PAEDIATRIC DEPRESSION: AN OVERVIEW ALONG WITH CONVENTIONAL AND HOMOEOPATHIC TREATMENT
Dr. Trapti Goel
(MD scholar, Department of Repertory, Bakson Homoeopathic Medical College & Hospital, Greater Noida, UP)
(BHMS, Nehru Homoeopathic Medical College & Hospital, University of Delhi, Defence Colony, New Delhi)
Abstract: Depression is a common condition among children and adolescents, with lasting detrimental effects on health, and social and occupational functioning. In this article we will discuss about depression in paediatric age group, about how to identify a child with problem, its management with conventional treatment and with Homoeopathic treatment.
Introduction: “Depression”, whenever we come across this word, we think of a man or woman going through a tough phase. Basically, we think of an adult suffering from a mood disorder experiencing feelings of sadness, loss, or anger that interfere with a person’s everyday activities. But have we ever pondered how much it affects children and teenagers? It is less discussed but a very serious issue.
Depression in children has always been a difficult topic to comprehend, both for society, and for healthcare professionals. There are also several myths around this: that children are too young to be depressed; that real depression occurs only in adulthood; and that the sadness is just a phase and children will grow out of.
In the World Health Organisation (WHO) report, ‘Health for the World’s Adolescents’, depression is highlighted as the main cause of illness and disability, for children and adolescents aged 10 to 19, and suicide is the chief cause of death after traffic injuries and HIV/AIDS.
Causes: The one who can get trapped in this depression has got some biological and genetic basis. It is noticed that the children with the family history of depression has got greater chances. Even familial and social factors can dwell the child into this annoying situation.
This is situation often pass unnoticed since it is often believed that a child won’t feel emotions intensely. But the tender heart of child notices simple things like separation from mother’s lap, fights of parents. Even the period of transition, the bodily changes physical and hormonal may not be as smooth as it should be leading to certain changes in the behaviour. It is a topic of concern since if this condition persists, it will surely affect child’s adulthood and degrade the quality of life, not just his but also of the family.
In today’s competitive world, children have lot of pressure to excel not just in academics but also in extra-curricular activities. This force them to conform strict rules and schedule. Some, children who cannot handle such pressure become susceptible to depression. So depressive cases are not only increasing among adults, but also among children, with a prevalence of 0.3% to 7.8% in children below 13 years old.
Several factors can lead to depression in children:
- Problems in learning can affect the self -confidence.
- Prolonged mental stress arising out of conflicts at home, for example, conflict with the family or between parents.
- Traumatic events such as violence, physical or mental abuse, or neglect
Depression among children can vary from being mild to moderate or severe.
Mild depression can cause a child to feel unhappy, but the child will be able to lead a normal life. The child may not show much interest in doing daily tasks or school work, but with the parents’ support and with simple lifestyle changes, the child can recover from mild depression.
Moderate depression can significantly affect the child’s life. The child may constantly feel miserable and low.
Severe depression can cause the child to feel worthless. The child may also have constant negative thoughts and feelings of sadness that he or she is unable to cope with.
Other way to classify Types of depression in children:
1.Acute depressive reactions: These are sort of healthy grief response following death or separation from loved one. These resolve in due course of time, occasionally after weeks or months.
2.Neurotic depressive disorder: These are unresolved grief reactions and are characterized by a feeling of guilt in relationship to dead.
3.Masked depression: This kind of depression is by denial and somatization of feeling of despair, hopelessness and helplessness by the adolescent. Its manifestations include school frequency, running away from home, multiple accidents, unexplained headache, abdominal pain etc.
4.Psychotic depressive disorder: It may have additional manifestations such as delusions of guilt, impaired reality testing and thought disorder.
Identifying depression in children:
Children who are less than eight years old and who experience depression may display the following behaviors:
- Clinging to parents
- Frequent tantrums or crying spells
- Drastic changes in sleeping and eating habits
- Refusal to go to school; losing interest in studies; to play with friends.
- Frequently complaining about headaches or stomachaches that don’t respond to treatment
Sometimes child may display these symptoms but if these symptoms are observed consistently for two or three weeks at a stretch, there is a possibility that the child may have depression. It is best to seek help to understand what the problem is.
Identifying depression in adolescents
Children over the age of eight years, and adolescents, show symptoms of depression similar to that seen in adults. These may include:
- Changes in sleep and appetite
- Sadness of mood
- Frequent mood swings
- Lack of interest in pleasurable activities
- Feeling lethargic s of the time
- Aggressive behavior
- Feeling of worthlessness.
- Talking about suicide, or actually attempting suicide.
When we are talking about these, one should be keen in observing signs and symptoms and understand what is normal. A two-year-old throwing a tantrum, Behavioral irregularities existing for a few hours or days; or have certain fears which do not impair their functioning are normal.
Need for treatment:
An eight-year-old is frequently throwing tantrums (developmentally inappropriate)
Behavioral irregularities are shown over 2-3 weeks.
Moods, symptoms or fears affect:
- The child’s functioning or self-care. The child does not eat, sleep or groom themselves regularly.
- The child’s social interaction: They refuse to go out to play with friends, or to spend time with family. They withdraw into their own world.
Role of family: Parents play a substantial role in shaping the emotional health of children and adolescents. Helping parents recognize that mental health includes family dynamics as well to improve treatment response.
Role of Diet: According to studies, a number of nutrients such as omega 3 fatty acids, vitamins D, E, B6, B12, and folate, magnesium, zinc, iron, copper, calcium, and tryptophan are important in the prevention and treatment of depression. Healthy dietary pattern including vegetables, fruits, dairy products, nuts, olive oil and green olive, fish, legumes and whole grains are rich in these nutrients.
Omega 3 long chain polyunsaturated fatty acids produce anti-inflammatory eicosanoids, which reduce the levels of pro inflammatory cytokines in depressed patients.
Unhealthy dietary patterns with high consumption of soda, sweets, and saturated fatty acids and low consumption of vegetables and fruits usually have inadequate amount of folate, magnesium, and n-3 unsaturated fatty acids. These nutrients are beneficial against depression.
Conventional Treatment: If a child displaying the symptoms listed above, consult a paediatrician or a mental care expert. Young children with mild to moderate depression can get better with therapy and other forms of treatment. Techniques such as art and play therapy can be very useful in helping them cope. Older children and adults may benefit from Cognitive Behavior Therapy (CBT) and similar therapies.
Children and adolescents with mild depression or anxiety primarily require therapy to cope.
Children with severe depression or anxiety may require medication in addition to therapy.
Homoeopathy and mental illnesses
Homoeopathy has history of successfully treating various psychological illnesses. Even before Dr. Hahnemann developed Homoeopathic science, he made important contribution to mental health care, being one of the few physicians of his time who perceived mental illness as a disease that required human treatment rather than confinement or punishment.
Homoeopath commonly treat both acute and chronic psychological disorders, including depression. The homoeopathic understanding of health is intimately connected to its understanding of mind in general. It is believed that mind and body are dynamically interconnected.
Common Homoeopathic remedies:
Homoeopathic medicines can be used on the basis of the similarity of drug symptoms with totality of symptoms of patient.
Argentum Nitricum: Thinks his understanding will and must fail. Fearful and nervous; impulse to jump out of window. Faintish and tremulous. Melancholic; Time passes slowly (Cann ind). Memory weak. Errors of perception. Impulsive; wants to do things in a hurry (Lilium). Peculiar mental impulses. Fears and anxieties and hidden irrational motives for actions.
Calcarean carbonicum; Excessive anguish, with palpitations of the heart, ebullition of the blood, and shocks in the epigastrium. Anxious agitation, forbidding rest. Disposition to take alarm. Apprehensions. Easily frightened or offended. Discouragement and fear of death. Absence of will. Great weakness of memory and of conception, with difficulty in thinking. Tendency to make mistakes in speaking, and to take one word for another.
Ignitia: The superficial and erratic character of its symptoms is most characteristic. Effects of grief and worry. Changeable mood; introspective; silently brooding. Melancholic, sad, tearful. Not communicative. Sighing and sobbing. After shocks, grief, disappointment.
Pulsatilla: The disposition and mental state are the chief guiding symptoms to the selection of Pulsatilla. For mild, gentle, yielding disposition. Sad, crying readily; weeps when talking; changeable, contradictory Symptoms ever changing. When first serious impairment of health is referred to age of puberty. Great sensitiveness. Weeps easily. Timid, irresolute. Fears in evening to be alone, dark, ghost. Likes sympathy. Children like fuss and caresses. Easily discouraged.
Natrum mur: Psychic causes of disease; ill effects of grief, fright, anger, etc. Depressed, particularly in chronic diseases. Consolation aggravates. Irritable; gets into a passion about trifles. Awkward, hasty. Wants to be alone to cry. Tears with laughter.
Rubrics: (few related rubrics)
- Sadness, mental depression- Mind Kent Repertory- page 75
- Depression- Mind BBCR- page 198
- Clinging, children of- Mind Complete Repertory
- Irritability (see anger)- Mind Kent Repertory- page-57
Conclusion: Paediatric depression can be treated with Homoeopathy, after proper case taking and prescription of simillimum on the basis of totality of symptoms. We can manage the progress of symptoms with similimum, proper diet, good familial support and by stress and sleep management.
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