Tag Archives: Hassenfield Children’s Hospital

Depression in Children: Signs and How to Help

Depression in Kids

Is My Child Depressed? What Parents Should Look For, and How to Help

Approximately 5-10% of children struggle with depressive symptoms. Indeed, children as young as 3 can demonstrate signs of clinical depression, and rates of depression increase sharply during adolescence, particularly for girls. Feelings of intense sadness, emptiness, and/or loss of interest in previously enjoyed activities are the cardinal features of depression in adults; however, depression sometimes presents differently in youth. Indeed, irritable mood can be the first sign of child depression, and persistent irritability that causes significant problems in your child’s life at school, with friends, or with family indicates concerns beyond typical adolescent behavior.

Signs your child may be struggling with Depression:

  • Withdrawing from extracurricular activities, or continuing to participate in them without enjoyment.
  • Spending more time alone, and isolating from family or friends.
  • Constantly feeling bored, like nothing is interesting or worthwhile.
  • A significant drop in school grades, homework completion, and/or overall motivation for school.
  • Urges to avoid school.
  • Significant change in behavior: being more oppositional or argumentative, using drugs or alcohol, or caring less about consequences that used to matter.
  • A change in appetite: eating much more or much less.
  • A change in sleep: difficulty sleeping, or sleeping much more than is typical.
  • Feeling tired, without energy.
  • Increased difficulty concentrating in school or in conversations.
  • Thoughts of death or dying.
  • Engaging in self-injurious behaviors (cutting).

How can I support my child?

  • Talk to your child. Ask how they are feeling and what might be bothering them. Actively listen, without judgment, and reflect back what your child says to show that you understand.
  • Tell your child’s pediatrician. Schedule an appointment with a mental healthcare provider to discuss your concerns and to learn more about treatment options. There are evidence-based therapies and medication that can help.

Therapy:

  • Cognitive-behavioral therapy helps children to identify the connection between depressive thoughts, feelings, and behaviors, to observe patterns in their mood, and to learn coping skills to improve mood. Behavioral activation is often a key component of CBT for depression, and focuses on helping youth boost mood by changing behavior.
  • Dialectic behavior therapy is a more intensive treatment for youth who struggle with chronic emotion dysregulation and problem behaviors, such as chronic suicidal thoughts or actions, self-injurious behavior, and other risky behaviors.
  • Other evidence-based therapies include interpersonal therapy and attachment-based family therapy.
  • Medication:  Selective Serotonin Reuptake Inhibitors (SSRIs) are considered the first line medication for depression. For more information about antidepressant medication, consult with your child’s pediatrician or psychiatrist.
  • Promote safety. Encourage your child to share their feelings, including thoughts about death or dying. Normalize that this is a common symptom of depression, and develop a plan that includes people to reach out to for help and mood-boosting activities to engage in when they have those thoughts. Ensure that your home is safe by locking up guns, knives, medicines, and alcohol.
  • Stick to the treatment plan. If your child is in treatment, ensure that they attend therapy consistently and/or take medication as prescribed. Your child may feel frustrated or defeated if they do not feel better quickly. Treatment works, but it takes time. Model hope, and communicate concerns with your treatment provider.
  • Provide praise and acknowledgement for small steps. Depression can feel like a weighted jacket, and activities (schoolwork, chores) that used to be easy to carry can feel impossible to lift. Rather than focus on what your child might not be doing, model attending to the positive by acknowledging and praising what your child is doing well.
  • Educate others and externalize the depression. People in your child’s life may misperceive depression as your child being lazy or purposefully grouchy, which can make it difficult for your child to receive the care and support they need. Remind yourself and others that depression is driving these symptoms, not your child.
  • Enhance social supports. Help your child to connect with peers and family. Look for opportunities to bolster the relationship you already have with your child by taking a brief “vacation” from daily chores and responsibilities to engage in enjoyable activities together. Facilitate social engagement by helping your child to schedule after-school hangouts with friends, providing transportation, and offering other means of support.
  • Monitor for risk factors for suicide, which includes your child having more intense or frequent thoughts about death or dying, talking about suicide online or in person, and using substances. The National Suicide Prevention Lifeline can be reached at 1 800-273-8255 or online at www.suicidepreventionlifeline.org.

Anna J. Swan, PhD is a licensed psychologist and clinical assistant professor in the Department of Child and Adolescent Psychiatry at NYU Langone Health. She sees patients for evaluations, individual cognitive-behavioral therapy, and group therapy as part of the Anxiety and Mood Disorders Service at the Child Study Center’s Manhattan and Hackensack locations, part of Hassenfeld Children’s Hospital at NYU Langone.

Back to School with Diabetes Management

diabetes managementAdapting Your Child’s Diabetes Management for a New School Year

With a new school year just around the corner, many parents are strategizing for their children to receive the medical care they need in their new classroom environments. The goal for families of children with diabetes is for their kids to have access to appropriate diabetes management while having the same school experience as children without diabetes. Here are some aspects of care at school that parents of children with diabetes should consider in order to meet that goal:

  • Is there a nurse at school? If not, who can take responsibility for helping to assist with the day-to-day management of diabetes? There should be a medical plan in place and parents should discuss that with the school administration.
  • If your child is involved with after-school activities or field trips, will there be care available at those places?
  • What supplies does your child need at school? Think about the amount of supplies they will need, whether they will be centrally located for the child, or whether they will be carrying their own testing equipment to treat hypoglycemia.
  • If your child is involved with after school sports, make sure the school administration is aware of their condition. Parents should also talk to the child’s coaches so they can assist if needed.
  • Make sure your child always has something on them to fix a low—and coaches, teachers, and other staff should be aware so they can help if necessary.
  • Some school systems, like New York City public schools, have carb count menus for school meals up online. If your child is buying their lunch at school, check the menu ahead of time and review it with your child. Kids dose insulin according to carb counts, so it’s very important to plan for that. If your school doesn’t have a menu with a carb count, work with the school cafeteria and school administration to come up with carb counts for the menu.
  • Your child’s schedule will change when they go back to school, sometimes going from a schedule where they are more active during the day to being more sedentary during the day and active in the evening. If you notice your child’s blood sugar levels are out of range, be in touch with your diabetes care team so they can adjust insulin doses to the new school schedule.

You should go to your child’s diabetes care team with any questions. Other great resources for Safe at School information can be found at the American Diabetes Association, JDRF, and Children with Diabetes websites.

 

Christine Lally, RN, CDE, is a registered nurse and certified diabetes educator at the Robert I. Grossman, MD, and Elisabeth J. Cohen, MD, Pediatric Diabetes Center at Hassenfeld Children’s Hospital of New York at NYU Langone. She provides education and support to patients, families, and caregivers, and helps them fit diabetes management into their lives in a healthful way.