How can I help my child with depression?
Having a child with depression can raise strong feelings in parents: sadness, frustration and guilt to name a few. It can also give rise to questions about the causes, and confusion over how to help.
Depression is usually diagnosed based on well-known problems like prolonged feelings of sadness and a loss of pleasure in everyday activities, but it can also present as low appetite, sleeplessness and a reduction in movement. In severe cases, young people may feel so hopeless that that they begin to consider suicide.
When faced with a young person who feels change is impossible, it can be easy to become pessimistic ourselves. All our attempts to change their point of view are rubbished and every suggestion dismissed. Yet it is vital that we as adults keep faith that change is possible and support a sense of hope in the young person.
If you think your teenager may be suffering with depression, contact their GP or seek advice from an expert in child mental health. Even the best possible treatment, however, is no substitute for a close and supportive relationship with a parent or other responsive adult. Here are three of the most important ways you can support your child at home.
1. Support basic needs - sleep, nutrition and exercise
Attending to basic physical needs is vital in supporting mood. Encouraging your child to sleep, eat and exercise may not feel like it will change much, but it really can help in reversing the processes of depression. It also sends a powerful message that you care and want them to look after themselves.
Insomnia is a symptom of depression, and many young people tell us that the same negative thoughts about themselves that make them feel low during the day also keep them up at night. However, some teens may begin to sleep more, especially during the day, as a way of escaping from difficult thoughts and feelings. Either scenario can lead sleep to become dysregulated, and in the worst case they may become completely nocturnal. This can prompt a negative spiral, as feeling tired or missing out on potentially rewarding activities during the day will further impact on mood. Click here for advice on supporting good sleep.
In an experiment in the 1940s (which definitely wouldn't be allowed today) it was shown that if you take perfectly healthy people and drastically reduce their food intake, those people begin to experience many of the symptoms of mental health problems. It's therefore vital that already vulnerable people eat sufficient food for their needs. Low blood sugar can make us feel tired and irritable, so it's important to eat regularly during the day. Getting a good balance of nutrients is also important to mental health; for example, amino acids (from protein) and fatty acids (from healthy fats) support the brain to function optimally, including in the regulation of mood.
Finally, exercise functions in a number of ways to improve mood. First, exercise triggers the release of endorphins, our body’s natural pain killers, which reduce feelings of stress and produce a “feel-good” high. It can provide feelings of accomplishment and improve self-esteem. Exercise can also have a positive impact on sleep and appetite. Getting out for a brisk walk a few times a week can be enough to make a difference, and if that means doing so as a parent and child or as a family, so much the better. Which brings us to our next point…
2. Help them engage in rewarding activities
One of the fundamental tenets of cognitive behavioural therapy for depression is that negative thoughts about ourselves and other people mean we are less likely to take part in rewarding activity. Reduced activity in turn confirms negative thoughts, for example, that we are “useless” or “lazy,” and so the cycle continues. Activity scheduling provides a way to systematically reverse this process, but it requires faith that it will work and plenty of support from those around us when things feel difficult.
Research has shown that activities are most likely to improve our mood when they fulfil three simple criteria, following the acronym ACE. Aim for each of the activities you include in a schedule to fulfil at least two of these.
Achievement - Activities that foster a sense of achievement contribute to self-esteem. This doesn’t have to mean running a marathon - when depression is at its worst, even getting out of bed and brushing your teeth can feel like a step forward. The important thing is that the activity provides a sense of accomplishment, regardless of how small it might appear to others.
Connection - Humans are social animals, but many people with depression experience a profound sense of disconnection from those around them; in fact, experiences of exclusion and difference can in many cases contribute to the onset of depression. Activities that generate what psychologist Peter Fonagy calls the we-mode counter this sense of isolation. Friendly team sports are one possibility, but even carrying out a simple task alongside another person can be enough.
Enjoyment - Although many teens with depression lose interest in things they used to enjoy, with some thought and ingenuity it is usually possible to find something that will raise a smile. Sit down and watch an episode of their favourite comedy together, take a trip to the beach or book a round of crazy golf. Reminding young people that they are still able to feel pleasure can address low mood and provide hope that things might be ok in the future.
Click here for a free activity schedule template. Take a moment to sit down with your teen and identify some simple activities to try in the next week; then, gain a commitment to giving this a go, in the knowledge that they might not feel like it on the day. It’s great to schedule one activity a day, but if this feels like too much, schedule what feels possible, then help them pay attention to the difference in their mood when they have tried something new.
3. Prioritise your relationship
Psychologist Steve Biddulph makes the point that, when many of us look back on our happiest memories of childhood, it is the times when we had our parents’ undivided, unhurried attention that we remember most fondly. In order to feel safe enough to trust us with their feelings, teens need to know that we are not watching the clock, not thinking about that important work presentation next week. When we make time to sit down and ask about their day, play a game or listen to their favourite new band, we are sending the message, You are the most important thing to me, and I am here to help you come back from depression, for as long as that takes.
Despite our best efforts, however, supporting a child with depression can make us feel useless, exhausted, even angry. All too easily these feelings can leak out and turn into an argument, one that leaves both sides feeling guilty and dejected. To avoid this, we need a supportive network around us to whom we can express these feelings safely. This helps us to keep our own emotional temperature low enough that we can still think about what is going on for our children. If you don’t feel comfortable talking about such problems to your friends and family, consider seeking out a support group for parents of children with mental health problems, like those run by Parenting Mental Health.
When things have become heated, don’t brush this under the carpet. Young people need to learn that ruptures between loved ones are not catastrophic and can be repaired. If arguments go unremarked, teens with depression may take this as confirmation that they are broken or a problem for others. When you are both calm, find a way to validate their feelings and acknowledge your own mistakes:
“I can understand you might have felt hurt by what I said, and I’m sorry. I think I was feeling upset that what I was doing didn’t seem to be helpful. Let’s see if you can help me understand what you’re going through, so that we can work out a way I can be helpful to you.”
If you have taken time to have conversations about the things in this article, you are already well on your way to building a nourishing relationship with your child that will support them on the way to recovery.
All of us feel low from time to time, especially when we are subject to unusual stressors such as grief or a setback in our work or academic life. If low mood persists for a number of weeks and is accompanied by other symptoms of depression, consider speaking to your child’s GP or a mental health professional to find out whether psychological therapy could help.