Monitor your child for signs of depression
MENTAL health experts have warned that children in South Africa are increasingly suffering from depression.
In January last year, an 8-year-old girl hanged herself at a children’s home in Durban.
In September 2017, a Grade 2 pupil hanged himself from a swing at a primary school in Mpumalanga.
According to media reports, both incidents were believed to be suicides.
Johannesburg-based child and adolescent psychiatrist Helen Clark said while there were varied statistics for the incidence of depression among children in South Africa, the overall statistic was 1% to 2%, compared to 5% in adolescents.
“Depression is on the increase in our children as the level of stress under which they live increases.”
Clark said depression was more common among boys than girls and that parents were often unaware of their children’s emotional state, and should encourage them to express their feelings.
Many children, she said, behaved badly when depressed, and disciplining them made the problem worse.
“For these reasons children are not referred to us nearly as often as they should be. We often find that children referred to us with other problems such as defiant or aggressive behaviour, poor concentration and difficulties at school turn out to be depressed, and their parents are surprised by the diagnosis.”
Although there were multiple causes of depression, it was often either preceded by, or occurred with, anxiety.
“Children can inherit a genetic predisposition to depression from parents. This is frequently exacerbated by the presence of depression in the parent,” Clark said.
Is your child depressed or suicidal? Warning signs and what to do:
1. Seeing a change in the child: The child may appear sad and irritable, cry more often, start having tantrums, start withdrawing, isolate themselves, become agitated and aggressive, and behave badly.
“The key is the change in behaviour. Talk to your child. Tell him that you have noticed he’s not the same as before. Is there something worrying him? How is he feeling? Suggest emotions and explain them to help him describe them,” Clark said.
“Encourage him to talk. This may be all he needs to know you know and are going to help him. You can also start watching him to elicit other signs of depression at which time you should seek professional help.”
2. The child is no longer interested in future activities – not looking forward to a birthday party or their birthday:
“The most important intervention is to talk to your child, which so many parents just don’t do. Ask the child why he does not want to go to the party – as there may be a very valid and real reason, or the child may just not feel like it, not have the energy or say no one liked him.
“Remember that a feature of depression is a poor sense of selfworth. Look for other signs of depression and seek help if indicated.”
3. Change in sleep or appetite:
These are what are called neurovegetative features. Sleep is often disturbed, with difficulty getting to sleep (lie awake thinking sad thoughts or worrying), may wake at night and not be able to get back to sleep, or awake early in the morning. Watch for the sudden onset of nightmares representing subconscious presentation of distress.
“Monitor. Settle the child at night, sit with the child while he falls asleep, and try to address the worries. Try to provide the food they like. Look at other symptoms of depression and act accordingly,” Clark said.
4. Starts complaining of physical complaints, for example, headaches, stomach ache or dizziness, but there is nothing physically wrong (when taken to the GP:
“Once there is a suspicion of depression, physical problems should be addressed symptomatically and referred to the GP or primary health care clinic if there is a concern. A good practitioner will suspect depression at this point. Once there is a suspicion of depression, a referral should be considered.”
5. It would be better if I was dead:
“This is a reason for severe concern. Check for other signs of depression but immediately refer for assistance,” Clark said.
The procedure of referral for psychiatric/psychological help is:
If you have contact with a psychiatrist/psychologist, consult directly.
Consult a GP, a primary healthcare clinic, or hospital paediatric casualty.
They will refer you to a psychiatrist, psychologist or medical practitioner (your GP may be able to assist you directly).
Suicidality is a child psychiatric emergency – if there is a child psychiatric ward with a bed available, the child should ideally be admitted. These children need treatment and close observation.