Your Child And Depression

Overview


            Children can become so confused about what is going on in their lives and so down on
themselves that they can hardly stand it. When the anger, frustration, sense of loss, and confusing
feelings that underlie their depression are persistent and not resolved, their depression likely will
worsen. They may feel like running away or just giving up on themselves. These are awful,
painful feelings. These kids feel afraid, angry, and very upset. They have more stress than they
can handle, their self-esteem is very low, and they cannot get their thoughts straightened out or
figure out their problems. They believe they have come to the end of their road and see no way
out of this lonely place. At the extreme, suicide may seem to them like their only choice.
Consider Richard, his depression, and the course his depression might take if no one notices, if
no one intervenes.


                        'What am I doing here? I should've just stayed home. I don't belong here. I don't
fit in. I don't fit in anywhere,' Richard thinks as he stands by himself watching the party. He
wants to join a cluster of young people talking in the kitchen but is afraid. 'Even if they let me
join in, I'll mess up. I'll just say something dumb or do something stupid and they'll laugh at me.
That would be worse than just standing here by myself.'


                        He had told himself he would do better this time. This time he was going to act
like he had as much of a right to be there as anyone else. This time he would not just stand
around and watch everyone have a good time.


                        Later that night, Richard is alone in his room. He had left the party after a half
hour or so; and no one even noticed.


                        'No one wants me around. What's wrong with me?' He sits in his chair staring off
into space feeling awful. 'I knew better. I knew it'd turn out like that. It always does. I was stupid
like usual.' He feels the tears as he turns off the light and gets into bed. 'It's never going to
change,' he says over-and-over to himself as he begins quietly sobbing.




Signs of depression


            The following questions highlight common signs of depression in children. You may
have noticed one or more of them in your child. Even if you have not, you should consider them
anyway. This will broaden your perspective as you think about the range of difficulties your child
can experience.


            As you consider each question, think about whether your child has had the problem
within the past month or so. If not, go to the next question. If he has experienced the problem,
put a check mark beside the question and then go to the next question. Repeat the process until
you have considered each question.




Does yourr child;


                        Seem not to be getting up-and-over the loss of an important relationship?


                        Seem not to be getting over a serious loss or disappointment?


                        Think he cannot do anything about what happens to him?


                        Talk about suicide?


                        Have a history of attempting suicide?


            These are very serious signs and progress from one sign to the next. It is hard to
acknowledge that your child has these problems, that your child is depressed and perhaps
suicidal. It is easier to think that he is just having a bad day. Though this may be true, it is
important to think about whether it is just one bad day or if perhaps he has been having a lot of
bad days lately. Honestly consider whether there may be a pattern of bad days that has been going
on over a few weeks.


Carefully consider each sign. Does it apply at all to your child? If so, start by assuming that he
has the problem. Since it is very easy to dismiss what you see, your safest course is to
over-interpret his behavior to be sure you are not taking it too lightly. The following sections will
help you better understand signs of depression that can lead to suicidal thoughts and behavior,
facilitate pinpointing the key issues, and enable you to appropriately respond to them.




Not getting up-and-over the loss of an important relationship


            Your child's feeling he cannot live without a relationship is his perception of how he
would be without the relationship. That is just how it is from his point of view. When you see
this sign in your child, he perceives that the relationship he lost was important, thinks it is gone,
and believes he cannot live without it. It does not matter how others see or think about him and
the relationship. His perception is his reality and the basis for his actions.


            You need to start with his reality, with his perceptions. It is easier to unilaterally decide
that what he thinks and feels are not valid, that the relationship was not actually so important, or
that he has not really lost the relationship. You are tempted to say to him, 'Things will work out.'
Your point is that he is wrong.


            Your helping him starts with adopting his perspective, his perception. Why does he think
the relationship was so important? What makes him think he lost the relationship; and most
importantly, why does he think he cannot live without it?


            Your child will be best served if you start the conversation like this. 'I want to
understand. Please help me understand. What about the relationship was so important for you?
What have you lost that is so very important to you? Will you talk to me about what you're
thinking and feeling?'


            Your child's grief, anger, fear, and emptiness are real and painful. His loss is real; and
living past the pain feels impossible to him. To help, you need to share his grief, his strong
feelings, and his pain. It is as if you take part of it into yourself. Your child cannot handle it by
himself; but together, you can.


            Here is how to tell if you are helping. Can you feel his loss, his emptiness, his grief, and
his pain? Is it a little as if the feelings were yours? If so, you have achieved empathy. That is the
level at which real help and healing for your child can begin.


            Of course, refrain from telling him how he should think or feel, and more importantly,
from saying that his feelings and how he thinks about what happened are wrong. You need to
listen and feel until empathy comes for you. When it does, you can then honestly say, 'I'm afraid
for you. I'm afraid for me. Maybe I don't totally understand; but I feel awful and hurt as if it
happened to me. I want to be close to you and help us get through this. Can I share your grief
with you and struggle through it with you?' Holding or touching your child may make him and
you feel better; but holding him emotionally is the key to really helping him.




Not getting over a serious loss or disappointment


            Your child's perception is his reality. Anything is disappointing if he feels disappointed.
He is the judge. Also, he is the only judge of how disappointing it was for him. This means that
not getting invited to a party can be more painful for one child than not getting a college
scholarship is for another. Not making the basketball team can devastate one child and not bother
another child much one way or the other. It is important to listen to what your child is telling you
and then believe him. He is the expert on his perceptions.


            When a disappointment of any kind is very painful for your youngster, this is what is
happening. He had started seeing himself as having what he wanted. In his mind, in the
viewfinder of his developing perception, he was someone who had reached his goal. He made the
team, was part of the group at the party, was going to be a college student. It matters little what
his goal was. It had become part of how he thought about himself, who he thought he was. In his
mind, he was a team member, one of the group, someone who fit-in, who belonged. It is how
children think about and understand important things.


            Your child's loss may be because of embarrassment and humiliation, because a
relationship is no longer there for him, because of a severe disappointment. Whatever its cause, it
is less belonging for him. He can come to believe that he does not belong at all, anywhere.


            You can say, 'I know a lot about disappointment. I think you may even know more than I
do right now. I remember how awful and painful it feels. I remember it feels like a huge crash or
sometimes like suddenly losing everything important. Can we talk about how you're feeling?
What's the first thing that comes to your mind?' Your objective is, of course, to get him to talk
about his disappointment, about his loss. At the same time, though, encourage him to talk about
his feelings, especially his angry feelings.


            Another example will help to show how disappointment, loss of status, and feeling
embarrassed and not accepted can lead to depression and suicidal feelings. It also shows how
events can accumulate and compound.


                        Things are going from bad to worse for Holly. It starts when her brother dies in a
car wreck. He was her best buddy, when they were not arguing. Steve was the only person in her
life she could talk with about things that really mattered. Steve just listened and thought she was
pretty.


                        She knows she will never get over Steve's leaving her but can handle that and
maybe even the stuff with her stepfather. At least she does not have to worry about dealing with
him every day now since she and her mother have moved away.


                        Things are getting worse, though. She finally gets up her nerve to try out for
cheerleading and now wishes she never had to go to school again. She thought it might be
different in this school. 'I should've left well enough alone. It doesn't get you many friends; but
being the best Math student in the school should've been enough.' She can hardly stop shaking
inside when she thinks about 'the incident,' which is only a thousand times a day.


                        The competition is in front of everyone at a pep rally. It starts out well enough
until it is Holly's turn. Not only does she forget the words to the cheer, she falls into the pep band
while trying to make a jump. If hurting herself is not enough, she also feels like the joke of the
school.


                        But just when she knows it cannot get any worse, it does. A new boy in school
moves in on her one special place. Not only is he a Math whiz, everyone likes him, including the
Math teacher. Her teacher's saying, 'Being the second best Math student in the school is nothing
to feel badly about,' only makes her feel worse.


                        'There's nothing special about me anymore. At least Steve thought I was pretty
and now he is dead. It's all too much.'


                        Holly's world is out of control. 'Being dead would be a relief. There is no way
out. I can't stand this. I've got to do something to stop the pain. I just want out.'




Thinks he cannot do anything about what happens to him


            This sign is the can hardly live without it, the cannot face it, the not getting over it, the
cannot handle it part of the other signs. It is your child's feeling of having lost control within his
life and being unable to get control back. Just as belonging is important to him, so is believing he
is in control of what happens to him. At least, he needs to know his life is not out of control.


            The child feels very little control and thinks he does not belong, does not fit-in. This is
what is causing his bad, painful feelings.


            His anger is a very bad feeling he has about what happened to him; and his fear is a very
bad feeling he has about what he believes will happen. He is angry about the position he is now
in and about his future's having been changed. Things are just not working out as they should,
from his point of view. His fear is a little less complicated. Who knows what might happen?
Even worse, he knows, is sure what will happen and it scares him.


            The child either did not or could not control what happened and is very angry. He cannot
control what he believes will happen and is afraid. The less control he feels, the more angry and
afraid he gets and the more hopeless he feels. It is a building pressure.


            It is important to help him get these feelings out. This holds most for his anger, as
discussed earlier. Additionally, there is another important step.


            Give him as much power and control as you can. You need to let him handle things with
your support whenever you can. Refrain from telling him what to do or how to act. Of course you
should talk with him about these things but also should let him be in charge of himself and his
actions as much as possible.


            You usually cannot do much about the big things that get out of control for your children;
but it really is the little things that count. For all children but especially for your older youngsters,
you need to let them have as much control as possible over as much as possible. As odd as it may
seem at first, this may be your single best way to help your children handle their anger and fear.




Talks about suicide


            Suicidal thoughts and feelings build in children. Anger and fear fester, negative
perceptions and strong emotions accumulate, and your child's perceived lack of control grows.
This building internal turmoil creates intense negative energy that boils up until suicide becomes
an attractive solution. It starts as a possibility and slowly becomes the child's first choice.


            The young person thinks about suicide more and more. He considers it and then rejects
the idea. Finally, he reconsiders it, struggles to find other answers, and comes back to suicide as
the only relief from his anger, fear, pain, his emptiness. It becomes his final way of assuming
power, of taking control of his world.


            About 80% of the time, children will tell someone about their thoughts and talk about
their solution. If they are believed, whomever they tell can and usually does get help for them.
Far too often, though, no one takes the child's talking about suicide seriously.


            Children do not normally say things like, 'I wish I were dead,' 'I would be better off
dead,' or 'I think I will just kill myself.' It is not true youngsters often say those kinds of things
or are just joking around when they say them. If someone asks them about it, they often do say
they were not serious and were just joking around. They may be embarrassed, may want to hide
their real feelings, or may not be comfortable talking about suicide with whomever is present.
Still, it is no joking matter and they likely were not just joking.


            Your child may bring up suicide in a joking way or may bring it up in a serious way. He
may seem quite depressed or may seem fairly normal for him. Whatever his mood, the need is to
respond to what he is saying. If you are talking with him, ask, 'What are you thinking about
doing? It feels to me like you may be thinking about killing yourself. Am I on track or off base?'
Your child may spontaneously start talking about suicide, someone who killed himself, or ways
to kill oneself. However he discloses his thoughts, the opportunity to help is right then.


            If he says that he was just kidding, say, 'Let's think about some better ways to get your
feelings out. When you joke about killing yourself, what's your message? I'll bet it has something
to do with feeling upset, something to do with feeling angry and maybe a little afraid and a lot to
do with feeling hopeless. Let's talk about it if you will. What are you thinking and feeling when
you joke about killing yourself?'


            Talking about suicide helps. It neither makes things worse nor makes it more likely the
young person will kill himself. You can say, 'I'm afraid for you. I'm afraid for both of us. Can we
talk about what's happening?'


            It is, of course, possible that your child is threatening suicide to get your attention but not
very likely. Even if he is seeking your attention, he can back himself into a corner if he keeps it
up. He says it so much that everyone stops taking him seriously. He has to take it one step further
if only to save face. The next step for him is actually trying to kill himself; and he might just
succeed, even if only by accident.


            Without a doubt, it was very serious the first time he threatened. If he is dead, whether he
was serious or just wanting attention no longer matters. There will not be another chance to take
him seriously.


            What is going on if your child uses threats of suicide to get attention? There are many
possibilities, none of which is good. Say, 'A part of me believes you want to kill yourself and the
other part thinks you are using threatening suicide to get my attention. Either way, I'm very
concerned. Can we talk about the getting attention side?' The conversation goes on for a little
while and you then say, 'Threatening is an effective way to get attention. You certainly got mine.
It worked. Here's my problem. When you use suicide to get my attention, it scares me and is a
little frustrating. I like to pay attention to you so you don't have to scare me to get my attention.
It's yours. I have some ideas but want to hear your ideas first. What are some other ways you
could let me know when you want my attention, want me to take you more seriously, want me to
understand how bad it is for you?'


            You also might spend some time thinking about why getting your attention is so difficult
for your child. That likely will point toward other problems.


            Keep this focus. Suicidal thoughts and feelings are always serious. Your youngster needs
specialized help immediately, in addition to your support, involvement, and sensitivity. Further,
the crisis has not passed as soon as your child's thoughts turn to other subjects or as soon as his
mood brightens. Among many needs, your child must develop better ways of communicating his
feelings, solving his problems, and getting others to understand and help. The underlying distress
continues past the here-and-now symptoms.




Suicide attempts


            Most children who kill themselves have attempted suicide before. Also, many children
who attempt suicide will later kill themselves. The point is that a suicide attempt is always
serious no matter how trivial it may seem at the time and no matter how non-lethal the means
used. It is not necessarily true that the child knew that the method he used would not kill him.


            Suicide is a process and not a single act. It is seldom just something that happened. The
child thinks about it for a long time. He adds up his losses, disappointments, humiliations, times
he does not fit in, and when he thinks he does not belong. These all build up to feelings of not
being in control, hopelessness, and being unable to make things better. A child who attempts
suicide always needs professional counseling and special help to understand these intense
feelings and to learn new ways to manage them. He also needs his parents, needs to talk with
them about his fears and frustrations, his anger and emptiness.


            (Note) About a third of the time when children succeed in killing themselves, there were
no signs sufficient to suggest suicide, that could have or should have been noticed by parents and
others in the child's life.



By Gary A. Crow, Ph.D. March 17, 2017