When Your Child’s World Collapses: Kids & Depression Part I

by James Lehman, MSW
When Your Child’s World Collapses: Kids & Depression Part I

Part one of a two part series by James Lehman, MSW, on kids and episodic depression.

Note from James: In our culture, sadness and depression have become almost interchangeable terms. In this article, we’re going to use the term “episodic depression” when referring to a level of sadness that children experience that interferes with their functioning.

Almost all kids will go through periods of sadness at one point or another. “Depression” itself is a clinical term that’s become part of our culture. Kids, as well as adults, will use the word “depressed” when they’re feeling sad about something. But know that there are many levels of meaning here, from feeling a little down all the way to clinical depression.

Know that when your child is depressed, their coping skills have collapsed.

If your child seems distressed, despondent or sad for a prolonged period of time, have them seen by someone with diagnostic skills. Be sure to have a pediatrician rule out any underlying issues that might be causing depression.

Rather than clinical depression, in this article I’ll be addressing the periodic episodes of depression that kids go through—times when they seem to get “stuck” and don’t know how to move forward. Kids often don’t have the skills to handle their overwhelming emotions, but as parents, we can help coach them through the tough times and teach them coping skills.

What Episodic Depression Looks Like
When your child is down, you may see them exhibit a variety of symptoms: lethargy, irritability, anger, impatience, changes in eating or sleeping patterns, acting-out behavior, high distractibility, crying, confusion and a general sense of sadness. During these times, it’s important to try to determine what’s triggering the episodic depression your child might be experiencing. Whatever the cause, once you determine what the problem is, you can help your child develop the coping skills to manage that problem.

For each child, the event or situation that has triggered the episode of depression is different. It can be anything from a death in the family to a divorce, social problems to difficulty at school—which may further inhibit your child’s ability to empower themselves. The result is that they can’t make decisions very well; in fact, there might seem to be an absence of decision-making in their lives.

Know that when your child is depressed, their coping skills have collapsed. And I want you to think of collapsing in terms of the speed at which they lose their coping skills—think of a building collapsing. And so it might look like this: one day your child is coping with things okay, and the next day, they can’t seem to solve the same functional or social problem. For some reason they can’t get along well with authority and they have a hard time meeting their responsibilities. These are sometimes the symptoms of episodic depression. So if there’s a chance your kid is going through episodic depression, the most important thing is that you help them maintain their coping skills until the underlying issue is resolved.

School-related problems
Episodic depression can stem from something that’s happening at school, such as a bullying situation. If you have a younger or middle school-aged child, you need to find out if the trigger of this episode is something that should be managed by the school. Schools have to take responsibility to keep kids emotionally and physically secure. There’s much too much intimidation, bullying and abuse going on these days, and schools have to be much stronger in having a code of conduct in how kids treat each other. You’ll also want to talk to your child’s teacher and find out how your child is doing in school. Has the teacher observed any changes in your child’s personality? Do they have schoolwork they can’t manage? It’s always a good idea to say, “Here’s what we’ve been noticing at home. What do you see?”

Medication
I want to note here that parents should be very wary of the medication used to treat depression in children. Personally, I’m not for or against medication, it’s strictly a child-by-child determination, but it’s important to be aware that some drugs that have worked with adults have been used on kids to a bad effect. Many of the SSRI family of antidepressants have been found to aggravate symptoms of sadness and desperation in kids. Sometimes these meds exacerbate the problem a child is experiencing and make self-destructive behavior more likely. So make sure that you talk candidly with your child’s doctor, do research online, read up on it as much as you can, and understand the risks if you decide to go that route.

When depressed kids act out
Misbehavior and acting out are two of the symptoms of depression that you’ll see in a child, and sometimes, two of the primary symptoms. In fact, a lot of the kids that I’ve seen diagnosed with depression had a very intense acting-out component to their behavior. Why? Because they could not access their problem-solving skills. When people can’t solve their problems, they act out in one way or another, and when children can’t solve a problem, they tend to act out their feelings. The most important thing parents can do is help their kids access their problem-solving and coping skills, whether they’re medicated or not, and give them the support they need to develop them. If you’re a depressed kid with no coping skills and you go on medication, then you’re a medicated kid with no coping skills.

It’s just that simple: children need added direction, structure and support when depressed. One of the most important things parents need to know is that during those periods of sadness, your child still needs to take responsibility for solving problems; that does not stop. In fact, letting your child avoid their responsibilities because they’re down is a big mistake. If you’re an adult and you tell me you’re depressed, I will tell you what tens of thousands of therapists will tell you: “Get up off your butt and go do the dishes. When you’re done with the dishes, go down to the park and walk the dog. Buy the paper and read it.” In other words, the whole idea about depression is you still have to live your life. Listen, growing up is hard, and if kids find a place to hide out, they will. Many kids find a place to hide out through acting out behavior. And they hide out there until they’re young adults, by being verbally and physically disrespectful and abusive. That’s how they really avoid growing up.

A word of caution: if depression builds and kids feel like they’re falling behind in life, they can start feeling more and more hopeless, more and more stuck, and more and more guilty. For some, thoughts of suicide start to look good. In fact, in one study that came out in the ‘90s, researchers found that 80 percent of the kids they were tracking who contemplated suicide were not clinically depressed. The kids who contemplated suicide the most seriously were those who were faced with problems they didn’t know how to solve and who had the means to kill themselves. Some even made attempts, and tragically, several were successful.

The researchers concluded that if you teach kids problem-solving skills (and if they have no access to weapons or other means to harm themselves), adolescent suicides would go down. The study also found that children and adolescents don’t have the problem-solving skills it takes to solve the very complex dilemmas teens get themselves into sometimes. People think of suicide when it’s the only solution they believe they have left. Sadly, for some kids, it looks like an easier solution than public humiliation, shame or dealing with a difficult adolescent issue.

Next week, James Lehman, MSW will discuss how to help your child identify depression and use the new coping skills you will teach them. He will also show you how to help your child focus on and complete their responsibilities, even when they’re feeling down. James will explain why, although it’s difficult to see our kids go through episodes of depression, it’s also an opportunity to help teach them coping skills they’ll be able to carry with them for the rest of their lives.


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James Lehman, MSW was a renowned child behavioral therapist who worked with struggling teens and children for three decades. He created the Total Transformation Program to help people parent more effectively. James' foremost goal was to help kids and to "empower parents."

READER'S COMMENTS

I´ve been waiting for this article for sometime and I think James was so precise in the way he put it.After tracking the right medical help and diagnosis this can be a clue for most of the problems a parent and kid are going through at a point of time and that can escalate to some of the behaviors we all "lost" parents face.I´m not saying this is the solution for all the cases but I´m sure that some of these "shocks" a kid can come in contact with can start and grow in front of us and still not be detected.

Comment By : Hope

I wish I had this information 8 years ago. Your explanation of a complete collapse of coping skills was enlightening. Description of symptoms was excellent. I probably would have handled the situation I was in much better than I did, recognized it earlier and worked with my daughter more effectively.

Comment By : Survivor Mom Susan

My son has become real upset about his situation on the bus. His bus driver is a real issue and i'm trying to get the school or the bus administration to do something about it. My son was being bullied on the bus and she told him that if she saw the bully treat him that way again that she was going to look the other way! I'm so upset over the situation. Now she is forcing him to sit with two other boys that a way bigger than him and they constantly squash him and cause the bus to be a very hostile environment for him. I feel like I can do nothing cause no one will help. I'm stuck with him riding this bus because it is the bus that picks him up at daycare. I am divorced so the other parent giving a ride is not an option. Yesterday he started crying over the littliest thing and when i asked what was really wrong he said, that he just has a very hard time on the bus. This is getting ridiculous. I don't know what to do...i'm actually in the process of writing a letter to the newspaper hoping that someone may reach out.

Comment By : salamonie parent

I really appreciated the word picture of a collapsing building as a description of what the collapse of coping skills looks like. This article was very timely and had given me tremendous insight into what my 11 y/o is going through. Thank you so much!

Comment By : Faith

My son is twenty-one this year. His older brother died of a herion overdose seven years ago at age twenty, and I don't think any of us have worked through it well - maybe never. I have had help from support groups and counseling, but my son and husband did not want to. My son has had more and more frequent episodes of intense anger/depression - it becomes impossible to even speak with him. He spirals in a matter of minutes. He's away at school, but these episodes have happened at home and at school. If there are any suggestions out there, I would love to hear. I've wondered if he may be bipolar, because he recovers from his anger with instant warmth, a smile and an ability to work through any issues related to school, friends...with steadfast calm and clear thinking. I don't think he'll go to a doctor, but I'm hoping I might be able to do something in my reactions to him, that don't contribute negatively. Mr. Lehman, are there specific skills in Total Transformation to help on this? I'm so anxious for the next article on coping skills.

Comment By : June

Very good article. I am iterested on the reasearch about suicide. I have done several funerals for teens who committ suicuide and I beleive this is accurate. Where was the reasearch done. CB

Comment By : Charlie

My sister acts just the same was as June's son. She is 21 years old but at times does not act like it at all. One minute she will be fine and the next she chews your head off, she says and does things that leave us speechless. And then after she has upset the whole household she seems to realize what she has done, she cries and says she is sorry and doesnt know why she acts the way she does but the next day it happens all over again. We tried giving her medication a couple of years ago but she had a very bad reaction to it, blackouts and shaking and nausea... She was not very good in school and still hasn't gotten her high school diploma, and she doesn't know how to drive (despite our many many efforts) she gets to scared while driving, shaky and cant seem to get the hang of it. It's like she can either driver faster or keep the car straight, but not both... I know there are alot of issues here but if anyone has some advice my whole family would really appreciate it.

Comment By : at the end of our rope

To the woman who is having trouble with her child on the bus. Your child is being assaulted on the bus, and that is a crime. Call the police, and have them talk to the bus driver and give her a warning. The children that are squashing your child should be losing their bus privileges for at least a week, if not the rest of the year. This should not be tolerated. I have taught my children to walk to the front of the bus, tell the driver what is going on, and stand there until the driver deals with it. If the driver does not deal with it, tell the driver to stop the bus and call you to pick them up. The bus will have to wait until you get there, as they cannot drop your child off in an unsafe place. I have told my children to get off the bus if they feel unsafe, and they know the children at the next stop. And then to call me. They have never had to resort to this, but we have succeeded in getting a child suspended from bus privileges for 1 week. The parents had to drive them to school for that week, and things improved the following week. Remember, assault is a criminal offense, and these boys who are sitting on your child are assaulting him. Take the most serious course of action you dare.

Comment By : Rosa

* Dear Salamonie Parent: It's such a tough situation when your child is being bullied at school or on the bus. Most schools have a zero tolerance policy for bullying behaviors and programs set up for addressing bullying. While it’s important to let your son know he must obey the school rules and the bus driver, you certainly should look into the system the school provides for addressing bullying. If continuing to work with the school staff is ineffective, you may want to go to the superintendent of schools in your district. An active local PTA (Parent Teachers Association) might be another good resource for you. This organization can work together with you and the school system over any concerns regarding bullying policies or issues about school personnel. Sometimes we need to advocate for our children, over and over again. Something you can do right away is help your son with his next bus trip. Since bullies usually pick on kids who are alone, having your son sit with other children could be a good idea. Ask your son if there are kids he’d rather sit with and see if you can arrange this with the bus driver. One of the best ways to safeguard your son from becoming a victim of a bully is to teach him how to be assertive but not aggressive. Encourage your son to say "no" when he feels pressured or uncomfortable, to stand up for himself verbally but not physically, and to walk away whenever he can. Finally, it’s great that your son is telling you about his concerns. I know that it’s upsetting, but try to stay as calm as you can when he talks with you. We don't want him holding back information because he doesn't want you to become upset. I hope this is helpful. Please check back in and let us know how it goes!

Comment By : Carole Banks, Parental Support Line Advisor

My son who is 13 has been subjected to the same type of bulling in school. A fellow student jumped my son from behind and hit him in the back of the head with his fist repeatedly. It has been 2 months and my son still faces the humiliation from fellow students, they tease and laugh at him. My son just cant seem tom get past it. I just keep telling him the other boy was a coward to hit him from behind. this has crushed his ego. I dont know what else to say to him. He is a great kid, he's funny,charming, and sweet. For some reason he does'nt see it.

Comment By : robin

It continues to be upsetting to me that a child is unsafe on a school bus, and that children who attack other children at school are allowed to stay in the school. We recently heard of a family that took 3 children out of a local school system, and are homeschooling their children because they feel their children are simply at risk on a day to day basis, and the risk and stress and lack of classroom and school action in dealing with perhaps 3 or 4 students by simply expelling them, affects 100's of children daily. This is a complete shame, and parents need to remove their children from schools where physical and verbal assault takes place (whether the assaults are from teachers, from administration or from other students). It just does not make sense to have our kids in an unsafe environment. It wrecks them for life. Bullying seminars must be attended by ALL parents. If the parents of bullies do not attend the seminars, those bullies are expelled until they attend anger management with their parents. It just cannot continue. We are making a sham of the education system if we think it can continue this way. Crime is punishable in this country. Assault is a crime. Treat it that way.

Comment By : Hot under the collar momma

i think my child may be depressed but im not sure...she has shown some of the signs but not all of them...or at least i dont think shes shown all of them

Comment By : hot momma

* Dear ‘hot momma’: Depression is treatable, but as James Lehman says, you need to know what the problem is in order to develop a solution. Anytime you are concerned about your child’s mental health, have her evaluated by a professional. You should start by taking her to your family doctor. Your doctor needs to check to see if a medical problem is causing the symptoms of depression. We wish your family the best.

Comment By : Carole Banks, Parental Support Line Advisor

My daughter suffers from clinical depression that her HMO didn't really address very well. Now that her insurance has changed I am hopeful a new support team will be better for her. One of the major factors that affected her depression was school. She was a bit of a loner, a bit different, an natural champion of the underdog and easily upset by cruelty and pressure. My husband (her stepdad) and I have taken a big step by pulling her out of public school last year to homeschool her. That in and of itself has made a huge change in her attitude. I realize that not everyone can do this - it's been a big sacrifice for us. I am very upset to see how many families are having to deal with severe school related issues. Considering the impact of teacher layoffs, reduction in the number of buses, the increase in size of classes and fewer school days this upcoming year, I fear is will only get worse and more children will fall to the pressures.

Comment By : Kirahfaye

My 13 year old son was a pretty good student...Until he got into 7th grade...First semester he failed Math...Second: Math and Science...Now we're tailend of the Third and he is failing Math,Social Studies,and Science....He was diagnosed with ADHD when he was 7 and after taking various meds(Ritaln,Adderall,etc..) he finally settled into Metadate 50mg...Now THAT med has seemed to have stopped working for him...He has an IEP at school and his teachers and myself are trying to help him..but he doesn't care..He has to stay after school everyday to do homework(owed and current) but while he's IN school during the day,he doesn't take tests correctly..he doesn't show interest in anything...He doesn't appear to be depressed..he's not having any mood swings...He's been punished(taking games and TV away,etc) but he adapts to it...He doesn't care...When I ask him what makes him not care, he says that he doesn't know...I'm all about letting him fail,but this is getting ridiculous...I'm at my wits end...HELP!!

Comment By : Sandi M.

* Dear Sandi M.: It sounds like you are concerned about your son, and frustrated by his apparent lack of motivation. It can be so frustrating when kids have an “I don’t care” attitude. The best place to start in helping your son is to go back to the doctor who prescribed his medication. Let that professional know what is going on with the grades and share your feelings that the medication may have become ineffective. It is also a good idea to ask that professional to evaluate your son for depression. This will give you a more clear understanding of your son’s behavior. With this understanding, you will then be able to better determine what Total Transformation tools will be appropriate for him moving forward. We wish you luck as you continue to work through this.

Comment By : Sara A. Bean, M.Ed., Parental Support Advisor

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