Children depressed parents

Depression 1. Child 2. Parent 3. Teacher, sitter, day-care director, coach, scout leader 1. Adolescent 2. Parent 3. Teacher, coach, employer... 

The initial choice of therapy is also dictated by the severity of the depression (e.g., the severity of depressive symptoms impedes an adequate trial of psychotherapy), subtype of depression (e.g., presence of psychosis, seasonal depression, or treatment-resistant depressions) presence of comorbid disorders, prior treatment history, child and parent motivation toward treatment, and the clinician s motivation and expertise in implementing any specific intervention. 

Nunes EY, Weissman MM, Goldstein RB, McAvay G, Seracini AM, Verdeli H and Wickra-maratne PJ (1998). Psychopathology in children of parents with opiate dependence and/ or major depression. Journal of the American Academy of Child and Adolescent Psychiatry, 37(11), 1142-1151. 

Blatt, S. J., Homann, E. (1992). Parent-child interaction in the etiology of dependent and self-critical depression. Clinical Psychology Review, 12, 47-91. 

Had they been known about, both instances illustrated above would have been significant child protection concerns. The emotional vulnerability engendered as a result of such unstable patterns of parental contact is just as significant. The following child s description of his disappointment that neither parent consistently comes to see him in foster care is a depressingly flat statement of his low expectations that they will turn up, or even really understand the importance of the visit to him ... 

Clinicians should be aware that many of their patients may be taking alternative treatments either via self-care or prescribed by CAM practitioners. Inquiring about this should be routine because of potential side effects and drug interactions. A working knowledge of CAM treatments will allow child psychiatrists to give parents and patients advice about safety and effectiveness. Use of St. John s wort in children with unipolar depression may at times be appropriate, particularly in cases where more standard treatments are contraindicated or have failed. However, it should be used cautiously and with an appropriate explanation of its risks and benefits, as a competent clinician would do for any treatment. Use of St. John s wort for other conditions is not currently recommended given the lack of evidence for efficacy. Kava extracts may be used for anxiety, with similar provisos. There are much fewer data about the efficacy and safety of other dietary supplements and their use cannot be supported at this point. 

Because the parents of depressed youth may also be experiencing depression and other psychiatric disorders (Weissman et ah, 1987 Klein et ah, 2001), parental depression itself may lead to adverse outcomes (Brent et ah, 1998). To treat the child successfully, the clinician should assess parents and refer them for their own treatment. 

Stein, D., Williamson, D.E., Birmaher, B., Brent, D.A., Kaufman, J., Dahl, R.E., and Ryan, N.D. (2000) Parent-child bonding and family functioning in depressed children and children at high-risk and low risk for future depression. / Am Acad Child Adolesc... 

Like any addictive stimulant, methylphenidate and amphetamine can cause withdrawal symptoms such as crashing with depression, exhaustion, withdrawal, irritability, and suicidal feelings. However, parents and teachers almost never recognize a withdrawal reaction when their student or child gets upset after missing a single dose. Instead, they mistakenly believe that the child needs to be kept on the medication. 

Warner V, Weissman MM, Mufson L, Wickramaratne PJ. Grandparents, parents, and grandchildren at high risk for depression A three-generation study. J Am Acad Child Adolesc Psychiatry 1999 38 289-296. 

Depression, as it is clinically used which should cause parents to seek help for their child), refers to a severe state of despondency in which a person becomes emotionally stuck, typically feeling trapped in hurt, hopelessness, helplessness, anger, and worthlessness, without having the energy or motivation available to make any positive change. 

During the inevitable ups and downs of adolescent growth (see Keys 19 to 23), times of significant, persistent sadness in their child should be taken seriously by parents because these may either be a precursor or consequence of substance abuse. What can a parent watch out for A few common signs of feeling seriously depressed include ... 

Although intermittent experiences of boredom are to be expected during adolescence, and although constructively coping with this sense of aimlessness is an important responsibility to learn, days of a child feeling bored, like days of feeling depressed, warrant parental attention and intervention. 

According to a study reported in the Brown University Child and Adolescent Behavior Letter, most parents think they can detect signs of depression in their children. In reality, fewer than 5 percent of parents could tell when their teenage offspring was clinically depressed and in need of medical treatment. Because depression can stem from a family situation, parents are often too distracted to notice changes in behavior and even if they do, shame may keep them from getting help for their children. 

Prozac and Paxil can now be prescribed to children as young as 7. However, there is much opposition to the idea of giving small children a mood-altering drug. Similar to the Ritalin controversy, parents feel that children on Prozac will not be able to mature emotionally, that an SSRI acts like a crutch for the child who should be dealing with problems causing the depression. The other side of the argument is that with some children there is no readily identifiable cause for depression ... 

The effects of community violence on parents may also mediate the impact of community violence on children. Violence and poverty affect parents ability to monitor and discipline their children consistently and to provide needed support and nurturance (Gorman-Smith et al., 2000). Inner-city children s exposure to violence predicted increases in aggression and depression at a 1-year follow-up, even after controlling for prior levels of these problems (Gorman-Smith Tolan, 1998). However, family support moderated the effect of community violence, such that in families with high levels of parent-child conflict, high-witnessed violence had no additional influence on antisocial outcome (Miller et al., 1999). 

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