Psychotherapist, Carly Francis is an expert in depression and how it affects young people. Carly answers questions on the symptoms of depression, as well as the part that social media can play on young peopleās mental health.
Transcript
Who are you?
Hi, my name's Carly Francis
and I'm a cognitive behavioural
psychotherapist working for Bupa.
Come and ask me some questions about depression
in children and young people.
What is depression?
Depression is a mental health condition that is typified
and characterised by a persistent low
mood, and sometimes, sadness.
It can last for weeks and months
and can really affect someone's quality of life.
Can children be depressed?
Yes.
It's not only adults that can be affected by depression.
Children and young people can be affected by depression too.
There are varying options for treatment
and support available for young people and children
should you be concerned that your child might be depressed.
What age can depression affect children?
Depression can affect children of all ages,
and it may manifest differently depending on the age
of the child, irrespective of gender, ethnicity,
or social background.
It's important to remember
that it can present differently irrespective of age.
It's also worth knowing
that sometimes depression can be more typical in girls,
teenage girls and older adolescents.
What's the difference between low mood and depression?
It is really normal for children
to experience fluctuations in mood
and really normal for children
to experience a change in mood over time,
particularly over a short period.
So feelings of unhappiness or low mood
or sadness are really common in response
to day-to-day issues and events.
However, these are usually short-lived
and experienced over a short period of time.
Quite often depression is different
because it usually lasts
for longer than a period of two weeks.
And peoples - or children's day-to-day activities may suffer
as a result of their low mood.
So really considering the timeframe over which something has
been experienced is really important when deciding,
is this typical low mood?
Or is this something that I should be more concerned about?
What causes depression?
There's no one single cause of depression in children,
adolescents, and young people.
It can be caused by a multitude of factors
that may contribute to the development of low mood.
One such factor could be life events
and stressful events, either cumulatively or as one-off.
Things that might be cumulative could be school stresses,
bullying, difficulties within the family
or sibling relationships.
And one-off events could be things such
as parental separation, the loss
of a family pet, breakdown of a friendship.
In addition to this, genetics can also play a role in
whether or not someone might develop depression.
So if there is a family history of low mood
or other mental health concerns, this can also contribute
to the development of depression.
And one other factor that is worth considering is sometimes
learned behaviour can be a
contributory factor to depression.
If someone else has experienced depression in the family
home, children can pick up on that
and start to mimic those behaviours in response
to certain situations.
What are the symptoms of depression?
There are a number of different symptoms
that can be experienced when a young person
or child experiences depression.
Things such as: losing interest in the things that they love
and enjoy, being tired and irritable,
are some common symptoms.
Also, things like feelings of worthlessness, guilt,
and a loss of confidence can also be experienced.
Lethargy and a loss of motivation are also common,
so you might notice your child no longer engaging in the
things that they love or just seemingly different to
what you know them to be.
These symptoms are not an exhaustive list,
but actually, you as a parent knowing your children
may notice a change in their behaviour,
and generally if that's persisted for a period of two weeks
or more, it's usually an indication
that maybe their mood is not a normal mood fluctuation
and could be worth further support or exploration.
What are the psychological symptoms of depression?
The psychological symptoms
of depression can generally be split into two categories.
One are related to the type of thoughts
and thinking that someone might experience,
and the other related to the feelings someone might
experience. In children and young people,
those thinking based symptoms may be based
around indecisiveness, a lack of ability to concentrate
poor memory or ability to retain information,
and even sometimes not really knowing what they think
and finding it hard to verbalise that.
From a felt experience,
it's quite common for young people to experience feelings
of shame, guilt, worthlessness, and sadness.
Sometimes a feeling of being numb
and not feeling anything can also be typical
for depression within young people.
In addition to this, those feelings can sometime lead
to thoughts about self-harm
and suicide, which can be really worrying for a parent.
And it's important to know that if you notice these symptoms
in your children, that getting support for this is possible.
What are the physical symptoms of depression?
There are a range of physical symptoms that a child
or young person might experience if they have
low mood or depression.
Firstly, it's not uncommon for their appetite
to be impacted upon.
This may be experienced as an increase in appetite
or a loss of appetite,
which ultimately could affect your child's weight.
So paying attention to weight gain
or weight loss can be a useful thing to pay attention to.
Secondly, it's not uncommon for a child
or young person sleep to be disrupted as a result
of low mood or depression.
Typically, people sleep longer
or less as a result of depression,
and it's really common to see sleep disruption being
experienced as a result of low mood and depression.
Thirdly, young people
and children can experience a sense of lethargy, a loss
of motivation and energy.
This can really impact on a child's movement
and engagement in day-to-day activities,
so noticing the impact that their lack
of energy is having on their general day-to-day movement
and activity can be a really useful thing to look out for.
And lastly, it's not uncommon for the thoughts
and feelings attached to depression in young people
to impact on thoughts of self-harm.
Some children may even act on those thoughts,
and so paying attention and looking out for cuts
or scratches on your child's skin or body, noticing bruises
or burns can also be a really useful thing
to pay attention to and look out for.
Naturally, all of these symptoms are hugely worrying
for parents to notice,
and it's important to know that there's a lot
of resources out there
and support available should you be concerned about any
of the previous symptoms described.
Also, talking to your GP
or making a doctor's appointment can be really helpful in
further exploring your child's depression
and low mood and finding out more.
What are the social symptoms of depression?
There are a range of social symptoms that a young person
or child may experience as a result
of their low mood or depression.
You may notice that there's a loss of connection
and interaction to the things and people that may
otherwise have been important in their life.
You may notice them disengaging from activities
and hobbies that they would've usually enjoyed,
and also maybe withdrawing
and isolating themselves from friends
and family members that they would usually engage with.
Connection's a fundamental part when working with children
and young people in relation to depression,
and if you notice a change in their ability to connect
with others or things they love,
that could be a really important thing to pay attention
to - alongside other symptoms.
It's important to note though,
that sometimes these behaviours are just typical young
person and teenage behaviours, so noticing these,
how frequently they've been experienced
for, alongside the presence
of other symptoms, could also be a really helpful way
of determining whether
or not these behaviours are something to be concerned about.
Are there different severities of depression?
There are different severities of depression that a child
and young person may present with,
and these are classified as either mild, moderate,
or severe, sometimes known as major depression.
How depression is classified
and categorised is dependent on the frequency
of symptoms experienced, and the type
and number of symptoms that a young person
and child may be showing,
and also the impact
that this might be having on their quality of life
and their day-to-day functioning.
So paying attention to things like is it affecting their
schoolwork, their ability to interact with other people
and their hobbies, could be useful
things to pay attention to.
It's not always easy to spot the symptoms
or decide whether a child or a young person is depressed.
And so seeking specialist support and advice
and guidance, perhaps from your GP, can help determine whether
a diagnosis of depression is needed.
How do I know when my child needs help with low mood or depression?
There are a number of ways that you can determine whether
your child or young person may need support
for low mood or depression.
You may have noticed a general change in their behaviour
over the last two or three weeks,
and you may feel like that's been persistent over time.
You also may notice that they're expressing symptoms
of depression, such as a general low mood
or sadness, a lack of interest in the things
that they would usually enjoy doing,
or perhaps they're more unmotivated
and lethargic, more than usual.
They may be presenting with irritability
or just a general disengagement from the
things they'd usually be doing.
If you do think that perhaps there's a concern in relation
to low mood or depression, it might be really helpful
to ask your child
and speak to them about what they're feeling.
They may be able to tell you more about their experience
of their mood and what's bothering them.
Another place you can go to just to perhaps see whether
or not other people have noticed a change in their mood is
perhaps their school and other people
who are engaged in their lives.
And if you do think that your child might need help,
it's also useful to perhaps speak to their GP
or your GP, just
to gather some more information about support available
and potential diagnosis, if that feels necessary.
I think my child or young person might have depression, what should I do?
If you're worried that your child
or young person that you care for may have depression,
acting on those thoughts
and concerns is a really important thing to do.
Firstly, it's a good idea to speak to your GP
or a GP in relation to support available for young people.
They'll be able to help
and guide you in relation to the next steps,
which may involve further support or treatment
and diagnosis for depression for your young person or child.
In addition to this, they may be able to signpost you
to local support groups and community groups
or resources that can support both your child and yourself.
Another useful thing to do is perhaps, again, speak
to your child's school in order
to see if there's anything available to them
through their school provision and whether
or not there are any groups available that the school know
of in order to support your young person.
How is depression diagnosed in children?
Depression is diagnosed in children
and young people by considering a range of symptoms
that they may be experiencing. A general sense of low mood
and sadness, coupled with a lack
of interest in things they would usually enjoy, need
to have persisted for a period of two weeks or more.
In addition to this, they may be experiencing a number
of other associated symptoms, things such as irritability,
loss of motivation, perhaps a sense of lethargy, loss
of appetite or disrupted sleep may also be experienced.
There are a range of other symptoms that also do exist
with depression, so there might be other things
that you are noticing that are perhaps out the ordinary
for your child or young person.
Depending on the frequency
that those symptoms are being experienced, the impact
that they're having on your child or young person's life,
and how many of them they might be experiencing, could
determine whether or not your child
or young person is diagnosed with mild, moderate,
or severe depression.
Seeing these symptoms occur in our children
and young people can be a really worrying experience
for a parent, and so if you are worried
and do notice the presence of these symptoms,
seeking support from your GP is a
really helpful thing to do.
They can help offer advice
and guidance in relation to diagnosis and further support,
but also validate your concerns.
Is depression hereditary?
It's known that depression can have a genetic link,
and if mental health has run in our families,
we sometimes can be an increased risk
of developing depression or other mental health concerns.
However, it's not the only factor that might contribute
to the development of depression
or other mental health concerns.
One's environment can sometimes play a role
and learned behaviour can sometimes influence whether people
develop mental health concerns,
things like depression. Learned behaviour could suggest
that actually when we are watching other people's behaviour,
we sometimes start to mimic those behaviours ourselves,
and that can sometimes be a contributory factor.
How can I start a conversation with my child about feelings of depression?
As families, we often exist in
what feels like separate bubbles.
That can make it sometimes difficult to speak to each other,
and so creating the opportunity to find ways of talking
to each other about how we feel
and what we've been up to can sometimes be really helpful.
Starting conversations with your child
or young person can be useful by asking open questions.
Asking questions about how their day's been,
how they're feeling, or how their week
or their day been, can be a useful way of starting
to get some information about what they're experiencing.
Follow up questions about what's coming up in their week
or what they're experiencing with their friendship groups
or their hobbies can also give us information about their
general demeanour and how they feel.
Sometimes, getting information from young people can be
really difficult and they don't always want to open up,
and sometimes as a parent, they don't always open up to us,
so letting them know that you're always there for them
and that they can speak to you
whenever you want is really important,
but also encouraging them to speak
to someone else who they trust.
Another trusted person can be another way of trying to
reassure them that there'll be someone there to listen
and help if they need it.
Where can I go for more information and support about depression in children?
It can be really worrying to notice that your child
or a young person might be experiencing symptoms
of depression. Naturally, as a parent
or caregiver, we will want to find out how we can help
further. Speaking
to your GP is often a useful place to start.
They'll be able to tell you whether
or not further support via onward referrals
or diagnosis could be helpful.
They also may be able to refer to specialist child
and young person Services that could support your child
further. National charities like the NSPCC
and Young Minds have a wealth
of information available online
and resources that could help inform you further about low
mood and depression in young people.
Accessing support from your child's school can also
be a useful place to go.
They'll be able to tell you about local support groups
or community groups that might be able
to give you further information about how
to support your young person.
There's lots of information online
and lots of available resources, like those found on the Bupa
website, that will help inform you further about how best
to support your child or young person.
How can I understand my child's depression better?
Sometimes as parents, it's really hard to understand
what our child or young person is going through,
especially in relation to depression.
It can be even harder if we haven't
experienced it ourselves.
As families, we sometimes feel like we're existing in
bubbles, and so opening the channels of communication
and finding ways to do that can be really helpful.
Listening to your child
and letting them know that you are there for them to speak
to can be really fundamental,
and listening in a nonjudgmental empathic way can help your
child open up and tell you more.
My child has depression - is there anything I should avoid saying or doing?
Sometimes it can be really hard to know what to say
to our children and young people in relation
to the depression they might be experiencing,
but being mindful of our language
and the things we say is really important.
Avoiding phrases like "just snap out of it", "cheer up"
or "you'll be fine", can be helpful.
It can make them feel unheard or dismissed.
Avoiding phrases that also might make them feel unheard
or disbelieved can be important.
Phrases like "you were fine yesterday"
or "you seem really happy recently",
can make them feel perhaps like they're making it up,
or perhaps that their experience
isn't as bad as it might be.
Also, being mindful of our own responses
to our own mood is really helpful.
Children sometimes learn responses through watching
what we do, so just being mindful about how we are reacting
to our own moods and
what they're watching is also a really useful thing
to consider.
My child's depression is affecting the rest of my family, what can I do?
Having a child or young person in the family
with depression can affect everybody else at times.
So having things to do
and strategies to use that reduces
that impact can be really helpful.
Firstly, we can plan activities to do together
that help connect the whole family.
It can remove attention away from the depression,
but also create opportunity for connection and interaction
and engagement in other things that are really helpful.
Another useful thing to do is to help people understand
what depression is and
how it might be affecting that young person.
It helps people just understand a bit more about what's
going on. And thirdly, ensuring that as a family,
we're engaging in lots of activities
that promote a really healthy lifestyle.
So having a good diet, being active,
but also thinking about our sleep routines can be really
helpful at reducing the impact
that someone else's depression can have.
Are there different types of depression in children?
There are a number of different types of depression
that children could be diagnosed with.
Major depression is one form of depression
where symptoms are experienced for a period of two weeks
or more, but often longer,
and symptoms are experienced to a severe degree
and are very frequent. Persistent Depressive Disorder
or PDD is an experience of depression
where symptoms are usually experienced for a period
of two years or more.
However, symptoms can be experienced
as either mild, moderate, or severe.
Seasonally Affected Disorder,
or SAD, as it's also known, is an experience of depression
that's affected by the seasons in the year,
quite often experienced during darker months,
such as autumn and winter.
Premenstrual Dysphoric Disorder
or PMDD is a hormone related low mood experience
that affects girls and women.
And Bipolar Disorder is a mood disorder
or a depression where people experience both high mood
and low mood at different frequencies.
What is 'major' depression'?
Major depression is a type of depression
that's typically categorised as being severe.
Usually, people experiencing this will have a low mood
or persistent sadness, as well as have a lack of enjoyment
and engagement in things
that would usually be interesting or pleasurable to them.
Symptoms would usually be experienced for a period
of two weeks or more, but typically much longer.
And the impact of major depression is
that it can really affect on someone's day-to-day
functioning and their engagement in life.
So school, hobbies,
interests would usually be severely impacted
by this depression.
What are the symptoms of 'major depression' in children?
There are a range of symptoms that children
and young people might experience if they have major
depression, and this can differ depending on their age.
Younger children, for example,
may demonstrate an increase in clinginess,
they may be irritable or have angry outbursts
or a general change to their behaviour.
They also might demonstrate a refusal to go to school,
or you may see changes in their appetite or their weight.
With older children,
you might notice similar things in relation to disengagement
with things that they would usually be doing
as part of their routine.
Perhaps they're not engaging with schoolwork
or their performance has started to deteriorate.
You may notice a change in their interaction,
so they may be more angry or irritable,
and in some circumstances, they may use alcohol
or drugs as a way to help with their depression symptoms.
Children with major depression can often experience episodes
of self-harm, which can be really worrying as a parent,
and so seeking support in how to manage
and support these symptoms can be really, really helpful.
Seeking advice from a GP and specialist child
and adolescent mental health support services can help you
as a parent.
What is 'persistent depression disorder'?
Persistent Depressive Disorder
or PDD as it's sometimes known, is an experience
of depression that is experienced over the long term,
usually for two years or more.
It sometimes categorised as either mild, moderate,
or severe, depending on
how many symptoms someone experiences,
and the frequency with which they're experiencing it,
as well as what impact it's having on their day-to-day
functioning.
What are the symptoms of 'persistent depression disorder'?
There are a range of symptoms
that present when someone has
persistent depressive disorder.
These symptoms typically last for a long time, usually
for a period of over two years,
and are often present for periods of two months
or more at any given time.
Symptoms such as a persistent low mood
and sadness, a lack of interest in things
that they would usually enjoy doing,
anger, irritability, a pessimistic view of the future,
can be commonly associated
with persistent depressive disorder.
There's lots of support available in relation
to helping manage these symptoms and speaking to a GP
or seeking advice can be really helpful.
What are the impacts of depression in children?
There are a range of impacts that children
with depression can experience.
It can impact on someone's quality of life
and their day-to-day functioning when they experience
depression, and we'll see this experienced in
lots of areas of their life.
Sometimes, people's relationships are affected
because depression can affect how they engage
in interact with other people.
You might notice an increase in conflict
or a disengagement from people
or things that they'd usually enjoy doing.
Another impact you might see is
that it might affect their work performance
or their school performance.
You might notice a change in their attendance
or their ability to perform in those areas,
which can also affect on their future prospects.
For some children and young people, they may seek ways
of coping with their depressive symptoms,
so it's not uncommon for young people to maybe use alcohol
or sometimes engage in substance use in order to cope
with their depression symptoms.
And for some young people, we may notice an engagement in
self-harm behaviour, or even suicidal thinking and ideation.
It's not uncommon for that symptom to be experienced
and also present as actual acts of self-harm or suicide.
These symptoms all seem really scary
and worrying as a parent to hear about or know about,
and so seeking support for these from your GP
or other resources online can be a really helpful thing
to do.
What is bipolar depression?
Bipolar disorder is a mental health disorder
that is characterised by someone experiencing episodes
of really high mood and episodes of really low mood.
These symptoms and episodes can last for weeks or months.
What are the symptoms of bipolar?
The symptoms of bipolar disorder will vary depending on
whether a child or a young person is experiencing a phase
of low mood or a phase of high mood. In a low mood phase,
what you'll notice is that typically a young person
or child will experience symptoms consistent
with depression, so a loss of interest
or engagement in activities that they'd usually enjoy,
a persistent low mood or sadness,
and possibly a loss of motivation
and lethargy. In a phase of high mood,
what we'll notice is quite the opposite.
Often your child or young person might present
with high energy, engage in activities more readily
and with a lot more enthusiasm than perhaps
they would've done before.
You may notice that they engage in impulsive behaviours
or even reckless behaviours
that are typically out of character.
It's important to note that bipolar disorder can sometimes
be quite complicated to diagnose
and is often seen more in older children
and adolescents as opposed to young children.
If you're noticing these symptoms in your children,
seeking support from a GP or a specialist child
and adolescent mental health service can be really helpful.
What is seasonal affective disorder (SAD)?
Seasonal affective disorder, also known as SAD, is a type
of depression that's influenced by the time of year
or the change of seasons.
Typically, this type of depression is experienced
during the darker months, so more usually
between autumn and winter.
What are the symptoms of SAD?
The symptoms of SAD that children
and young people might experience are a loss
of engagement in activities they enjoy, perhaps changes
to their sleep routine, feeling lethargic,
having a loss of motivation.
You might notice also a change in their appetite
where they may crave more carbohydrates
and sugar compared to usual.
One of the things that people believe causes SAD is the
influence of daylight on our production of certain hormones.
So melatonin is really important in inducing sleepiness.
So children and young people may have a change in their
sleep routine, and darker months may influence
how much melatonin is produced.
It's thought that people with SAD often produce more
melatonin than is necessary.
Equally, the production
of serotonin is influenced by daylight.
So when there's a loss of daylight,
our serotonin levels are affected and can
therefore impact on our mood experience.
If you're noticing these symptoms in the children
and young people that you look
after, it's useful to explore them.
So speaking to a GP or seeking more support, advice
or guidance can be really helpful.
What is premenstrual dysphoric disorder (PMDD)?
Premenstrual dysphoric disorder, also known
as PMDD is a severe form of premenstrual syndrome.
It causes a range of emotional and physical symptoms
and can often be known
as a severe premenstrual syndrome condition.
It typically is experienced in the week or two
before your period is due to start.
What are the symptoms of premenstrual dysphoric disorder (PMDD)?
There are a range of symptoms that girls
and young women can experience
with premenstrual dysphoric disorder.
Typically, these symptoms are quite severe
and can have a huge impact on their functioning within
relationships at home, at school, or work. Emotionally,
it's quite common for girls
and young women to feel overwhelmed, anxious, irritable,
perhaps irrational, tearful, sad, and on edge.
Physically, it's common for girls
or young women to experience bloating, breast tenderness,
general aches, and pains and headaches.
They may also notice a change in their appetite
or have cravings for particular things.
If you notice these symptoms being experienced by
your young child or young person, it's important
to seek some support and advice
as there is support and treatment available.
Can grief impact depression?
Children and young people can experience grief
for a variety of reasons.
Some factors such as separation of parents, loss
of a loved one, even loss of a pet,
can be common experiences of grief
and loss for young people. It's not uncommon
for grief in young people
to perhaps be a more temporary experience,
but it can be experienced over prolonged periods of time,
which can influence development of depression
and other mental health concerns.
Is there treatment for depression in children and young people?
Yes, there is treatment for depression in children
and young people, and this is often recommended
to be either cognitive behavioural therapy, also known
as CBT or medication.
Cognitive behaviour therapy is a type of talking therapy
designed to help a young person explore their experienced
depression, particularly focusing on those factors
that might be maintaining it. With medication,
often a GP or a specialist doctor may prescribe medication when
a child or young person's depression is experienced
to a moderate to severe degree.
It's not uncommon for both CBT
and medication to be prescribed together,
particularly when depression is experienced
to a severe degree.
Sometimes with specific types of depression, such
as seasonal affective disorder
or premenstrual dysphoric disorder, different types
of treatment can also help.
So with seasonally affective disorder, the use
of a light box can often be useful in replicating daylight.
This influences the production of melatonin
and serotonin, which are known to influence sleepiness
and mood. For premenstrual dysphoric disorder
or PMDD, quite often the prescription
of a contraceptive can be recommended alongside an
antidepressant in order to influence the hormones
that may be being experienced in a young person or child.
Who should provide CBT for children with depression?
Cognitive behavioural therapy or CBT should be
provided to children and young people
by an appropriately qualified professional.
Cognitive behavioural therapists should have the right
credentials and should be accredited
by the British Association for Behavioural
and Cognitive Psychotherapists.
In addition to this, you should seek someone
who has experience of working with children and adolescents
and young people.
How effective is CBT for depression in children?
Cognitive behaviour therapy
or CBT as it's also known, is known to be one
of the most effective psychological therapies
for treating a range of mental health conditions,
including depression.
What happens during CBT and how long does it last?
Cognitive behaviour therapy
or CBT as it's known, is a talking therapy
that helps a child
or a young person to understand
how they're experiencing their depression
and what factors maintain it.
It focuses predominantly on understanding the link in the
relationship between the way a child
or a young person thinks, how they feel emotionally, how
that affects them physically,
but also how they respond behaviourally
during CBT sessions are interactive with a therapist,
but it's really common that a child
or a young person will be given homework as part
of their therapy in order to be trying out different tools
and techniques and strategies as a way
of helping them manage their depression outside of session.
CBT can last for anything between 6 to 20 sessions,
and it's usually delivered on a weekly or fortnightly basis.
Sessions usually last between 30 minutes
and an hour, depending on the severity
of someone's depression and low mood.
What antidepressants are prescribed for children or young people and are they safe?
There are different types
of antidepressant medication available, but for children
and young people, the preferred medication for prescription
is a selective serotonin re-uptake inhibitor.
Also known as an SSRI.
Typically, this type of medication is very safe
and effective, but sometimes children
and young people can experience side effects associated
with using this medication.
If you are worried about any side effects attached
to the use for medication, you can speak to your GP
or a medical professional to gain some information
and advice about the prescription
or administration of this medication.
How long do doctors typically prescribe antidepressants?
Antidepressant medication can be really effective
for children and young people experiencing depression.
It can take up to six weeks for an antidepressant medication
to take effect. Even when a child
or young person starts to feel better,
it's recommended that they continue to take their medication
for a period of 9 to 12 months
after in order to maintain progress
and maintain improved mood.
Quite often some people may have some concerns
about taking medication,
they may worry about the stigma attached
to using a medication,
or they may also worry about any additional symptoms
or side effects that could be experienced.
It's important that we encourage children
to take their medication regularly to ensure
that it's effective at helping their mood.
If you're worried about any signs
or symptoms that your young person
or child may be experiencing attached to their medication,
or if you'd like to just find out more about medication
available, it'd be really helpful to speak to a GP
or medical professional.
My child is having suicidal thoughts, what do I do?
Learning that your child or a young person is experiencing
suicidal thoughts can be really alarming
and really distressing.
It can create a lot of worry,
and so it's important to try not to panic,
but also important to act quickly.
Speaking to your GP as soon as possible is important.
They will be able to support in relation to diagnosis,
but also referral onto specialist support services.
If your child or young person is already engaged
with specialist support services
or paediatric services, speaking
to the professionals involved in the care of your child
or young person can really be helpful in gaining advice
and guidance about how you can support them,
or also giving them information so
that they can better support your child or young person.
If you believe your child is in immediate danger,
in relation to these sorts,
contacting your local crisis support team or attending A&E,
either yourself with your young person
or by ambulance, is crucial.
Learning that your child or young person is experiencing
suicidal thoughts can also be really difficult for you
as a parent or carer.
It's really important to consider
what support you may need in this situation.
What is self-harm?
Self-harm is when a child
or young person engages in a deliberate
act of harming themselves.
Quite often, young people
and children may self-harm to deal with intense emotions
and experiences that they're going through.
Quite often, that self-harm is an expression in a way to deal
with underlying mental health conditions such as depression.
Conversely, it's quite common for young people
and children to maybe self-harm as a way
of feeling something in experiences
where they perhaps feel numb or emotionless.
I'm worried my child is self-harming - what should I look out for and what should I do?
If you are concerned that your child
or young person is self-harming, there are a number
of things that you can look out for.
Paying attention to physical signs
and symptoms on their body can be a useful indicator.
So noticing cuts, scratch marks, burns, bruises,
or even bite marks on their body could be an indication
that self-harming behaviour is happening.
You also might want to pay attention to their behaviour.
How are they wearing their clothes?
Are they wearing clothes that cover
their body more than usual?
Are they wearing long sleeves in warm weather?
These could all be indicators
that perhaps they have marks on their
body that they're trying to cover.
Often with self-harming behaviour, scratching
and cutting can draw blood.
So noticing whether there are more bloody tissues in the
waist bins at home can sometimes be a useful thing
to look out for. In relation to
what you can do about self-harming behaviour,
trying to understand why your child
or young person might be engaging
it can be really helpful.
If it's a way of trying to alleviate distress,
encouraging them to open up
and talk to you can be really helpful,
or letting them know that they can talk to a trusted adult.
Engaging in activities such as holding an ice cube
or flicking an elastic band, perhaps drawing
or scribbling in relation to how they might be feeling
or writing things down could be helpful strategies.
If you are concerned about self-harming behaviour
and would like some more advice, support,
and guidance in relation to your child's experience
and how to help, speak to your GP and get some support.
My child isn't being open with me about their feelings, how can I support?
As a parent, it can be really worrying if you feel
that your child or young person isn't able to open up
to you about how they're feeling. Considering different ways
of communicating with them can sometimes make it easier
for your child or young person
to speak to you about how they feel.
Perhaps sending messages or phoning them can be useful.
Encouraging them to write down how they feel or
write you a letter can be useful at helping them communicate
with you what's going on for them.
Letting them know about some online resources
or about other services that they can contact, such
as childline, could be useful.
If your child has a dedicated GP,
generally with older children, encouraging them
to have an appointment with their GP
could be a useful strategy,
helping them to open up to another trusted person.
If they feel that they can't open up to you,
encouraging that communication with another trusted adult,
perhaps someone in the family
or at school, can be really helpful
or encouraging them to talk about how they're feeling.
It's really important not
to blame yourself if you feel your child
isn't opening up to you.
It can be a really common experience for young people not
to want to speak to their parents in the first instance.
So offering different options
and alternatives can help open that channel
of communication.
How can I protect my child from the potential impact of social media?
Social media can have an impact on the way children
and young people feel.
Social media is used for a variety of reasons,
and there are both positive and negative impacts.
Positively, children and young people can feel connected
when they're online and using social media.
They can gain enjoyment
and they can also engage with their friends in relation
to learning material and activities
for fun. However, negatively it is thought
that social media can impact on a child's
and young person's mood.
It can sometimes fuel unhelpful comparisons,
but also the nature of content available readily
to children can sometimes be disturbing and harmful.
In order to protect our children from the impact
of social media, there are a number of things we can do.
Setting a good example of how to use tech when we're
around our children can be really helpful.
Setting tech-free time
or tech-free zones in the house can be helpful at helping
control how much a young person uses their devices
and gains access to social media.
Another really helpful strategy can be to plan
and schedule activities
that require not using social media or tech.
So doing things together as a family,
engaging in other activities, can not only manage the amount
of time spent on social media,
but can also really boost a child's mood
and self-esteem by getting them
to engage in other fulfilling activities outside
of technology.
I am worried my child is exposed to content on social media that is affecting their mood
If you are worried about what your child
or young person is watching online
or on social media, there are some things you can
do in order to help.
Keeping an open communication with your child
or young person can encourage them to speak
to you about what they're viewing online.
Being curious and interested in the sorts
of things they're watching can help them want to talk
to you about the things they're looking at.
Raising awareness and educating young people about
how social media platforms work can sometimes be useful,
and if your child or young person does speak to you about
what they're watching, and this is causing concern, trying
to talk to them without judgement , but also without panic
or concern can help them come
to you in the future without worrying about
your reaction or impact.
It can be really difficult to navigate social media
and the impact it can have, but generally just being open
and curious about how they're using social media
and what are the things that they're watching
or being exposed to can be really helpful.
My child has depression - How do I approach this issue with my employer?
You can approach this with your
employer in a few different ways.
Going to your line manager directly
and asking them about the support available can be helpful.
However, if you don't feel comfortable talking directly
to your line manager, you may want
to consider sending them an email, speaking
to them on the phone, or even arranging a teams
call to discuss this.
If you don't feel comfortable talking
to a line manager at all, finding out
what your organisation offers in terms of the support
and provision available for mental health services could be
really helpful in gaining support you might need.
Am I entitled to any support or help from my employer?
You may well be entitled
to support from your employer if your child
or young person has depression.
Speaking to your line manager to find out
what support is available can be useful,
and you may also want
to consider things like condensed hours, flexible working,
and maybe working from home more if the situation requires
that. Every organisation is different,
so seeking to find out
what provision is available would be useful.
Can my employer support my child in any way?
Your employer may be able
to support your child in relation
to their current experience of depression and low mood,
but this is dependent on the provision available
through your employer.
Finding this out via your line manager will help you
determine if there's any support available.
If you do have access to private healthcare through Bupa,
as part of your work's benefits,
you can access the family mental health line
and speak to a registered nurse
to talk about your children's
and young people's emotional needs
and wellbeing as well as that of your family.
However, if you're not a customer
and you don't have private healthcare,
you can access a wealth of resources online, which have lots
of advice and guidance in relation to how
to support your children, young people
and families, emotional and mental health needs.
Iām struggling with my mental health as a result of this, where can I go to for support?
Looking after your own mental health when you're caring
for a child or young person
with depression is really important.
Paying attention to the signs and symptoms
and warning signs that your own mental health may be
deteriorating will be really useful.
You can access a wealth of resources online
that offer advice and guidance about how to look
after yourself, and these can be
provided from a range of sources, including Bupa.
If you do have access to an employee assistance programme
through your workplace, it could be a helpful option
to consider accessing that.
If you do have private healthcare cover,
you can contact the mental health specialist support team in
order to find out what support may be available to you.
How can I support my child's mental wellbeing to prevent depression developing?
There are a range of different things that you can do
to support your children and young person's mental health
and prevent depression from developing.
Sometimes as families,
we feel like we might exist in bubbles,
and so finding ways to burst those bubbles so
that we can engage more helpfully together is useful.
Creating a supportive home environment can be really helpful
in encouraging young people
and children to talk to us about how they're feeling.
Allowing them to express things without judgement
and allowing them to express things openly can really help
gain an understanding of how they're feeling,
but also prevent depression from developing. Planning
and scheduling activities
and exercise to do together can also be really
helpful for mood.
Doing this together as a family
or encouraging your young person to do that
with friends, can be really helpful.
Not only does it create improved mood,
but can also create a sense
of accomplishment and achievement.
The influence of food on mood is really well known,
so eating a healthy diet together
as a family can be really helpful.
Shopping and cooking and eating together can create
connection, but can also help children learn about why diet
is important to mood.
Having a good sleep routine can also be important at
preventing depression.
When we're sleep deprived
or have disrupted sleep, it can affect how we feel.
So helping your child develop a good sleep routine
will be really important.
There are lots of strategies that you can use in order
to prevent depression from developing
within children and young people.
Unfortunately, depression in teenagers has become quite common. It can sometimes look different to adult depression, so it’s important to know what to watch out for. Here, I’ll explain what the signs of depression in teens are, and what treatment options are available.
What is depression in teens?
Depression is a common mental health condition that can affect both adults and young people. Around one third of young people aged 16 to 24 currently have a mental health issue such as anxiety or depression.
And since 2019, there has been a 50 per cent increase in mental health referrals for teenagers with depression in the UK.
What causes depression in teens?
There’s not always an obvious cause for depression in teenagers. And often there might be more than one cause. But there are some factors that might make it more likely. These include:
- going through a big life change, such as a house move or bereavement
- using alcohol or drugs
- having an unstable home life
- experiencing or witnessing violence or traumatic events
- physical health problems
- genetic factors – such as a parent with the condition
Teenagers are often going through many different changes, such as preparing for exams, going to college, or university. These life changes can involve stress and pressure and teenagers can struggle to adapt to the new demands they face.
They might struggle to make new friends, or they might encounter alcohol and drugs for the first time. These factors can worsen existing mental health issues, or lead to new problems for some.
Does social media use cause depression in teenagers?
There are mixed opinions about the role social media use may have in teen depression. Some experts believe a lot of screen use may lead to poor self esteem and low mood as teens may compare themselves to others. There are also concerns around screen use and poor sleep – as sleeping badly can affect our mood.
Other experts think the evidence around social media and teen mental health is inconsistent. They also suggest that social media can help lonely teens to connect to others. More evidence is needed to reach a strong conclusion. But, limiting screen time, and considering the type of content being consumed may be helpful.
What are the symptoms of depression in teens?
It’s important to remember that mood changes are a normal part of teenage life. But, when these are frequent, or extreme, they might suggest something else is going on.
With depression, your teenager might:
- have trouble falling asleep
- wake frequently
- no longer enjoy things they used to
- become socially withdrawn
- be irritable or annoyed around others
- be continually low in mood
- cry often
- misuse alcohol or drugs
- struggle with concentration and behaviour at school
- overuse smartphones
- overeat or under eat
Some teenagers with depression may not want to go to school at all, and others will appear happier than they actually are – this is called ‘masking’.
It might be difficult for parents and caregivers to decide if these symptoms are just a normal part of teen life, or something more serious, like depression. With depression, the symptoms are usually persistent and will last for a couple of weeks or more.
Depression is also sometimes linked to other conditions. Issues in teenagers that may be linked to depression include:
- self-harm
- eating disorders
- anxiety or panic attacks
- being bullied
- neurodiversity such as ADHD
How is depression in teens diagnosed?
For a diagnosis of depression in teens, a doctor or mental health professional will usually ask about how they are feeling, and for how long they’ve had symptoms of depression.
They will often also use a symptom questionnaire. This will help to show how often your teen is having depressive symptoms, and how severe they might be. They might also be screened for anxiety at the same time, using a similar questionnaire.
How can you treat depression in teens?
Luckily, depression is a treatable condition. It’s usually treated by talking therapies, and/or specific medications. Often a combination of both is recommended. But, for others, talking therapies alone can make a big difference.
Talking therapies for teenagers with depression include:
- counselling
- cognitive behavioural therapy
Some medications used to treat depression in adults may be unsuitable for teenagers. This is because of the possible effects the medication can have their developing brain. So, a doctor will help to select the most appropriate option for their age and health.
It’s also useful to focus on creating a healthy lifestyle. This would include regular exercise, good sleep, and a balanced diet. These changes have been shown to reduce the risk of low mood. Moderating alcohol use may also have a positive impact. Replacing excessive screen time with more face-to-face contact may help some teenagers.
How can I talk to teenagers about depression?
It’s important to be sensitive about your teen’s feelings. Try to avoid direct and constant questioning which may make them feel attacked. But it can help to explain your concerns about their mood, and to let them you know you’re there if they want to chat.
Sometimes, it can be easier to have these conversations via instant messaging or phone if this is more manageable for your teen. You can also refer them to see a doctor or speak to someone else if they would feel more comfortable (such as a family friend).
Going to the doctors about depression can be daunting, so you could offer to go with your teen. It might help to prepare a list of questions to ask the doctor such as:
- what treatment options are available to them
- whether they will be referred to CAMHS (Child and Adolescent Mental Health Services)
- how long waiting lists are
- whether they would recommend medication or not
- if they can recommend any local support groups or services
Support and resources for teenagers with depression
While a GP is a good place to start, there are many sources of support and information for both you and your teenager. Here are a few useful resources.
Local Minds is a mental health service that offers localised support across England and Wales. They can provide talking therapies and other services for young people.
The Mix is a UK charity that provides support to young people aged under 25, including a crisis text line and a webchat forum. They also provide counselling online.
Frank is a national anti-drugs service, where teenagers can get free, confidential support and advice around drug use here.
If your teenager is feeling very overwhelmed, then the Samaritans offer 24/7 support via text and phone. If they are feeling suicidal then call 999 and ask for an ambulance.
Looking for more support? Our Family Mental HealthLine connects you with mental health nurses for advice and guidance about your child's mental wellbeing.
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