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When Your Preteen Sings the Blues
Depression in Your Child
By Virginia Gilbert
In assessing possible clinical depression in a preteen, Havivi examines the major areas of the child's life: family, social, academic and the interior world. Havivi says that most of the troubled preteens he sees don't have major depression. Instead, they're demoralized by frustrations in one of the primary areas. Once Havivi pinpoints the problem, he works with the family to devise an appropriate treatment. For instance, if a bright boy is making poor grades at a highly competitive school, his parents might consider transferring him to a school that provides a more nurturing environment. Or, if a teacher complains that a girl seems distracted by her constant doodling, the parents might want to enroll the child in an art class instead of inadvertently thwarting her creativity by insisting she quit doodling.
Dr. Havivi stresses that medication is last on his list of preferred treatments for children. Although the new class of antidepressants -- selective serotonin reuptake inhibitors (SSRIs) which include Prozac, Zoloft and Paxil – are considered as safe for children as for adults, no one really knows if these drugs can cause subtle, long-range changes in a preteen's developing brain chemistry. Together with his patient and the family, Havivi weighs the risks and benefits of prescribing antidepressants. Is the child withdrawn, losing friends? Does she have low self-esteem? Is her concentration impaired to the point that she's failing school? If the child is suffering in each of these areas, then the potential benefits from medication could override the unknown risks.
According to Dr. Havivi, parents should strive to take away some of the pressure weighing on their child and create opportunities for him to find activities he enjoys and feels good about doing. A child doesn't have to be wildly popular to be happy, but he does need at least one good friend. Parents also should encourage their child to be active; going to a movie or playing ball is more likely to make a child feel better than staying home alone doing nothing.