A Holistic View of the Depressed Child

A holistic view of depression in children and adolescents includes many perspectives, including environmental stressors, the unconscious and conscious aspects of the depressive experience and the emotions of depression.

Environmental Stressors

Four major areas of environmental stress are marital conflict, parental mental health, school failure and peer rejection. Marital conflict interferes with good parenting and may cause a lack of bonding between parent and child. Good marital communication, effective conflict resolution, and the absence of coercion in the marriage, are all qualities that work to prevent depression in the family members. Children who live with parents who are in constant turmoil may protect and distance themselves through a shield of depression.

Research indicates that depressed parents often have depressed children. When both parents suffer from depression, the children are at an even higher risk of becoming depressed themselves. For example, mothers who are depressed report that their infants consistently turn away and avert their eyes. Attunement through the mutual gaze is disturbed, leaving both the parent and infant depressed. Depression causes the parent to retreat into his or her own misery, and to be shallow and distant in emotional responsiveness, thus making the child or adolescent feel isolated and lonely. The inner wounding of the self in the child will continue throughout childhood and adolescence if the parent does not get therapy to alleviate their own depression. As parental depression lifts, the child's depression is replaced with closer affection and bonding.

The parenting style of depressed parents contributes equally to the perpetuation of depression in a family context, as does the biological, or genetic predisposition to depression. Parental depression leads to impatience, agitation and anger-qualities of harsh parenting. Authoritarian and severe parenting styles are most apt to produce depressed children and adolescents. To the children, the parents feel punitive and rejecting. Coercive parenting creates family stress and models poor coping styles. Punishment-based parenting does not help children learn to adapt to the normal stressors of their life-world.

School failure is a sign that a child or adolescent might be depressed. Poor sleeping habits, fatigue, and a lack of interest are symptoms of depression that make it difficult for the student to perform successfully in school. Problems in focusing attention, concentrating and remembering make reading and math comprehension difficult. Performance is low, and the resulting lack of reinforcement for achievement interrupts the child or adolescent's motivation. The pain of depression makes it almost impossible for these children to live up to school demands and so they start missing school, creating more school failure. If teachers are depressed themselves, they are more likely to be impatient, irritable and to use harsh teaching styles that further aggravate child and adolescent depression.

Peer rejection is prevalent in the social world of the depressed child or adolescent. They are criticized and shunned by their peers because they have poor social skills. Often they are unable to participate energetically at parties, school functions or athletic events due to fatigue and a lack of vigor. Friendships for the depressed child or adolescent are often short-lived because the depression itself feels negative, angry and unpleasant to others. So peers avoid the depressive child, further isolating them in their misery and loneliness.

Four functions of the psyche that were delineated in the psychology of Carl Jung are thinking, feeling, sensation and intuition. Thinking gives meaning and understanding to experience, judging it to be true or false. Feeling judges experience to be good or bad. Sensation is perception based on impressions through the body of what one can see, feel, hear, taste or smell. Intuition is perception arrived at through unconscious processes like hunches or gut reactions.

Conscious Aspects of Depression

Self-monitoring and self-evaluation are based on cognition, or the thinking function, and they are used for self-control. Depression is accompanied by negative thinking and self talk. Negative ideas and judgments interfere with the ability to appropriately self-monitor and self-evaluate. Habitual negative inner talk prejudices the perceptions of depressed young people so that they only see the negative, bad, and ugly in themselves and in their life-world. Countering their negative inner talk with positive affirmations that give meaning and understanding to their life is necessary to alleviate depression. Have the depressed child carry a hand counter to count their positive thoughts and how many times they see events, other people or things as positive. Chart the results at the end of the day. Over time, this directed activity will change the negative emphasis in the child's perception of his world to a more positive appreciation of the non-depressing things in life. This is a way of teaching positive self-monitoring, self-evaluation and self-reinforcement by enabling the child to see their own progress in the daily charting.

Feeling is the function that makes depressed children or adolescents judge themselves as worthless. Rejection by parents, teachers and peers makes them feel unloved. The negative self-evaluations of feeling worthless and helpless become deep-seated value judgments that are at the core of the depressed child's psyche. Feeling helpless and worthless comes from the poor school performance and trouble with peer relationships that accompany childhood depression.

Unconscious Aspects of Depression

Sensation deals with the given physical facts of experience. It is irrational because it is just presented to the person, it is not thought out. In depression, the child or adolescent most easily perceives the negative facts in their environment. For example, they may hear five good comments about their behavior or appearance, and one negative one. They will hear only the negative and ignore the positive, accumulating negative evidence that makes them feel worthlessness and helplessness. These children need to be taught to find positive evidence that is opposite to their negative perceptions. Intuition is an irrational function of perception that is received through the unconscious in the form of hints and clues. The depressed child or adolescent intuits that his life-world will never change. Intuitive perception is contaminated by the child's emphasis on negative hints and hunches that cause him to perceive his future as hopeless. They suffer from low self-esteem and a lack of motivation because their self-concept is poor and their self-evaluation is negative as they intuitively compare themselves socially to others. The negative triad of feeling worthless, helpless and hopeless is now complete with internal evaluations of being no-good and incompetent, that no one cares and that the future is hopeless

The Emotions of Depression

Overwhelming sadness, anger, disgust, contempt and guilt are the unconscious emotions of depression. Sadness, the main emotion of depression, is caused by loss, such as lost friendships or the loss of safety and security from having a depressed parent. Guilt is caused by feeling incompetent, such as not living up to parental expectations of academic success or athletic performance. Disgust, contempt and anger are inner-directed hostility that gives rise to suicidal thoughts and wishes. When the hostility of disgust, contempt and anger is outer-directed it creates oppositional behavior and the more serious conduct disorders in children and adolescents.

Body sensations and instincts, and the fantasies they stimulate, create unconscious images in the mind that increase negative feelings, like sadness or fear. Body temperament and genetic structure play influential roles in shaping the depressed child's feelings of worthlessness, helplessness and hopelessness through fatigue and the lack of vigor for motivation or action. Depressed child and adolescent bodies are bombarded by coercive, harsh messages from parents, peers and teachers. The negative sensations emerge from the unconscious as depression.

Depression in childhood and adolescence is one of the saddest and most debilitating of human conditions. These children need love and caring to guarantee their safety, security and belonging needs. The power of love can overcome depression. Impatience and punishment cause parents to feel guilty and sad for inflicting pain upon their children. So love heals the parent and the child, and restores health with joy and hope in the whole family. Love replaces depression and darkness with light and beauty.

References

Izard, C. E. (1991). The Psychology of Emotions. New York: Plenum.

Kendall, P.C. (Ed.). (1991). Child and Adolescent Therapy: Cognitive Behavioral Procedures. New York: Guilford Press.

Kronenberger, W. G. & Meyer, R. G. (Eds.). (1996). The Child Clinician's Handbook. Boston, MA: Allyn and Bacon.