Emotional Problems In Childhood/ Childhood Anxiety And Depression

“Childhood is the one story that stands by itself in every soul” – Ivan Doig

Childhood is an important part of everyone’s life. The interactions we have in our childhood, the way of parenting, early childhood experiences help in molding the person we become in the future. However, many children tend to face emotional and behavioral difficulties during childhood. The understanding of such emotional problems in children among parents and caregivers is minimal or tends to be viewed as less problematic compared to other behavioral disorders. Because they are marked by internal distress that is not always evident to others externally, they can occasionally go unnoticed and unreported.

The major emotional problems seen in children and adolescents can be:

• Separation anxiety disorder: One of the most prevalent anxiety disorders in children is separation anxiety disorder (SAD). Symptoms of social anxiety disorder (SAD) include extreme worry, dread, and concern over the actual or anticipated separation from an attachment figure such as the mother. Separation anxiety often affects most kids between the ages of 6 and 12 months, which is developmentally normal or appropriate. Up to the age of three, this physiological or normative separation anxiety is consistently present, after which it usually goes down and subsides. Although separation anxiety is a developmentally normal phenomenon, when it persists over the age of three in children with unusual severity and in inappropriate settings, the condition needs to be considered as SAD.
• Phobic anxiety disorders in childhood: Children can also develop a fear of a specific object or situation similar to what is seen in adults. The fear might be of extreme severity that they completely avoid any situation in which exposure to the anxiety-related object is needed. Social anxiety disorder in childhood is common and shows as persistent fear and avoidance of strangers. The child will have a degree of selective attachment with familiar persons such as parents or caregivers. The avoidance and fear of social situations are to the extent that is unusual for their age and are linked to problems in social functioning.
• Depression during childhood: It is a myth that “only adults will have depression.” Children and adolescents also suffer from depression, as quoted in recent studies that more than one in seven teens experience depression every year. Symptoms include persistent sadness, loss of interest and difficulty enjoying pleasurable activities, loss of energy, change in appetite or weight, changes in sleep, feelings of worthlessness, a pessimistic view about the future, difficulty in concentrating, and suicidal thoughts and ideas.

Risk Factors:

• Biological factors: Imbalances in neurotransmitters such as serotonin
• Genetic factors: More prevalent in children with a family history of depression and anxiety
• Psychosocial factors: Conflicts with family, ineffective and punitive parenting, presence of abuse in childhood
• Environmental factors: Presence of life stressors such as loss of loved ones, adjustment difficulties at home or school, issues in peer relationships, and bullying

Treatment:

• Pharmacological Interventions: Antidepressant medications such as SSRIs, TCAs are commonly used.
• Psychological Interventions:
  • Play Therapy: Play may serve functions by acting as a medium through which children express feelings, gain a sense of control, cope with difficult situations, communicate with others, and develop relationships.
  • Interpersonal Family Therapy: A specific type of family intervention, utilizing systems, cognitive behavioral, and object relations theory to help restructure the interactions of family members in which there is a depressed child.
  • Behavioral Therapy Interventions: In vivo systematic desensitization or exposure—graduated exposure of the child to the feared stimulus/situation (e.g., dog, separation from the parent).
  • Cognitive-Behavioral Therapy: Treatment focuses on producing cognitive changes that, in turn, will produce behavior changes incompatible with anxious or phobic symptomatology.

“In order to manage and cure emotional disorders in children and avoid long-term detrimental effects on their development and well-being, early detection and intervention are essential.”

-Vasudha