If you notice any warning signs of suicide such as aggressive or hostile behaviour, excessive thoughts about death, or detachment from reality , seek professional help immediately by calling either your child's doctor, a professional counsellor, or a local mental health or emergency service. Create a plan to help keep your child safe. Lock away knives and other sharp objects, firearms, poisons, and medicines. Call if you feel your child is in immediate danger.
Although experts believe that, for many children with depression, the benefits of medicine outweigh the risks, research on antidepressant medicine in children is limited. The long-term effects and safety of medicines used to treat depression in children and teens are still unknown. You may have heard about concerns regarding a possible connection between antidepressant medicines and suicidal behaviour. For example, Health Canada advises against the use of paroxetine Paxil for depression in children less than 18 years of age.
Especially during the first few weeks of treatment with an antidepressant, there is a possible increase in suicidal feelings or behaviour. A child beginning antidepressant treatment should be watched closely. But children with untreated depression are also at an increased risk for suicide. So it is important to carefully weigh all of the risks and benefits of antidepressant medicine. Antidepressant medicines include:.
Antidepressant medicines such as fluoxetine Prozac, for example can be effective in treating depression, but it may take 1 to 3 weeks before your child starts to feel better. It can take as many as 6 to 8 weeks to see more improvement. Make sure your child takes antidepressant medicines as prescribed and keeps taking them so they have time to work.
If you have any questions or concerns about the medicine, or if you do not notice any improvement by 3 weeks, talk to your child's doctor. When a child starts taking antidepressant medication they should be closely monitored, especially during the first 4 weeks of treatment. Look for the following signs: worsening of their depression, suicidal thoughts or behaviours, as well as changes in their regular behaviour.
Examples of behavioural changes include: not being able to sleep, being agitated, or withdrawing not participating from normal social situations. Some antidepressants may also be effective in treating other conditions such as anxiety. Your child may have to try several medicines or different dosages before the most effective treatment is discovered. After the right medicine and dosage is found, your child may need to continue taking the medicine for several months or longer after the symptoms of depression have subsided, to prevent depression from occurring again.
Some children who are first diagnosed with depression are later diagnosed with bipolar disorder , which has symptoms that cycle from depression to mania very high energy, often with euphoria, agitation, irritability, risk-taking behaviour, or impulsiveness. If your child or teen has bipolar disorder, a first episode of mania can happen spontaneously. But it can also be triggered by certain medicines such as stimulants or antidepressants. That is why it is very important to tell your child's doctor about any family history of bipolar disorder and to watch your child closely for signs of manic behaviour.
For more information about bipolar disorder in young people, see the topic Bipolar Disorder in Children and Teens. Health Canada and the FDA do not recommend that people stop using these medicines. Instead, a person taking antidepressants should be watched for warning signs of suicide. These signs may include talking about death or suicide and giving away belongings. This is especially important at the beginning of treatment or when doses are changed.
Besides taking medicine, other treatment for depression includes professional counselling and electroconvulsive therapy. Complementary medicine is sometimes used for depression in adults. But there is no evidence that these therapies are safe for use by children or teens. Always tell your doctor if you are using any complementary therapies.
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Health Canada has approved the vagus nerve stimulator VNS implant for treatment of depression in adults. This device may be used when other treatments for depression have not worked. A generator the size of a pocket watch is placed in the chest. Wires go up the neck from the generator to the vagus nerve. The generator sends tiny electric shocks through the vagus nerve to that part of the brain that is believed to play a role in mood.
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More study is needed to see how well this works in children who have depression. If you want to save this information but don't think it is safe to take it home, see if a trusted friend can keep it for you. Plan ahead. Know who you can call for help, and memorize the phone number. Be careful online too. Your online activity may be seen by others. Do not use your personal computer or device to read about this topic. Use a safe computer such as one at work, a friend's house, or a library.
Many of the resources below have toll-free phone numbers and provide help 24 hours a day, 7 days a week in multiple languages. In an emergency, call Check your local phone book or provincial or territorial website.
Mental Health of Adolescents
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Cause Depression is thought to be caused by an imbalance of chemicals called neurotransmitters that send messages between nerve cells in your brain. Depression runs in families. Children and teens who have a parent with depression are more likely to develop depression than children with parents who are not depressed. Experts believe that both inherited traits genetics as well as living with a parent who is depressed can cause depression. Depression in children and teens may be linked to stress, social problems, and unresolved family conflict. It can also be linked to traumatic events, such as violence, abuse, or neglect.
Certain thinking patterns and coping styles may make some children and teens more likely to develop depression. Children or teens who have long-term or serious medical conditions, learning problems, or behaviour problems are more likely to develop depression. Some medicines can trigger depression, such as steroids or opioids for pain relief. As soon as the medicine is stopped, symptoms usually disappear.
Alcohol and drug misuse may trigger depression in children and teens.
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Symptoms The symptoms of depression are often subtle at first. Less common symptoms Severely depressed children may also have other symptoms, such as: Hearing voices that aren't there hallucinations. Having false but firmly held beliefs delusions. Normal moodiness vs.
Bipolar disorder Some children who are first diagnosed with depression are later diagnosed with bipolar disorder. What Happens At first, depression in a child or teen may appear as irritability, sadness, or sudden, unexplained crying. Drugs and alcohol Some teens will have alcohol or drug use problems along with depression.
Other problems Often a child who is depressed will have other disorders along with depression, such as an anxiety disorder , a behaviour disorder like attention deficit hyperactivity disorder ADHD , an eating disorder , or a learning disorder. Children and teens with depression are also at a higher risk for problems such as: Poor school or job performance. Problems in relationships with peers and family members. Early pregnancy.
EARLY BRAIN AND CHILD DEVELOPMENT
Physical illness. Treatment in the hospital For severe depression, your child may need to be hospitalized, especially if he or she is out of touch with reality psychotic or is having thoughts of suicide. Relapse During treatment for depression, make sure that your child takes medicines and attends counselling appointments as directed, even if he or she feels better. Suicide and depression It's very important to recognize the warning signs of suicide in your child or teen.
Carefully watch for signs of suicidal behaviour if your child has recently: Broken up with a girlfriend or boyfriend. Had disciplinary troubles in school or with the law. Had problems with poor grades or had trouble learning. Had family problems. Been the victim of repeated bullying. Had substance use problems.
Started, stopped, or changed doses of an antidepressant medicine.