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Depressive Symptoms in Children
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PEERS Program
Mental Health
Roundtable
Session for
Teachers
Mental Health
Consultation Team
February 2012
What is depression?
Depression is an internalizing disorder. Other internalizing disorders include anxiety, social withdrawal, and obsessive‐compulsive disorder. Depression involves a child’s feelings, thoughts, and behaviours. It is characterized by persistent feelings of sadness, hopelessness, social withdrawal, lack of energy, and/or irritability. With internalizing disorders, children try to maintain too much control over how they think, feel and behave, and may ruminate excessively over any difficulties or perceived failures.
Depression is often missed or misdiagnosed in young children as externalizing disorders (e.g. ADHD, ODD). Internalizing disorders appear in young children at rates comparable to some externalizing disorders. What causes
depression?
There is no one cause for depression. Research suggests there is a dynamic and complex interplay between several factors that can lead to depression: genetic risks or a family history of depression, psychosocial factors, and biological factors. Depressive Symptoms in Childhood
Depressive symptoms in both children and adults can include:  Extended periods of excessive sadness, feelings of hopelessness, or crying.  Loss of interest in activities.
 Sleep problems (too much or too little).
 Change in appetite.
 Lack of energy or excessive fatigue.
 Feelings of worthlessness or guilt.
 Difficulties thinking or concentrating.
 Increased irritability or anger.
 Somatic complaints.
 Preoccupation with death.
 Social withdrawal. The most important symptoms to watch out for in young children are: irritability and somatic complaints. Somatic complaints typically include: stomachaches, nausea, headaches, body aches, or vague complaints. Children might also refuse to go to school, cling to a parent, or withdraw socially (e.g., avoid other children). It is especially important to be mindful of changes in children’s behaviours, particularly if these changes become persistent, disruptive and affect their academic or social functioning. Depression in Young Children
Clinical levels of depression are estimated to affect ~4% of young children. Depressive symptoms that do not meet clinical criteria are estimated to affect ~15% of children. Depression often co‐
occurs with anxiety and also with externalizing disorders (e.g., ADHD, ODD, conduct disorder). Young girls and boys show comparable rates of depression in childhood. Gender differences do not typically emerge until early adolescence. Depressive Symptoms in Childhood
February 2012
Types of Depression
Clinical depression: At least 5 symptoms, where one is depressed mood or loss of interest, are present for at least 2 weeks. Depressive symptoms: Multiple symptoms of depression may be present, but child may not meet criteria for clinical depression.
Dysthymic disorder: Mild or moderate depression that is present for at least a year. Adjustment disorder with depressed mood: Depressed mood that occurs in response to a negative experience (e.g., death of a family member) and lasts for 6 months or less.
Strategies to Help Children with Depressive Symptoms
Teachers can play an important role by observing the warning signs and creating a school environment that is sensitive to the needs of children with depression. Teachers can:
1. Communicate with parents:
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Focus on the positive:  Keep a positive tone and provide specific, constructive feedback.  Express optimism in children’s abilities.  Encourage children to ask for help when needed. 6.
Create opportunities for healthy living such as daily physical activity (e.g., stretching between subjects). 7.
Teach short‐term goal‐setting for academic work and help children meet their own goals. 8.
Build a support network by promoting peer assistance in the classroom or encouraging children to walk with you at recess. 9.
Record unusual behaviours (e.g., in a log) and communicate concerns with mental health professionals (e.g., school counselor).  if you notice persistent changes in children`s behaviour or mood that impact their ability to learn or to interact well with other children.
 to discuss strategies for helping children learn and feel better. 2.
Invite children to share their feelings and create routine opportunities for reflecting on and sharing their feelings (e.g., circle time or journal writing). 3.
Refer children to and encourage children to use the PEERS feelings strategies:  Calm down and relax.  Imagine solving the problem.  Practice positive self‐talk (e.g., I can do this!).  Talk about it.  Do something fun. 4.
Be consistent with routines and use visual schedules (e.g., daily activity schedules on the board) to help children know what to expect for the day. 10. Connect families to community resources, such as CASA (780‐ 438‐0011) or the U of A Education Clinic (780‐492‐ 4742).
Resources
 Alberta Education (2011). Depression (Medical/disability information for classroom teachers). http://www.learnalberta.ca/content/inmdict/html/pdf/Depression_E.pdf  Canadian Psychiatric Research Foundation. When something's wrong: Ideas for teachers: Depression. http://cprf.ca/publication/pdf/teacher_07_eng.pdf  Merrell, K. (2008). Helping students overcome depression and anxiety: A practical guide. New York: Guilford Press.  National Association of School Psychologists (2004). Depression: Helping students in the classroom. http://www.nasponline.org/communications/spawareness/depressclass_ho.pdf PEERS Program Mental Health Roundtable Session for Teachers
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