Experts at Schneider Children’s emphasize that undiagnosed and untreated depression in children can lead to recurrent and lifelong chronic illness.
Prof. Silvana Fennig, Director of the Department of Psychological Medicine at Schneider, notes that “about 400 cases connected to suicide attempts are treated in the ER each year. It is essential to raise awareness among parents about the importance of early identification of depression in children and youth. The earlier depression is identified, the greater the chances of recovery and the prevention of related complications.”
Depression is described as an emotional state characterized by feelings of sadness, helplessness and despair. Most people suffer from temporary periods of depression at some time in their lives. Depression doesn’t only affect adults but also children and adolescents. However, childhood depression is not a passing phase or symptomatic of normal mood swings as in adulthood, but a serious and fatal illness that is identifiable and affects millions of children under 18 in Israel and abroad.
About 2%-3% of children (one per class) and some 8% of adolescents (2-3 per class) in the general population suffer from depression. Incidence is the same among both boys and girls up till age 13. Thereafter, the rate in girls rises to three times higher than in boys. Depression, like anxiety, is an emotional disorder defined as an introverted problem. In childhood depression and anxiety, the child suffers alone without necessarily exhibiting any outward signs or telling his parents. This is in contrast to extroverted disorders such as hyperactivity or behavior difficulties that are noticeable and impact upon society and therefore easily and quickly identified and treated.
Prof. Alan Apter, a world-renowned expert on depression and suicide in children and adolescents and head of the Feinberg Child Research Institute at Schneider Children’s, notes that “complications that can result from untreated depression at a young age include deterioration of studies and school dropout, alcohol and drug use, eating and behavioral disorders, anxiety, social isolation and even the risk of suicide. About 80% of cases seeking help show improvement in a number of weeks, but left untreated, the signs of depression can be prolonged and worsen leading to suicide attempts. Effective therapy can prevent the recurrence of depression.”
Within the framework of the Psychology Clinic at Schneider, headed by pediatric psychiatrist Dr. Noa Ben-Aroya, and Dr. Orit Krispin, head psychologist at Schneider, there is a Mood Clinic headed by psychiatrist Prof. Apter and psychologist Dr. Liat Haruvi Katlan. The multidisciplinary staff includes psychiatrists and psychologists who offer a combination of psychological (such as Interpersonal Therapy [IPT] and Cognitive Behavioral Therapy [CBT]), environmental and therapeutic medication approaches.
These methods focus on the "here and now", and attempt to assist the child and his family with organization and support concerning the present situation alongside providing skills and tools for coping with depression and its ramifications. Initially, the therapist and child define treatment objectives together and the areas wherein lies the most significant difficulty. Treatment focuses on these factors to provide a response to the specific problem.
The objective of treatment is to assist the child to gradually return to the previous level of functioning both from the scholastic and social standpoints. With this, there are cases where the level of educational and/or social functioning prior to the onset of depression was unsatisfactory and this provides an opportunity to identify the source of the difficulty and assist in defining the appropriate response.
In cases where there is a risk of suicide, immediate intervention is essential with the aim of reducing the danger and providing assistance to the youngster and his or her family in order to cope with the situation.
Concomitantly and as an integral part of treatment, parents become key partners in their child’s therapy, since they can significantly influence the success of therapy. Treatment is accompanied by regular parental guidance during which they receive tools to handle the whole family and learn ways to provide support. They also learn how to involve a wider circle such as school to help create a supportive environment adapted to the individual needs of each child.