Caring for depression in children with chronic disease

A chronic disease diagnosis is difficult to accept at any age. When your child receives a diagnosis of a condition that will have lasting impacts on their life, they may have a strong emotional reaction or become depressed. The changes to their quality of life, such as chronic pain, frequent medical tests or care, or other lifestyle changes, can make them feel anxious, stressed and saddened.

In addition to the uncertainty a diagnosis brings and changes in lifestyle, depression can have a biological cause, says Lana Harder, Ph.D., pediatric neuropsychologist at Children’s Health℠.

Some neurological conditions, such as multiple sclerosis, can affect the brain and cause the development of depression symptoms. Other children may be genetically predisposed to depression. Nonetheless, a chronic disease may make it more likely a child will experience depression.

Parents of children with chronic disease should keep an eye out for symptoms of depression, helping their child receive the treatment and support needed.

Signs of depression in children

Dr. Harder says children may show different signs of depression than adults. Signs of depression in children and teens can include:

• Increased irritability
• Angry outbursts
• Emotional reactions that are disproportionate to a situation
• Withdrawing from friends
• Refusing to go to school
• Not taking pleasure in activities they used to enjoy
• Changes in appetite
• Changes in sleep (too much or too little sleep)

If you notice any of these signs in your child, Dr. Harder suggests you speak with the child’s medical team or primary care physician.

“It is beneficial to have ongoing conversations with your child’s chronic illness treatment team,” says Dr. Harder. “Ideally, the team would include an expert with experience in pediatric mental health.”

Treatment for depression in children with chronic disease

The first step in treating depression is to have a healthcare professional perform an assessment. The assessment can help identify depression, anxiety or other issues that could be affecting your child’s mood and behavior. You and your child may undergo interviews with psychology professionals during the assessment. The medical team may ask questions about your child’s symptoms and mood.

Based on this assessment, your child’s treatment team creates a plan. It might involve more acute inpatient care, family safety planning or outpatient appointments with a psychologist or other mental health professional.

“A combination of therapy plus medication can be incredibly effective,” says Dr. Harder. “That’s the good news. There are treatments we know work to address these challenging conditions.”

Your child’s treatment might include:

• A healthy diet
• Antianxiety medicines
• Antidepressant medicines
• Cognitive behavioral therapy
• Family therapy
• Group therapy
• Improvements in sleep hygiene
• Individual therapy
• Physical activity

“I believe every child is unique and their expression of depression can be very different from others, even others the same age,” says Dr. Harder. “That is why it is important that treatment is designed for each child. It’s not a one-size-fits-all situation.”

How parents can help children with depression

Dr. Harder says parents are key to helping each child receive support at home, not just when they are in therapy. It is important for parents to participate in the treatment planning with their child.

“We encourage parents to have conversations with the therapist while respecting the privacy of the child,” says Dr. Harder. “We develop a treatment plan together, and will often meet one-on-one with the child. After therapy, we invite the parent into the therapy room and talk about ways they can continue to support their child at home.”

For instance, if your child is learning coping strategies, your child’s therapist can help you recognize how and when to support your child in using that strategy outside of therapy. When you see your child using one of those strategies, you then have the confidence to positively reinforce the behavior with praise.

Children with chronic disease need support, care and love when coping with depression. Parents can take an active role in their child’s care, working with physicians, nurses and counselors to improve their child’s health and happiness.

Learn more

If your child has a chronic disease, find tips for helping them succeed at school. If you think your child is dealing with depression, learn more about psychiatry and psychology services at Children’s Health.