Depression in children

When 13-year-old Tina (name changed by the editor) began to withdraw, her mother didn’t notice straight away. She was still struggling with the separation from Tina’s father, even though they split two years ago. And she suffers from a mental illness herself. But she was worried that her daughter was coming home more and more before the school bell had rung.

Some days, she didn’t want to go to school at all. Tina found it hard to fall asleep at night. Gunter Groen recalls: “When her mum spoke to her about it, Tina burst into tears. She said that she couldn’t go to school any more. She wasn’t good at anything. And she would never achieve anything in life anyway”.

Groen is professor for psychology at University of Applied Sciences in Hamburg, specialising in child and adolescent psychiatry. At his psychotherapy practice, he also works with children who suffer from depression. Tina is one of his patients.

One illness, many triggers

Cuddling one minute, then slamming doors the next. When children reach puberty, parents often don’t know how to respond to their behaviour. In this phase, young people suffer from inner turmoil, feel betrayed by their bodies and misunderstood by their family. They really want affection, but at the same time they also feel the need to be independent. 

It’s difficult for parents to determine what their child really wants from them. That’s why it’s not easy put your finger on what exactly triggers depression. It can be a mix of individuals factors. These include:

• Genetic disposition; a vulnerable personality
• Problems at home, such as illness or divorce; parents who can’t give the child what it needs 
• Problems at school, failed relationships, cyberbullying 
• Worries about climate change, wars, the COVID-19 pandemic

Symptoms of depression in children

“Most young people go through phases when they’re growing up when they are sad or don’t believe in themselves. That is totally normal,” says Groen. If children show several symptoms, if they have problems sleeping, don’t want to eat, they are lethargic, or even irritable and aggressive, these can be signs of depression. It’s important to remember that depression isn’t just an adult problem – it is the most common mental illness among children and adolescents. 

How parents can help

Since the COVID-19 pandemic, the number of children and young people suffering from depression has risen again sharply. A study conducted by UNICEF showed that a third of 14 to 19-year-olds in Switzerland and Liechtenstein suffered from mental health problems last winter. And just as many young people in the survey said that they didn’t speak to anyone about their problems.

Of course, parents are aware when they’re not the first choice as sounding board. But listening is important, even if the child’s mood may make communication difficult. “Don’t try to resolve the situation too quickly or play down their fears. Don’t adopt a ‘keep calm and carry on’ approach or say that you felt exactly the same when you were young”, advises Groen.

In a survey, young people affected by mental illness noted the phrases they’d like to hear. These included simple messages such as “I’m here for you” or “How can I support you?”. This shows the child that their feelings are being taken seriously and that they are valid.  

Parents can offer support by showing affection and working with the child to find solutions: “Are there problems in the family that I can talk to my child about? Does our child want more time and affection from us? Is there stress at school? Is he or she under too much pressure? Or not enough? Does he or she need more structure or hobbies?”, explains Groen. 

When does my child need professional help?

Depression may be diagnosed if the child experiences several symptoms for two weeks or longer – regardless of what is going on in their life at the time. Nothing can cheer them up, not even an upcoming birthday or if their favourite team wins. Parents should be prepared to seek medical help early on, says Groen. “A serious mental illness should be handled in the same way as an inflamed appendix. Parents wouldn’t try to operate on their own child, and they shouldn’t think they have to handle mental illness on their own either.”

First point of contact is a medical professional or health insurer. They will help you take the next step and find a place in therapy. Since the pandemic, there have been long waiting times for child and adolescent psychiatrists in Switzerland. However, studies show that outpatient treatment is the best way out of the crisis in many cases.

Discover your strengths

Tina has been going to psychotherapy sessions for around eight months. She now has her emotions better under control. Her mother has spoken to her about the painful separation – and discussed with the father how they can make the situation easier for Tina. Both parents agreed not to badmouth each other in front of Tina.

Gunter Groen explains that Tina has already come up with strategies to help herself. “She’s learned to open up to her parents about her feelings. She meets with friends regularly, and her hobbies give her a sense of achievement.” Her new passion is her analogue camera. “She doesn’t see the world through rose-tinted glasses, but it’s not all black any more either. She has discovered her strengths,” says Groen.