My child's or teen's answer is always, "I don't know."
Parents bring their child and/teen to therapy with me for many reasons. Usually it is after many attempts to resolve problems, conflicts or worrisome behaviors. Perhaps it appears that your child or teen is acting in a defiant or oppositional way, or is anxious, --or has difficulty with social skills or making/keeping friendships. Some of you may be worried about your child or teen's depression or sadness. When it comes to emotions and children and teens it can be difficult for parents to decode behavior, mostly because it is difficult for children to accurately describe or explain their own behaviors or feelings. Children do not have the emotional vocabulary adults do. It is a great source of frustration for you and your child or teen when they cannot (or seemingly will not) explain behaviors to you. How often are you perplexed and frustrated when your child or teen repeatedly says, "I don't know" when pressed for answers about why they behave a certain way or demonstrate feeling a certain way? The "I don't know" answer causes a good deal of conflict between parents and their children or teens. Parents may interpret this as the chid being obstinate or untruthful. However; more often than not, the "I don't know" answer is the truthful answer, because from a developmental perspective, children and teens may not able to explain impulsive behavior or reactions to certain triggers. Their actions and ability to analyze and make sound judgements are not fully developed until about age 25. It can be disappointing and disheartening to parents when they cannot "fix" their own children's problems. I believe that children generally want to be good and please their parents. I believe each child can live up to their full potential if they have to tools to do so.
As a therapist and parent of former teens I understand and empathize with you. I understand your feelings of anger, frustration, worry, sadness, disappointment and helplessness. I want you to know you are not alone in your struggle. Your children are not alone in their struggle. There is no shame for parents of a child struggling with social or emotional difficulties. There is no shame in getting help. If you are committed and active in the therapeutic process, I believe I can help provide the relief you deserve and the hope that things can change for the better for you and your child or teen.
How does therapy begin with children and/or teen?
I encourage parents, guardians and other caregivers to be part of their child's therapy. It is important for me to gather information from adults beyond the reason you've brought your child to therapy. I gather information regarding your child's developmental history, family background, genetic or hereditary mental health, school history, friends and family constellations and relationships. I also gather similar data directly from your child. This process may take one or two sessions to complete. The information I gather helps me get a clearer picture of your child, as well as the way your child views themselves in the world and the world around them. Together we all discuss the goals or desired outcomes for therapy. I then develop a treatment plan to address the presenting problems. My treatment approach utilizes a variety of integrated treatment modalities, and varies depending upon the child's presenting problems and personality style, as well as their developmental age. Some of the interventions are cognitive behavioral in nature, humanistic, and psychodynamic. Their may be homework assigned to your child or teen to be completed between sessions.
On occasion there may also be homework for you as parents, guardians and/or caregivers. Don't worry--the homework assignments will not require writing essays or taking tests. Each intervention I use is designed to build upon your child or teen's inherent strengths, and develop healthier ways of behaving and communicating effectively. Other times we may spend time during therapy playing games, which can be important for many reasons, such as helping your child express feelings through play, or as a distraction that allows the child to talk about things that may be difficult or embarrassing.
Children and Depression
How do I know if my child is depressed?
Depression in individuals can be difficult to identify. Depression differs from sadness usually precipitated by an event which is identifiable. It is when the sadness persists or when the child’s behavior becomes disruptive and affects relationships at school and home or even in play, or exceeds what once could expect as part of the child’s developmental level. Depression in children can present differently than in teens or adults, but sometimes it presents as sadness, hopelessness similar to adults. About 2.5% of children in the United States suffer from depression. Depression is more common in boys than girls for children ages 10 and under. Between the ages of 10-15 depression is equally common for boys and girls. Depression is significantly higher for girls aged 16 and older than for boys the same age.
In order to diagnose a child with depression, the child’s symptoms must have lasted longer than two weeks. If your child’s symptoms have been present for longer than two weeks, the child should first see a pediatrician to rule out any medical reason for their symptoms. If there is not a medical reason for these symptoms a consultation with a mental health professional is recommended.
Why is my child depressed?
Depression is caused by any number of reasons and differs from person to person. I believe depression may be attributable to biological, psychological and sociological factors. Any combination of things such as: medical illness, brain chemistry, family history, genetics, loss, change and stressors environment can cause depression. The good news here is that depression is a treatable illness.
What are my treatment options?
Regardless of a person’s age treatment options are this same, which are psychotherapy or counseling and/or medication. For children I believe psychotherapy is the first option to consider. If symptoms do not relent or improve, parents may consider medication as the next option. Studies show that the most effective treatment for depression is a combination of psychotherapy and medication. Parents should consult with a medical professional (psychiatrist and/or pediatrician). In my practice I usually confer with parents and medical professional about treatment. I believe that a parent has the right to choose whether medication is right for their child. If a child is taking medication to treat depression they should be closely monitored by parents, therapist and prescribing physician.
It may be difficult for parents to accept their child’s depression diagnosis because social stigma for mental illnesses still exists in our country. As a parent you want your child to be happy and productive, living up to their potential. Some parents and children feel a sense of shame over something that is no one’s fault. It can be very difficult for a parent to watch their child suffer, or to live with a child with a depressed child, but neither of you have to continue to suffer. I believe therapy can help you and your child get the relief you need.
Common reasons parents bring their child or teen for therapy with Dr. Goodwin include:
If you are a parent or caregiver of a child or teen who is struggling emotionally or socially you are not alone. Worrying about children is common for most caring parents. Using the term "worried" to describe the feelings of a parent of a depressed or anxious child is an understatement. Life with a child who is struggling not only causes strain between parent and child or teen, it can cause stress on your marriage and your entire family system. I have worked with many children and teens and their families who come to therapy for a variety of reasons. For many parents and caregivers decoding your child's moods or behaviors can be exasperating and confusing for you and your child or teen.
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What are the symptoms of depression in Children and Teens?
There are some common symptoms of depression that may be identified. Please keep in mind all depressed children might not have all of the signs or symptoms of depression listed below.