Typical Sadness or Depression?
Supporting Your Child’s Mood Changes and Behaviours
As the COVID-19 pandemic continues to limit our ability to live as we would like, we need to be on alert for signs of depression, particularly in our children with ADHD and/or Learning Disabilities (LD). Feeling down in this time of cancelled activities and social distancing is unavoidable. Many of us are struggling to stay positive. But depression is more than just feeling sad or having bad days. A child who seems to be stuck in a negative “low” mood, such as feeling hopeless and not able to enjoy anything, may have depression and may need more help. However, with everyone struggling in these uncertain times, how does a parent of a child with LD/ADHD tell the difference between a child who is just feeling irritable/frustrated and a child who is slipping into depression? What signs or symptoms should parents watch for? And, how can they best support their child through their emotional struggles?
The Link Between Depression, ADHD and Learning Disabilities
Everyone, including our children, feels sad from time to time. However, children who learn and think differently (like those with LD/ADHD are more likely to have these feelings often enough and intensely enough for them to be considered signs of depression.
ADHD and Learning Disabilities can create many challenges for children.Those learning challenges can lead to increased sadness and/or depression. Specifically, children with LD/ADHD are at a higher risk of developing emotional disorders. Some reasons may include a history of failures, negative perception of themselves as a learner, low self-esteem, negative peer comparison, and emotional regulation issues. For example, classmates might tease or exclude them, which can make them feel isolated or even hopeless. Because children with ADHD can be more impulsive than their neurotypical peers, they are more likely to act “in the moment” when they’re feeling down or hopeless. They may struggle to step back and see the bigger picture. Social-emotional and behavioural challenges can make academic difficulties worse. Likewise, academic difficulties can often contribute to and worsen social-emotional and behavioural problems. Research has also suggested that some children with ADHD may also be more likely to develop depression. Reportedly, some differences in brain chemistry that can cause ADHD may make some children more likely to feel depressed.
Typical Sadness vs. Depression: What is the Difference?
Typical sadness is described as temporary feelings of sadness that are an appropriate response to what is going on. It is normal - and even expected! - for children to display sadness when they have experienced an upsetting event or situation. Situations that may cause sadness could include performing poorly on a test, not winning a sporting event, getting into an argument with a friend, or even the loss of a valuable object. Additionally, children with LD/ADHD may have more reasons to feel sad than other kids due to the challenges they’re facing. For example, they might fail a spelling test even after they studied all of the words extra hard. Or, they might seek the chance to socialize, but struggle to get along with their peers. Typical sadness will not persist for extended periods of time and will often occur when there is an upsetting event (as noted above). Typical sadness usually passes quickly on its own or with some reassurance from caring adults or friends.
Depression is characterized by frequent and intense feelings of sadness that are out of proportion to what is going on. These feelings happen often - more days than not and for most of the day - and last much longer than typical sadness - at least two weeks. Depression is not a passing mood. It tends to include feelings of hopelessness, worthlessness, and/or helplessness. Depression makes it difficult for the individual to function at home, in school, and with friends and family. When making a diagnosis, trained professionals take into consideration the duration and timing of symptoms and/or behaviours caused by their intense feelings. This may include a diagnosis of Disruptive Mood Dysregulation Disorder (DMDD), Major Depressive Disorder (MDD), or Persistent Depressive Disorder (Dysthymia). These diagnoses are all in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5).
What Can It Look Like?
There are some common indicators that can help parents recognize what typical sadness looks like in children. Some common characteristics of sadness include:
- appearing more quiet or reserved,
- challenges with eating and/or sleeping, and
- difficulties with motivation.
With typical sadness, these characteristics often do not persist and do not severely impact an individual's overall functioning on a daily basis.
It is important to note that depression in children can look like persistent or pervasive sadness, it can also include consistent patterns of irritability. Some common characteristics that parents can look for in their children include:
Lack of motivation, trouble focusing, and/or difficulty making simple decisions
Challenges with motivation will impact various aspects of functioning. It may affect the ability to complete school work (eg. studying and completing homework assignments), home responsibilities (eg. chores), and could even result in school refusal. Individuals may withdraw from previously enjoyed activities such as spending time with family and friends, physical activity, or participating in extra-curricular activities. Depression can also make it more difficult for children with LD/ADHD to focus and make simple decisions quickly.
Low/flat affect, sadness, and/or irritability
Depression can express itself in different ways. Some common indicators to watch for include children acting out more and/or becoming easily frustrated or irritable. They may even display a low or flat affect. This means that they might have limited expression and difficulty demonstrating excitement.
Changes in appetite and/or sleeping habits
These symptoms may include changes in appetite. They may overeat or under-eat. Their sleep patterns might change. They may have difficulties sleeping (insomnia) or over-sleeping (hypersomnia). Challenges with sleep can further impact other symptoms of depression. Poor sleep can result in irritability, moodiness, and an individual’s ability to manage their emotions.
Feelings of hopelessness, helplessness, and/or worthlessness are also common characteristics of depression. Signs of this can be negative self-talk, such as saying “I am dumb,” or “What’s the point?” or “My life is not worth living anymore”.
In extreme cases, depression can also express itself through suicidal ideation (i.e., thoughts about killing yourself), self-harm (i.e., the act of purposefully physically harming/injuring yourself), and/or suicide attempts/completion. If your child has expressed thoughts or displayed actions of self-harm/suicidal ideation, please refer to the list of resources provided below or contact 9-1-1 for immediate support.
How Can I Help My Child?
If your child is showing signs of depression, there are strategies that can be implemented to help your child manage their emotions, as well as their negative thoughts. Some of these strategies include:
Validate your child's feelings and provide a safe space to talk about their emotions
Depression can result in big feelings. These big feelings can be scary or even uncomfortable for children to cope with on their own. Providing a safe and non-judgmental space for your child to talk about their feelings will help validate and normalize their emotions and experiences. Keep in mind, it is important not to pressure your child into talking. Instead, simply let them know that you are there for them if/when they are ready to discuss their emotional struggles.
Challenge negative thoughts/thinking patterns
Negativity is a key component associated with depression. Some strategies to combat this thinking include:
- Make plans and goals: Help your child come up with a plan/activities that will help them feel more engaged and invested in their own life. This gives your child something to look forward to. It may also possibly also give them a sense of accomplishment and pride once the goal is met. These positive feelings can help combat the negative thought cycle related to hopelessness/helplessness.
- Focus on gratitude: Encourage your child to express one positive thing that they did or noticed throughout their day. Try it as a family activity. Have each person discuss different things they are grateful for or positive things they would like to share about themselves, others, and/or things going on around them. Acknowledging what they are grateful for can help your child shift their negative perspective to a more positive and fulfilling one.
- Keep a realistic perspective: Depression often shows up as having a hard time noticing positive aspects and over-focusing on the negative. Help your child challenge their negative thinking and keep a more realistic perspective of situations. Avoid focusing on the worst case scenario or catastrophizing the situation. As parents, it helps if you model this for your child.
Engage in physical activity
Lack of motivation and appearing lethargic can be key characteristics of depression. Trying to stay active helps provide different avenues of enjoyment. It can lead to social engagement, connection, and physical stimulation. When trying to get your child engaged, some strategies include:
- starting small (i.e., going for a short walk around the block and building up to a nature walk),
- involving your child in the decision making process, and
- trying various options to engage interest.
Access professional support
While typical sadness normally resolves itself, depression often requires professional support. If your child’s symptoms appear to increase in frequency and duration, then it is recommended that they receive professional counselling. Counselling will help them develop appropriate coping strategies to deal with their emotional intensities.
Cognitive Behavioural Therapy (CBT) is one of the most common and most effective therapies used for treating depression. CBT specifically targets the negative thoughts associated with depression. It helps individuals replace their negative thoughts with more positive/helpful thoughts. Research suggests that the most effective treatment for depression is the combination of CBT and medication (i.e., antidepressants). As such, in addition to counseling, it is recommended that families seek support from a physician to guide their decision around the risks and benefits associated with using medication to treat depression.
If your child is in immediate distress, the following resources are available:
- Call 911 or access your nearest Emergency Department/Urgent Care centre
- Wood’s Homes Community Response Team (CRT) for mobile family crisis support: 403-299-9699
- Distress Centre (24-hour crisis support): 403-266-HELP (4357)
- The Mental Health Helpline (24-hour telephone support): 1-877-303-2642
To find ongoing psychological support:
- Access Mental Health: 403-943-1500 ext. 2
- Psychologists’ Association of Alberta: https://psychologistsassociation.ab.ca/referrals/
Resources for your child:
Teen Talk: www.teentalk.ca
Kids Help Phone (call or text):
- Phone: 1-800-668-6868
- Text: CONNECT to 686868
Understood.org - Signs of Depression at Different Ages
Child Mind Institute - Signs of Depression During the Pandemic
Understood.org - ADHD and Depression: What You Need to Know