Anxiety and Depression in Children: what are the signs?
February 4th – 10th is Children’s Mental Health Week in the United Kingdom and Strong Hope wishes to bring to the forefront the prevalence of anxiety and depression in children and in doing so increase awareness and hopefully meaningful conversations about mental health in our children.

Anxiety disorders are the most common mental illness in the U.S. affecting 40 million adults in the United States age 18 years and older or 18.1% of the population every year.

The rates of childhood depression and anxiety have also been rising over the last decade at an alarming rate. Despite this, awareness and information about childhood depression and anxiety has not been advancing at the same rate and many people wonder whether children can even be depressed. In addition to misunderstanding, this leads to stigma and the idea that mental illness is a taboo subject which should not be discussed.

Based on data from the National Comorbidity Survey Adolescent Supplement (NCS-A), an estimated 31.9% of adolescents had an anxiety disorder between 2001-2004. Of these 8.3% had severe impairment based on DSM-IV criteria.

Anxiety and depression are treatable. However, 80% of children with a diagnosable anxiety disorder and 60% with diagnosable depression are not receiving treatment according to the 2015 Child Mind Institute Children’s Mental Health Report.

While depression can affect anyone, children and adolescents with immediate family members with a history of depression or other mood disorders are at increased risk of developing depression due to genetic predisposition. Children with chronic illnesses or severe medical conditions are also at a greater risk of developing depression and anxiety. In addition to depression, anxiety disorders in children often co-occur with eating disorders and attention-deficit/hyperactivity disorder (ADHD). Other factors that increase the risk of these disorders in children include family difficulties, bullying, physical, emotional or sexual abuse and sometimes depression can be triggered by one difficult event such as parents separating, a bereavement or problems at school or with friends.

Anxious children have been shown, through studies, to have less depressive symptomology and tend to be younger while concurrently depressed and anxious children are more symptomatic and older, although the anxiety symptoms generally predate the depressive symptoms (Brady EU, Kendal PC, 1992).

What to look out for in your children:
• Difficulty sleeping or concentrating
• Sad or irritable mood that doesn’t go away
• Feeling angry or irritable
• Mood swings
• Feelings of worthlessness, being not good enough or restlessness
• Frequent sadness or crying
• Changes in eating habits
• Withdrawal from friends or activities
• Loss of energy or interest in things they used to enjoy
• Indecisiveness
• Thoughts of death or suicide

What to do if you suspect your child is suffering from anxiety and/or depression:

If you suspect or recognize the signs of anxiety and/or depression in your child you need to contact your child’s paediatrician or general practitioner and arrange a consultation for you to discuss this and determine what may be the best course of action/treatment in your country or area and obtain a referral for your child to a suitable and qualified mental health treatment provider or therapist.

Anxiety disorders can become chronic unless properly treated and most children find that they need professional guidance in order to successfully manage and overcome their anxiety whether through prescription medication or therapy or both. A major research study found that a combination of therapy and antidepressant worked better for children ages 7-17 years than either treatment alone.

Medication can be a short or long-term treatment option depending on the severity of your child’s symptoms and how they respond to treatment.

Cognitive Behavioural therapy (CBT) is a type of talk therapy that has been scientifically shown to be effective in treating anxiety disorders regardless of age and teaches skills and techniques to your child to help them reduce their anxiety levels. CBT is generally short-term with sessions lasting approximately 12 weeks, but the benefits and skills gained are long-term. Other forms of therapy that have been noted to be extremely beneficial in treating these disorders in children are Dialectical Behaviour Therapy (DBT) where children are taught how to take responsibility for their problems and deal with conflict and negative emotions, and Acceptance and Commitment Therapy (ACT) where strategies of acceptance and mindfulness are learnt as a way to cope with unwanted thoughts, feelings and sensations.

Where can you get advice and guidance?
United Kingdom
NHS provider in your town or community
Youth Wellbeing Directory – lists of local services for children’s mental health and wellbeing.
Youth Access – offers information and advice about counselling services for children ages 12-18 years.

U.S.A
Anxiety and Depression Association of America (ADAA) www.adaa.org

Canada
Anxiety Canada at www.anxietycanada.com
Canada.com at www.bodyandhealth.canada.com