I know from experience that of the biggest challenges in parenting is knowing how to help a child who suffers from depression. The recent CDC report about our teen mental health crisis shows that more and more us are facing that challenge. Young people who have suffered childhood trauma also are at higher risk for mental health problems, including depressive disorders, so it’s something that we have to watch for in our foster children and stepchildren.  

        Of course, the first line for treatment of depression is mental health professionals, but there are some important steps we can take to help our family members suffering from mood disorders.  Below are some science-based techniques that I wish I had known much earlier. Every child is different, and we don't have studies for every age group, so some of these tips may work better that others for your child. Odds are, though, that something on this list will help you be able to help your child who is struggling with depression.

        • Sadness Is Not Depression

        The first thing we have to understand is that depression is much different from sadness. Everyone has times when they are sad. We will lose friends, jobs, pets, or even family, and it is perfectly normal and appropriate to be sad about those losses. Our kids will not be able to avoid things that make them sad, and part of growing up is learning how to deal with that temporary sadness. Some psychologists have criticized current mental health trends as “medicalizing sadness,” or treating ordinary sadness as a mental health disorder.  

        Furthermore, traditional and social media can give us and our kids an unrealistic view of normal life, making us think that our low time are unusual and require professional help. We have to be careful that we don’t buy into that philosophy. Instead, we need to help our kids navigate sadness and learn the life skill of dealing with bad events.  Even young children can learn (and need to learn) how to move past temporary sadness.

        Depression, on the other hand, is not temporary. It is both extended and debilitating. We shouldn’t dismiss our kids’ sad feelings that last for weeks, particularly when those feeling interfere with their daily lives. Those extended moods require that we pay attention to the distinct possibility of mental health issues.

        • Find Professional Therapy

        If you believe that your child is struggling with depression, find a good therapist who understands the issues and enroll either individual or family therapy or both. Two treatment options that have been proven to help with major depressive disorder are Cognitive Behavioral Therapy (CBT) and Dialectical Behavior Therapy (DBT). CBT focuses on changing thinking patterns and developing problem-solving skills. Abundant research has found that CBT is very effective in treating depression. DBT is a type of CBT and was initially designed for tough-to-treat patients, such as those with borderline personality disorder or suicidal behavior. Recent research shows it to be effective for helping other people suffering from depression.

        If your child’s depression may be related to trauma, then be sure you choose a therapist who understands how to create a treatment plan that deals with that trauma. Trauma-focused CBT is a model that uses trauma-sensitive CBT interventions. Recent studies have shown it to be effective in reducing depression symptoms.  DBT has trauma-responsive components built into the protocol.  These mental health services can provide an effective treatment for major depression

        Acute depression can require medication. However, all medication comes with side effects, and depression meds are no exception. The most serious side effect is that suddenly discontinuing psychotropic medication can cause relapses, complicate recovery, and even increase suicidal thoughts. Unfortunately, teens are impatient, and in my experience they are prone to giving up on medication when it doesn’t solve problems right away. Policing them to be sure that they are taking their medication regularly can cause a lot of family conflicts and increase the stress underlying their depression. So think carefully through all of the ramifications before starting a medication regimen with your child.

        Definitely always pair medication with regular talk therapy. Good mental health care involves many different tools.  CBT actually can be as effective as medication alone, and some model of therapy is essential for our kids to learn the skills they need to learn in order to handle depression symptoms.  

        • Limit Social Media

        Fortunately, there are some things that you can do at home in conjunction with professional help. One of the most helpful seems to be limiting children’s access to social media. The problem is so new that there is not much research on the topic. But we do know from the recent CDC report that the number of high school students in the United States who experienced persistent feelings of sadness or hopelessness (i.e., depression) increased from 28% in 2011 to 42% in 2021. The biggest spike coincided with the COVID lockdowns, but the trend was upward even before the virus.  

        The greatest increase in depression symptoms was among young women, with the percentage rising from 36% in 2011 to 57% in 2021. Young men, by contrast, showed a more moderate increase from 21% in 2011 to 29% in 2021. Social psychologist Jonathan Haidt has argued persuasively that the increase coincides with increased teen use of social media. Other studies show a high correlation between frequent social media use and depressive symptoms. At the least, excessive social media use can be a factor in teen depression.

        It’s easy to say “limit social media,” but very difficult to actually do it. The task can be particularly challenging with foster children, who often view their cell phones as their only lifeline to friends and family. Cutting off that lifeline can be both disruptive and harmful. Even stepkids who have not suffered trauma will resist losing their ability to communicate with their biological parents. In both cases, we have to approach the question very carefully.

        The good news is that at least one systematic review indicates that the effects of social media on teenagers are highly individualized.  Social media has many positive aspects, such as increased information and the ability to connect to people at long distances. Teenagers who know how to use social media in a healthy way, for example, resisting or avoiding cyberbullying, for example, can benefit from social media, or at least be a lower risk of depressive symptoms.  Furthermore, teens and older children can learn to like less social media in their lives. One recent census found that 84% of teens use social media, but only 34% of them say they enjoy it “a lot.”  You might be surprised to find that your children will appreciate your taking the lead in disengaging them from social media.

        As with almost all habits, a gradual limitation is easier than a sudden prohibition. Consider having “electronics-free” times or zones in the house. During those times, have a substitute available, such as a family game night or group hike or the like. Above all, be prepared to model good behavior by giving up your cell phone periodically. This article has some good tips for healthy social media use, including how to develop a family media plan.  At the very least, have long and in-depth conversations with your kids about the family rules.  Then be prepared to capitalize on all of the small effects that you see from the new limits.

        •  Help Them Build Coping Skills

        Help your kids develop healthy behaviors and habits that might help stave off depression.  Of course, some children will listen to you more than others, but find ways to encourage all of your kids to find ways to help themselves. Some of those habits include:

•  Regular Exercise — Regular physical activity not only helps physical health, but it has a positive effect on mood and can reduce symptoms of depression in teens. The more they can get out of the house (and away from social media), the lower their risks of severe depression.

• Mindfulness — Mindfulness-based interventions have shown great promise in reducing anxiety and depression. Those interventions include meditation, yoga, deep breathing, and prayer.  You can find some possible exercises here and here. This list of books for teens also may be helpful.

•  Nutrition — Some studies suggest that nutrition can play a role in depressive symptoms. It certainly won’t hurt to encourage teens to avoid sugar, carbohydrates, and fried foods as part of a healthy lifestyle. We can control the food that we have in the house and that we serve our kids. Life-long good nutrition, however, requires that our kids develop their own habits. So, again, we need to encourage them to develop their own good habits.

•  Sleep hygiene — Many studies have shown a strong association between sleep deprivation and teen depression. Having them get enough sleep is not just a matter of going to bed earlier. Studies show that teens naturally shift to a later sleep cycle in middle adolescence. In other words, they simply fall asleep later, no matter what time they go to bed. Many school systems have recognized this research, and have shifted to later start times for middle and high schools. If your child’s school is stuck in the old schedule, you will have to find other ways to help your teen get enough sleep, such as limiting their work hours or letting them sleep as late as possible in the mornings.

                 

        •  Give Them Independence — Our tendency as parents is to try to fix things for our kids, including protecting them from unpleasant experiences. Numerous studies, however, show that encouraging independence helps our kids avoid clinical depression and build resilience. Being too involved with our kids actually increases their risk of suffering an anxiety disorder both now and when they grow into young adults. Our kids will be much better off if we instead concentrate on creating a loving, stable environment in which they feel safe making their own decisions and learning from failure.

        • Help Them Find Social Support — Finally, help your child build a social support network. A strong support network is important for teenagers who are experiencing depression. Several studiesshow that children and teens with strong peer support, particularly at school, show fewer symptoms of depression. Studies of resilience have found that a sense of belonging to a community is strongly associated with resilience and overcoming trauma.

        We can’t simply manufacture social support for our kids. What we can do is encourage them to participate in group activities where they can build positive relationships. Encourage your children to reach out to family and friends. Help them find group activities that they enjoy. Even introverts can find activities, perhaps in smaller groups, where they can build relationships over shared interests and community projects.

        Our country is in the grip of a mental health crisis, and our kids are not exempt.  Helping our kids recover from their trauma requires that we be ready to help them cope with any depression that they may experience.  These science-based techniques may not work with every child, but they offer us a solid place to start helping them.

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Debbie Ausburn

Helping foster parents and stepparents learn how to be the person who is not supposed to be there.