4 Ways to Help if Your Kid Is Depressed

By https://www.sandiegopsychiatricsociety.org/author
June 7, 2020

The New York Times

By Melinda Wenner Moyer

June 2, 2020

Some children may need professional help during the lockdown, but there are several things parents can do to ease the quarantine blues.

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Alva Skog

A couple of weeks ago, I noticed a worrying shift in my 9-year-old. His characteristic silliness — his goofy giggles and incessant bad jokes — had disappeared. He stopped wanting to go outside and said he was too tired to play. He crawled under his bed covers and lay quietly in his room, while the next room over, my heart was breaking.

It’s no surprise that children are feeling sad right now — they’re missing their friends, their teachers, their play practices, their birthday parties. Some are even mourning loved ones lost to Covid-19. “This unusual, unprecedented, extraordinary public health crisis is literally affecting everyone’s mental health,” said Dr. Harold S. Koplewicz, M.D., a child psychiatrist and the medical director of the Child Mind Institute in New York City. As I watched my son unravel in front of me, I wondered what I could do to help him and what symptoms I should look for that might indicate he was crossing the threshold from disheartenment to clinical depression.

Let your kids be sad.

Remember that it’s OK and understandable for kids to be sad right now, and that it’s not a parent’s job to rescue children from their feelings. “The way you help a kid is by managing the sad feelings, not by denying them, not by distracting them,” said Madeline Levine, Ph.D., a psychologist based in San Francisco and the author of “Ready or Not: Preparing Our Kids to Thrive in an Uncertain and Rapidly Changing World.”

Parents sometimes think of themselves as their children’s protectors and saviors — who need to shield their kids from hardships and heartbreak — but this approach can backfire and make kids less, rather than more, resilient, Dr. Levine said. We should instead help our kids learn how to live with their feelings and accept and overcome life’s inevitable disappointments.

“I think it’s really important to let kids be sad,” Dr. Levine said, “just as I think it’s important for adults to be able to tolerate their own sadness. How could you not be sad at this time in history?”

If your child seems despondent, don’t try to fix it — just try to be supportive and empathetic, and give them the opportunity to talk about their feelings, Dr. Levine suggested. You can open the door by talking about your own. A few days ago, I sat down with my son, who had just had a meltdown over something seemingly small, and I told him I was upset that we were stuck at home over Memorial Day weekend when we should have been on our annual family vacation. As it turns out, he was sad about the very same thing, but he hadn’t known how to express it. We sat and talked about our sadness and frustration, and we both felt much better afterward.

Talk to your kids about the coronavirus — and bring optimism into conversations.

Sometimes, in an effort to protect kids, parents also deny their children important information. We assume that kids don’t really need to know what’s going on.

“That’s always a mistake, because then the child’s anxiety about what it might be, or what the eventual outcome might be, is almost always worse than the actual reality,” said Dr. Joan L. Luby, M.D., a child psychiatrist at Washington University in St. Louis. So with regard to the coronavirus, “I do think parents need to stop and take time to explain the situation — what it means, how we got here, when it’s likely to be over, so that children can have a realistic assessment of what’s going on,” Dr. Luby said. (You might not be able to provide a specific timeline for when it will end, Dr. Luby said, but you could say that things will improve once we have a vaccine or better treatments, and that scientists are working very hard on both of these things.)

Parents should try to infuse some optimism into their coronavirus conversations, too. In our house, we often point out the “silver linings” of the pandemic — that we get to spend much more time together, that we get to sleep in each day, that we’ve gotten the chance to play lots of chess. “I do think, under the circumstances, it’s important for everyone to try to focus on what are the things that they can enjoy, what are the advantages of the situation,” Dr. Luby said.

Build structure and physical activity into every day.

Routines are important right now, because they help kids feel settled, cared for and in control. “The thing that’s so upsetting about Covid is the uncertainty,” Dr. Koplewicz said, so it can help to weave certainty and predictability into your kids’ lives and give them concrete things to look forward to. Maybe every Thursday becomes movie night, and every Saturday you go on a family hike. Dr. Koplewicz suggested making sure that weekends still feel different from weekdays, too, so that they continue to be something everyone can happily anticipate.

But while maintaining structure is important, experts also recommended easing up on kids during this difficult time, too. “It’s probably a good time to relax some of the rules that you can relax without causing damage,” said Dr. Neal D. Ryan, M.D., a child and adolescent psychiatrist at the University of Pittsburgh. Maybe ease up on screen time rules a bit (or, uh, a lot), or let kids have dessert with lunch sometimes. The idea is to sprinkle some comforting or joyful moments into each week to keep spirits up. Mindfulness meditation is another thing to consider, Dr. Koplewicz said; some popular mindfulness apps include Headspace for Kids and Stop, Breathe and Think.

And do what you can to keep your kids moving. “Physical activity has a track record as both a preventative and a treatment for depression,” said Dr. Gregory N. Clarke, Ph.D., a clinical psychologist who studies the prevention of depression at the Kaiser Permanente Center for Health Research. You don’t have to buy your kid a Peloton; just go out for regular walks or bike rides or do some Cosmic Kids yoga or GoNoodle. (Dr. Clarke noted that exercising outside may have added benefits compared with exercising inside, but that the activity itself is the most important thing.) My kids have roped me into playing freeze tag with them in the afternoons, which they find hilarious, probably because I’m a terrible sprinter.

Look out for the signs of depression and get professional help if needed.

When my son was moping around the house a few weeks ago, I wasn’t sure how to tell the difference between normal sadness and diagnosable depression. Dr. Luby said that when kids are clinically depressed, they lose interest in the things that they usually enjoy. They may no longer like their favorite foods, their favorite TV shows or their favorite games. “The inability to enjoy activities and play is one thing you can say with confidence that’s starkly abnormal for a child,” Dr. Luby said, so it’s “probably the most obvious symptom.” Other signs of depression are when kids begin eating a lot more or less than usual or start sleeping a lot more or less than usual. And of course, kids can seem quite sad or irritable.

My 9-year-old certainly seemed to have the loss-of-interest and sadness symptoms. He no longer wanted to play soccer outside, an activity he usually adores. But the psychologists and psychiatrists I spoke with emphasized another important difference between sadness and depression: Depression persists. “It’s about duration,” Dr. Koplewicz said. “If something lasts more than two weeks, and it’s occurring every day, that’s a red flag.”

If you’re concerned, consider getting professional help. The experts I spoke with said that the incidence of child depression is almost certainly increasing because of the coronavirus, so some kids are going to need extra support. You can start by contacting your pediatrician and asking for referral suggestions. Or reach out to a local mental health clinic, hospital, or academic medical center, which may be able to triage your child online and recommend appropriate help. (The Child Mind Institute, for instance, offers initial 45-minute remote consultations starting at $150.) Thankfully, most mental health therapies can be provided online, so kids can get the help they need from the safety of their home.

As for my 9-year-old: I’m relieved to report that his slump eased up after about a week, and the following week he seemed much better. He even began giving his little sister soccer lessons, which then made her so much happier, too. My son still has his mopey moments, of course. But right now, don’t we all?

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