Psychiatry News and Blog
Depression In Children
When physician Elliot Rubin a new and unknown method at his paediatrics practice in East Brunswick and Highland Park – His aim and goal was to ensure that he could measure his patients aged 11 years and older susceptibility to depression. As a result, he could develop a treatment plan for depression as part of their routine physical wellness sessions. He achieved all this, by asking them to fill out his well-crafted questionnaire.
The questionnaire he developed, The Patient Health Questionnaire, requires his young patients to rate the frequency of their experiences with symptoms that plague depressive disorders. The rating ranges from not at all to nearly every-day. The questions range from “having no interest or finding pleasure in activities” to simply asking if patients “feel down, depressed or hopeless” to more extreme scenarios such as whether patients had “thoughts of being dead or self-harming”.
The doctor who is based at University Paediatric Associates and is affiliated with Robert Wood Johnson University Hospital, in New Brunswick, has admitted that his mental screening method has been very telling and revealing. He goes on to indicate that the questionnaire has helped many kids and teens disclose feelings and thoughts that were hidden even to their parents.
By the time the American Academy of Paediatrics urged paediatricians to routinely ask their young patience if they had any self-harm urges and depressive thought, Dr Rubin had already formulated his initiative. This recommendation came as response to studies that showed that depression, long associated with an increased risk for suicide, is on the rise among children and adolescents.
Many a paediatricians have been heeding this call and implementing various methods of tracking their adolescent patient’s thoughts and behaviour patterns. One of the initiatives being used is known as a “collaborative care model”. The method embeds mental health professionals such as child psychiatrists, psychologists and social workers within a paediatric primary care practice for the purpose of screening all patients for mental health issues. As these professionals are already embedded, they can be more proactive in addressing the patient’s mental health challenges and begin treatment without delay.
It is of vital importance that young individuals who are depressed to be identified and recognized as they are prone to committing suicide if left untreated or unacknowledged. Paediatricians are being perceived as the frontline in helping identify and combat depressive symptoms and behaviours amongst adolescents. They can help a mile in shedding light to this issue. Parents often cannot identify or connect their children’s depressive behaviours, they are advised to go to a paediatrician who has an ongoing, trust founded relationship with their children. This will help parents be aware of any changes in their child’s behaviour, based on previous interactions.
The key to the success of this collaboration is consistency and routine. According to Tom Zaubler, a psychiatrist and chairman of the Department of Psychiatry at the Atlantic Health System, “All paediatricians and family doctors should routinely ask screening questions for depression or mental illness”. The consistency and track record will allow the professional to track and monitor any developments or changes in the child’s behaviour.
With Mental illness still carrying around heavy stigmatization, it is even more essential that parents destigmatize it within their children and ensure that the topic is one that is constantly being addressed. This ensure that their children don’t feel as if there is something wrong with them once they start having feelings or thinking depressive thoughts or exhibiting changes in their behaviour.
There are a variety of symptoms and behaviours that should raise concerns for parents and compel them to seek out their child's paediatrician for further consultation, especially if these signs persist for two weeks or more. These include: frequent sadness, tearfulness or crying; withdrawal from friends and activities the child previously enjoyed; continuous feelings of hopelessness and recurring thoughts or talk of death, suicide or self-destructive behaviour.
The key is getting to that diagnosis. After this, with the correct treatment plan, most patience bounce back and are able to make leaps and bounds in their recovery. There are a number of treatment plans available ranging from therapy to administering antidepressants. The choice of plan will depend on the severity of the child’s condition. Below is a list of various treatment plans available for children and teens:
This is more effective with younger children who aren’t able to fully verbally expressive themselves. For example, a mental health professional, with the help of toys, board games or card games, can use play to help facilitate a discussion with a troubled child.
Government studies have suggested there might be a link between the use of antidepressants and an increased risk of suicidal thoughts and behaviors, although there did not seem to be a connection to "completed suicide," according to the Child Mind Institute's Children's Mental Health Report. But it is now more widely accepted, Minion says, that "most people get better from these medications and only a small percentage get worse." The antidepressants most commonly prescribed to children and teenagers are known as selective serotonin reuptake inhibitors, or SSRIs.
This type of talk therapy is more age-appropriate for adolescents than for younger children who might not possess the ability to talk in detail about their feelings. Whatever their age, though, "it's important for kids with depression to see a child psychologist or therapist who is trained in the treatment of children with mental health disorders," says Jason Minion, a child psychiatrist at Morristown Medical Center.
A school counselor can help a child or teen get back on track with their studies once the mental health crisis has settled down. Family counselling can help parents and siblings better understand a child's mental health issues and handle them in a more. It gives the teen the opportunity to voice their thoughts and feelings in a non-threating environment.
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