Depression in Your Child
"It used to be, a kid could get average grades, play kick-the-can, read a few books at the public library, and that would be good enough. Now being average has become stigmatized."
So says Dr. Abraham Havivi, a child psychiatrist in Los Angeles. Havivi believes the pressures of modern life have led to an increase in depression among children. Now, at the end of the 20th century, parents perceive that the gap between the "haves" and the "have-nots" is widening. Consequently, they try to ensure that their children will become part of the "haves" by urging kids to excel in the classroom, on the athletic field and in their social circles. Although parents have their children's best interests at heart, they may be unwittingly forcing kids to assume too much responsibility too soon.
Julie Drake, a former elementary school teacher who now works for the Los Angeles County Office of Education, adds that kids today have a lot more homework than their counterparts 10 or 20 years ago.
"It's not necessarily meaningful homework, plus they have dance lessons, sports lessons," says Drake. "There's not enough time to sit back and process the day's events."
Fifth-grade teacher Carmen Dean attributes the increase in childhood depression in part to our culture. "Boys are made to think they have to have a pretty babe, a big car, all this external stuff. Girls feel they have to live up to this impossible physical ideal, so immediately there's a sense of failure. It used to be 14- and 15-year-olds who were reacting to these messages. Now it's filtering down to the younger kids."
In a Slump
It's normal for a preteen's burgeoning hormones and increasing need for autonomy to cause mood swings. Dr. Havivi says parents shouldn't overreact if their children occasionally get down on themselves. According to Havivi, kids commonly suffer from "situational depression" -- frustrations stemming from problems with school pressures or with friends. This kind of slump is short-lived and usually will lift without intervention.
Sixth-grader Blake Clausen experienced such a slump when he left the nurturing world of his small elementary school to begin a much larger junior high. A genial boy who adjusted remarkably well to his parents' divorce, his mother's subsequent remarriage and the birth of his half-sister, Blake found the first few weeks of junior high to be the most stressful time of his life.
"Suddenly, he has to change classrooms, he's expected to keep his notebooks a certain way, and he's passing eighth-graders with beards in the hall," says Blake's mother, Gina, looking a bit overwhelmed herself.
Blake readily admits the school pressures have affected his temperament.
"I'll be really happy one minute, then an hour later, I'll be in the worst mood, like if I forget my homework," he says.
Luckily, Blake's bad moods last no more than an hour. And after several weeks in junior high, he feels he's better able to handle the stress. He attributes part of this newfound ease to his parents' reassurances.
"They told me once I got used to the schoolwork, things would get better. And they did."
Parents should be concerned about their child's depression if it continues for a long period of time and is so pervasive that it colors everything. This is clinical depression, which Dr. Havivi likens to wearing "gray-tinted glasses." He explains that the seriously depressed child feels that "everything is bad, nothing is fun, and no one likes him or her."
In assessing possible clinical depression in a preteen, Havivi examines the major areas of the child's life: family, social, academic and the interior world. Havivi says that most of the troubled preteens he sees don't have major depression. Instead, they're demoralized by frustrations in one of the primary areas. Once Havivi pinpoints the problem, he works with the family to devise an appropriate treatment. For instance, if a bright boy is making poor grades at a highly competitive school, his parents might consider transferring him to a school that provides a more nurturing environment. Or, if a teacher complains that a girl seems distracted by her constant doodling, the parents might want to enroll the child in an art class instead of inadvertently thwarting her creativity by insisting she quit doodling.
When to Medicate
Dr. Havivi stresses that medication is last on his list of preferred treatments for children. Although the new class of antidepressants -- selective serotonin reuptake inhibitors (SSRIs) which include Prozac, Zoloft and Paxil – are considered as safe for children as for adults, no one really knows if these drugs can cause subtle, long-range changes in a preteen's developing brain chemistry. Together with his patient and the family, Havivi weighs the risks and benefits of prescribing antidepressants. Is the child withdrawn, losing friends? Does she have low self-esteem? Is her concentration impaired to the point that she's failing school? If the child is suffering in each of these areas, then the potential benefits from medication could override the unknown risks.
How Adults Can Help
According to Dr. Havivi, parents should strive to take away some of the pressure weighing on their child and create opportunities for him to find activities he enjoys and feels good about doing. A child doesn't have to be wildly popular to be happy, but he does need at least one good friend. Parents also should encourage their child to be active; going to a movie or playing ball is more likely to make a child feel better than staying home alone doing nothing.
Dr. Havivi says the best thing parents can do for a depressed preteen is to talk to her.
"Conversation among families is most important, better than therapy," says Havivi. In these conversations, parents should practice "active listening": express interest in what their child thinks; validate her feelings, rather than minimize them. It's also helpful for parents to share what it was like for them at their child's age. But Havivi warns parents to maintain their boundaries and not project their own issues onto their child.
Carmen Dean and Julie Drake feel that teachers and school administrators should provide children a safe place to say how they think and feel. For example, teachers can set up social skills groups in classrooms. These groups can help kids whose inappropriate behavior may be alienating peers to discover what's hurtful, what feels good, how to compliment. Teachers also can tap into community resources that can benefit the entire family: outreach counseling and parenting classes.
Remarking on one of her fifth-grader's complaints that too often adults trivialize children's feelings, Dean says it doesn't take much effort on an adult's part to reach out to a troubled child, listen to him and really believe him. She quotes another student's number-one suggestion for parents: "If you spend time with us, it makes us feel you care about us."