Anxiety and depression in children, adolescents
Childhood mental health awareness has increased in recent years, but the majority of children and adolescents with mental health issues remain undiagnosed and untreated.
This is particularly the case for children with "internalizing disorders" such as anxiety and depression, according to a University of Alabama expert. These problems are not always clearly visible, but they are highly prevalent in the population.
For example, a recent Centers for Disease Control and Prevention report estimated that 3.0 percent of children ages 3-17 had an anxiety disorder, while 2.1 percent met criteria for depression based on data from 2005-2011.
Not surprisingly, anxiety and depression very commonly co-occur with evidence for anxiety-related problems often preceding depression in children and adolescents.
Anxiety has an average age of onset in middle childhood, while depression more typically emerges in mid-adolescence. There are generally limited differences between genders in childhood, but girls become much more prone to these disorders by mid-adolescence.
The University of Alabama's Dr. Matthew Jarrett offers advice for recognizing and treating anxiety and depression in children and adolescents:
What are some signs that your child may be experiencing anxiety and/or depression?
- A younger child with anxiety or depression might refuse to go to school, complain of stomach aches, be afraid to separate from a parent or caregiver, worry that a parent may die or become injured or appear more withdrawn and sad than usual.
- An older child or adolescent with anxiety or depression may encounter school problems, withdraw from peers and pleasurable activities, worry about performance or day-to-day events, be afraid or reluctant to interact with others or appear excessively irritable.
What should you do if you think your child is experiencing anxiety and/or depression?
- The first step would be to visit with your child's pediatrician or with a mental health specialist. In some cases, your child's pediatrician may refer you to a mental health professional for further assessment, a critical first step prior to pursuing a course of treatment.
What are the options for treatment?
- The most common treatments for anxiety and depression are psychotherapy and medication. In more severe cases, medication may be prescribed first prior to psychotherapy. Such medications may include anti-depressants such as selective-serotonin reuptake inhibitors,or SSRIs. The American Academy of Child and Adolescent Psychiatry offers practice parameters and guidelines for when to consider anti-depressants for anxiety and depression. In general, psychotherapy is recommended before medication, particularly for mild to moderate cases.
- Mild to moderate forms of depression and/or anxiety might first be treated with therapies such as cognitive-behavioral therapy , a treatment with a strong evidence base.