Major depressive disorder remains one of the most common psychiatric disorders in children. Due to the variations of the symptoms from the adult criteria, such conditions often go unrecognized and thus undetected. This condition represents an emerging public health issue that requires an urgent response. Despite the prevalence of the depressive disorder in children, it remains one of the most treatable disorders if diagnosed early enough. Major depressive disorder (MDD) can have a significant impact when the onset occurs in childhood and can proceed on to adolescence and adulthood if not treated. Effects such as the decline in the academic performance and unexplained crying have been normal occurrences amongst children. Yet, most parents fail to recognize that their children are suffering from a depressive disorder. The onset of this condition in children can be diagnosed through observation of the symptoms. Statistics show that many types of depressive disorder occur in children, with symptoms ranging from mild to severe, which can impair socio-cognitive development. Early diagnosis and understanding of the risk factors present a great treatment opportunity, with a combination of therapy and antidepressant medication is considered the most effective option.
Childhood Depression: An Emerging Public Health Issue
There have been increasing incidence rates of psychiatric disorders amongst children, which has attracted much attention from the scientific world. While depression was initially thought to be common amongst adults, the recent trends are presenting a different view of the whole issue. According to the reports by the World Health Organization, depression will emerge as the second-largest cause of the disease burden globally (Mullen, 2018). Depression has been rising not only in adults but also in children. At least 12.8% of the children under the age of 16 have been diagnosed with depressive episodes in America (Mullen, 2018). In another research, the prevalence rate of depression amongst children under 13 years has been estimated to be at 7.8% (Mullen, 2018). The depressive symptoms in children are usually not recognized, leading to a low rate of diagnosis and treatment. Even as the prevalence rate of depression amongst children continues to increase, the number of those who get treatment remains at its lowest.
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As a biopsychosocial condition, childhood depression tends to have serious consequences for children. These consequences can be long-lasting, moving through to adolescents and finally to adulthood. The problem especially affects the child's social and cognitive development, thus having a lasting problem on the child (Lima et al., 2015). Cases of suicidal thoughts and declining academic performance continue to be recorded in many parts of the country. The consequences of this condition tend to increase, especially if interventions are not taken early enough. This condition is emerging as a new public health issue due to the lasting effect of childhood depression on child development. Previous studies show that in the short run, this condition can be a source of suffering to the children (Lima et al., 2015). In the long run, it can adversely impair and compromise the child's cognitive, social, and emotional development. Due to these serious consequences, more special attention needs to be directed towards this emerging public health issue. More attention through early intervention through the identification of risk factors and symptoms to provide treatment.
Symptoms of Depressive Disorder in Childhood
Studies into the depressive disorder in childhood have focused on the identification of the symptoms as the first major strategy for interventions. There are many different types of depressive disorders, each coming with various symptoms that directly impact the lives of a child. Depressive disorder directly affects the social life of the child leading to low self-esteem and anti-social behavior (Boukhris et al., 2016). Many studies have also identified impaired school performance as one of the major depressive disorder symptoms in childhood. Due to the psychological sufferings caused by this condition, children are less likely to concentrate on academics. According to Boukhris et al. (2016), depressive disorder impairs the cognitive abilities of the children, affecting their ability to learn or even memorize certain contents.
Research into the social aspect of the child has been focusing on how depressive disorder affects social and personal relationships with others. Due to the psychological suffering that is caused by depression, children tend to show low social esteem. They are more likely to demonstrate signs of disturbed personal relationships, which can then lead to social isolation (Weir, Zakama & Rao, 2014). In a few instances, researchers have linked depression with substance abuse amongst children. Children are more likely to engage in drug use due to their inability to cope with depressive disorder. It is sought to help them cope with the psychological suffering that is caused by depressive disorder. Another key area of focus has been the relationship between delinquent acts and depression amongst children. Children with extreme cases of depression are more likely to display delinquent behaviors. The symptoms of depression in children are far different from those in adults (Weir, Zakama & Rao, 2014). Due to these differences, parents and teachers may fail to recognize that children are suffering from depression. Failing to take early intervention is highly associated with increased risk of the condition having a lasting impact on the child, sometimes getting into adulthood.
Depressive Disorder and Child Development
As more focus shifts towards the rising cases of depression amongst children, many researchers have been more concerned about how depressive disorder affects child development in various aspects. The depression at this early stage of life has been greatly associated with significant impairments in multiple areas of social, cognitive, and emotional development (Lam et al., 2014). The risks of depression tend to be higher as one transitions from childhood to adolescence. Many developmental areas mark this stage. A study into the impact of depression on the child's cognitive and social development examines the effect of stress on brain development. Childhood is marked by brain development as one learns and acquires more skills (Lam et al., 2014). The period of brain development is usually marked with improvements in the ability to understand both the emotional and social cues. This stage is also marked with a gradual increase in cognitive capacity and the ability to be responsive to interpersonal relationships. Depressive disorder in childhood majorly impacts the functioning of the brain's different regions responsible for cognitive and social development.
Research to study the role of depression on child development has focused on short-run and long-run impacts. According to Wagner et al. (2015), depressive disorder in children tends to have little or no serious impacts on child development. The short-run consequences are only associated with psychological sufferings. However, the long-run consequences tend to affect various developmental domains adversely. Depressive disorder in adulthood tends to impair the cognitive functions of the child. Depressive disorders affect the development and functionality of different regions of the brain responsible for the processing of information (Wagner et al., 2015). Due to this impairment, children who experience long term depressive disorders tend to display low cognitive capacity. It is mainly evident in their ability to process information or memory time for some information. While more research continues in this area, low cognitive capacity is associated with low academic performance amongst depressed children.
Similar studies on the impact of depressive disorder in social and cognitive development show a serious impairment in these developmental domains. Children tend to be more responsive to interpersonal relationships and improve social skills (Lima et al., 2016). However, research shows that depressive disorder tends to slow down or impair the development of social skills. Depressed teens appear to be less socially adept compared to nondepressed youth. Social development and skills are acquired when children engage in play with their peers. Through constant interaction with peers, teens can be more socially adept. However, depressed children tend to be anti-social and are unlikely to interact with their peers (Wagner et al., 2015). These findings show how serious the consequences of depression can be affecting the child's whole developmental aspect.
Risk Factors Associated with Depressive Disorder in Childhood
Solving the problem of depressive disorder in childhood requires an understanding of the exact causes of depression in children. Even though the clear cause of depressive disorder in children remains unknown, researchers have associated it with several factors. The environmental factors, genetic factors, and chemical imbalances have all been associated with depression amongst children (Weir, Zakama & Rao, 2014). Many researchers view past trauma as one major cause of depressive disorder in children. A past traumatic experience, such as physical abuse, can have a long-lasting effect on the child's brain, leading to depression. Besides, poor parenting and lack of close relationship with parents is a risk factor for depressive disorder amongst children. Children require parental care and love, and any strained relationship with parents is more likely to lead to depression. Other factors, such as personality disorder and sexual abuse, have also been associated with increased risks of developing depressive disorder amongst children (Weir, Zakama & Rao, 2014). Understanding the risk factors associated with childhood depressive disorder is important in developing the right interventions towards helping end this emerging public health issue.
Interventions and Treatment Options
Many studies have assessed the importance of efficacy and effectiveness of various treatment options for depressive disorder in children. A combination of therapy and various antidepressant medications are emerging as the most effective treatment options to help manage this condition (Lemmens et al., 2015). Besides, research is examining the effectiveness of the school-based programs aimed at addressing the issue. Psychotherapy has been used and proved to yield positive results in helping adults manage stress (Lemmens et al., 2015). Current research also views the effectiveness of taking children through psychotherapy to help them acquire coping skills. Psychotherapy majorly includes cognitive behavioral therapy, interpersonal therapy, or supportive counseling. The goal of psychotherapy is to address the behavior management problems and relationship issues as well as the strategies to help the teens cope with the situation.
The most effective psychotherapy is one that involves the child, family, psychotherapist, and school. In this composition, all the issues affecting the child's psychological well-being are addressed, and the most appropriate coping strategies developed (Lemmens et al., 2015). It needs to be backed by school-based mental health services. Because children are most likely to show signs of depression in a school environment, setting mental health service programs within the school can be an effective strategy. Early identification of the warning signs remains the best step to ensure early intervention. Schools working together with the parents can help identify any warning signs in a child and then immediately provide treatment. In a meta-analysis of psychotherapy, results show that it is 80% effective for patients with mild signs (Driessen et al., 2015). The effectiveness of the psychotherapy treatment has also been demonstrated in supportive counseling in the school-based clinic. Amongst adolescents. Such findings support the effectiveness of psychotherapy and school-based programs in helping the teens manage and cope with depressive disorders.
Despite the effectiveness of the therapy programs, certain studies are examining the most effective combination of medication and therapy. According to Driessen et al. (2015), antidepressants are considered the most effective treatment options for mild to severe depression. It is also effective for conditions that have not responded to the psychotherapy trials. Even though recommended, medication needs not to be the only treatment option. Instead, they should be used in combination with psychotherapy to enhance effectiveness. When used together, these interventions not only reduce the signs but also promote positive behavioral change.
Conclusion
Depressive disorders in childhood continue to be an emerging public health issue that needs urgent attention. The prevalence rate for depression among children is increasing. This condition tends to have a lasting effect on the life of a child. It impairs both the cognitive and social developments, the domains which are essential for human functioning. However, there is evidence of scientifically proved treatment options for this condition. Psychotherapy and medication, when used together, can produce the best outcome. Early identification of the warning signs and risk factors is important to develop an early intervention. Parents, schools, and therapists need to work together to identify risk factors and develop interventions to help them cope with this condition.
References
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