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Welcome to familywisdom.com, a website dedicated to informing and inspiring couples and families. Each week you will find a new article, story or essay about parenting, marriage or life. Suggestions for articles and questions to Ellen Terich are welcome. You can contact her at e.terich1@verizon.net |
PREVENTING DEPRESSION IN CHILDREN 2002-11-07 While listening to a radio program about depression in children, I was intrigued by a call from a concerned mother of a four year old. She reported that both she and her husband had been plagued by depression for years and she wondered about the vulnerability of her son to depression. She noted that her son had begun showing signs of "anxiety" which she thought might be excessive and she asked the guest on the program, a psychiatrist, for advice on how to help her son. The example she gave of her son's excessive anxiety was that he became frightened in parking lots and asked her to stay close so that he wouldn't get hit by a car. The psychiatrist told her (without even seeing the boy) that indeed she had cause for worry as depression and anxiety disorders run in families and what she should do is keep an eye on him and bring him for psychiatric help (including the possibility of medication) if symptoms continued to be present in the ensuing months. I'm not sure if this answer was a satisfactory one to the mother. If I had been the child's mother it would not have helped me at all. I would have wanted to know what I as a mother could do to help him manage his anxiety so that it did not grow and evolve over the years into a full blown disorder. It may very well be that depression and anxiety occur commonly among members of the same family. There are, however, three possible reasons why this may be so. One is that there is some neurochemical defect in the brain that is carried in the genes and passed from parent to child, which makes a person susceptible to depression. The second is that children learn to be anxious or depressed from watching their parents who are also anxious and depressed. The third is that it is some combination of the two: a genetic weakness or predisposition which is exacerbated by the modeling of parents. If the sole cause of depression and anxiety is the first possibility, then the only solution to the problem of depression and anxiety is to take pills to change the neurochemistry and thus the brain function. This is, of course, the easiest type of treatment, but there is a cost. All medications for anxiety and depression have some unpleasant side effects and the results of long term use are still not known. In addition, the patient becomes emotionally, if not physically, dependent on the medication and does not have the sense that they are able to help themselves. They remain passive victims of their neurochemistry. In children, medication can be even more risky as most of these medications have not been thoroughly tested nor been approved for use in children. If either the second or third possibilities are valid, then something other than, or in addition to medication might be helpful. Behavioral counseling programs might be recommended or parents can be encouraged to parent vulnerable children in a very specific way. If I were the parent of a potentially vulnerable child, this is the information I would want. How could I parent my child in such a way that the possibility of developing depression was reduced? First let me make a comment about the example of excessive anxiety that the mother gave. As the parent of four grown children, I do not think this is a manifestation of excessive anxiety. Rather, it may be an example of a very cautious and intelligent child. Perhaps this child has seen stories on television of people being hit by cars. Just a few short years ago there was an instance here in California of a car going through a fence at a preschool and killing two children. It was featured on the local news for days. Or perhaps the child has seen cars driving erratically in parking lots. This one instance of fearful behavior does not by any means indicate that this child may grow up to have excessive anxiety and depression, even with parents who have been diagnosed at some point with depression. Even if this child may be more anxious than the average child, however, there are still things parents can do to help the child learn to manage anxiety. A parent, for instance, can tell the child that it is good that he is cautious because that is how he will stay safe. (Anxiety, after all, has a protective function.) But the parent also needs to remind the child that she is there and will take care of him. "Stay next to me, Johnny," she might say "and you will be okay. That's why I'm here with you. Mommys take care of their children and keep them safe." This is a message that will probably need to be repeated over and over. In every situation where the child expresses fear, the mother or father can acknowledge the child's fear but not let it dominate the conversation. Parents can repeatedly reassure the child and even give him little phrases to repeat to himself so that he doesn't worry as much. If signs of depression (negative thinking, negative self-evaluations and negative predictions) begin, parents can also help children by teaching them other ways to view things. If Susie says "no one ever likes me" mom can help her look at the people who do like her and see that it isn't true that "no one" likes her. Again, this type of reevaluation of the child's thinking will need to be done over and over again. Think how often children use the words "always" and "never." Simply helping children learn to use words like "sometimes" and "a lot of times" is one technique that may be helpful. Recent research even shows that this type of cognitive reappraisal, practiced over time, actually changes the brain. The bottom line is that it takes time and energy to parent children and possibly even a little more time to parent a child who is at risk for mental illness. But it is possible to make at risk children less vulnerable to depression. Children have exaggerated fears and distorted thinking because they haven't learned to manage their emotions or think in a more balanced way. It is up to parents to not only to give them good food and keep them physically healthy, but do everything possible to give them positive, balanced thoughts in order to keep them mentally healthy. If I were to give advice to this concerned mother, I would acknowledge that her job may be a little more difficult than that of the average parent and I would encourage her not to give up. Sometimes we have to be like broken records with our children before they finally catch on. But we are our children's first teachers and helping them to manage emotions and think more rationally are two of the most important things we do. When we do them consistently and well, we can truly help our children grow up less vulnerable to depression. |