Patient Education and Depression

Pediatric depression affects millions of children worldwide (Giardino & Benton, 2016) and presents prevalently as a child ages. "The risk for depression increases during childhood" (Bonin, 2016). A comparatively common mental health problem that usually continues intermittently into maturity, pediatric depression may be brought on by various factors. It may be triggered by biologic processes, damaging experiences, or a combination of both. A main determiner for pediatric depression remains up for debate. What is certain, is that chemical changes in the brain bring in the closing common pathways to depression.

To help a child struggling with depression, it is important to understand and learn to identify the signs and symptoms. Major depressive episodes seen in pediatric depression frequently last anywhere from two weeks and include a minimum of five symptoms. A list of symptoms is provided below. Depressed (or irritable) mood Diminished interest or loss of pleasure in almost all activities 3. Sleep disturbance 4. Weight change, appetite disturbance, or failure to achieve expected weight gain 5. Decreased concentration or indecisiveness 6. Suicidal ideation or thoughts of death 7. Psychomotor agitation or retardation 8.

Fatigue or loss of energy 9. Feelings of worthlessness or inappropriate guilt (Giardino & Benton, 2016, p. 1). For these symptoms to count towards a diagnosis, they must cause major impairment/distress of vital functioning as well as must not be attributable to a pre-existing psychiatric or medical condition or the direct action of a substance. Chronicity, seasonality, catatonic/melancholic features, and psychotic symptoms might or might not happen with depression.

Some atypical features can exist with depression that include mood reactivity as well as a minimum of two of the following for a minimum of two weeks. They are increased sleep, major weight gain and/or increase in appetite, major impairment in occupational/social functioning stemming from a pattern of long-term interpersonal rejection sensitive, and feelings of heaviness in legs/arms. Some organic etiologies may imitate pediatric depression such as medication, tumor, endocrine disorder, neurologic disorder, and infection.

While there are no laboratory assessments that would be used for diagnosis of depression, workup can be performed to assess the patient's state of health. Treatment options vary but typically include cognitive-behavioral therapy, pharmacotherapy, interpersonal therapy, behavior therapy, group psychotherapy, family therapy, or psychodynamic psychotherapy. A psychiatrist may or may not prescribe medication in the realm of anti-anxiety or anti-depressant medications like MAOIs, TCAs, and SSRIs (Moreland & Bonin, 2016).

Psychiatrists greatly prefer SSRIs as the main choice of medication for pediatric depression due to less adverse effects seen in the class of medication treatment. Depending on severity, age of patience, number of previous episodes, subtype, contextual issues, and chronicity, pediatric depression may be treated with just therapy or a combination of therapy and medication. A 2016 article on pediatric depression noted the lack of effective CPGs or clinical practice guidelines for treating and managing symptoms; stating only two existed to help manage depressive disorders in teens and children.

Those are "the National Institute for Heath and Care Excellence and the Beyond Blue CPG. These CPGs aim to provide strategies to treat depression in minors in a way that is multi-faceted and comprehensive, giving options to patients suffering from a varying degree of depression. Because depression has no definitive cause, it is important when treating children and teens, to aim for treatments that cover several areas and promote progress in the patient towards self-awareness, self-regulation, and creation of positive coping mechanisms for anxiety and stress.

In terms of differential diagnoses, the same diagnostic criteria considered for depressive disorders is used for teens and children as for adults (Bonin, 2016). If a pediatric patient manifests symptom clusters like hypomania/psychosis, seasonality, or atypical symptoms the diagnosis may be MDD or Major depressive disorder. Should a patient's depressive state change to a manic state, it could mean pediatric depression may have been a precursor to bipolar disorder. Youths experience depressive and manic symptoms in a mixed episode.

Other comorbid symptoms associated with pediatric unipolar depression is anxiety, attention deficit hyperactivity disorder, substance abuse, PTSD, and sleep disorders. Potential health risks associated with pediatric depression are: hard drug use, smoking, early sexual debut, marijuana use, and disordered eating. The list of differential diagnoses are as follows: Pediatric Generalized Anxiety Disorder, PTSD, ADHD, and Pediatric Bipolar Affective Disorder. Prognosis for pediatric depression depends on level of severity of symptoms for the patient among other previously discussed criteria.

The first line of treatment is often therapy in the form of CBT and/or a combination of pharmacotherapy. Evidence-based practice suggests cognitive-behavioral therapy as effective for mild to moderate episodes of pediatric depression. However, with moderate to severe depression, use of SSRIS such as fluoxetine, citalopram, and sertraline have provided relief along with CBT. When youth display major depression coupled with psychotic features like auditory hallucinations, that is indication for hospitalization. A patient with demonstrated suicide ideation and concrete planning may also warrant hospitalization.

While mild depression may see an early prognosis of recovery, moderate to severe depressive episodes may take years to see improvement. Meaning depression may end up as a chronic condition where up to 85% of youth with depression experience a recurring episode within fifteen years of the initial episode (Bonin, 2016). Some complications come from depression because of the increased risk it puts suffers for development of a variety of other psychiatric disorders and health problems.

For example, children and adolescence suffering from depression may experience poor academic performance and engage in risky behavior like early sexual intercourse and substance/drug abuse. Those that experience complications from depression typically end up having trouble as the mature at maintaining employment, and dealing effectively with social or family disruptions. It is important for those with depression to learn how to positively cope with normal life stresses to lead productive lives when they reach adulthood. Patient education is an important part of dealing with pediatric depression.

Patients must learn ways of dealing with the anxiety and the difficulties experienced with depression. For example, exercise and healthy eating help minimize symptoms of depression in many people (Giardino & Benton, 2016). Consistent exercise helps rebalance neurotransmitters in the brain and can help patients handle stress. The same goes for a healthy diet high in.