Depression in children and adolescents: an adult thing

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Depression can occur in young people. Reasons for bullying and exclusion are often. The treatment opportunities are good. A doctor of child and adolescent psychiatry reported developments in the therapy.

Deutsche Welle: Mr Kölch, Figures of the Foundation German depression aid, the three to ten percent of all young people between 12 and 17 years suffer from Depression. How is the judge? There is a rising trend?

Michael Kölch: There is no direct evidence that the disorders are on the increase. Depression are now recognized better and observed, in addition, a better supply situation. You can definitely say that there is now increased attention and sensitivity to the issue. This has the positive consequence that those Concerned are also more likely to have mental health problems.

Prof. Dr. Michael Kölch is a specialist in child and adolescent psychiatry and psychotherapy

Depression in adults is much spoken of more often. What are the reasons that children and adolescents suffer from depression?

The causes of Depression are very different and individual. Classic trigger so-called “Life Events”: moving house, separation of parents, loss or illness of a parent, bullying. As an especially severe “Life-Events” are Neglect, Abuse or see abuse experiences. More but can also lead to a permanent Over – or under-demand or ongoing dispute relations to depressive symptoms.

More: Every second Teenager in the world of violence or bullying in the school

Dispute family relationships can impact children mentally.

What can be other causes? Can, for example, have high media usage of young people to influence the risk of Depression?

Purely clinically, we see that some depressed patients are busy on the Computer or Smartphone and thus social limit. This can lead to lack of concentration and to a shift in the day/night rhythm. And of course, there are the Internet direct risks, such as cyber bullying, which can be a cause of a depressive disorder.

In the case of intensive media can contribute to consumption, thus to the triggers of depression – but to say generally: “Because of the new media are more depressed or conducive to depression” – for which we have no note and would be brought to far away. Because it always depends on how the whole social integration and the direct environment of an Individual. If the media is using the only social contact and the only employment, then, is to be regarded, under certain circumstances, be problematic. But if the child has, for example, otherwise, an active circle of friends, then it can deal with still three hours a day with media. This is not necessarily a risk factor, but part of everyday life for the youth of today: contact via the new media has for some equivalence as in the past, for example, the telephone or direct contact.

Therefore this should be considered in a differentiated way, not everything is bad. It also allows for opportunities: in the Meantime, there are preventive or therapeutic measures, through the modern media such as Apps.

Young people spend a lot of time with Smartphone, Computer and co. – can lead to mental health problems?

How can parents recognize that their child is suffering from Depression?

Until puberty, the is relatively simple: If the typical behavior of the child changes when it is suddenly socially withdrawn, tired on the games and also irritated, and sad. In adolescence this can be more difficult, because many symptoms of depression can have a high Similarity to the behavior and feelings of young people in puberty: mood swings, interests shifts, loss – all of which can also occur in puberty. But always if the symptoms last longer and function limitations you should be attentive: The young people living a reclusive life, there is a performance articulated in the school, it comes to self-conduct that violates that Sense of zero gravity, or thoughts of Death. These are serious warning signs.

How important is it that a Depression is detected at an early stage?

There are two principal points why it is important to recognize depression early and treat. The first point is that depression generally lasts a tendency to chronicity – the longer, the more severe and persistent the symptoms are. This also makes the treatment more difficult. If early intervention can be manufactured with smaller and shorter interventions improvement.

The second point is that depression have a large impact on the psycho – social level of functioning-that on the everyday lives of young people. In view of the fact that the period of childhood and adolescence is a particularly eventful and future, can have a Depression also impact on decisions such as secondary school or vocational choice.

By depression whole problem can arise plaits. An example: A child gets because of a traumatic event Depression. This can cause it to get bad grades and that is why a class needs to repeat. The next risk factor arises: It loses his / her usual social environment, perhaps his best friend. In the new class, it is inhibited that is why social is hard to friends and can be a victim of bullying. So an arisen problem mesh to resolve is therapeutically difficult. But it is possible, therefore, it is very important that at a young age and early intervention.

By depression the problem of fencing, which can increase further.

What should I do if I notice that my child has the symptoms of depressed? What are the treatment options?

There are established child and adolescent psychiatrists and psychotherapists, child and adolescent psychotherapists and clinics, hospitals with outpatient clinics and day. The can get the contact person where you both make an informed diagnosis, as well as the necessary therapy.

If it is a lighter Depression, may be a short intervention is sufficient to increase the level of functioning. Maybe in the Form of an advice or a supportive observation. It is, however, a more severe Depression, due to which, a school visit is not possible, many social contexts are broken away, or suicidal thoughts? Then may pulled a full or partial in – patient child and youth psychiatric treatment into consideration. This can be supported by medication: antidepressants can help, that the psychotherapy can work better. However, the use of drugs in young patients, it is only on the very persistent, and moderately to severely depressed cases limited.

In the case of severe depression a hospital stay is usually necessary.

Depressed adults wait in Germany, under certain circumstances, for a very long time on a psycho-therapeutic treatment or a hospital stay. As in the case of children and young people – there are long waiting times? And there are enough facilities?

Actually, there are enough facilities. Unfortunately, it is a question of the supply of justice. There are cities with a very good supply. And there are rural regions where, under certain circumstances, within a radius of 60 kilometers is not a child and adolescent psychiatrist or psychotherapist for children and adolescents.

And unfortunately, Yes – there are also in children and adolescents waiting times. The regional is very different and depends on how big the capacity is and how strong the rush is. So, waiting for a therapy place to a place can be up to three weeks, and at the other to two months. There are, however, in the case of emergency treatment in hospitals and outpatient institutions, which can be contacted in case of an emergency.

In the meantime, there are plenty of offers on the Internet that deal with depression. This ranges from the exchange platforms to the first self-assessment to Online therapy measures. How effective these platforms can be, especially in relation to young people? And: Can counter such media-based treatment options of the listed supply to injustice?

In the research, “E-therapy” is a large topic. Here will arise in the future, some of the development possibilities and opportunities.

These General prevention programmes, such as exchange platforms can be a good start, when it comes to first aid. And just in the case of young people, who are much in the Internet. The big question here is: How do you design these platforms so that they are subsequently also effective? Say: you must go to the young society to be tailored for early depression intervention.

A self-help platform of the Foundation German depression aid: Fideo – fighting depression online

In addition, therapy offers under the addressed aspect of the supply of justice will be Online-an important point. Because of long paths to the therapy space can be an additional burden. Therefore, therapy offers, such as a via Apps a meaningful and effective way in order to meet the supply shortages. The big Problem is that Such programs sometimes have drop-out rates of up to 80 percent. Therefore, there is still plenty of scope for improvement. A Consideration is a model of “Blended Therapy”. This means that there is still need to the therapist contact, but some of the therapy elements of the media be supported. So, we hope to follow us for the future even better therapy.

May occur not struggled with Depression in adulthood?

Depression is generally treated or untreated – have a high tendency later on. It is estimated that up to 60 percent of those who had a depressive Episode will suffer up to the age of 30 years, again a Phase. Therefore, it give also important in the young patient: If the symptoms come back, then immediately seek help. And it is not until severe stages.

If Depression is detected early – what are the chances of Healing?

Depression in adolescence can be treated as a serious depression in adulthood. There are studies which show that 60 to 70 percent of depression in adolescence are improved after 12 weeks of Intervention really good. This is also true for severe depression. And this is an important therapeutic optimism, you have to communicate to the patient.

Michael Kölch is a Professor at the Medical University of Brandenburg for children and youth psychiatry and for the past three years, chief physician of the clinic for child and adolescent psychiatry and psychotherapy in the Ruppiner clinics.

 


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