From normal blues to debilitating depression

Recognizing the signs and symptoms to help your child or teen.

This is the third in a weekly series on mental health for children and youth.

Dr. David Smith

We all feel sad from time to time. It is a normal and appropriate response to disappointment and loss. But how do you tell whether your child or teen is experiencing normal sadness or suffering from clinical (or major) depression that may need expert help?

Telling the difference can be difficult as the symptoms of depression can be different  in children and teens from adults. In young children, it may express itself by being excessively clingy, frequently crying, expressing fear that they or others will die, losing interest in toys or friends, losing interest in school or refusing to go, frequent headaches, stomachaches or feeling sick.

In older children and teens, along with many of those symptoms can come others like withdrawal and social isolation. Other symptoms can be a lack of energy, extreme boredom, inability to concentrate or communicate, loss of friends, or lack of desire to see friends. Changes in patterns of eating and sleeping (either too much or too little) are common signs, as is being unable to get out of bed or off the couch. If your teen has previously been involved in sports and hobbies, depression may show up as an inability to enjoy or partake in activities that used to bring pleasure. Also common are feelings of excessive regret, guilt and remorse and increased irritability, aggression and hostility, as well as extreme sensitivity to rejection, criticism or failure. Sometimes untreated anxiety can turn into depression when the child or youth feels overwhelmed by their fears. One or two such symptoms usually aren’t enough to make a diagnosis, but a pattern of sadness or loss of interests or pleasure combined with three or four such symptoms extending over two weeks or longer is more suggestive of clinical depression.

For parents, some of these symptoms can seem at times like normal teenage angst, lack of motivation or even misbehaviour. In fact, up until about two decades ago, it was thought that depression was primarily an adult disorder that rarely affected children or teens. Any symptoms displayed were put down to “a phase,” moodiness, over-dramatization, or self-indulgence. “Snap out of it!” many a parent would bark — thinking erroneously that cajoling or scolding might help.

Now we know much better. Depression is a serious mental health issue that affects about two per cent of BC children and adolescents every year. It is more common in girls, but it may be that depressed boys and teenage males display other behaviours like aggression, substance use, and delinquency, which can mask the depression.

The risk of experiencing an episode of depression rises with age and with family history. While sometimes depression comes seemingly out of the blue, it can also be triggered in susceptible youth (with a genetic predisposition or with low self-esteem, perfectionist tendencies, for example) by trauma, anxiety, guilt or regret, or the death of a loved one or other significant loss.

On its own, depression is bad enough, but its hopelessness and despair, with the inability to see a brighter future, can also lead to suicide, which is the second leading cause of death among 15-24 year olds.

Fortunately, depression is highly treatable and youth are more likely to respond well to treatment if they receive it early. Treatment can consist of psychotherapy to teach youths how to address thoughts and behaviours that can lead to depression. Also, anti-depressant medication can be very effective at reversing depression and keeping relapses at bay.

If your child seems to be showing symptoms of depression, talk to your family doctor, a mental health professional or the mental health clinicians through the Ministry of Children and Family Development (MCFD).Call Service BC at 1 800 663-7867 to find the MCFD office nearest to you. Their experts will screen for depression and help your child access the most appropriate treatment if needed.

We do know that healthy diets, regular exercise, good sleep, and the ability to talk about problems with people who care are all protective against depression or relapses. Information and support are available through a number of websites, such as:  ok2bblue.com, dwdonline.ca, heretohelp.ca; mindyourmind.ca; keltyresources.ca, mindcheck.ca, openmind.ca.

For youth with suicidal thoughts please call the BC youth crisis line 1-800-suicide, visit youthinbc.ca to chat with a counsellor in real time, or go to the Emergency Department of your nearest hospital.

Dr. David Smith is an adolescent and adult psychiatrist and the medical director of the Okanagan Psychiatric services for Interior Health.

Just Posted

A tent housing a mobile vaccination clinic. (Interior Health/Contributed)
Over 5K jabbed at Interior Health mobile COVID-19 vaccine clinics

The clinics have made stops in more than 40 communities since launching last week

Provincial Health Officer Dr. Bonnie Henry talks about B.C.’s plan to restart the province during a press conference at Legislature in Victoria, Tuesday, May 25, 2021. THE CANADIAN PRESS/Chad Hipolito
Interior Health COVID-19 cases falling slower than the rest of B.C.

More than a third of provincial cases announced Thursday came from the Interior

Students at Creston Valley Secondary School put together an art installation of a replica residential school room. (Photo by Kelsey Yates)
Creston students create art installation of residential school room

The replica was decorated with a small bed, school uniform, and notes written with pleas for help

A tent housing a mobile vaccination clinic. (Interior Health/Contributed)
Second dose vaccinations accelerating throughout region: Interior Health

To date, more than 675,000 doses have been administered throughout the region

1914
It happened this week in 1914

June 13 - 19: Compiled by Dave Humphrey from the archived newspapers… Continue reading

Marco Mendicino, Minister of Immigration, Refugees and Citizenship during a press conference in Ottawa on Thursday, May 13, 2021. THE CANADIAN PRESS/Sean Kilpatrick
Canada to welcome 45,000 refugees this year, says immigration minister

Canada plans to increase persons admitted from 23,500 to 45,000 and expedite permanent residency applications

Emily Steele holds up a collage of her son, 16-year-old Elijah-Iain Beauregard who was stabbed and killed in June 2019, outside of Kelowna Law Courts on June 18. (Aaron Hemens/Capital News)
Kelowna woman who fatally stabbed teen facing up to 1.5 years of jail time

Her jail sentence would be followed by an additional one to 1.5 years of supervision

Cpl. Scott MacLeod and Police Service Dog Jago. Jago was killed in the line of duty on Thursday, June 17. (RCMP)
Abbotsford police, RCMP grieve 4-year-old service dog killed in line of duty

Jago killed by armed suspect during ‘high-risk’ incident in Alberta

The George Road wildfire near Lytton, B.C., has grown to 250 hectares. (BC Wildfire Service)
B.C. drone sighting halts helicopters fighting 250 hectares of wildfire

‘If a drone collides with firefighting aircraft the consequences could be deadly,’ says BC Wildfire Service

A dose of the Pfizer-BioNTech COVID-19 vaccine is pictured at a vaccination site in Vancouver Thursday, March 11, 2021. THE CANADIAN PRESS/Jonathan Hayward
NACI advice to mix vaccines gets varied reaction from AstraZeneca double-dosers

NACI recommends an mRNA vaccine for all Canadians receiving a second dose of a COVID-19 vaccine

A aerial view shows the debris going into Quesnel Lake caused by a tailings pond breach near the town of Likely, B.C., Tuesday, Aug. 5, 2014. THE CANADIAN PRESS/Jonathan Hayward
Updated tailings code after Mount Polley an improvement: B.C. mines auditor

British Columbia’s chief auditor of mines has found changes to the province’s requirements for tailings storage facilities

A North Vancouver man was arrested Friday and three police officers were injured after a 10-person broke out at English Bay on June 19, 2021. (Youtube/Screen grab)
Man arrested, 3 police injured during 10-person brawl at Vancouver beach

The arrest was captured on video by bystanders, many of whom heckled the officers as they struggled with the handcuffed man

Patrick O’Brien, a 75-year-old fisherman, went missing near Port Angeles Thursday evening. (Courtesy of U.S. Coast Guard)
Search for lost fisherman near Victoria suspended, U.S. Coast Guard says

The 75-year-old man was reported missing Thursday evening

Most Read