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The Informed Parent

Childhood Depression

by Peter W. Welty, M.D., F.A.A.P.
Published on Dec. 31, 2007

If you have concerns that your child or adolescent is depressed, speak with your child’s pediatrician. A diagnosis of depression is one that the pediatrician or other mental health professional makes when certain specific symptoms are present. These symptoms must be significant and severe, and be the cause of real disruption in the child’s daily functioning at home, school and in the community.

An example of these symptoms are a child having difficulty sleeping. He may have lost interest in outside activities. There may be feelings of guilt followed by a loss of energy. There may be poor concentration at school resulting in lower grades. There might be a change of appetite accompanied by an increase or decrease in the level of activity. Present also may be thoughts of suicide. These symptoms need to be present most of the time, for at least two weeks.

Treatment for depression may involve therapy services for the child, and probably the entire family. Serious cases may also benefit from a medication. Different medications are useful in the treatment of major depression in children and adolescents. In this article, we will discuss the use of St. Johnswort for depression. Next month we will discuss the use of antidepressants and  prescription medications. Of course, all of these options need to be discussed at length with your child’s pediatrician, in order to determine the best diagnosis and course of treatment.

There has been interest recently regarding the use of herbal preparations in the treatment of various disorders. A recent study investigated the efficacy of St. Johnswort. Thirty-three youths were enrolled in the study. The children were between the ages of 6-to-11 years, and the adolescents were between 12-to-16 years of age. All of the children met the symptom criteria for major depression. They were all diagnosed as moderately depressed. The patients received treatment with St. Johnswort. Doses were increased as necessary. Side effects of the herbal preparation included dizziness, increased appetite, and loose stools. Improvement in the children’s depression, recorded by improvements in questionnaires, were noted in 25 of the 33 youths, at the end of the 8-week trial.

Discuss with your child’s doctor if you are concerned that your child may be depressed. He or she may benefit from a referral to a mental health professional for a complete evaluation. If therapy alone does not improve your child’s depression, discuss the possibility of the use of an herbal preparation, such as St. Johnswort, to help with your child’s depressed mood. Many children are also helped with the use of a prescription antidepressant. There has been recent research regarding the use of antidepressants. This will be discussed in our next article.

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