Helping Kids with Depression


By: Skip Corsini

According to what I see in my neighborhood, read in the papers, and hear on public radio reports and call-in programs, more and more children are being diagnosed with depression. In many cases I can say with some certainty that parents, peers, friends, and pediatric doctors are getting better at spotting the disease in kids, though there's still a lot to be learned about how to treat it, even among those that are supposed to know how.

As an adult depressive in treatment myself, this is the kind of thing that I truly hate to think about. I can recall what it felt like to be depressed when I was a young person (in the days before the acknowledgement of the disorder as a real mental health problem) and not really know whether to ignore it, deny it or scream for help. I could feel something was wrong but it was years before I was able to address it.

And because I am a parent of four seemingly well-adjusted children (knock on wood), I can understand how challenging the disorder would be for other parents. Indeed, there is nothing like prior personal involvement with a serious problem such as depression to create feelings of empathy for people who are affected by it.

Depression and Stress

Studies of childhood depression have shown that stress in its many forms, and inability to deal with stress, are major factors in creating and exacerbating the problem. The catch here, of course, is that there is about as much chance of living a stress-free life as there is, for example, of locating John Rocker alone in a New York subway.

For adults and children diagnosed with depression, there are several treatment options available today and they include medication, such as the selective serotonin reuptake inhibitors (SSRIs) like Prozac or Zoloft, intensive psychotherapy, adjustments to diet, introduction to physical exercise programs that can relieve stress, or some combination of the above.

These kinds of treatments focus on the individual depression sufferer, and they have proven to be very valuable to a number of people, myself included. But depression is also a family matter. It affects, some might say infects, everyone with whom it comes into contact, not unlike addiction to substances.

Which is why I believe that, particularly for children, steps must be taken to address the environmental issues related to the disease. All the medications in the world are not necessarily going to ensure that a person with depression is going to be able to function well if his or her living environment is a root cause of further problems. And this is the part that, because it is not as objective as following a doctor?s prescription, is so difficult to deal with. But I am also convinced that we parents can take steps to create mostly stress- and depression-free environments for our children.

Love and Limits

Here is my prescription, based on personal experience with the disease, some training as a public school educator, and as a father of four children aged ten to nineteen. To be sure any application of the accompanying principles is going to be a stumbling, bumbling, faltering, groping, mistake-ridden exercise. But in my book you will earn an "A" for effort.

It starts with the somewhat conflicting concepts of love and limits. It has been my experience that all kids need major doses of these two golden ideas, and depressive kids need more of both than other kids. These are the two principles that I have tried to utilize above all others in raising my kids. What all kids need most are equal measures of unconditional, unrestricted parental love and uncompromising, non-negotiable parentally imposed limits.

The free flow of love from parent to child over time generates trust, confidence, resilience, respect, and integrity, the kinds of things that help young people become comfortable in their own skins. I believe that most depressed kids, no matter how much love they may have received, are troubled by who they are, how others perceive them, and what is expected of them. I know I was, and you couldn?t necessarily have known it just by looking at me.

It stands to reason that people who are deeply unsure of themselves ? for reasons based either in their biology or their environment -- are going to have trouble with basic decisions, because they don?t have an easy time with the most basic conviction of all, that they have a valid place in the world. What love ultimately engenders in the confident child is the ability to create his or her own limits and stick to them. Kids who have the basic ability to say "no" with conviction are kids who are going to succeed eventually.

Limits come into play because depressive kids respond well to thoughtful structure of all kinds. I know I did. Start by arranging things in the child?s life that can be made routine, such as bedtimes, mealtimes, and other daily activities. Help your child by requiring that homework be attended to immediately upon arrival at home after school, not put off until he or she is exhausted and hungry from playing outside with friends in the neighborhood.

Most of all, help your child understand the consequences of exceeding the limits that you impose by saying what you mean and meaning what you say. If you threaten to take away a privilege when a limit is exceeded, do take away the privilege. The child needs to know that you mean business. I do not advocate establishing a lot of unnecessary rules for the child to have to remember. That is a stress in itself. But households with no rules, no consequences, and no limits are bound to fail in creating the best possible environment for children with depression.

As with anything else in life, the job of raising children who are beset with depression is going to be challenging, frustrating, and overwhelming at times. Parents in these circumstances also need to take good care of themselves in the process, both to model good life habits and to maintain health. Focusing on what you can truly manage, what you do and how you do it, is better than trying to control what is beyond your reach. This kind of approach is going to rub off on your kids in positive and gratifying ways.

© 2003 Skip Corsini. All Rights Reserved. This article is used with the full permission of the author.

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