The incidence of mental disorders in children and adolescents, and particularly of depression, is often underestimated. On the surface, young people’s problems may seem less serious, because what seems important to them (academic pressures in school, being rejected by friends, etc.) may seem trivial to adults. But these problems are just as real, and 2% of all children and 5 to 10% of all adolescents experience episodes of depression.
Children who are subject to depression tend to blame themselves, and only themselves, for any unfortunate event. Usually, these are children who receive little support from their family setting.
Depression in young people is a serious concern. For one thing,
the frequency of suicide attempts in children and adolescents is related to depression
in most cases. For another, preventing depression in children
seems to be the best way of preventing it in adults.
Children who are abnormally preoccupied with negative ideas should be identified as early as possible. The appropriate interventions would then consist in helping these children to see their problems as temporary, to perceive reality from different angles, and not to take more than their fair share of responsibility when things go wrong.
SYMPTOMS, TREATMENTS, AND CAUSES OF DEPRESSION
Daily events and the way that we react to them can sometimes
trouble our peace of mind. Anyone can go through a period
when they feel sad and lonely every day. But when feelings
like this go on for weeks or even months, they may be the
first signs of depression.
An estimated 1 out of 5 women and 1
out of 10 men will experience depression at some time in their
lives, which makes this a very common ailment. Depression can
prevent people from coping with their normal activities, their
work, and their relationships, thus seriously compromising their
sense of well-being and their ability to live their lives.
Psychiatrists generally consider someone to be suffering from depression when
they present at least 5 of the following symptoms almost every
day for at least 2 weeks:
Depressed mood for a large part of the day
Lack of interest or pleasure in
almost all daily activities
Decrease or increase in weight or appetite
Insomnia or excessive sleeping
Agitated movements (such as wringing of hands) or slow
Fatigue or loss of energy
Feelings of worthlessness or excessive guilt
Indecisiveness or difficulty in thinking or concentrating
Recurrent thoughts of death (in 60% of cases) or suicide
Once a doctor diagnoses depression, it is important to begin a
course of treatment as
quickly as possible, to prevent the depressive state from getting
worse. Left untreated, depression tends to become chronic or recurrent,
and major depression leads to suicide in about 15% of the people
who suffer from it.
Research on the causes
of depression has increasingly revealed how complex this disease is and how
many different factors can contribute to its onset.
Pregnancy and childbirth
are very intense experiences that can cause all kinds of
upheavals for women. The terms “baby
blues” and “day 3 syndrome” refer
to the episodes of crying and short-term depression that
about 50 to 70% of all mothers experience on the second or
third day after giving birth. This condition is attributed
to the sudden drop in their levels of certain hormones, as
well as to the exhaustion resulting from childbirth, lack
of sleep, recurrent strong emotions, and so on. This mild
form of depression does not require any treatment and generally
disappears after about 10 days.
But 10 to 20% of women experience a more severe form of depression,
known as postpartumdepression.
Its symptoms are similar to those of major depression, but
it is often diagnosed late, because both the woman and the
people around her tend to attribute it to the usual overwork
following the birth of a baby. Postpartum depression
can appear at any time during the year following childbirth
and lasts an average of three to six months, though
it sometimes stretches out for over a year.
A final note: cases of depression during pregnancy
are at least as common as postpartum depression.
During the short days
of winter, many people have less energy and feel a little
down, but 2 to 6% of the population of northern countries
actually experience a particular form of depression known
as seasonal affective disorder. The exact causes of this
disorder are not yet known. But it is known to be associated
with the lack of light due to the reduced hours of sunshine.
Various studies have shown that nearly 65% of the people
with this disorder feel better after undergoing treatments
with “light therapy”, which simply means spending
about 30 minutes per day under a lamp that gives off a very
In children and adolescents,
some periods of hyperactivity are obviously normal. Just
because children decide for a while that they are really
Superman, Batman, or Spiderman does not mean that they
are in the throes of a clinically manic episode.
The term “cyclothymia” refers
to a particular mood disorder where individuals experience
the ups and downs of bipolar disorder, but to a lesser
extent. The periods of mania, known as “hypomanic
episodes”, are shorter and less severe than in full-blown
bipolar disorder. During such episodes, individuals can
still attend to their jobs and their social activities,
but not optimally.
SYMPTOMS, TREATMENTS, AND CAUSES OF MANIC DEPRESSION
has been known since ancient times, but it was a German
psychiatrist, Emil Kraepelin, who first described its symptoms
more systematically, in the late 1800s. Today, specialists
prefer the expression “bipolar disorder”, which
avoids the negative connotations associated with the word “manic”.
Both the painter Vincent
Van Gogh and the author Ernest Hemingway suffered
from manic depression throughout their lives.
Unlike ordinary people whose moods are
influenced by specific events in their lives, people with bipolar
disorder seem to follow their own cycle of mood fluctuations.
Like passengers strapped into a roller coaster, they have no
choice about the ups and downs; they must simply go along for
During these manic phases, individuals are excessively exuberant.
Their thoughts race feverishly, leading to extravagant behaviour.
They see patterns everywhere—everything seems connected
to everything else, and the smallest event can take on an exaggerated
meaning. These people can also be very creative; the connections
that they draw between things constantly inspire them with
new ideas and new theories.
More systematically, specialists often
distinguish four major categories of symptoms of
1) External appearance. The individual’s
external appearance is extravagant or sloppy, provocative,
or even indecent. A person in a manic phase may call
out to strangers in the street with an abrupt familiarity,
sometimes mixed with sarcasm.
2) Mood exaltation. During manic phases,
individuals feel exuberant and have extreme confidence
in their own powers and charm. They have sexual adventures
with no thought for the possible consequences and often
with a total lack of inhibition or tact. They do not
tolerate any criticism of themselves and are easily
irritated and angered.
3) Accelerated thought processes.
thoughts come so fast that their words can’t keep up
with them. They evoke one image, then move on to the next before
their listeners have had time to absorb the first one. They
keep jumping from one unrelated topic to another and keep talking
even if people have stopped listening. Their ability to focus
their attention is greatly diminished, but their imagination
is greatly amplified.
4) Motor hyperactivity. In manic phases,
people don’t know the limits of their own strength.
They don’t take the time to eat or sleep. They
take on several projects at once without stopping to
determine whether they are even feasible. These individuals
make major upheavals in their lives (change jobs, go
on long trips, make foolish expenditures, etc.) and
may become distrustful or even paranoid, accusing the
people around them of wanting want to keep them from
carrying out their grandiose plans.
From all these symptoms, one can easily see why it is vital
to ensure that people with bipolar disorder receive appropriate
treatment quickly. Even though the
causes of these diseases are still incompletely understood,
there are ways to reduce their effects considerably.