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Depression in children. Dr.Ksh. Chourjit Singh Prof. of Pediatrics Regional Institute of Medical Sciences, Imphal National Chairperson, Growth & Development Chapter, IAP National Executive Board Member Advisor HIV/AIDS in Children Task Force, Manipur State. Past President, East Zone, IAP

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Depression in children

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Depression in children

Depression in children

Dr.Ksh. Chourjit Singh

Prof. of Pediatrics

Regional Institute of Medical Sciences, Imphal

National Chairperson, Growth & Development Chapter, IAP

National Executive Board Member

Advisor HIV/AIDS in Children Task Force, Manipur State.

Past President, East Zone, IAP

President, NNF, Manipur State Branch



  • Depression in school-age children and adolescents remain a long-overlooked Health problem

  • As prevalent as in adults

  • Common cold of mental illness – Clinical Depression

  • Specially in childhood – is a major health problem

Severity of problem

Severity of Problem

  • 5% children at any given time

  • 1% of Pre-school children

  • 2% of school-age children

  • 5% of adolescents are affected

  • 25-50% of all children & adolescents in Psychiatric treatment are for depression & its related problems

  • More common in boys than girls – 5:1 school-age children

  • Adolescent girls than boys - 2:1

Severity of problem1

Severity of Problem ….

Untreated Depression can be taken as important cause of suicide in adolescents, even adults

Why depression in young

Why depression in young ?

A) Risk factors

  • Children referred to mental health providers for school problems

  • Children with medical problems

  • Asthma

  • Diabetes

  • Epilepsy

  • Many chronic childhood diseases

Why depression in young1

Why depression in young ? …….

  • Law and order problems

  • Frequent bandh/ strikes

  • Frequent school closures

  • Ethnic group clashes

  • Insecure feelings

  • Conflict environment

  • Watching television a lot i.e. more than 6 hours a day

Risk factors

Risk factors …..

  • Rural vrs Urban children

  • Sexually harassed children

  • Children with family history of depression

  • Genetically potential

  • What is happening in an individual child’s life

B why depression runs in families

B) Why depression runs in families

  • Genetics

    • Even if a child never contacts with depressed parents, child may also likely to be depressed

  • Marital difficulties

    • Broken family/ marital problems

    • Divorce plus depression in parents

  • Parenting problems

    • Hard to be good parent when depressed

    • Parenting problems whether from parents or from child

C can experience depression at any age presentation

C) Can experience depression at any age – Presentation?

  • Shortly after birth & very young

    • Failure to thrive

    • Disrupted attachments to others

    • Developmental delays

    • Social withdrawal

    • Separation anxiety

    • Sleeping and eating problems

C chance of depression at any age

C) Chance of depression at any age…

  • Between 6-12 years of age

    • Fatigue

    • Sadness

    • Inability to feel pleasure

    • Irritability & Insomnia

    • Lack of self esteem

    • Stomach ache and headache

C chance of depression at any age1

C) Chance of depression at any age…

  • Hallucinations

  • Agitation & extreme fears

  • Weight changes

  • Difficulty with school work

  • Apathy

  • Lack of Motivation

  • Social withdrawal

C chance of depression at any age2

C) Chance of depression at any age…

  • Adolescent

    • Over-sleeping

    • Socially isolated

    • Acting out in self destructive ways

    • Sense of hopelessness

    • Despairing thoughts

    • Weight changes

Future of depressed school age children

Future of depressed school-age children

  • If untreated in time – affects the children

  • School performance and learning

  • Social interaction and development of normal peer relationships

  • Self-esteem and life skill acquisition

  • Parent-child relationship & sense of bonding

Future of depressed school age children1

Future of depressed school-age children….

  • Lack of trust – can lead to Substance abuse

  • Disruptive behaviour

  • Violence and Aggression

  • Legal troubles and even suicide

    Depression thinking can become part of a child’s developing personality, leaving long-term effects in place for the rest of the child’s life.

Behavioural changes what

Behavioural changes – What?

  • Professional attention decreases

  • Classroom disruption

  • Expulsion from school

  • School failure

  • Injury to themselves or others

  • Symptoms ADHD

  • Truancy

  • Delinquency

Stress in students leading to depression

Stress in students leading to depression

  • Parental pressure to perform and to stand out among other children

  • If not come up to expectations

    • Frustration

    • Physical stress

    • Aggression

    • Undesirable complexes

Stress in students leading to depression1

Stress in students leading to depression…


  • Negative traits

  • Shyness

  • Unfriendliness

  • Jealousy

  • World to loner

Over scheduling a student s life

Over-scheduling a student’s life

  • Non-availability of time for extra-curricular activities after school

  • No proper place for ventilation & breathing space

  • Unwanted learning like music, painting or outstanding in sports

  • Too many crammed schedule & unmindful of the children’s choice

  • Unadjusted school systems and tremendous amount of homework – spending their evenings, weekends and vacations

Over scheduling a student s life1

Over-scheduling a student’s life…

  • Loss of interest in studies

  • Under-perform due to excess academic pressure

    Students often carry enormous amount of anxiety and negative personal traits & massive attention problems

  • Non-effortless learning

  • Physio-Psychological transition of students

  • Mainly affected elementary to Junior High School

Diagnostic points

Diagnostic Points

  • Transient depression or sadness

  • Impairment in child’s ability to function

  • Two types

    • Dysthymic disorder

    • Major depressions

  • Dysthymic disorder – less severe but lasts longer

  • Chronic depression/Irritability > 1 year

Diagnostic points1

Diagnostic Points ….

  • Onset about 7 years of age

  • 2-6 symptoms within 5 years

  • Leads to major depression/ Double depression

  • Untreated Dysthymic disorder will experience Remission within 6 years

  • Prevalence of depression increases with age – 5 percent of all teens

What can be done

What can be done

  • Diagnostic evaluation – success to treatment

  • All disorders be discovered and addressed

  • Medication

    • Mood stabilisers

    • Anti-anxiety

    • Anti-depressants

    • Stimulants

What can be done individual therapy

What can be done…Individual therapy

  • Often beneficial for patients & specially help with issues

  • Family conflicts

  • Self-esteem

  • Relaxation strategies

  • Mood and anger control

  • Better communication

School environment

School environment

  • Interaction

  • School Counsellor

  • Principal

  • Psychologist

  • Teachers and Parents

  • Psycho-educational treatment

  • Speech and occupational therapy

School environment1

School environment…

  • Counselling

  • Curriculum modification

  • Resource classes

  • Behavioural modification system

  • Self-contained classrooms

Home parental environment

Home/ Parental environment

  • Family and Home modification\

  • Homely life environment

Family therapy

Family therapy

  • Defining Family members role and responsibility

  • Better communication & behavioural Reward systems

Depression in children

Don’t overload your child with too many after-school activities and responsibilities.

Let children learn to pace themselves.

Don’t enrol them in every class along and don’t expect them to be first in everything.

Thank you

Thank you

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