Is your child depressed? Here are the signs you should look out for

Is your child moody, quieter than usual and disinterested in everything around him/her? Maybe it's time to play closer attention.

Mr. and Mrs. Sharma were surprised to find their 15-year-old son, Ryan, still sleeping instead of getting ready for school in the morning. On trying to get him to wake up, they found him completely unresponsive and unconscious. Hysterical, they called their family doctor and for an ambulance, and then rushed him to a private hospital. He was in the ICU for seven days. Through blood tests and other medical investigation, it came to light that he had consumed a large quantity of sleep medication.

His parents were in a state of shock, disbelief and denial. They had no idea why their bright, good-looking, sensitive and hardworking son would do something like this. He was doing well academically, he had friends. Apart from being withdrawn and quiet in the last few weeks, there was nothing out of the ordinary in his behaviour.

The Sharmas refused to believe and accept that he may have any kind of psychological or psychiatric problem. They explained to the doctors that they had a stable home environment— they were a nuclear family, close to each other and financially stable. However, later, they divulged that there was a family history of depression on Mr. Sharma's side.

After Ryan regained consciousness and was medically stable, the hospital insisted on a psychiatric and psychological assessment and intervention. It was through these timely sessions by a child psychiatrist and psychotherapist that his parents came to know that their young son was suffering from a major clinical depressive disorder with anxiety. There were no circumstantial reasons or causes for him to feel these symptoms. The only aspect that came out during therapy sessions was that he had a crush on a girl from his class and, after peer pressure, had told her about it. This girl apparently told her friends about the same and happened to turn his proposal down. This may have triggered how he began to feel. However, these are normal aspects of life that every adolescent probably goes through. 

But Ryan went through symptoms minute after minute, hour after hour and day after day. His symptoms included low mood, lack of interest in almost everything, loss of appetite, extremely negative thoughts, low self-confidence, suicidal ideations and inability to focus or concentrate on anything else, among others. He could not study. He did not feel like speaking with his friends or going out. Ryan said he started thinking of cutting himself but then got scared. He also kept feeling embarrassed and guilty.

It took over a week for his parents to accept his condition and over two weeks to convince them to start anti-depression and anxiolytic medication. They took over three different medical opinions and changed psychiatrists twice before becoming comfortable with a treatment plan. For six weeks thereafter, no one advised them or their son to seek counselling and psychotherapy, which is such an integral part of therapeutic intervention. The child was confused and emotionally distraught and shut down even further.  

Finally, with the right holistic and multi-disciplinary plan of action, the child got back into his normal routine, resumed school and even performed well in his 10th standard board exams. He still consults with his psychologists and continues to take medications, which have tremendously helped with his recovery, to complete its given course. 

10% of children between the ages of 5 and 16 have some kind of "clinically diagnosable mental health problem" (i.e. a medical psychological issue rather than just "bad behaviour" or "teen angst"). Part of the problem in diagnosing mental illness in children is that the symptoms may manifest very differently in them than they do in adults. Often, children often do not have the vocabulary to express their inner problems accurately. 

There are thousands of such children and families like Ryan. But most don't reach out for professional help owing to the stigma, shame or myths regarding mental health and psychiatric intervention. 

We thus lose so many of our youth to suicide and death. Let's start paying attention.

Dr. Zirak Marker is a child and adolescent psychiatrist and Medical Director, Mpower.