Children and adolescents ages 7 to 17 and adults show depressed mood, inability to experience pleasure, fatigue, concentration problems, and suicidal ideation. Children and adolescents differ from adults in more guilt but lower rates of early-morning wakefulness, early morning depression, loss of appetite, and weight loss. Depression in children is recurrent. Prevalence among adolescent girls is 15.9% which is almost twice that among adolescent boys of 7.7% showing few differences in the types of symptoms they experience. Depression is also comorbid with anxiety. Genetic influences are similar to factors identified in studies with adults. A child with a depressed parent has four times greater risk than a child without a depressed parent. Gene-environment interactions show the short allele of the serotonin transporter gene AND significant interpersonal stressful life. Early adversity and negative life events include financial hardship, maternal depression, and chronic illness as a child. Stress response occurs when cortisol is taken first thing in the morning which predicts the onset of depression as well as the volume of the hippocampus growing more slowly. Cognitive distortions and negative attributional style include the stable attributional style which develops by early adolescence. Attributional style does not interact with negative life events to predict depression. By middle school, attributional style serves as a cognitive diathesis for depression. Antidepressants have side effects including diarrhea, nausea, sleep problems, and agitation with the possibility of increased risk of suicide attempts as children taking medication were at risk for suicidal ideation. In school settings CBT is more effective and associated with more rapid reduction of symptoms than family or supportive therapy. Benefits of CBT may not last long for young people but is most beneficial for Caucasian adolescents, those with good coping skills at pretreatment, and those with recurrent depression. Selective prevention programs target youth based on family, environmental, or personal risk factors. Universal programs target large groups, typically in schools, and provide education about depression. Selective prevention is more effective than universal programs as those in selective prevention programs had fewer depression episodes than those in the usual care group.
Anxiety in childhood is characterized by fears and worries common in childhood and is more common in girls than boys. For fears and worries to be classified as disorders, the child’s functioning must be impaired unlike adults who do not need to regard fear as excessive or unreasonable. The prevalence is 3-5% of children and adolescents and higher in minority youth but may be due to bias in assessment measures. Social anxiety may prevent acquisition of skills and participation in activities enjoyed by peers. Genetic influences suggest heritability estimates from 29-50% with a stronger role in separation anxiety with more negative life events. Parents control and overprotectiveness play a small role. Problems arise such as emotion regulation and attachment problems. Social influences include experienced bullying, overestimation of danger is social situations and underestimation of ability to cope in social situations. PTSD environmental influences include level of family stress, coping styles of the family, and past experiences with trauma. CBT Kendall’s Coping Cat program involves the confrontation of fears, development of new ways to think about fears, exposure to feared situations, relapse prevention, and parents also being included in a couple of sessions. Social anxiety disorder involves behavior therapy and group cognitive behavior therapy. OCD involves CBT being recommended as the first line treatment for mild to moderate OCD with medication plus CBT for severe OCD. PTSD has available research suggesting CBT, whether individual or group, as effective.
In recent news, it was reported that studies say depression and anxiety symptoms have doubled among youth during the COVID-19 pandemic. The percentage of depression and anxiety symptoms and cases has doubled in percentage in severe cases compared to moderate. This meta-analysis gathered this evidence from over 29 global studies on over 80,000 youth that showed an increase in these symptoms due to social and family isolation, disruption of normal interactions, and school routines such as academics being transitioned into an online platform. By the ongoing of the pandemic, the risk of children not following the timeline of when they are supposed to achieve their milestones is disrupted. The rates and prevalence of anxiety and depression in adolescents will only continue to increase throughout the pandemic.
Vasquez-Peddie, A. (2021). Depression and anxiety symptoms have doubled among youth during pandemic, study says. Henry Herald .