When your child is depressed

‘Fortunately, our awareness of childhood depression and other disorders has increased greatly in the last decade, and kids do improve quickly in therapy.’ — Molly Palmer, Trinity Counseling Center

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   AH, the carefree days of childhood! The lighthearted joys of being young and free-spirited.

   Alas, that sweet picture is not always in focus, particularly for youngsters who suffer from the torments of depression, anxiety and even panic attacks. Childhood is hardly carefree when small people are stalked by disorders that seem grotesquely ill-suited to their size and age.

   "All children can go through periods of low self-esteem and struggles with peer issues," suggested Molly Lependorf Palmer, a child psychotherapist with Trinity Counseling Center in Princeton. Ms. Palmer cautions, however, that any such mood/behavior pattern that marks a major change in functioning deserves attention and professional intervention.

   "If a happy kid suddenly becomes sad or withdrawn, and that symptom lasts for more than a few days, it’s time to take notice," said this psychotherapist. "If there’s persistent unhappiness, constant complaining, lots of frustration and crying, and it’s not related to a specific event, a parent needs to pay close attention."

   Other related symptoms of a childhood emotional disorder include bed-wetting, physical ailments like stomach-aches, sleeping problems and an overall lethargy.

   "What makes all this difficult is that some dissatisfaction with life is quite normal for children and certainly for teens," said Ms. Palmer. "Words like ‘No one likes me — I’m no good!’ may be in the realm of routine — or may actually signal a serious problem."

   When this therapist begins to treat a child who is brought to her because of emotional problems, including depression in children as young as 4 or 5, Ms. Palmer knows that it’s often tough to get relevant verbal communication going. "I often use play and art as a way to connect," she said, noting that it’s common to ask a child to draw a house, and then to analyze that drawing for clues. If all is not well, it will often show up in the child’s depiction.

   Ms. Palmer also prefers working with a child within the context of her family, and will typically involve parents and siblings, at least initially.

   For Dr. Bob Eckhart, another member of the Trinity staff who also maintains a private practice in Princeton, the anxious child is always a professional challenge.

   "Children can mask anxiety in a lot of ways," said Dr. Eckhardt. "Separation anxiety is a very common diagnosis in young children who may have fears about leaving home and the familiar at every milestone step out into the world. But separation anxiety becomes problematic," said Dr. Eckhardt, "when the child doesn’t want to go to school because he envisions something catastrophic happening to mom while he’s there."

   This is when separation anxiety turns into generalized anxiety disorder, suggests Dr. Eckhardt, who sometimes sees the condition in very young children. Another manifestation: the child who has excessive worries about competence, even in elementary school, and questions her ability in every area, from academics to social interaction and sports.

   "A classic way generalized anxiety manifests itself is in sleep disturbances, from difficulty in falling asleep to actual fear of going to sleep because nightmares intrude," said Dr. Eckhardt, who is himself a father of school-age children.

   And don’t assume that children can’t pick up on their parents’ anxiety. Both Trinity therapists agree that children are acutely aware of everything around them, including disturbances on the domestic front. Panic disorder, which is quite rare in children, does occasionally manifest itself, even in the very young child. The symptoms can be severe and sometimes disabling, and in the worst cases, the child may need to have someone around him/her all the time. Fortunately, these situations are definitely uncommon," said Dr. Eckhardt.

   But what’s a parent to do about the more common childhood anxieties? Especially after 9/11, these experts recommend bringing a child’s fears and anxieties out into the open; addressing them honestly; and seeking outside help when symptoms are severe or long-lasting.

   "The best gift you can give children," said Molly Lependorf Palmer, "is to help them in their struggles. Fortunately, our awareness of childhood depression and other disorders has increased greatly in the last decade, and kids do improve quickly in therapy. Childhood should be a happy time, and with the right intervention at the right time, it can be."



Trinity Counseling Center is a nonprofit counseling service, begun in 1968, and accredited by the State
of New Jersey. Trinity’s mission includes providing a source for families in need to come to the staff for
understanding and skillful treatment. Its staff is interdisciplinary and ecumenical, being composed of clergy,
psychiatrists, psychologists, and social workers from all religious denominations within the Judeo-Christian
tradition, its hope is to blend many skills and perspectives for the better treatment of the families in its
care. For more information, visit www.trinitycounseling.org.