special daily rhythm of depression can be noted with a worsening of the condition in the evening, in contrast to the daily fluctuations typical for 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 relationship between the risk of suicide and the severity of depression. Delusional depressions, which are rarely observed in childhood, are considered the most suicidal. Perhaps this is due to the relative rarity of suicide attempts in childhood, especially younger ones. 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, insults, undeserved accusations, etc. In adolescents, the risk of suicide increases many times over, which is associated with the predominant structure of depression at this age (reasoning depression) and such sensitivity, sensitivity to external influences, which is characteristic of patients of this age.

Depressions can proceed atypically, masked by other psychopathological and somatopsychic disorders. A special type of masked depressions are somatized forms. In children, against the background of a moderate change in affect, various somatovegetative disorders develop, imitating various somatic diseases. External manifestations of a decrease in mood are a drop in energy potential and somatic tone. Children complain of lethargy, weakness, and a dull mood. People around them note that the child is capricious, whiny, uninterested in toys, and does not respond to gifts. Doctors and parents associate these behavioral features and affective reactions of the child with the child's imaginary somatic ill-being. As a rule, children in these cases are placed in a somatic hospital, where the examination results cannot 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 are referred to a psychiatrist, often years after the onset of the disease.

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

In recurrent depressions and depressive syndromes within the framework of periodically occurring schizophrenia, a variant with hyperthermia and latent depression is quite often observed. The peculiarity of thermoregulation disorders in patients is significant temperature fluctuations from subfebrile to high with a drop to hypothermic values, specific daily fluctuations (a morning peak with a subsequent decrease during the day or an evening peak and a drop at night), a seasonal periodic nature. Along with hyperthermia, patients complain of headaches, dizziness, nausea and vomiting, which requires the exclusion of not only somatic, but also neurological diseases.

The most common manifestations of somatization in endogenous depressions are the appearance of pain symptoms, which can be localized in any part of the body, and be paroxysmal or constant. As a rule, unpleasant bodily sensations and pains do not correspond to the manifestations of known somatic diseases and are not amenable to treatment with symptomatic means.

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

For young children, endogenous depressions are most characterized by changes in the rhythm and quality of sleep, decreased appetite, temporary cessation of development, and pseudo-regressive vegetative disorders. The latter are characterized by partial loss of speech and motor skills, the appearance of enuresis and encopresis.

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

V.N. Mamtseva also described, within the framework of neurological masks, attacks resembling atypical epileptiform ones, occurring with a feeling of severe weakness, gait disturbance, sometimes accompanied by a fall, but without loss of consciousness.

Adolescent depressions are characterized by a significant number of atypical phases, which complicate diagnosis. Somatized depressions are characterized by the presence of massive vegetative dysfunctions (sweating, chilliness, tachycardia, constipation, vascular dystonia, etc.).

Quite often in adolescence, relatively shallow depressions are observed, which are masked by behavioral disorders, which complicates their diagnosis. In ICD-10, this type of depression is allocated to a separate category - mixed disorders of behavior and emotions.

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

• Disturbances of appetite - increase or, conversely, loss of appetite;
• Drowsiness or insomnia;
• Irritability;
• Regular mood swings;
• The child feels worthless and a feeling of hopelessness appears;
• Suicidal thoughts;
• Boredom and disinterest;
• Hysteria, capriciousness, tears;
• Constant fatigue;
• Memory impairment;
• Loss of concentration;
• Slowness and awkwardness;
• Problems in studies;
• Weakness, the appearance of causeless pain, nausea and dizziness;
• Teenagers develop problems with various strong drugs or alcohol.

Also, with depression, a child may experience high sensitivity and compassion, dissatisfaction with how others treat him, and doubts about parental love.

Young schoolchildren, being in a state of depression, are afraid of answers at the board, do not want to go to school, forget what they have learned when the teacher asks them about it.

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First signs

The onset of depression in a child may be gradual, but it may also appear suddenly. The child becomes overly irritable, and has a constant feeling of boredom and helplessness. People around him or her note that the child has become either overexcited or, on the contrary, too slow. Sick children also develop excessive self-criticism or begin to think that others are unfairly criticizing them.

The first signs of depression are usually barely noticeable to others, and they are not given much importance. This is why it can be difficult to find a connection between the symptoms that have arisen and understand that depression is the cause.

An important point is the timely detection of symptoms of suicidal behavior in a child - they usually vary depending on the age of the patient. Depression in children, as well as teenagers, in this case is expressed in the form of cessation of communication with friends and obsession with the idea of death.

Many children suffering from depression show signs of excessive anxiety – worrying too much about everything or being afraid of being separated from their parents. These symptoms sometimes appear even before depression is diagnosed.

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Autumn depression in children

Many people think that autumn depression mostly affects adults, but children are not spared from this disease either. Each age group experiences this depression in its own way, so you should clarify for yourself what symptoms are typical for each group of children:

• Babies are capricious during meals, refuse most foods altogether, have slow reactions, and gain weight very slowly;
• Depression in preschool children is manifested in weak facial expressions, an "old man's" gait. They also become too quiet and sad;
• Symptoms of autumn depression in primary school children include isolation, causeless melancholy, unwillingness to communicate with friends, indifference to studies and games;
• Depressed high school students become excessively tearful or even aggressive. They lose interest in the life around them, their memory deteriorates, they lose the desire for active activity, and they react slowly to new information.

Seasonal depression needs to be recognized in a timely manner. Otherwise, it will develop into chronic depression, and in such a situation, the child may even have suicidal thoughts. This is, of course, the worst-case scenario, but it is better to be on the safe side and identify the disease in advance.

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Depression in children under one year old

Depression is a mental disorder that manifests itself in a variety of forms and symptoms. Among them are loss of interest in active activities, constant depression, slowness of thinking, physiological symptoms such as loss of appetite or insomnia, and the emergence of many unfounded fears.

Depression in children and adults varies greatly in the severity of symptoms. For example, unlike adults who enter the so-called “social withdrawal” stage when depressed, a child may become overly rude and aggressive.

It is also important to understand that symptoms such as learning difficulties and refusal to learn at all, absent-mindedness and lack of concentration may indicate not only depression – the cause of such behavior may also be the so-called attention deficit syndrome. Also keep in mind that each age has its own signs of depression, although there are some common manifestations.

Depression in children under one or two years of age has been little studied, and there is very little information about it. Small children, if they do not have the opportunity to form their own attachment, since maternal affection and care are absent, show signs that are similar to the onset of depressive disorder: this is alienation, apathy, weight loss, sleep problems.

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Depression in preschool children

Most parents have a hard time coping with depression in preschool-aged children. Many children are vulnerable to developing mental disorders, but if they have not yet been diagnosed with depression, they may be treated as overly naughty, lazy, detached, overly shy, which is fundamentally wrong, and only worsens the situation.

Nowadays, depression in children is often explained by such reasons as attention deficit disorder, temporary reaction to a stressful situation, oppositional defiant disorder. When such diseases are observed in children, it is necessary to understand that they can go together with depression or be incorrectly diagnosed instead of it.

Age from birth to 3 years: During this period, signs of the disorder may include developmental delays that have no apparent physical cause, feeding difficulties, frequent tantrums and whims.

3-5 years: The child develops exaggerated fears and phobias, and may show developmental delays or regression (at key stages, such as toilet training). Children may constantly and exaggeratedly apologize for minor mistakes, such as untidy toys or spilled food.

6-8 years: Complains vaguely about physical problems, sometimes behaves aggressively. Also clings very much to his parents and does not want to accept strangers.

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Depression in school-aged children

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

If stupid depression in children becomes protracted, depressive pseudo-debility develops against its background, which creates self-deprecating ideas in teenagers about their own failure in all areas, both at school and in relationships with peers. In addition, children may have aggressive or hysterical reactions to others. If a child has such depression, you need to see a psychiatrist to determine his intelligence level - this will exclude the possibility of mental retardation.

Depression in any form is a serious problem and it must be treated. In this case, you should seek the help of a qualified doctor - a psychiatrist or psychotherapist. Only a professional will be able to find the symptoms of depression behind a variety of different behavioral disorders and choose the best treatment that will help the patient.

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Forms

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

• F31 Bipolar affective disorders.
• F31.3-F31.5 Current depressive episode of varying severity within bipolar affective disorder.
• F32 Depressive episode.
  • F32.0 Mild depressive episode.
  • F32.00 Mild depressive episode without somatic symptoms.
  • F32.01 Mild 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.

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Complications and consequences

Depression is a very serious psychological disorder that develops mainly against the background of various stresses or long-term traumatic situations. Sometimes depression in children can be disguised as a bad mood or explained by individual character traits. Therefore, in order to avoid serious consequences and complications, it is necessary to promptly identify depression and find out what caused it.

Emotional manifestations during depression are very diverse. Among them are low self-esteem, a feeling of despair and anxiety. A person with a depressive disorder constantly feels tired, is in a sad and melancholy state. His behavior also changes. The presence of depression is also indicated by a person's loss of the ability to perform purposeful actions. Sometimes it gets to the point that a person with depression becomes addicted to drugs or alcohol to relieve attacks of anxiety and melancholy.

In general, depression often becomes the cause of drug or alcohol addiction, as they can help to detach and create a false sense of good mood. Depression can also result in various social phobias.

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Diagnostics child depression

Practicing doctors believe that special questionnaires and ratings will be very useful for diagnosing depression in a child. Among them are: the rating of children's depression from the Center for Epidemiological Research, the questionnaire of children's depression and the self-assessment rating of depression. But the most popular and most effective diagnostic method is considered to be a clinical interview with the child himself, his relatives, and other adults who are familiar with him and know about his condition and problem.

Depression in children is not diagnosed using specific biological tests, although there are some biological markers that are currently being studied to see if they are suitable as a diagnostic tool.

For example, some patients experience hyposecretion of the hormone responsible for growth during a severe depressive phase. 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.

However, truly sensitive methods of specific diagnostics, which could be of great importance in the process of identifying a depressive state, have not yet been developed, but diagnostic criteria can be identified:

• Decreased mood with a gloomy pessimistic vision of the future (the meaninglessness of existence in so-called rationalizing depression).
• Ideational inhibition (not always) with decreased ability to concentrate and pay attention.
• Motor retardation (lethargy, feeling of unexplained fatigue).
• Ideas of self-abasement and guilt (in mild cases - low self-esteem, lack of confidence in one's own strength).
• Somatovegetative disorders characteristic of depression include sleep disturbances, loss of appetite, and constipation.

Read also: 8 Things You Need to Know About Antidepressants

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Differential diagnosis

For a pediatrician, the most relevant differential diagnosis is between somatized depression and somatic disease with a depressive reaction to the disease. Differential diagnosis primarily requires excluding a somatic disorder. This is assessed based on the totality of the results of laboratory and instrumental research methods, medical observation. The presence of signs of a depressive disorder requires additional consultation with a psychiatrist, based on whose conclusion the issue of the place and methods of treatment is decided.

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

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

If depression in children has psychotic symptoms, in addition to antidepressants, ECT or neuroleptics are prescribed. If the patient exhibits such atypical symptoms as increased appetite with a strong craving for sweets and carbohydrate-rich foods, as well as anxiety, mood swings, drowsiness and unwillingness to accept refusal, it is necessary to prescribe either drugs that enhance serotonergic activity or monoamine oxidase inhibitors.

Depression with psychotic features (hallucinations, delusions) may or may not coincide with depressive motives in content. Catatonic manifestations include such features as negativism, psychomotor problems, echopraxia and echolalia.

Treatment child depression

To treat depression in a child, modern antidepressants of the following group are used - selective inhibitors acting with reverse serotonin uptake. This group includes the following drugs: paroxetine, fluoxetine drugs, citalopram, sertraline drug, escitalopram. They have a calming and analgesic effect on the body, helping to overcome obsessive fears and cope with panic attacks.

The effectiveness of these drugs is no worse than that of drugs from other groups, and at the same time the risk of side effects due to their use 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, making it much easier for him to adapt to society.

Among the tasks of individual psychotherapy is teaching the student to correctly express his own emotions, talk about any traumatic moments and overcome these difficulties.

If there are any problems in the relationships between relatives in the family, and the parents cannot find a common language with their child, family psychotherapy can help.

Medicines

Fluoxetine antidepressants can be very effective in treating depression. However, it should be understood that it may take 1-3 weeks for the child to feel better. In some cases, it may take as long as 6-8 weeks for improvements to occur.

It is necessary to ensure that the child takes the medication exactly as prescribed by the doctor. If there are any doubts or questions about taking the medication, or if there are no changes for the better after 3 weeks of taking them, you should discuss this with the attending physician.

Depression in children is treated with vitamins (vitamin C is especially effective); B-group substances, vitamin E and folic acid are often used.

Magnesium (in the form of Magnerot and Magne B6) has a good antidepressant effect.

Among the drugs that help with depression, the dietary supplements "5-NTR Power", "Sirenity", and "Vita-Tryptophan" are noted. They contain 5 hydroxytryptophan, which improves the process of serotonin synthesis 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, which contains hypericin, which improves the production of good mood hormones in the body.

Children over 12 years of age can take the medicine "Negrustin".

Vitamins

Depression in children can also be treated with various vitamins. It is worth considering in more detail what vitamin needs teenagers have:

• It is necessary to take up to 2 g of vitamin C daily. Moreover, it should not be ascorbic acid, but a natural product, which in addition to the vitamin will contain bioflavonoids. Without this supplement, the absorption of the useful substance will not be as effective;
• Group B-6 – vitamins in the form of pyridoxal phosphate or pyridoxine (doses must be divided, gradually increasing in size);
• A vitamin complex containing manganese and zinc;
• Calcium complex, which, together with calcium, contains such elements as zinc, boron, magnesium, chromium and a chelated form of vitamin D-3, since in it this vitamin is better absorbed by the body;
• Tablets containing pressed seaweed, iodized salt, or kelp.

In addition, you should take a multivitamin complex, which, among other things, contains iron, which prevents the development of anemia. It also contains a very useful vitamin, molybdenum, which helps normalize the balance during bone growth during puberty.

Teenagers are also recommended to drink herbal tea with a spoonful of honey added – it has a calming effect – and eat valerian extract at night (2 tablets).

Folk remedies

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

Depression in children mainly occurs when the brain has to deal with a serious psychological problem that occupies it so much that it cannot cope with other things that need attention. In this situation, the problem begins to absorb all available mental resources, due to which after some time the person will no longer be able to think sensibly and perform adequate actions. As a result, due to nervous overstrain, cognitive, emotional, etc. problems begin, which demonstrate a failure in brain activity.

To strengthen the nervous system, you can turn to folk remedies:

• Baths with infusions of poplar leaves;
• Morning rubdowns with salted water;
• Use of tincture from ginseng root;
• Use of Eleutherococcus extract;
• A decoction made from mint leaves (add 1 tbsp of tincture to a glass of boiling water). Drink half a glass in the morning and before bed. You can also add mint leaves to tea;
• Tincture of chicory roots (add 1 tbsp of chicory to a glass of boiling water). Dosage: 1 tbsp 6 times a day.

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Herbal treatment

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

The root of the zamaniha is poured with 70% alcohol (proportions 1:10) and infused. It is taken in a dosage of 30-40 drops before meals twice/three times daily.

3 tablespoons of chopped straw are poured with 2 glasses of boiling water and infused. The resulting decoction should be drunk within 24 hours. The tincture has a general strengthening and tonic effect on the body.

1 tbsp. of chamomile aster flowers is poured with 1 glass of boiling water, then cooled and filtered. The infusion should be drunk 1 tbsp. 3-4 times a day. The decoction helps to strengthen the nervous system and add tone to it.

Dried ginseng leaves or roots should be poured with boiling water (proportion 1:10), then infused. Take in a dosage of 1 teaspoon daily.

Chopped ginseng leaves/roots are poured with 50-60% alcohol in proportions of 1.5 to 10 for leaves and 1 to 10 for roots. The tincture is drunk twice/three times daily, 15-20 drops at a time.

1 teaspoon of angelica root is poured with a glass of boiling water and infused. It should be consumed half a glass 3-4 times a day. The tincture helps with nervous exhaustion, strengthening and toning the nervous system.

Homeopathy

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

When depression is combined with insomnia, Arnica 3, 6 and 12 dilutions should be taken. Acidum Phosphoricum (as phosphoric acid is called) 3x, 3, 6 and 12 dilutions also treat depression well.

Arnica montana helps when the patient demonstrates indifference, cannot act independently, is sullen. Also strives for loneliness, is tearful and hypersensitive. Also absent-mindedness, nervous and mental agitation, irritability, willfulness appear. During the day he may seem sleepy, but he cannot fall asleep.

Sepia treats severe memory problems, mental inability, irritability and touchiness. It also helps if the child begins to fear loneliness, becomes sad and anxious. He experiences weakness and mental exhaustion. When in company, he experiences overexcitement, but the rest of the time he is very gloomy. During the day he is very sleepy, but at night he can hardly fall asleep.

Zinc valerate works well for severe insomnia and headaches, as well as hysteria and hypochondria.

Phosphoric acid helps with nervous exhaustion, memory loss, and inability to think. The child is very irritable and taciturn, focusing on his own inner world. He becomes apathetic and indifferent to the world around him. He has difficulty finding the right words and collecting his thoughts. He is very sleepy, has difficulty waking up, and has disturbing dreams.

Homeopathy is good for dealing with psychological problems and helps with depression.

Prevention

Prevention and treatment of childhood depressions directly depend on the microsocial environment in which such children live. The most important thing is the environment in the group (kindergarten, school class, extracurricular sections) and family. In severe cases, it is necessary to contact psychiatrists, but in mild depression, it can be cured by a tolerant and attentive attitude of parents.

This is the main thing - the correct attitude towards the child on the part of his adult relatives. You should show concern for him, demonstrate your love, be interested in his affairs and experiences, accept his character traits and desires, i.e., appreciate him as he is.

This behavior will be the most effective medicine, thanks to which depression in children will 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, it is necessary to learn to cope with stress. This is facilitated by a healthy lifestyle, regular exercise, the correct regime, both at work and at rest. All this helps to cope with stress and maintain mental balance.

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Forecast

Depression in children, if it manifests itself in a severe form, can cause problems with learning, as well as abuse of prohibited psychotropic drugs. Many teenagers develop suicidal thoughts against the background of depression.

If there is no treatment, remission is possible after six months/a year, but relapses often occur after that. In addition, during the depressive period, children fall far behind in their studies, lose contact with their friends and fall into a high-risk group for possible abuse of psychotropic drugs.

According to the prognosis, the likelihood of depression returning in a teenager after the first episode is quite high:

• 25% of teenagers become depressed after just one year;
• 40% – after 2 years;
• 70% experience new depression within 5 years.

In 20-40% of children, bipolar disorder develops due to depression. In most of these cases, an aggravated heredity is revealed during treatment, i.e., a mental disorder was/is present in some relative.

Children and teenagers who have fallen into a depressive state need care, sympathy and attention from relatives and loved ones. Do not subject their psyche to excessive stress, so as not to worsen the situation.

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