30 Depression in children and adolescents (1)

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30 Depression in children and adolescents (1)

Overview and statistics of depression in children and adolescents

·         The young human being below the age of puberty are called children.

·         The period from birth to puberty is called childhood.

·         Children before puberty are called children for convenience.

·         Stage of children and adolescents within the age range of 0-18 years old referred to childhood .

·         Depression is one of the most serious mental disorders that can occur to anyone in all walks of life, the poor or rich, the young or the old.

·         If anyone had suffered from severe depression in childhood, the depression may recur within five years thereafter.

<Bipolar disorder is a mental illness that causes dramatic shifts in a person’s mood, energy, and ability to think clearly. People with bipolar experience high and low moods—known as mania and depression—which differ from the typical ups-and-downs most people experience.

The average age-of-onset is about 25, but it can occur in teens, or more uncommonly, in childhood. The condition affects men and women equally, with about 2.8% of the U.S. population diagnosed with bipolar disorder and nearly 83% of cases classified as severe.

If left untreated, bipolar disorder usually worsens. However, with a good treatment plan including psychotherapy, medications, a healthy lifestyle, a regular schedule, and early identification of symptoms, many people live well with the condition (source:Google).>

·         Bipolar disorder has increased 40-fold since 1994 in pre-adolescent and adolescent children (source- Dr. Mark Olson, The Journal of archives of general psychiatry 2007).

·         One in 10 children and adolescents (ages 0-18) can develop depression.

·         It is reported that 4 to 18% of adolescent children develop depression.

·         30% of adolescent children with severe psychosis are receiving treatment.

·         It is reported that 50% of adults with severe psychosis start at age 14-years-old (source; Journal watch pediatrics and adolescent medicine, August 2008. p 769).

·         The main symptoms of depression can lead to impaired feelings and behaviors, and an overall weird health condition.

·         Most depressed adolescents are treated appropriately soon, but some depressed adolescents don’t even know they are depressed, and sometimes parents don’t know if their children are depressed. Because of this, some of the adolescent children suffering from depression do not receive appropriate treatment for depression.

·         In addition, there are many cases where treatment for depression is not recommended even though it is recommended.

·         Depression in adolescent children is a major cause of suicide.

·         Suicide is the third leading cause of death among adolescent children and young adults aged 15-24 years-old.

·         Suicide is the third cause of death among 15-years-old adolescent children.

·         ⅔ of adolescent children with depression are not receiving treatment from a psychiatrist for various reasons.

·         Drinking alcohol, alcoholism, and addictive drug abuse can result from depression. Conversely, alcoholism or substance abuse can lead to depression.

·         If the depression of adolescent children is not properly treated, symptoms become more and more severe without knowing, and symptom and signs of
the depression penetrates deeply into their daily life, and eventually, depressed people  may not be able to perform their daily life normally and their entire life may be ruined.

Diagnosis of symptoms of depression in children and adolescents

If anybody with the following symptoms and signs and/or conditions he or she most likely has depression.

If there are at least 5 or 5 more symptoms and signs which are described as 1 to 11 below, and /or such symptoms persist for at least more than two weeks, and /or such symptoms and signs are severe,  and /or if they cannot perform their daily activities normally

1.

·         Thinking about death.

·         Thinking of wanting to die.

·         “I think I’m dying”.

·         Thinking about how to die from suicide.

·         Sometimes they commit suicide.

If the children experience symptoms of depression with thinking about death like this, parents should seek immediate consultation with their doctor or take them to the hospital emergency room for psychiatric treatment.

2.

·         Feeling sad.

·          “There is no hope”.

·         Symptoms of crying for no reason may persist.

3.

·          Lack of pride.

·         Guilty feeling for no reason.

·         Feeling that ‘I am no longer a good human being’.

4.

·          It means nothing to live.

·         Think there will be anything better in the future’.

5.

·         There is no feeling

6.

·   Saying “I lost interest in studying, social activities, physical activities, extracurricular activities, etc”.

·  Saying “I don’t hang out with my close friends anymore”

·   Saying “I spend time alone almost”.

7.

·  Saying “It’s difficult to decide what to do”.

·  Saying  “I can’t start or do anything new”

·  Saying “my memory is definitely lost and I can’t concentrate well”.

8.

·   Saying “my nerves become sensitive”.

·   Saying “I get mad at the little things”.

·   Excessive reaction.

9.

·  Saying “I can sleep too much or less than normal”.

·  Saying “I can eat more or less food than usual”.

·  Saying “My weight is abnormally increased or decreased”.

10.

·  Saying “I am always tired for no specific reason”.

11.

·  Some of the depressed adolescent children may have problems such as substance abuse, alcoholism, indiscriminate heterosexuality, school problems, poor grades, etc. and may have problems with family or friends, he can be rebellious and destructive to authorities or parents.

If parents suspect that their child or adolescent has depression

① Tell your family or friends that “I think he or she is depressed and consult with a depression treatment specialist or a pediatric psychiatrist.

② Otherwise, he or she will receive diagnostic treatment from his or her regular pediatrician immediately.

③ Get help from school counselors, nurses, and social workers.

④ Get help from a psychiatrist. If possible, seek help from a pediatric psychiatrist.

⑤ Seek the help of a priest, pastor, or rabbi who is qualified and experienced to provide counseling.

⑥ It is important to seek help and treatment from a pediatric psychiatrist in the early stages of depression before symptoms become more severe.

⑦ Weak mind and body, lack of sound healthy self-esteem, problems with studying at school or doing extracurricular activities, and not trying to do their best to do something well or not doing anything at all can be a symptom of depression.

⑧ Most adolescent children with depression are well treated with counseling or anti-depressant drugs.

⑨ Depression is a relatively common psychotic disease and can occur in both men and women of all ages. If parents think your child is depressed, you should immediately seek help and treatment from a pediatric psychiatrist.   

Drugs used to treat depression in children and adolescents

·  Fluoxetine,

·  Paroxetine,

·  Sertraline,

· Fluvoxamine,

·   Citalopram.

·  Escitalopram,

·  Amitriptyline,

·   There are several other types of Drugs used to treat depression, including imipramine. One or more of them can be used to treat one or two of several antidepressants.

· However, most of the drugs used to treat depression are effective in treating severe depression, but not in treating mild depression(according to a February 2008 study by Irv Kirsch of the University of Hull,).

Major Depressive Disorder is also treated with escitalopram oxalate (LEXAPRO).

Figure 3-249. The rate of using antidepressants is higher among adolescent girls than among adolescent boys. (The number above is the number of children treated with antidepressant drugs out of 1,000 adolescent children aged 10-19 years old)

Source-Medico Health Solutions Inc. and Elsevier Medical News, 2007