Depressie bij kinderen: komt vaker voor dan u denkt

Depression in children: more frequent than you think and it can start really early.

Prof Dr. Max J. Coppes is momenteel hoogleraar kindergeneeskunde aan de Universiteit van Nevada, Reno School of Medicine and medisch directeur van het Renown Kinderziekenhuis in Reno (staat Nevada). Max J Coppes werd in Leiden tot arts opgeleid en vervolgens in Utrecht tot kinderarts.  In 1988 vertrok hij voor een jaar naar Toronto om zijn opleiding tot kinderoncoloog te voltooien, maar is sindsdien in Noord Amerika gebleven.  Hij werkte naast Toronto respectievelijk in Cleveland,Max J Coppes Calgary, Washington DC, Vancouver, en nu dus Reno .  Hij is bovendien met Nederland verbonden als lid van de raad van commissarissen van het recentelijk geopend Prinses Maxima Centrum voor kinderkanker in Utrecht. Een kinderoncoloog die bijna een vluchtchirurg werd, is hij net zo comfortabel in een benedictijnenklooster als in een internationale meeting met over 10,000 gedelegeerden.Depressie:

A new study of over 100,000 children demonstrated that by the time they reach 17 years of age, more than a third of girls and over 1 in 8 boys have experienced depression with an onset as early as age 11. These numbers are much higher than previously estimated and provide a somewhat alarming insight in the state of children’s mental health in the United States.  Understanding what is going on and how best to approach this condition is essential as depression is linked with school performance, relationship development, and suicide.  Over the past decades suicide has in fact become the leading cause of death for youth ages 10-24 year of age. 

Similar to discussions of cancer many years ago, we seem to be reluctant to openly talk about depression, especially if it affects our children.  Whether we are ashamed that our own kids might be affected or whether we feel guilty about possibly having contributed to their depression, it doesn’t really matter: hoping it will soon pass or assessing it is not that serious is not a real solution. As with many conditions that can lead to very serious problems over time, the sooner we try to address depression professionally, the better the chances of managing or curing depression altogether. In fact, between 80 and 90% of people with depression eventually respond to treatment. 

What is depression? Medically, it falls under the category of ‘mood disorders’. It is a illness that negatively affects how one feels, thinks, acts and experiences life.  Importantly, depression is different from simply feeling or being sad.  The end of a relationship, losing friends after relocation, the death of a grandparent may well lead to profound sadness; this is a normal part of grieving.  But unlike with depression, a grieving sad child will usually fluctuate between normal and sad and his/her self-esteem will be maintained.  Therefore, just because a child may seem sad does not necessarily mean that he/she is depressed.  However, if sadness becomes persistent or is accompanied by disruptive behavior or thoughts of suicide, one should consider a depressive episode. 

Other symptoms that should trigger concern may include: irritability, anger, vocal outcries, changes in appetite (either increase or decrease), social withdrawal, continued feeling of sadness/helplessness, difficulty concentrating, feelings of worthlessness or guilt, and sleeplessness.  Unfortunately many of these symptoms accompany the transition from childhood to adulthood and are often passed off as normal emotional changes ‘typical for puberty’.  In general, if children continue to function reasonably well, it likely is related to ‘puberty’.  If, however, the symptoms persist, hamper normal teenage functioning, lead to poor academic performance, and/or are accompanied by a sudden change in appearance, contact your pediatrician or family physician for a more formal assessment, because other conditions (like thyroid problems or vitamin deficiencies amongst others) need to be ruled out. Once the diagnosis of depression has been made, treatments are available and can mitigate or avoid potentially serious or life-threatening consequences.  

Dr Max J Coppes
Physician-in-Chief Renown CHILDREN’S Hospital
Nell J Redfield Chair of Pediatrics, UNR Med

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