SingaporeMotherhood | Parenting

September 2020

Depression in Children: Spot the Signs and Seek Help Now

Depression in children is on the rise, and more kids in Singapore are seeking help for mental health issues than ever before. Child Guidance Clinics at the Institute of Mental Health (IMH) saw an average of about 2,400 new cases per year from 2012 to 2017. That means 2,400 children and teenagers aged six to 18 years old diagnosed with conditions such as stress-related, anxiety and depressive disorders every year at the IMH alone.

Yes, depression can affect children too. And just like a cancer, if left untreated, depression can continue to worsen. It can even lead to death.

In fact, suicide remains the leading cause of death for Singaporeans aged 10 to 29 years. According to the Samaritans of Singapore (SOS), there were 94 such cases in 2019, the same as the year before. The SOS hotline received 1,144 calls (and 678 emails) from those aged 5-19 years in 2019/2020. Tinkle Friend, Singapore Children’s Society’s helpline for primary school children in distress, received a total of 5,085 calls and online chats in 2019.

(See also: Child and Adolescent Suicides: How We Can Help Prevent It)

Facing a (Post) COVID-19 World

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Unsurprisingly, the COVID-19 pandemic has resulted in a spike in Singaporeans — including children — seeking help. The Straits Times reported that Tinkle Friend received 564 calls and online chat requests in April 2020 alone. Many of the calls were children worried about themselves and their parents contracting the virus. Others were stressed about Home-Based Learning.

The National Care Hotline that was launched on 10 April saw over 6,600 calls by the end of that first month. While not targeted at children per se, callers also include parents, grandparents, teachers… everyday people who contribute hugely to a child’s well-being. The rise in family violence cases since the Circuit Breaker lockdown period began certainly isn’t helping.

(See also: Expecting my first Baby during the Covid-19 Pandemic Lockdown)

Spot the Warning Signs

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How do you tell if your child is battling depression and how can you help It’s not always obvious when a child may be struggling with depression. Furthermore, working parents may not even have the chance to spend enough time with their children to notice anything amiss. These are some warning signs to look out for:

  • Expressions of stress, fear, anxiety or worry
  • Often sad or lethargic, struggling to concentrate
  • Becoming withdrawn and avoiding social activities
  • Repeatedly complaining of stomachaches or headaches, to avoid attending school or other activities
  • Displaying defiant or aggressive behaviour, often accompanied by angry outbursts
  • Changes in personality, becoming quieter or more talkative than usual
  • Changes in behaviour, sleeping habits or appetite
  • Temperamental changes and inexplicable mood swings
  • Highly self-critical or expressing hopelessness and worthlessness
  • Unexplained injuries such as cuts or bruises

(See also: When your Child has a Headache)

Ms Ann Hui Peng, Director of Student Service @ Children’s Society, one of 13 service centres operated by Singapore Children’s Society, suggests that parents start building a trusting relationship with their children from a young age. “This ensures that their children feel comfortable sharing their problems or worries. We advocate for parents to actively listen whenever their child initiates conversations on what is troubling them. Do not trivialise their sharing and revisit the issue later to ensure that the negative feelings are no longer troubling your child.”

Causes of Depression in Children

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“Youths in our modern society are faced with increasing pressure and multiple challenges. It is a period in life that is often confusing, leaving teens feeling isolated from family or peers,” explains an SOS spokesperson. However, problems can start long before the teen years, and children who don’t get adequate help can find themselves on a downward spiral as they get older, even continuing into adulthood.

So what causes depression in children to begin with? Ms Ann shares her observations: “Common topics that children approach Tinkle Friend about are school-related, such as too much homework, exam stress or disappointment over their results. Family and peer issues are also common. Some children also chat with Tinkle Friend simply out of boredom and loneliness.”

(See also: Theory of Mind – How It Helps Improve Your Child’s Friendships and Quality of Life)

Depression in children — and in adults — can be caused by any combination of factors. These can include physical health or even appearance, as well as happenings in their home, school or other environments. Major life events such as a divorce or death in the family can be especially traumatising. Children with a family history of depression are genetically more vulnerable to depression, as are those from chaotic or conflicted families. Depression can also be caused by a chemical imbalance in the brain.

How You Can Help Your Troubled Child

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It’s important to recognise that depression isn’t something that only happens to ‘others’. Parents are often unaware or in denial that their children are not as happy as they should be. If you suspect there might be a problem, here’s what you can do:

1. Offer a listening ear

Begin by encouraging your child to express themselves. The key here is to listen without judgement. Don’t tell them that they shouldn’t feel like that, but rather, reassure them that it’s ok to feel this way and that together you’ll figure it out. Getting them to talk about their problems is half the battle won. On your part, focus on their strengths and how much you appreciate their efforts.

2. Don’t be an intrusive parent

In a five-year study on primary school children, National University of Singapore (NUS) researchers found that children with intrusive parents — parents who exert undue expectations and stress on their children — tend to be overly critical of themselves. High levels of self-criticalness are linked to elevated depression and anxiety symptoms. Remind yourself that it’s okay if your child makes mistakes. Allow them to learn from it, rather than jumping in to correct them and prevent the mistake being made.

When parents become intrusive in their children’s lives, it may signal to the children that what they do is never good enough. As a result, the child may become afraid of making the slightest mistake and will blame himself or herself for not being ‘perfect’.

Over time, such behaviour, known as maladaptive perfectionism, may be detrimental to the child’s well-being as it increases the risk of the child developing symptoms of depression, anxiety and even suicide in very serious cases.

Assistant Professor Ryan Hong, Department of Psychology, NUS

(See also: Tweens: 8 Fail-proof Strategies to Better your Relationship with them)

3. Get ‘outsider’ support

An SOS spokesperson has this advice: “Some parents may find that their child resists their advances and isn’t willing to confide in them. When the child insists their parents just ‘don’t understand’, encouraging them to talk to someone else can be helpful.” This can be someone they trust, like a favourite cousin or teacher, or even a complete stranger. You can also offer them the following alternatives to turn to when they need support:

Specifically for children and youth:

Marital and parenting issues, and family violence:

Overall mental well-being:

sad child

4. Seek professional help

Remember, depression is an illness. Try to approach it objectively and don’t take it personally. If your child falls physically ill, you would take her to see a doctor, right? Remember, the sooner your child gets the treatment they need, the sooner they can start to get better. Consult your doctor or approach one of the organisations listed above. They will be able to advise you on suitable treatment options for your child.

The issues that a child shares may appear simple or minor to parents, but the magnitude and intensity of the issues troubling them may be significantly bigger in the eyes of the child.

Ms Ann Hui Peng, Director, Student Service @ Children’s Society

(See also: Parental Stress, Anxiety, and Burnout: are they happening to you?)

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Depression in Children: Spot the Signs and Seek Help Now