Children with motor impairments such as cerebral palsy, especially coupled with associated disorders, are at a heightened risk of developing depression. Depression rates are three to four times higher for people with disabilities, when compared to non-disabled people. As a parent or caregiver, it’s crucial to understand the signs of depression, including warning signals of when to get help immediately.
According to the American Psychiatric Association (APA), depression is defined as a medical condition that affects the way someone acts, feels, and thinks. Depression symptoms can vary in severity, from mild to serious, and can lead to a number of physical and emotional ailments. Common symptoms of depression include:
- Weight loss
- Appetite change
- Feelings of persistent sadness
- No interest in previous hobbies and activities
- Thoughts of suicide, and in severe cases, suicide attempts
- Feeling hopeless and “empty” inside
- Slower movements, slower speech
- Excessive irritability and outbursts
- Sleeping too little or sleeping too much
- Hand wringing
- Excessive crying
- Difficulties functioning in class and in school activities
- Feeling guilty, worthless
- Stomach pain and head pain that doesn’t go away after treatment
The APA states that the symptoms must be present for at least two weeks in order for depression to be professionally diagnosed. Furthermore, other medical conditions can mimic depression and should be ruled out first, including brain tumors, vitamin deficiencies, and thyroid problems.
The Link Between Cerebral Palsy and Depression
According to a study published in The Scientific World Journal (Volume 2013, Article ID 468402), children with cerebral palsy or similar neurodevelopmental disorders are prone to psychiatric issues. One out of every two children with CP will meet the criteria for some form of psychiatric disorder, with attention deficit hyperactivity disorder (ADHD) being the most prevalent. The study indicated that around 40% to 50% of school-aged children with cerebral palsy exhibit emotional and behavioral problems.
Children with cerebral palsy who exhibited depressive disorder and anxiety issues were generally on the same academic and functioning level of their peers. Researchers suggest that depression may manifest due to having shortcomings because of their disabilities, as they probably had the same expectations in the classroom as other non-disabled kids.
Problems with peers seems to be a large factor in children with CP developing depression, specifically bullying issues. Bullying can happen at any age in school, but middle school tends to be the highest association of bullying, name calling, and ridiculing.
The study also indicated that overlapping conditions were overwhelming in children with CP who developed depression. For example, many of the children with depressive disorders also had ADHD and/or oppositional defiance disorder (ODD).
Symptoms of depression can vary greatly according to each child. While one child may exhibit sadness and isolation, another one may become easily irritated and angered. Biochemistry, genetics, personality, and the child’s environmental factors all play a part on how someone with depression will react.
Stress or Depression?
Children with cerebral palsy are also prone to mood swings and stress, but since the signs are similar, it’s sometimes becomes difficult discern whether they’re having a bad day or if they’re truly depressed. There are a few ways that mood swings differ from depression, but you should keep in mind that since children display depressive behavior in different ways, you should always speak with a physician if you suspect any issues.
- Depression lasts for days and weeks, whereas a child having mood swings can be happy during certain parts of the day.
- Feeling nervous and anxious, but still motivated at school generally leans more towards stress or mood swings.
- Stress is characterized by a feeling of being overwhelmed, but with depression, the overwhelming feelings can affect literally every of a child’s life.
How is Depression Treated?
APA reports that around 80% to 90% of people with depression will respond favorably to treatment, which is great news for parents with children who are going through daily struggles. Yet, for to be successful, you’ll need to find the right approach. It make take some trial and error, but with effort, persistence, and with professional medical guidance, the odds of beating depression are typically favorable.
In general, there are three types of traditional treatments that most medical professionals recommend. Some children can benefit from just form of treatment, whereas others may need all three forms.
Psychotherapy is a form of talk therapy, which has been proven in a number of instances to work as a standalone treatment for mild forms of depression. Psychotherapy consists of using psychological methods, such as personal interaction and cognitive behavioral therapy (CBT) in a regular, routine setting, to improve mental health and a sense of well-being.
If brain chemistry contributes to the child’s depression, certain medications may be beneficial in battling depression. Typical medications for depression include SSRIs or SNRIs, two types of antidepressant prescription medications. Common brand names include Prozac, Paxil, Zoloft, and Celexa. Full benefits of antidepressants usually don’t manifest until a few months of use.
Although many physicians indicate that antidepressant medications aren’t habit-forming, you should always understand the side effects of these types of medications before you decide to let your child take them. There have been numerous reports that antidepressant drugs cause nausea, dizziness, fatigue, drowsiness, dry mouth and more. Many people report that tapering off the antidepressants can be physically difficult, so it’s important to know the both the pros and cons before making a decision.
Electroconvulsive Therapy (ECT)
ECT treatment is usually reserved for the most severe cases of depression who didn’t have success with other types of treatment. It involves electrical stimulation of the brain while the patient is put under anesthesia. ECT treatment consists of receiving the stimulation a few times a week, for a total of up to 12 treatments.
Although there is a stigma attached to ECT treatments, the Mayo Clinic suggests it comes from older versions of the treatment, before patients were offered anesthesia, and when extremely high amounts of electric currents were administered.
If You Need Immediate Help
If you suspect your child will self-harm or is suicidal, or if you just need someone to talk to, contact the National Suicide Prevention Hotline at 1-800-273-TALK. Skilled and trained counselors are available 24 hours a day, 7 days a week. If your child starts to give away prized possessions and sees no hope for the future, the APA suggests to seek out immediate help.