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3.2 Signs of stress and depression

Stress and depression in children are caused by a combination of external and internal factors. Outside the child, there is perceived turmoil and tension either at home, at school, or with peers. Inside the child, there is intensely felt frustration, fear, and uncertainty. For maltreated children, there are the added elements of horrible past experiences and possibly the lack of permanence in their lives today.

As the child's fear and frustration increase, the perceived turmoil and tension increase. This in turn increases the child's fear and frustration. The vicious circle builds and the child becomes less able to cope. The result is mounting stress and deepening depression. To help, you need to first slow and then stop the vicious circle.

To help a child, the first order of business is to never add fear or frustration to the equation. To some extent, the child feels out of control. You must provide the personal and emotional control the child is seeking, keeping in mind it will take time and patience. You certainly can't do that in an hour or a day and it may take weeks and months.

For a specific child in care, you may need to work with the available professionals to develop an intervention and support plan. For all children, though, the plan will include the following techniques. After each technique, write a sentence or two about why it is appropriate for children.

•           Patience, patience, patience.

•           Staying calm and open to the child.

•           Being available to sit with and listen to the child. (Note this doesn't call for your talking much or offering advice and suggestions.)

•           Being gentle but firm with the child in terms of your rules and expectations. ("I know you are having a rough time of it; but you still need to. . . .")

•           Trying to understand the external problems and issues from the child's point of view. (When you can quietly explain things in a way that fits how the child perceives them and see why the child is so upset, you have reached empathy: you and the child are on the same page.)

•           Offering other ways of thinking about or looking at the situation, without judging or contradicting. (If the child tells you that you don't understand or your ideas are stupid, you can say, "I guess I don't get it yet. Help me understand why what I said was stupid. It isn't much fun being stupid. Will you help me get smart about this?")

If any of the following signs has been noticed within the past couple of weeks, stress and depression are likely a problem. Be sure to talk with the child about your observations and share your concerns. Listen carefully and start developing your plan to help. After each of the following signs, write a sentence or two about what you think may help the child with the problem.

Signs:

•           Frequent restlessness and trouble calming down.

•           Frequent sleeping problems or bad dreams. (Also might have nightmares.)

•           Frequent crying or getting upset very easily. (Also might have crying spells.)

•           Frequently losing his temper very easily and quickly, with little to no provocation. (This can be easily misinterpreted as a behavior problem.)

•           Frequently worrying and fretting about not doing things well enough and about failing.

•           Frequently not starting things because he assumes they will turn out badly anyway. (Also, past life experiences may cause the child to be afraid of adult reactions if the child displeases them.)

•           Frequently giving up on tasks and activities too quickly.

•           Frequently not liking himself. (Also might put himself down.)

•           Frequently not feeling like he fits in or belongs anywhere.

•           Frequently not feeling loved by anyone.

•           Becoming extremely embarrassed over something and not being able to deal with it or get over it.

•           Not getting over a serious loss or disappointment.

•           Feeling unable to do anything about what happens to him.

•           Talking about or threatening suicide. (This isn’t normal behavior and must never be disregarded as something the child is just doing for attention.)

Discussion point:

•           How might differences such as racial, economic, religious, language, developmental, or disabilities contribute to stress and depression for children in care?

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Please send comments or questions to Gary A. Crow, Ph.D. GAC@GaryCrow.net