When a child becomes physically ill, parents regularly turn to their pediatrician or primary care provider for treatment. However, parents may be less sure about what to do and where to seek help when concerned about their child’s mental health.
According to the American Academy of Pediatrics (AAP), 1 in 5 children experience depression during adolescence. However, many of those children will not have access to a mental health specialist.
In response, the AAP has released updated guidelines on identifying and treating adolescent depression. The guidelines are meant to support primary care providers, their patients and families as they treat children not only for physical concerns, but also for any mental health concerns that may arise.
A pediatrician or family doctor can help fill the need for care by identifying any potential mental health issues, talking with both the child and their family about treatment, and helping connect them to mental health practitioners as needed.
“Our clinic has been screening for depression in teens for years and these guidelines further emphasize the importance of screening for a disease that is incredibly common and can be incredibly debilitating if not treated,” says Dr. David Hall, a board-certified internal medicine and pediatrics doctor with Sharp Rees-Stealy Medical Group.
Dr. Hall answers some of parents’ top five questions about recognizing and treating their children’s mental health concerns.
1. What might be the signs of depression in a child?
Major symptoms of depression include sad or irritable mood, increased anger, and decreased interest or pleasure in activities that they used to enjoy. Changes in weight or appetite, sleep disturbances, fatigue, impaired concentration or attention, social withdrawal and decreased school performance may also be symptoms of depression in teens.
2. What should parents do if they are concerned about their children?
If you suspect your teen may be depressed, try to bring up your concerns in a loving, nonjudgmental way. Let your teen know what specific symptoms or behaviors you have noticed and why they worry you. Ask your teen to share what they are going through and focus on listening, not lecturing.
3. How can parents talk to their child's doctor about these concerns?
When it comes to talking to your child’s doctor, it is generally helpful to discuss the behavioral or mood changes that you have noticed in your child. As opposed to starting off with diagnostic terms like “depression” or “anxiety,” it may be more constructive to have a discussion about your child’s symptoms and how they have impacted their quality of life, social relations or school performance. Any family history of mental illness or substance abuse can also be important information for the doctor to have.
4. What can kids and parents expect when they next see their doctor?
The new guidelines recommend universal screening for patients ages 12 through 21 as well as for children who are over 10 and at a higher risk for depression — for example, those with a family history of mental illness. Each well visit generally involves asking questions about diet, exercise, school, home life, etc. In addition, we generally screen for depression with a short, two-item questionnaire, which addresses interest in doing normal activities as well as feelings of depressed mood, feeling down and hopelessness. Depending on the results, we then screen with another tool that further explores depressive symptoms.
The screenings would then be followed by a discussion involving the teen, their parent and their pediatrician. It is also important for the doctor to speak privately with the teen and remind them that what is discussed will be confidential, except in cases where there may be an immediate danger to self or others.
5. What comes next for a young patient diagnosed with depression or another mental health disorder?
It’s important to establish a treatment plan including the patient, family and available mental health professionals. Often this can be multifaceted and includes referral to a therapist for counseling, addressing lifestyle factors — sleep, diet, exercise, social support and stress management — and developing a safety plan including emergency communication methods.
The patient may also be a candidate for medication, which can often help in cases of depression and anxiety. This can be prescribed and monitored by a pediatrician or an adolescent psychiatrist. Regular follow up with the pediatrician and the involved mental health professionals is crucial.
Talk to your doctor if you have concerns about your child’s mental health. Sharp Rees-Stealy and other Sharp pediatricians and primary care providers are prepared to identify and help children struggling with mental health issues.
For the news media: To talk with Dr. David Hall about depression in teens for an upcoming story, contact Erica Carlson, senior public relations specialist, at firstname.lastname@example.org.