“Over one-third of teens are likely to experience anywhere from mild to severe depression”. (CNMAT, n.d)
“[Sixty-five percent] of adoptees reported that they have been depressed at some point in their lives” (Flynn, Welch & Paget, 2004). We hear a lot about depression and see it depicted in the media, but what does this mood disorder look like in everyday life for children and youth in general, and children and youth who join their family through adoption? Why is this important for adoptive parents to know? Everyone feels sad every once in a while, although depression is more than a feeling of sadness; it is a medical condition just like diabetes or heart disease. Like these conditions, depression needs to be treated.
Depression impacts the way a person thinks, feels and functions. When trying to identify the factors that contribute to depression, it is important to consider their experiences with grief, loss, trauma and attachment, as well as their genetic predispositions. There are many things to consider if you suspect your child or youth may be suffering from depression. For a child or youth living in foster care, there could be various factors impacting their mental health. This section on depression will provide some tips, tools and techniques for families considering adopting a child or youth living with depression, as well as a history or diagnosis of depression.
Signs of Depression
The signs and symptoms of depression can vary greatly depending on your child or youth. Not every child/youth who is diagnosed with depression will have the same symptoms, and the symptoms your child exhibits may change over time. Therefore, if parents are aware, it would be easier for them to take action.
Symptoms of depression in children and youth
According to Children’s Mental Health Ontario (2016), some specific symptoms in children might include the following:
*This is not a comprehensive list
Also according to your children’s Mental Health of Ontario (2016), adolescents and youth have common symptoms including some of the following:
*This is not a comprehensive list
Older children and youth can still exhibit some of the same symptoms as younger children. However, older children and youth are more likely to verbalize their emotions. Many teenagers with depression may say things such as “Why do I bother?” or “I hate myself”. It is also common for a teenager living with depression to withdraw from their friends and family, spending increasing amounts of time alone. They might also start to become forgetful and begin missing homework deadlines or fail to complete tasks that they normally would have done. You many find them sleeping a lot more and feeling tired or lethargic throughout the day.
When to seek out services and support
Occasional feelings of sadness are completely natural and normal. However, many children in care have experienced traumatic early life events and may be having a difficult time working through these experiences at different ages and stages. This does not necessarily mean that they are depressed. However, if feelings of sadness persist for more than two weeks, or if you fear that your child or youth may be at risk, (i.e cause harm themselves or others), it may be time to seek help.
If you suspect that your child may suffer from depression, it is important to seek help from a professional (psychologist, psychiatrist or an adoption competent therapist). NOTE: Oftentimes you have to start out with a family doctor for a referral. Each type of depression has its own criteria and an approved mental health professional will help determine whether your child fits the criteria for a certain form of depression. If you are concerned there are immediate safety risks to your child or youth, do not hesitate to call 911 or your family doctor. It takes a village to raise a child.
Types of Depression
It is important to be well-informed about depression and to seek out the services of a doctor or counselor for a diagnosis and treatment plan. Becoming informed about your child’s needs and experiences prepares parents to be able to access supports and better understand, communicate, and meet the needs of their child. There are several different types of depression that can occur during childhood and adolescence. Below is a description of just some types of depression (American Psychiatric Association, 2013).
Major Depressive Episode: A severe feeling of sadness that does not simply go away on its own. Depression can also have physical symptoms such as headaches, stomachaches and fatigue. These symptoms will be present for most of the day, every day or for at least two weeks.
Seasonal Affective Disorder: Seasonal Affective Disorder is a disorder that occurs during the late autumn and winter months, when there is less daylight. The low mood and depressive symptoms will be persistent during those months and they will subside once the spring and summer months begin.
Disruptive Mood Dysregulation Disorder: A form of depression that is diagnosed in children and youth between the ages of six and eighteen. A child or youth with DMDD will appear to be irritable most of the day and they will have outbursts or temper tantrums at least three times a week. In order to be diagnosed with DMDD, these symptoms must be consistent for at least twelve months.
Depression Associated with Bipolar Disorder: Bipolar disorder is different from Major Depressive disorder, however they do share some common symptoms. Bipolar disorder is characterized by periods of euphoria (manic period) followed by periods of depression.
How is Depression Diagnosed?
Possible contributors of depression
Many children in care have experienced grief and loss, and or trauma (i.e neglect or abuse pre-placement), in combination with the transition to a new home. These factors may contribute to depression. It is important for you to know your child’s history and how he/she has been impacted past and present. A question you can ask is if your child has previously received any counselling or support.
Other risk factors for depression include:
Supporting a child or youth with depression
“Help can make a difference for 80% of people who are affected [by depression], allowing them to get back to their regular activities” (CMHA, 2016).
There are various forms of treatment available to support your child or youth. There is not one specific technique to treat depression and treatment needs to be tailored to the needs of your child, youth and/or your family. Counselling and medication can both be successful in treating children with depression.
A psychiatrist may determine that your child would benefit from anti-depressant medication to help manage their symptoms. Medication can take some time in order to take effect, it is important to be patient and to give the medication a chance to work while monitoring side effects. If the side effects are not bearable or are worsening with time, you may want to talk to your child’s psychiatrist or doctors about changing the dose or brand of their medication.
Ongoing medical follow up is needed to ensure your child or youth is getting appropriate support from counsellors, doctors or both.
Parenting a Child or Youth with Depression
Tips and tools
*This is not a comprehensive list
Helpful Links and Resources for Depression
Canadian Network for Mood and Anxiety Treatments-http://www.canmat.org/
Children’s Mental Health Ontario- www.kidsmentalhealth.ca
Keck, Gregory and Kupecky, Regina. (1995). Adopting the Hurt Child: Hope for Families with Special Needs Kids. Colorado: Pinon Press.
Keck, Gregory and Kupecky, Regina. (2002). Parenting the Hurt child: Helping Adoptive Families Heal and Grow. Colorado: Pinon Press
Mood Disorders Association of Ontario- http://www.mooddisorders.ca
Mood Disorders Society of Canada- https://mdsc.ca/
Permanency and Adoptive Support Services (PASS) contact: firstname.lastname@example.org
Teen Mental Health- http://teenmentalhealth.org/learn/mental-disorders/
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
Canadian Mental Health Association (2016) Retrieved from- http://www.cmha.ca/
Canadian Network for Mood and Anxiety Treatments (CNMAT) (n.d) Retrieved from- http://www.canmat.org/
Children’s Mental Health Ontario (2001)- www.kidsmentalhealth.ca
Flynn, C., Welch, W., and Paget, K. (2004). Field-Initiated Research on Successful Adolescent Adoptions: Final Report 2004. The Center for Child and Family Studies, College of Social Work, University of South Carolina.
Ji, J., Barth, Richard, Brooks, Devon, & Kim, H. (2010). Beyond preadoptive risk: The impact of
Mood Disorders Association of Ontario (n.d) Retrieved from- http://www.mooddisorders.ca
Mood Disorders Society of Canada (2013) Retrieved from- https://mdsc.ca/
Stoner, M., Alision, Leon, C.S, & Fuller, K. A. (2015). Predictors of reduction in symptoms of