Saturday, July 25, 2009
Whether we are therapists, psychiatrists, pediatricians, family therapists, or parents we should all be concerned about childhood depression and the accompanying risk of suicide, especially given the spate of recent suicides by pre-adolescents. As I told San Diego News Network, among a therapist’s first actions is to screen for mental illness including depression and suicide risk. In addition, I make a referral to or consult with the child’s doctor to rule out medical conditions that may cause, contribute, or appear as mental health issues. If depression is the issue, I refer the parent to a child psychiatrist for a medication evaluation. The combination of therapy and medication is the accepted treatment for depression. Screening children means we can start earlier to address hereditary depression as well as depression caused by environmental factors. The key for parents and providers is that depression looks different in children and is easy to miss or attribute to behavior and developmental issues. In addition to changes in eating and sleeping and mood, children with depression often appear agitated, irritable, or angry. Parents and teachers can miss it or minimize it. So, short simple screenings with the Beck Depression Inventory or the Child Depression Inventory are tools for doctors and therapists to use. At the least we will educate about depression. If it means saving a child’s life, then we are using safety contracts with parents and children and accessing psychiatric services up to and including hospitalization. However, the earlier we can treat depression the more success we can have in helping children not only enjoy their childhoods but also grow up to be well adjusted adults.