GOSH doctors talk about the impact of depression

According to World Health Organization, depression is the leading cause of disability worldwide, with a substantial impact on individuals and their loved ones. Depression can have a substantial impact on the societal level, with it being recognized as a major contributor to the overall burden of disease. So Clinical Psychologists, Dr Eve McAllister and Dr Daniel Stark from Great Ormond Street Hospital for Children (GOSH) are calling for parents to be aware of the signs and symptoms of depression in children.

Q: Why do you think WHO chose depression as its focus this year?

A: The importance of mental-health in people’s day-to-day lives is being increasingly recognized. The World Health Organization has demonstrated that depression is the leading cause of disability worldwide, with a substantial impact on individuals and their loved ones. Depression can also have a substantial impact on the societal level, with it being recognized as a major contributor to the overall burden of disease. Encouragingly, there are good treatments for depression. However, despite having a substantial impact on individuals, families and society in general, not many of those with depression actually receive effective treatment. Hopefully, raising the profile of depression will help reduce the impact it has.

Q: Can you describe what depression is like?

A: Depression can present in a variety of ways. It normally involves a depressed mood, no enjoyment in activities, even a lack of enjoyment for activities the person used to enjoy. It can also include irritability, a lack of interest in activities and reduced levels of energy. Depression can result in large amounts of suffering, as well as problems with basic day-to-day activities like eating, sleeping and self-care. As a result, it has substantial impact on the affected person, their friendships and relationships with others, wider home-life as well as work, or in the case of children, their schooling.

Q: What are the root causes and symptoms of depression? Also, is depression genetic?

A: Depression in both children and adults can be the result of a variety of factors. The current best scientific evidence indicates that depression is the combined result of a person’s genetics, as well as other factors, over the course of a person’s life. In children, these might include friendship difficulties, challenges in school, family factors or stressful life events. Whilst understanding the genetics of depression is important in terms of understanding and possibly in reducing risk of depression in individuals in the future, it is not the sole cause. It is also important to recognize that for the affected individual, working on and modifying the more environmental factors, as well as treating the symptoms of depression will result in the best outcome.

Q: People often confuse sadness with depression. Can you tell our readers how to differentiate?

A: This is a really good question. Sadness and depression are very different things. Sadness is a normal emotional response that we all have. It typically involves short-term feelings of low-mood, normally in response to challenges faced in day-to-day life. These periods might last for a few hours up to a few days, and are typically quite mild. On the other hand, depression is a more serious condition that affects the way people think, feel and act over a prolonged period of time. It might include periods of low-mood becoming more serious, or lasting for two weeks or more. These episodes might be hard to cope with.

Q: As Clinical Psychologists, what are your thoughts on research/ reports currently being done on the effects of neural activity specifically related to depression?

A: Again, this is another really important area, and understanding the neural and neurobiological factors in depression is an important area of research. The hope here is that it might help us prevent depression in people in the future, or possibly lead to new ways of understanding and treating depression. However, for individuals and families affected by depression, the most important aspect is identifying difficulties as soon as possible and accessing existing, good and scientifically-proven treatments.

Q: Major depression is on the rise in youth, what will help young people today in maintaining their mental health?

A: Having good mental-health depends on a wide range of factors, including how well they perceive things to be going at home, in the family, with friends and school, in addition to other activities they may be engaged in. Supporting young-people in making sure these are going as well as possible is an important first-step, as is making sure they are eating, sleeping and exercising regularly.

It is also important to build young-people’s confidence and self-esteem, typically by identifying successes in the course of day-to-day life, and finding activities they are good at. This can be something as simple as highlighting something that the young-person did well everyday. Practicing this on a longterm basis can help protect against low-mood or depression for when difficulties occur.

Q: How does one support someone with depression?

A: Supporting someone with depression can be challenging, and the first step would be raising concerns with the most appropriate health-professional. This might be the child’s general practitioner or pediatrician, who will be well placed to explore concerns in more detail and help the parent identify suitable means of support and effective, evidencebased treatments. It is important to take a kind and compassionate approach with children who are depressed. It might also be helpful to support the child undertake activities that they used to find enjoyable to prevent things worsening.

Q: Could you outline some tips for the parents worried that their child has depression or a mental health condition?

A: If you have suspicions that your child has mental-health difficulties, we would strongly encourage parents to raise this with health professionals. In many ways, having a mentalhealth condition is no different to a physical health condition - they can have a substantial impact on children’s day-to-day wellbeing, can cause substantial problems in day-to-day life as well as other health-related difficulties and typically have good treatments for them. In the same way you would raise concerns about a possible physical illness with your child’s healthcare providers, raising concerns about their mental-health is likely to lead to the best outcome in the long-run.