Research Paper on Childhood Depression

Introduction

One of the issues that are affecting the world today is depression. According to the American Psychiatric Association, depression is a mental illness that has a negative impact on how one feels, thinks and acts thus leading to a range of physical and emotional problems that reduce the individual's ability to function normally (Barch et al., 2019). It is important to note that depression is different from stress and sadness as it lasts longer and requires treatment as opposed to stress and sadness which disappear as soon as the stressor is no longer present. Some of the symptoms of depression include feelings of intense sadness, difficulty concentrating, variation in appetite that can lead to either weight gain or loss, irregular sleeping patterns, contemplation of suicide, feelings of worthlessness or guilt, unexplained fatigue, intense anxiety and loss of interest in previously enjoyed activities (Barch et al., 2019). These symptoms vary from one individual to another depending on the severity of the depression. Some situations are mild while others are severe. Predisposing factors for depression include personality and self-esteem, variations in certain brain chemicals, genetics and environmental factors such as incessant exposure to abuse, neglect, and violence (Infurna et al., 2016). Nevertheless, depression is treatable and the most important thing is to seek help from a professional who can diagnose the problem and advise accordingly.

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Although depression is common in adults, it also occurs in children. Teenagers are also categorized as children since they have not yet become independent adults. Unfortunately, depression in children has been ignored for a long time since it is not expected to occur (Barch et al., 2019). The question that most adults often have in mind is how a child can get depressed yet they are too young to understand the world, its dynamics, and stressful situations. In most cases, depression in children is mistaken for normal tantrums that characterize various developmental stages in children (Zahl et al., 2017). This makes it difficult to give serious thought to depression when it comes to children and it explains why very few researchers have ventured in this field. Depression in children is real and must be considered as a serious health risk since if left untreated, it can increase the risk of severe depressive incidents in future that can lead to harmful actions and complications.

Issues with Childhood Depression

There are various interventions that can work in treating depression in children. However, it should be noted that the treatment has to be done depending on the level of depression and the benefit-risk assessment of the intervention. For instance, antidepressants can be used to treat the condition. However, research shows that the idea of suicide increases in children under ten who are treated for depression using antidepressants (Devenish et al., 2016). This information is echoed by Infurna et al., (2016) who assert that children who are under antidepressants are likely to reject the medication and begin to contemplate suicide as the only end to their uncontrolled feelings. However, older adolescents have shown a higher degree of efficacy to antidepressants than their younger counterparts. This, therefore, means that using antidepressants, and probably any other pharmacological interventions, to treat depression in younger children is not advisable although it works relatively well with the older children.

There are alternative interventions for treating childhood depression as soon as it is diagnosed. Due to the ineffectiveness of pharmacological interventions, researchers have come up with alternatives. According to Devenish et al. (2016), psychotherapeutic treatments such as behavioral activation that are age-appropriate have been found to have more efficacy than medication in younger children, particularly those below the age of ten. A study by Whalen et al. (2017) who investigated the prevalence of childhood depression among preschool children also recommends age-appropriate psychological interventions for children suffering from the depression condition. However, Devenish et al. (2016) in their research found out that the efficacy of psychosocial interventions decreases with age. As a child gears towards late adolescence, psychological interventions fail to be effective unless they are combined with other therapies such as pharmacological ones (Whalen et al., 2017). Nevertheless, psychotherapy is effective for mild cases while a combination of psychotherapy and pharmacotherapy has efficacy for severe cases. Psychotherapeutic techniques such as interpersonal therapy and Cognitive Behavior Therapy (CBT) have been found to be particularly effective in treating childhood depression (Barch et al., 2019). CBT helps an individual (especially younger children) to regulate their emotions, fight against negative thinking, solve their problems, and improve their communication and coping skills so that they relate appropriately with others. On the other hand, interpersonal therapy works better with older children as it helps an individual form meaningful interpersonal relationships, adapt to change and adjust to personal roles.

Due to the adverse effects of childhood depression and its likelihood of recurring after its onset, current research is concerned with preventive therapies. According to Devenish et al. (2016), preventive therapy is more effective than curative therapy thus researchers ought to concentrate on how to prevent childhood depression. Researchers have classified preventive therapy programs as either universal or indicated. The universal program is applied to all the children in a particular setting while the indicated program targets children who are vulnerable due to the predisposing factors (Devenish et al., 2016). The prevention or delay of the onset of depression is very important. If the first episode of depression is avoided, it decreases the likelihood of a future one. By the time a future one occurs, if any, the child will have matured enough to deal with it in a better manner.

Role of Occupational Therapy in Childhood Depression

Occupational therapy is a crucial service in healthcare which helps in solving problems that prevent a person from performing their normal duties. In the case of childhood depression, the occupational therapist has to work closely with the child's family so as to understand the emotional needs of the child as well as receive and give the necessary feedback. The occupational therapist may need to involve more family members if working with a younger child than they would with an adolescent because they would wish to build trust with the adolescent which is a non-issue with a younger child. To help the affected individual, the occupational therapist first identifies the roles that the depressed child is supposed to undertake such as going to school, playing with peers, eating, sleeping, among others then determines what makes them no longer able to accomplish these roles (Creek & Lougher, 2011). 1 In the current setting where childhood depression is on the rise, the work of an occupational therapist cannot be taken for granted. After identifying the roles of the client and what interferes with their ability to fulfill these roles, the occupational therapist helps the client come up with strategies that can help them strike a balance between relationships and demanding roles such as schoolwork (Creek & Lougher, 2011). In so doing, the child is able to recognize what they may not have noticed and begin to move towards behavioral change. Although there is no clearly established role of occupational therapists in the context of childhood depression, the fact that these practitioners work with families is a clear indication that they are best placed to offer therapy to children suffering from depression.

Conclusion

In conclusion, it is clear that childhood depression exists although it is often mistaken for common outbursts and irritabilities among children. Though it may be difficult to diagnose, especially if it is a mild case, a parent ought to be cautious enough to identify any sudden changes in the behavior of their child that may characterize childhood depression. Some of the signs to look out for include intense feelings of sadness and worthlessness, difficulty concentrating, unexplained fatigue, variation in appetite that can lead to either weight gain or loss, irregular sleeping patterns, contemplation of suicide, intense feelings of anxiety and loss of interest activities that the child previously enjoyed. If a child displays such symptoms, it is important to take them to hospital for proper diagnosis. The information available on childhood depression is little since the condition is not common. However, the little that is available indicates that childhood depression has been on the rise over the last few years (Barch et al., 2019). This means that it is an issue of concern to health practitioners and society as a whole.

I have learned a lot on this topic. I was aware that the main interventions for childhood depression include psychotherapy and pharmacology. Both can be combined for severe cases and older children. However, I did not know that for children under the age of ten, psychotherapy interventions alone are enough. I have also learned that currently, there is a new and practical approach that encourages preventive rather than curative approaches towards the treatment of childhood depression. This approach seems better because if the first incidence of depression is avoided, then the likelihood of the condition occurring in the future is low. This kind of research is being encouraged so as to find out what can work and what cannot. As an assistant occupational therapist, I will use this knowledge to ensure best practices as I carry out my duties and responsibilities.

References

Barch, D. M., Harms, M. P., Tillman, R., Hawkey, E., & Luby, J. L. (2019). Early childhood depression, emotion regulation, episodic memory, and hippocampal development. Journal of abnormal psychology, 128(1), 81.

Creek, J., & Lougher, L. (2011). Occupational therapy and mental health. Elsevier Health Sciences.

Devenish, B., Berk, L., & Lewis, A. J. (2016). The treatment of suicidality in adolescents by psychosocial interventions for depression: A systematic literature review. Australian & New Zealand Journal of Psychiatry, 50(8), 726-740.

Infurna, M. R., Reichl, C., Parzer, P., Schimmenti, A., Bifulco, A., & Kaess, M. (2016). Associations between depression and specific childhood experiences of abuse and neglect: a meta-analysis. Journal of affective disorders, 190, 47-55.

Whalen, D. J., Sylvester, C. M., & Luby, J. L. (2017). Depression and anxiety in preschoolers: A review of the past 7 years. Child and Adolescent Psychiatric Clinics, 26(3), 503-522.

Zahl, T., Steinsbekk, S., & Wichstrom, L. (2017). Physical activity, sedentary behavior, and symptoms of major depression in middle childhood. Pediatrics, 139(2), e20161711.