Wednesday, July 14, 2010

Talking to children about depression

[My Tisha b'Av article for YU To Go is now on-line here.]

Here’s a question I’ve asked and been asked over the years: At what point should parents talk to their children about depression?

The question arises for two reasons:

1. Stories in the news - From time to time there are news items about pre-adolescents, kids aged 9, 10, 11, taking their own lives, often in response to abuse from their schoolmates. The parents say the normal things – “We never knew it was this bad,” “He would swing in and out of moods, but he never talked as though he was a danger to himself,” and so on. And we wonder how we should introduce the question to our children. “Are you going through…?” “Are you thinking about…?”

2. Family histories - Studies show that one can, in fact, inherit a vulnerability to clinical depression. So when an adult is diagnosed with this condition, the follow-up questions include, “What about my children? Is there a way to test them for this? Do I warn them? How?”

It seems to me that normal child-rearing must include teaching, in an age-appropriate way, coping mechanisms for normal, non-biochemical depression. Dealing with frustration, with boredom, with tough peer groups, with love and loss – we cannot immunize our children against these situations, but we can, and I think must, help them find ways to cope, both directly and by modeling the behavior. This doesn’t require a conversation about clinical issues and genes and biochemistry.

But I’m asking about more than that, about helping our kids recognize when an emotion is outside of the normal range, and it’s time to call in the experts. Can that happen at age 10? Age 13? Age 15? Age 18?

I’m not suggesting that kids at these ages could diagnose an abnormal personal, emotional reaction – it’s hard enough for trained and objective adults – but perhaps we could tell them a little bit about the problem and its dangers, empowering them to seek out help… without terrorizing them and without leading them to a false self-diagnosis.

Obviously this not a one-size-fits-all subject, but surely someone with knowledge of developmental psychology could make some general recommendations.

I’m sending this question to my favorite Internet counseling resource. In addition, though, please comment with your thoughts, and any recommended reading material.

5 comments:

  1. If the parent has suffered from clinical depression, I will assume the parent has gotten treatment for it. I have learned from my own many years in therapy that depression is anger turned inward. So the key is to teach our children how to express one's emotions in a healthy manner, including anger. One should teach one's children to find an adult to talk to if one has a problem. Having a therapist who is familiar with a family can be helpful if a parent suspects depression.

    We should take preventative measures with our mental health in a similar way that we do with our physical health.

    Thank you for raising this important topic.

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  2. Difficult topic. I'm not an expert, but I believe it is a matter of controversy in the psychiatric profession as to whether young children can suffer from depression: some say they can, others say they can't (I think the reasoning is that they don't have enough of a sense of self to get depressed).

    I don't know what the benefit would be of telling very young children about depression, unless someone in the family is actually suffering from it and the kids need to understand what that person is going through.

    Certainly if there is a history of depression in the family, the children should be told about it. When I was being diagnosed with depression, I was asked a lot by doctors and psychiatrists whether there was any family history of depression. I said no, which I thought was the honest answer, but a couple of years later I discovered that several close relatives had suffered from it. I don't think I'd have been diagnosed faster or differently if the doctors had known that, but it would not have hurt to have told them, and in a less clear-cut case it might have made a difference to diagnosis.

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  3. Depression should definitely be taught as a health education topic. As a parent, I have seen my kids literally worried sick over the depressive or self-destructive behaviour of a friend. One of the most important messages to get out to them is that such a person is ill, and that THEY CAN BE HELPED. One of these situations went on far too long because of the teenagers' mistaken loyalty. We finally convinced our kids that a promise to keep a friend's secrets may and must be violated if that person is a danger to themselves.

    In some ways, it is easier to teach about depression by discussing how to react if it happens to someone they care about. I hope I got across the important part, that there is help.

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  4. Just wanted to add my .02 from personal experience. My own depression manifested itself around age 12-13. I think that's pretty common for many, and would be a good benchmark for parents, if the topic has not come up previously in the child's life (personal history or a family/friend connection).

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  5. Leora-
    Thanks for your comments, and you're welcome!

    Daniel-
    I agree with much of what you say here, but the key question is still the test for "very young" and "young" as they apply here.

    Laya-
    You did, thanks.

    Jendeis-
    Thank you; that number is helpful.

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