Heal children's depression with feeling

By Donya Betancourt

SANUR, Bali (JP): In health care and child development, mental health in children is still a relatively new area but it has been proven that even babies can suffer from depression.

I was reading a story about depression in babies and infants when I remembered that it was not until the early 1980s that people began thinking children could also suffer from clinical depression.

The first case I recalled was a six-month-old baby whose mother thought there might be something wrong with him. Since birth, he was difficult, sucking very little milk, hardly taking food, irritable, crying and he had difficulty getting to sleep. When he was sleeping, he would be easily woken up by the slightest sound or noise. When he woke up, he would cry and scream for hours before finally stopping.

The mother's main concern was she had never seen him smile, while people around them said that "he was very quiet". He never showed any facial expression. After leaving hospital, he only gained a kilogram and his development was slow for his age. He could not roll over or make gurgling sounds.

When examining him, his doctor could not find any physical illness. He also never experienced any clinical problems during the prenatal and natal periods.

At the same time, his mother looked very distressed, anxious and restless. She had dark eyes from crying all the time.

The doctor asked the mother about her own emotions and feelings and she told him that she was sad, depressed and anxious throughout most of her pregnancy. She was not sleeping, had poor appetite and could not understand why she was feeling so sad. She blamed herself for her son's condition, considering herself a bad mother. Sometimes, she even thought about dying. Her own mother committed suicide when she was only four years old and she did not want to leave her son the way her mother had left her.

The second case I recalled was concerning a 14-month-old girl. Her grandmother took her to the hospital because of her changing behavior.

The little girl, who had been living with her grandmother for two months because her mother had gone to another country to further her education, had been active, talkative and showed good development. But the child's mood could swing from joy to anger in minutes. She lacked energy, cried a lot and had lost all interest in toys except an old toy from her mother that she kept holding. She did not eat well or gain weight for two months.

Both infants are suffering from depression.

Depression is not just a bad mood, feeling down or sad. Feeling "blue" or "down" is as normal in children as it is in adults, especially when major disappointments occur.

When these dark moods of depression occur for long periods -- like weeks, months or longer -- and especially begin to limit a child's ability to function normally; it can be "depression".

Depression is not caused by one event or thing. Risk factors that could trigger or predispose depression in children are a family history of maternal illness like suicide as in the first case, abuse (physical, mental or sexual), or chronic illness.

The second case provides an example of other possible factors triggered by loss of a parent at an early age due to death, divorce or abandonment.

The truth is, life for children is not carefree nor trouble free. They worry about parental acceptance, parents' expectations, peer acceptance and grades in school.

Babies need a lot of interaction and variety. Babies are naturally curious. They are constantly trying to figure things out while at the same time, they also need some level of consistency and predictability. If things are constantly changing, it is hard for babies to develop a basis of trust in people and the world around them. That is the reason for babies becoming depressed.

How can we know if a child is suffering from depression?

The main symptoms that can be observed in infants are irritability, restlessness, crying and having difficulty calming down. They also show loss of interest and activity, slow development, loss of appetite, they are difficult to feed and have problem sleeping.

For older children, it can be in the form of persistent sadness or irritability, low self-esteem, feeling worthless, loss of interest in activities they previously enjoyed, change in appetite -- either increased or decreased, sleeping or oversleeping problem and physical pain -- such as a headache or stomach ache that seems to have no cause.

We now know that infants can experience depression.

In the first case I spoke of, the doctor explained to the mother about depression and asked her if she would allow herself to see a psychiatrist and be treated with antidepressants. Her therapy comprised behavioral and psychological treatment, which included advice on taking care of her baby.

The mother was taught how to stimulate her child with techniques, such as talking to her, massaging and hugging her, explaining that the child needs this at a minimum of 15 minutes each time, many times a day. Now, the first child is very active, intelligent, happy and has good development while the mother is still taking antidepressants.

In the second case, the doctor advised the mother to call and talk to her daughter often and fly back to visit whenever she has time. Eventually, the mother decided to take her daughter and the grandmother to stay together with her and three months later, the little girl's behavior was back to normal.

Treatable

Fortunately, depression can be effectively treated; and like many diseases, treatment is most effective when it is recognized early on.

If you discover that your child has more than a few of the above symptoms lasting for at least two weeks, you may have reason for concern. Do not think that the symptoms will go away by themselves: they probably won't and may get worse.

In cases of divorce and separation, remember that it is not your fault that your child has depression, it is nobody's fault. What you have to do is, let your child know that you are there for her/him, remind your child of this over and over again. The child will need to hear it a lot because she/he feels unworthy of love and attention.

The important point is, if your child shuts you out, do not walk away, but remain there with her/him. Once your child begins to talk, let him/her talk and say whatever they want to talk about without criticism from the adult. Feeling is healing and talking about feelings can be a powerful treatment for depression.

Remember children and babies are people too and they are sensitive to what is happening around them. The environment children are raised in is instrumental in determining what sort of adult they will become. So for the world and society let's teach our children to love.

-- The writer is a pediatrician based in Sanur, Bali. Questions? Contact her at drdonya@hotmail.com, or features@thejakartapost.com.