No child is immune from having a bad day. When young kids have tantrums, anger and irritability, it’s tempting to chalk it up to hunger, exhaustion or any number of other causes. This was the case for a 6-year-old boy who, after weeks of challenging behavior, was referred by his school to the Center for Children and Families (CCF) at Erikson Institute in Chicago. Experts at CCF actually found that he was experiencing depression.
“Most people believe that young kids can’t be depressed, that it’s not even a possibility. That’s the biggest myth about depression in young kids,” explains Sara Anderson, Licensed Clinical Social Worker and Associate Director for the CCF.
Depression presents differently in children than it does in adults, Anderson says.
“Because of their level of emotional maturity, children especially in the 0-5 age range are still learning about how to express their feelings. There’s a big growth in language and that development is still happening,” she explains. “What they show through their behavior is not always a clear sadness.”
In young children, depression’s underlying feelings of sadness or loneliness often surface as anger — as in the 6-year-old boy’s situation. Irritability, aggression, changes in appetite, difficulty concentrating or sluggishness are also symptoms. The child may have an increased activity level or express guilt and self-blame when playing.
All of these symptoms can impact a child’s relationships and make it difficult for them to participate in activities that are appropriate for their age group.
“The criteria for depression in children is having symptoms more days than not for at least two weeks. And they’re in this chronic state without other explanation,” Anderson says.
Children can experience depression
When a child is diagnosed with depression, child mental health professionals work to support parents in understanding the diagnosis. They also work collaboratively with the family to move forward.
In the young boy’s situation, his parents learned that depression is possible, but also that it’s treatable. Effective treatment involves the child and their caregivers, Anderson says.
“Working with children in their family system and with the most important people in their lives has the biggest impact,” she says. This relationship-based approach helps both parents and children understand the diagnosis and work proactively while being supported and encouraged by the therapist.
“The biggest part of treatment is play therapy. This is a safe space where a child can express and show their feelings while a caregiver is present and available in the therapy room,” says Anderson. Compared to a home setting, where there are many tasks and distractions competing for a parent’s attention, play therapy is all about uninterrupted interaction between parent and child.
“In the treatment room, the parent is present and available and not trying to multitask. The therapist is also there to hold the process and support the caregiver so they can support the child,” she explains. This is where parents can model regulation skills, too.
In the 6-year-old’s case, his parents learned to validate, name and hold space for uncomfortable feelings he was experiencing — and helped him regulate those strong feelings. They also learned to check in with themselves about how they are feeling when their child is uncomfortable.
Treatment for children includes parents or caregivers
When a child feels safe and secure in the therapy space, they’re more apt to show the caregiver more of their internal world, which leads to greater understanding on the part of the parent or caregiver.
“As play develops, the child gains language that helps them understand the world and the self. As the play themes become more rich and the caregiver is more clued in, the therapist may find they don’t have to intervene as much and they can take a back seat,” Anderson says.
During the course of play therapy, parents and children encounter natural moments from daily life and they learn together to overcome them effectively.
“A child might be having a wonderful time and is having trouble stopping play and transitioning. That’s a moment from daily life, but as treatment moves on, parents can help their child manage this transition better. When they know their child has a hard time ending play, they become more proactive and learn to give their child natural warnings,” Anderson says.
Relationship-based approach for childhood depression
As a center for parent-child therapy for families of children under the age of 9, CCF is focused on the needs of families whose children are experiencing depression and anxiety, grief and loss and challenges within the parent-child relationship.
Through a unique relationship-based approach to child mental health, CCF helps families recognize the importance of responsive parenting and learn how to develop strong, positive relationships within their families.
“Children greatly benefit from having a parent validate and make space for their feelings. This helps children know that their caregivers will help them manage uncomfortable feelings,” Anderson says. “We know that attachment and relationships are pivotal to everything a child is going through in their mental health and development. Supporting the relationship is at the forefront of the work we do with families.”
The Center for Children and Families at Erikson Institute has locations in Chicago’s River North and Little Village neighborhoods, as well as Oak Park and offers services in English and Spanish. Learn more at erikson.edu.