Parenting with a PhD: When Kids Get Sad

We all know kids get sad. At my house, it happens 20 times a day in response to all kinds of injustices: not getting to push the elevator button, having to turn off the TV, rain when we’re headed to the pool. And, yes, even spilled milk. For most of our kids, the sad moods pass like fast-moving cloud cover and that usually sunny mood is soon restored. However, some of our kids are sad a lot. Most of the time, even. In those cases, we might call it “depression.” No one likes to think that depression can happen in kids, especially in young kids, but it can and does. There have been suicide attempts in children as young as six, some of which have been successful. Fortunately, this is an extremely rare event but a very, very scary reality. Here are warning signs to look for and some ideas for helping your child cope with sadness, be it occasional or chronic.

Depression in Kids: When a child is depressed, her parents, coaches, or teachers might notice any of the following:
Mood changes: Irritability or anger, sadness, increased worry or anxiety, becoming upset over trivial matters
Behavioral changes: Crying more than usual, no longer enjoying activities he once liked, making negative statements about himself (e.g., “I’m stupid,” “I can’t do anything right,” “No one wants to be my friend”), social withdrawal or disinterest, becoming more clingy or demanding than usual
Physical changes: Greater or poorer appetite, sleeping too much or not enough, weight gain or loss, decreased energy level
Cognitive changes: Thinking and/or talking about death, sudden decrease in ability to concentrate

Red Flags that almost always indicate a serious problem are:
Talking about suicide
Wishing to be dead
Giving away prized possessions
Threatening to or trying to harm himself

Why Do Kids Get Depressed? One of the most frustrating aspects to depression in children is that it’s not always possible to figure out why it’s happening. Many parents report that they ask and ask but their child simply won’t say what’s bothering her. In most cases, there isn’t some hidden, underlying cause that your child is keeping secret. Instead, she feels as clueless about it as you do. This is a good time to take stock of how things have been going over the past few months. Has your child experienced recent losses? Consider what might seem like relatively minor changes like having a friend “break up with” her or promoting to a new grade, as well as major things like moving, death, and divorce. Has someone in the family been having medical problems that your child could be worried about? Has school become more difficult? Is someone teasing or bullying him? Is she sitting out most of the game at baseball? Keep in mind that small setbacks often feel huge to children and can affect them in ways we don’t anticipate. If you identify problematic areas, talk about them with your child and see what kind of reaction you get. Do the best you can to reassure your child about how things are being handled and the great things she has to look forward to along with the changes.

Helping Your Child Cope: A crucial thing parents should know is that depression doesn’t usually look like depression in children. Instead, kids tend to act angry and irritable when what they really are is sad. When our kids act this way, they often get in trouble because of their “attitude” and difficulty obeying rules. Unfortunately, from the child’s perspective, this may feel like being punished for having feelings – something we should always try to avoid. If it seems that your child is regularly irritable, start conversations with him about how he’s feeling. Instead of sending him to time out for snapping at you, try something like, “I notice that your face looks mad and that your voice sounded irritated when you answered me. I think you might be feeling angry about something.” See where the conversation leads. In some instances, there will have been a specific trigger that led to the angry response. Through open discussion, you may find that your child is actually feeling sad or hurt, perhaps over something that someone did. Once you’ve identified the feeling, you can affirm it but ask for a different behavior in the future. “I’m really proud of you for telling me that you felt didn’t care about you because I forgot to wash your soccer uniform and it’s o.k. to feel that way. But, it’s not all right for you to snap at me. Next time, please tell me when I’ve hurt your feelings and let’s talk it out.” In this way, you’re setting an appropriate limit for your child’s behavior (that is: speaking to you in a calm voice) but you’re not punishing him for feeling sad or upset. You’ve also opened the door to more communication about feelings.

One thing that’s hard for children who are sad is noticing the positive. Research has found that individuals with depression tend to be very realistic, and sometimes pessimistic, versus optimistic and hopeful. This is true of children as well. It’s not true that “looking on the bright side” will magically get rid of sadness or depression but it can help your child manage things better. Consider some of the following ideas:

At dinner, everyone pick their favorite part of the day and tell about it. It’s also fine to let people talk about the worst part of their day, provided that others can listen, be supportive, and offer help when needed.

Make a point to notice positive things when you are with your child. Keep your tendencies to focus on the negatives, worse cases, and mistakes in check. I know as well as anyone that it’s fun to be snarky sometimes but this isn’t a great way to talk in front of your kids.

Keep a running list of positive, funny, or enjoyable things you and your child have noticed. Or, write things down and put them in a jar for anyone in the family to refer to when he or she is feeling down. I dare you to think about that YouTube video of the sneezing baby panda without smiling just a little.

Teach your child to use Positive Self-Talk. Think of the kinds of things you might tell your child when she’s discouraged and teach her to use those statements on her own. For example, if she is frustrated in reading, teach her to say to herself, “I can get through this,” “I don’t have to get it perfect,” or “I can take one word at a time.” Resilient kids are their own cheerleaders and this is an important skill for any child to learn in order to overcome obstacles and frustrations. Create a game where you write various problems on flashcards and have your child come up with appropriate positive self-talk statements. Then, write down your child’s five favorite statements and keep them somewhere handy like the fridge, her backpack, or a bulletin board. Use those statements when your child is frustrated and encourage her to use them as well.

Get Help: When sadness is a most-of-the-time kind of thing for your child, it’s time to seek professional help. Your child’s pediatrician can give you a referral for a psychologist or counselor who is experienced in helping children with depression. The therapist will likely want to spend some time with both you and your child in order to get a good sense of what’s going on. He or she may give homework (seriously!) to both you and your child to help address the symptoms when they’re occurring and to improve positive coping. Depending on the situation, the therapist will likely want to meet weekly or every other week. In some cases, the therapist may suggest that you also meet with a child psychiatrist who can prescribe medication to address your child’s symptoms. Of course, medication is not warranted in all cases and many children do great with therapy alone. Ask questions and stay involved. You may not be able to “fix” your child’s depression but you do know him well and are his best advocate.

About this column: Send your parenting- and kid-related questions my way and I’ll tell you what I can: parentingwithaphd@gmail.com Please be aware that email is not a secure method of transmitting personal information so it’s best to keep your questions general. If your question is featured, your name and email will not be published. Submitting a question does not constitute a professional relationship in any way and this column is not meant to substitute for face-to-face therapy. If you feel you’re doing the best you can and still need help, it may be time to bring in a professional. Start by talking with your child’s pediatrician to get a referral.

Kristen Berthiaume, Ph.D. is a clinical psychologist with Grayson and Associates (www.graysonmentalhealth.com). She obtained her doctorate in clinical psychology from the University of Kentucky. She completed a predoctoral internship in clinical psychology at the University of North Carolina at Chapel Hill and a post- doctoral fellowship in the Attention Deficit Hyperactivity Disorders (ADHD) Program at Duke University Medical Center. She specializes in providing assessment and treatment of children, adolescents, and families dealing with the following issues: ADHD, learning disorders, social skill deficits, organizational problems, behavioral difficulties, anxiety, and depression. She generally focuses on behavioral and cognitive- behavioral techniques, but maintains a flexible approach to therapy. Her other day job is as mom to her five-year-old daughter and 2-year-old son.