Keywords: childhood depression, major depressive disorder, persistent depressive disorder, talk therapy, Nigeria.
Introduction.
Can children suffer depression? What are the causes and risk factors to childhood depressive disorders? Do Nigerian children suffer from depression? What are the symptoms and signs of depressive disorders in children? Are there complications following depression in children? How is depression in children treated?
Depressive disorders in children are often not recognized by parents, rarely diagnosed and undertreated and most often left untreated. Sometimes, this could be due to the fact that some parents mix the symptoms up with normal hormonal changes in adolescents.
Childhood depressive disorders are quite common, chronic and recurrent, causing impairment in functions, educationally, occupationally, and socially.
Depression is not due to a mood that will pass. It is not due to laziness. And it will not go away without treatment.
Depression is characterized by three core symptoms, sadness, loss of interest in previously pleasurable thing and loss of energy. But sometimes, depressive disorders in children don’t follow the normal pattern seen in adults.
What are the causes and risk factors to childhood depressive disorders?
Childhood depression can be brought about by issues related to physical health, genetics and biochemical problems. There are also adverse childhood events and other environmental issues.
When it comes to genetics, children that have family history of depression are also at risk of having depression. They can inherit the genes from either the father or the mother.
Other biological causes include trauma on the head during the delivery of the child or at any point during childhood. Even childhood diseases can bring about depressive disorders in children.
Then problems with brain chemicals such as low levels of neurotransmitters like serotonin, etc. can cause it. Also problems in different parts of the brain can bring about depression, e.g. problem in brain size and weight.
Children affected by environmental factors where there is child abuse and other family violence, can breakdown with depression. Other environmental factors like family bereavement, separations, peer conflict and bullying can bring about depressive disorders in children. And children who abuse substances like alcohol, cannabis, etc. are also at greater risk of depression. They can also have depressive disorders if any of their parents abuse substances.
Do Nigerian children suffer from depression?
As stated above, depressive disorders in children are not easily recognized by parents, especially Nigerian parents. In Nigeria, depressive disorders are stigmatized and those who suffer from it are seen as lazy. So they don’t understand how a child that should be active, full of energy should be depressed. Besides, to them, children should not be worried about anything, anyway.
And because parents do not recognize depression in children, children who suffer from it are not taken to the doctor for treatment. Rather, these children are seen as possessed by evil spirit called ‘ogbanje.’ And they are taken to the native doctor or the church for treatment, so that the devil will be cast out.
Globally, in childhood depression, males and females have equal rate initially, but after puberty, females have higher prevalence of depression. And globally, the prevalence of major depressive disorder is about 8%.
Among secondary school students in Port Harcourt, the prevalence of depression was 21.9%. In Anambara, as at 2021, the prevalence rate for depression among adolescents was 12.5%. And in Southwest Nigeria, a prevalence rate of 12.6% was obtained.
What are the symptoms and signs of depressive disorders in children?
Actually, children mainly present with two types of depression. These two main types are Major Depressive Disorders or MDD and Persistent Depressive Disorders or PDD.
The symptoms are practically the same in the two types, but the symptoms in PDD are longer lasting. Although the symptoms in PDD last longer, they are less disabling than those of MDD.
Children present in varying ways when it comes to depressive disorders. Very young children can present with what is called masked depression. In masked depression, the child will present with anger behaviours or acting out. So they can have verbal rage as well as physically lashing out on people and properties.
But as they get older, they can have sad mood or mood changes and hopelessness. And they will start having the same symptoms as adults.
Apart from the anger and sadness, children suffering from depression cry easily and prefer being alone. And they feel helpless with low self esteem.
They also have poor or excessive sleep, poor or excessive appetite and poor concentration. It makes it difficult for them to remember what they have read in school or in their books.
These children feel weak and complain a lot about pains, especially stomach pains and headaches. They may end up losing interest in school. Children age less than 8 years present complain more of abdominal pains and headaches, these are somatic.
These children feel guilty and they can talk about suicide. Unfortunately, adults don’t take these suicide talks seriously until it happens.
Are there complications following depression in children?
If left untreated, depressive disorders in children can predispose them to complications. These complications include poor academic achievements and dropping out of school.
There could also be the abuse of substances such as alcohol, cannabis, cocaine, codeine, etc. These children use the substances to actually self medicate their symptoms. And this can predispose them to crime and cultism.
When it comes to relationship issues, the females are susceptible to starting intercourse early and thus teenage pregnancies. Later in life, in adulthood, they will have problems with interpersonal relationships.
Depression can predispose the children to self harm, and death by suicide.
How is depression in children treated?
Actually, depressive disorders in children are not easily recognized by parents, teachers and even the medical personnel. Rather these children are labeled as lazy, glutton, stubborn and not academically intelligent. They are frequently taken to hospital to receive treatment for their physical complaints. They are also subjected to unnecessary and expensive investigations.
Parents and teachers can help these childrem. It is important that parents and teachers keep open the line of communication with these children. Remember that the symptoms they feel are very real to them and they don’t know what to do.
There is also the need for parents and teachers to be very good listeners. By doing so, they may discover early, the difficulties the child is going through.
Every school should have a school counselor. These people are trained to be able to detect mental health issues in children and advice the parents.
The earlier these children are referred to see a clinical psychologist and a psychiatrist the better the outcome.
At a younger age, all they require is treatment from a clinical psychologist who will use talk therapy. For most children the talk therapy will suffice. And even for the older children, for those whose depression is of the mild to moderate type, talk therapy may just be all the need to recover. Also family therapy may be needed.
But for most children with moderate or severe forms of depression, they will require to consult a psychiatrist who will use medications. Many a times, these children will need the combination of talk therapy and medications.
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