Can children also suffer from “depression”? Xiao Fang, a 6th grade student, was performing her own dance for the audience at the graduation celebration party. Ms. Lin, Xiao Fang’s mother, was also watching from the stage. Another child’s mother said, “Xiao Fang is such a happy child.” To her disbelief, Xiao Fang was once a depressed person. Shortly after Ms. Lynn and her husband divorced six years ago, Fang stopped singing and dancing, and when other children played in the park, Fang lay on the ground and watched from afar. She also had no interest in celebrating birthdays or buying new clothes. Ms. Lin thought her daughter might be in a bad mood because of her parents’ divorce and didn’t care at first. After a while, Fang continued to cry and was reluctant to go to school, her appetite decreased, and she became so weak that she was bedridden. Ms. Lin had to take her daughter to a psychologist, where she received counseling and antidepressants. Fang’s condition was brought under control and she soon began to sing and dance again. Ms. Lynn says, “Now her daughter has stopped taking the medication, and although she has bad moods and sometimes cries, that is a normal emotional response now.” In the past, many psychiatrists and psychologists believed that children could not suffer from depression because children were not mature enough to internalize or repress their anger and rage and thus transform them into depressive symptoms. And now we have come to realize that depression can occur in children. Xiao Fang is one of these cases. There is no exact statistics on the incidence of depression in children in China. According to the data, 500,000 to 1 million children and adolescents in the United States take antidepressants each year, and one in 20 American children and adolescents have “depression” that meets clinical diagnostic criteria. Depression can interfere with a child’s normal development and growth. If we do not recognize and treat depression in childhood, it can be recurrent, interfere with learning, and lead to anxiety and stress or manic episodes during adolescence. So, as a psychologist or a parent of a child, how can you tell if your child is suffering from “depression”? Or is it simply a bad mood? Dr. Fassler, an American psychologist, divides children into three groups: preschool, school age and adolescence, and suggests that each group has different symptoms of depression. Symptoms in preschool-aged children include frequent unexplained stomachaches, headaches and fatigue. School-age children often have excessive lethargy, too much or too little sleep, and monotonous and unemotional speech. Adolescent patients may have eating disorders, significant weight gain or loss, promiscuous sexual behavior, and drug dependence; in addition the mood may become irritable and easily agitated; behavior is inconsistent with usual, and tantrums are easily lost. Some people may also experience symptoms similar to those of adult patients, such as low self-esteem, self-blame, tearfulness, withdrawal, and recurrent thoughts in the mind about death. One of the questions in the treatment of depression in children is: to medicate or not to medicate? Some fear that medication will adversely affect the development of the child. Such a dilemma dates back to 1987, the year the U.S. Food and Drug Administration (FDA) approved a new antidepressant, Prozac, for marketing. This was followed by four other drugs of the same type (Seroquel, Zoloft, Phenformin, and Xipomol), known as the “Five Golden Flowers. These drugs have fewer side effects and fewer risks than the earlier antidepressants, and have the added advantage of responding well to depression in children. However, once we have made a diagnosis of depression in a child, should we start treating it with medication? Michael Fine, director of the National Institute of Mental Health, says, “I think all children with depression should receive counseling first, then medication if necessary, and medication is just another form of talking throughout the treatment process.” Second, self-assessment for depression Everyone has bad moods at times, but if the depression lasts too long, then it should not be taken lightly. If left untreated, a depressed person can become withdrawn, confused or uncaring, or even unable to work or study. But the signs are gradual, and many people do not notice the change in mood themselves and therefore do not actively seek help. Since depression is a disorder that can seriously affect a person’s mental state and behavior, early psychological treatment of depressed people and caring for them is the first step to help recovery. Below is a list of questions that can be answered to help determine if there is a tendency toward depression and when to seek professional help. While answering these questions is not a substitute for a diagnosis by a specialist, it is an important first step in assessing depression. 1. Do you feel depressed and frustrated and lose confidence in your future life? Yes, No 2. Do you feel that you have no appetite or eat or drink a lot? Yes, No 3. Do you have problems sleeping or wake up a few hours earlier than usual? 4.Do you get nervous or unhappy for no reason? Yes or no 5.Do the things that normally make you happy (such as hobbies, work, or pet ownership) no longer appeal to you? Yes or no 6.Do you feel annoyed by the people around you? Do you lose your temper or are you indifferent to your friends and relatives? Yes, no 7, do you become uninterested in sex life? Yes, no 8.Do you feel tired, sleepy, no mood to do anything? Yes, no 9.Do you feel that your mistakes or shortcomings are a failure and have a sense of guilt? Yes, no 10.Do you find it difficult to think clearly, concentrate, or make decisions? Yes, no 11.Are you overly worried about minor discomfort or pain? Yes, No 12. Do you often think about death or have suicidal thoughts? Yes, No. (Anyone who answers “yes” to this question should seek expert help as soon as possible) Answer “yes” for 1 point, answer “no” for 0 points. Adding up the scores of each question, a score of less than 5 points is a normal mood swing in life. If the score is 5 or more, it is possible to suffer from depression, so you should go to psychological counseling or seek expert help from a specialized hospital outpatient clinic. Depression can be overcome and most patients will recover as long as they can face it properly and receive treatment. Regaining a good feeling can start with a self-assessment of depression. Understanding the manifestations of depression helps people to have an early awareness of psychological problems and to know that they are not alone. With the help of a psychiatrist and a step-by-step recovery plan, mood can improve little by little and soon it will be as bright as the sun again.