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How to Safeguard your Mental Health while Quarantined

More people are being exposed to infection as the number of COVID-19 cases continue to grow, resulting in an increased need for quarantines. The fear, stress and stigma associated with being quarantined can be damaging to one’s mental health.

The differences between isolation, quarantine and social distancing

The U.S. Centers for Disease Control and Prevention (CDC) defines medical isolation, quarantine and social distancing as follows:

Isolation – The separation of a person or group of people confirmed or suspected to be infected with COVID-19, and potentially infectious, from those who are not infected. This can prevent spread of the virus. Isolation for public health purposes may be voluntary or compelled by federal, state, or local public health order.

Quarantine – The separation of individuals who have had close contact with a COVID-19 case, but are not showing symptoms, to determine whether they develop symptoms of the disease. This keeps the person from potentially spreading the virus in the community. Quarantine for COVID-19 should last for a period of 14 days in a room with a door. If symptoms develop during the 14-day period, the individual should be placed under isolation and evaluated for COVID-19.

Social Distancing – The act of remaining out of congregate settings, avoiding mass gatherings and maintaining distance (approximately 6 feet, or 2 meters) from others when possible. Social distancing strategies can be applied on an individual level (e.g., avoiding physical contact), a group level (e.g., canceling group activities where individuals will be in close contact), and an operational level (e.g., rearranging desks in an office to increase distance between workers).

 Emotional impact of quarantine

The simple act of being quarantined can be distressing. When people are quarantined, they:

  • Can be completely separated from loved ones
  • Lose their freedom of movement
  • Don’t know if they will show symptoms or not
  • Don’t know how the disease may affect them
  • Have no understanding of how long they will be separated
  • Experience boredom and have too much time to worry about the situation

People who have been quarantined have reported or shown a high prevalence of symptoms of psychological distress and disorder. Symptoms reported include emotional disturbance, confusion, depression, stress, irritability, insomnia and post-traumatic stress symptoms. In addition, the stigma surrounding those in quarantine can lead people to feel rejected and/or avoid seeking help.

How to reduce the negative effects on mental health

  • Seek trusted information sources. COVID-19 information and news is everywhere, and it’s hard to know what’s true. Follow news from the World Health Organization, the CDC and your state health department. Stay away from suspect information that well-intentioned people may share on social media. If you have specific questions about your situation, call your doctor.
  • Make sure you have adequate supplies. Make your experience as tolerable as possible. Make sure you have basic supplies such as food, water and medicine for the duration of the quarantine period. Many communities have stores or services that will deliver essential items to your door, so keep a list in case you need anything.
  • Make the most of your downtime. As noted above, isolation, boredom and stigma negatively impact mental health. Call old friends you haven’t talked to. Catch up on your reading, do crossword puzzles or play electronic games. Listen to music. Organize those piles of paper you haven’t gotten to. If you can, work remotely.
  • Keep a journal, blog or vlog about your experience. Writing down your feelings and experiences, or talking about them, can be cathartic for some people. And if you are comfortable sharing it, your journal can be helpful for other people in the same situation.
  • Don’t be afraid to reach out. Talk to a neighbor or two and let them know of your situation so they can help. Find others who are going through the same thing or have been in your shoes before. Talking to someone who knows what you’re going through can help you feel less alone.
  • Focus on how you are helping. Remind yourself that your isolation, while difficult to bear, is truly helping contain the spread of disease and potentially saving lives.

If you find yourself feeling overly sad, angry or anxious, contact a behavioral health professional. They can conduct appointments over the phone and provide helpful advice.

After the quarantine

You’ve stayed away from everyone for 14 days, and you’re still healthy. When you are released from quarantine, remember that social distancing may still be in force.

You might have some residual stress from being alone for so long, or you might be angry that you had to stay separated from loved ones when you weren’t contagious. It’s OK to have those feelings. If they don’t subside after a few months, talk to a behavioral health provider.

 

For more information and tips, visit www.MagellanHealthcare.com/COVID-19.




Stamp Out Stigma during May: Mental Health Awareness month

May is Mental Health Awareness Month. This is an opportunity to increase public awareness of mental health conditions.  We can break down the stigma by ending the silence. About 1 in 5 Americans experience mental illness. It is important to be able to talk openly about it to get people the help they need. It is particularly timely this year, as we are seeing stigma associated with COVID-19, and we must do what we can to stamp out stigma in all its forms.

Understanding mental illness

According to the National Alliance on Mental Illness (NAMI), a mental illness is a condition that affects a person’s thinking, feeling or mood. Such conditions may affect someone’s ability to relate to others and function each day. Each person will have different experiences, even people with the same diagnosis. If you have — or think you might have — a mental illness, the first thing you must know is that you are not alone. Mental health conditions are far more common than you think, mainly because people don’t like to, or are afraid to, talk about them.

Mental illness can affect anyone regardless of age, gender, income, social status, religion or race/ethnicity.

  • 1 in 5 U.S. adults experience mental illness each year
  • 1 in 25 U.S. adults experience serious mental illness each year
  • 1 in 6 U.S. youth aged 6-17 experience a mental health disorder each year
  • 50% of all lifetime mental illness begins by age 14, and 75% by age 24

Depression and anxiety disorders are the most common mental health disorders worldwide.

The exact causes of mental illness are not fully understood. However, factors that can contribute to mental health problems include:

  • Genes and family history
  • Biological factors such as brain chemistry and brain injury
  • Serious medical conditions
  • The use of alcohol or other drugs
  • Traumatic life experiences
  • Isolation and other social factors

Mental illness is not a character flaw or something that a person can just “snap out of.” For many people, recovery — including meaningful roles in social life, school and work — is possible, especially when you start treatment early and play a strong role in your own recovery process.

Sadly, many people never seek treatment out of fear and shame. The stigma of having a mental illness or substance use disorder is two-fold: people suffer needlessly even though effective treatments are available, and they’re also at higher risk of premature death. For example, people with depression have a higher risk of heart disease and cancer. Studies also show that people with severe mental illness have a higher incidence of chronic diseases and tend to die 10 – 25 years earlier than the general population.1

 

Stamping Out Stigma

Everyone experiences the ups and downs of mental health. Many people have a mental illness or know a friend or family member who has struggled with one. To stamp out stigma and get people the help they need NAMI offers these practical tips:

  • Talk openly and honestly about your own experiences with mental illness and addiction.
  • Educate yourself and others about the facts of mental illness. Mental disorders are treatable just as physical diseases are, and people with mental illness are not to blame for their condition.
  • Recognize the signs of mental illness and seek professional help when needed.
  • Show empathy for those living with mental health and substance use disorders.
  • Be aware of your attitudes and language used to describe mental illness and people with mental illness. Jokes and name-calling are hurtful and perpetuate demeaning stereotypes.

 

Let’s work together to Stamp Out Stigma!

 

Sources:

[1] Management Information Sheet. (n.d.). Retrieved from https://www.who.int/mental_health

2Social Stigma associated with COVID-19. (2020, February). Retrieved April 10, 2020, from https://www.unicef.org/media/65931/file/Social%20stigma%20associated%20with%20the%20coronavirus%20disease%202019%20(COVID-19).pdf




Tips for Managing Anxiety during COVID-19

Fear and anxiety about a disease can be overwhelming and cause strong emotions in adults and children. The Social Distancing concept, which is intended to reduce disease transmission and currently being practiced by communities at large, can be very isolating and lead to increase in stress levels. How you respond to the outbreak can depend on your background, the things that make you different from other people, and the community you live in.

People who might have more difficulty responding effectively to the stress of a crisis include:

  • Those who have mental health conditions including problems with substance use
  • Children and teens

If you, or someone you care about, are feeling overwhelmed with emotions like sadness, depression, or anxiety, and feel like you want to harm yourself or others please call 911.

In general, health impacts from stress during an infectious disease outbreak can include:

  • Fear and worry about your own health and the health of your loved ones
  • Changes in sleep or eating patterns
  • Difficulty sleeping or concentrating
  • Worsening of chronic health problems
  • Increased use of alcohol, tobacco, or other drugs

People with physical and mental health conditions should continue with their treatment and be aware of new or worsening symptoms. Make sure you continue to take your medications as prescribed and contact your healthcare provider if you find you are starting to feel worse.

Taking care of yourself, your friends, and your family can help you cope with stress. You can do this remotely through phone or video.

Things you can do to support yourself

  • Take breaks from watching, reading, or listening to news stories, including social media.
  • Take care of your body. Take deep breaths, stretch, or meditate. Try to eat healthy, well-balanced meals, exercise regularly, get plenty of sleep, and avoid alcohol and drugs.
  • Make time to unwind. Try to do some other activities you enjoy.
  • Connect with others over phone or video. Talk with people you trust about your concerns and how you are feeling.

Look out for these common signs of distress:

  • Feelings of numbness, disbelief, anxiety or fear.
  • Changes in appetite, energy, and activity levels.
  • Difficulty concentrating.
  • Difficulty sleeping or nightmares and upsetting thoughts and images.
  • Physical reactions, such as headaches, body pains, stomach problems, and skin rashes.
  • Worsening of chronic health problems.
  • Anger or short-temper.
  • Increased use of alcohol, tobacco, or other drugs.

Reduce stress in yourself and others

  1. Take breaks from watching, reading, or listening to news stories, including social media.
  2. Take care of your body. Take deep breaths, stretch, or meditate. Try to eat healthy, well-balanced meals, exercise regularly, get plenty of sleep, and avoid alcohol and drugs.
  3. Make time to unwind. Try to do some other activities you enjoy.
  4. Connect with others over phone or video. Talk with people you trust about your concerns and how you are feeling.
  5. Use trusted sources for information such as the U.S. Centers for Disease Control & Prevention (CDC), The World Health Organization and state health department websites and encourage others to do the same.

For Parents

Not all children and teens respond to stress in the same way. Some common changes to watch for include

  • Excessive crying or irritation in younger children
  • Returning to behaviors they have outgrown (for example, toileting accidents or bedwetting)
  • Excessive worry or sadness
  • Unhealthy eating or sleeping habits
  • Irritability and “acting out” behaviors in teens
  • Difficulty with attention and concentration
  • Avoidance of activities enjoyed in the past
  • Unexplained headaches or body pain
  • Use of alcohol, tobacco, or other drugs

There are many things you can do to support your child, including:

  • Take time to talk with your child or teen about the COVID-19 outbreak. Answer questions and share factual information about COVID-19 from the aforementioned trusted sources in a way that your child or teen can understand.
  • Reassure your child or teen it is ok if they feel upset. Share with them how you deal with your own stress so that they can learn how to cope from you.
  • Limit your family’s exposure to news coverage of the event, including social media. Children may misinterpret what they hear and can be frightened about something they do not understand.
  • Try to keep up with regular routines. If schools are closed, create a schedule for learning activities and relaxing or fun activities.
  • Be a role model.  Take breaks, get plenty of sleep, exercise, and eat well. Connect with your friends and family members over the phone or through video.

Call your healthcare provider if stress gets in the way of your daily activities for several days in a row.

To learn more about what Magellan Healthcare is doing to support clients during the COVID-19 pandemic, visit MagellanHealthcare.com/COVID-19.

To learn more about Magellan Health’s corporate response to the COVID-19 pandemic and to view Magellan’s available resources click here: https://www.magellanhealth.com/news/covid-19/

 




Mental Health in the Workplace: One Size Does Not Fit All

Mental health disorders are among the costliest health concerns for employers in the United States. According to the National Institute of Mental Health, nearly one in five adults live with a mental illness. Depression and anxiety are among the most common mental health disorders but often go undiagnosed and untreated.1

Many factors may contribute to mental health issues, including traumatic or abusive life experiences, biology, and family history of mental health problems. Unfortunately, social stigma and fear of discrimination prevent many people from seeking help.

Employee mental health impacts the bottom line

Poor mental health and stress can negatively affect employee job performance, productivity and relationships. In addition, as physical health is inextricably linked to mental health, many people with mental health disorders are at high risk for chronic physical conditions such as heart disease, diabetes and respiratory illnesses.2

The reverse is also true; physical illness, such as cardiovascular disease, may cause or worsen mental health issues, particularly symptoms of depression.3 Healthcare costs to treat people with both mental and physical disorders can easily be two to three times higher than for people without co-occurring illnesses.4

Employers have a unique opportunity to improve employee mental health

Investing in mental health treatment in general has proven to be cost-effective. Employers can reduce health care costs for their businesses and their employees by addressing mental health issues in the workplace. Many evidence-based treatments can save $2 to $4 for every dollar invested in prevention and early intervention.5 An effective approach is not one-size-fits-all but takes into consideration generational differences and employee diversity.

A recent study published in the Harvard Business Review called “People want their employers to talk about mental health” indicated that millennials (the cohort of people born between 1981 to 1996) were three times more likely to experience anxiety than baby boomers.6 Gen Zers (those born between 1997 to 2012) report even higher rates of anxiety and depression. Millennials and Gen Z employees are the largest demographic in the workforce, and those who took part in the survey indicated an expectation that mental health be addressed in the workplace openly and without stigma.

Develop a customized approach to promoting mental health resources

The Harvard Business Review study recommends a multi-faceted approach that includes a more accepting culture starting from the top, with training and support, as well as clear information about employee resources such as availability of mental health benefits, wellness programs and employee assistance programs.

Employers should be cognizant of where their different employee groups seek information and use those channels (whether it’s the intranet, staff meetings, one-on-one meetings, employee resource groups, digital signs and posters, instant messaging platforms, or other social media venues) to provide needed information. Virtual mental health counseling and the availability of mental health apps offer convenient and mobile-friendly emotional support, particularly for younger employee groups accustomed to using their smart phones for everything from texting to shopping.

Dislodging stigma and experimenting with different communications channels to meet the needs of a diverse workforce can be challenging for human resources departments and managers. But the end result will be worth the effort: a healthier work environment that supports healthier employees and enhanced productivity.

Learn more about how your organization can benefit from an EAP solution.

 

1 “Facts & Statistics.” Anxiety and Depression Association of America, ADAA, https://adaa.org/about-adaa/press-room/facts-statistics.

2 “Chronic Illness & Mental Health.” National Institute of Mental Health, U.S. Department of Health and Human Services, https://www.nimh.nih.gov/health/publications/chronic-illness-mental-health/index.shtml.

3 “Chronic Illness & Mental Health.” National Institute of Mental Health, U.S. Department of Health and Human Services, https://www.nimh.nih.gov/health/publications/chronic-illness-mental-health/index.shtml.4 https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2748662?

5 Lerner D, Lyson M, Sandberg E, & Rogers W.H. (2018). The High Cost of Mental Disorders- Facts for

Employers. Retrieved from https://onemindinitiative.org/at-work/the-business-case/

6 Greenwood, Kelly, Bapa, Vivek, Maughan, Mike (2019). Research: People want their employers to talk about mental health. Retrieved from https://hbr.org/2019/10/research-people-want-their-employers-to-talk-about-mental-health




Mental Health in America – Perception and Reality 30 Years Later

In 1989, one survey of the general public found that more than half of respondents believed lack of discipline was a possible cause of mental illness. The survey found that, at that time, Americans were more likely to receive information about mental illness from mass media than from medical providers or psychologists. Thirty years later, with the availability of information on the internet, the public should theoretically have a more accurate and balanced perspective of mental illness. But is the public obtaining their information from science-based sources? While there is still much to learn about mental illness, scientists have identified several factors that can play a role in mental health, including genetics, environmental exposure, altered brain chemistry, significant stress, and comorbid medical conditions. With the availability of misinformation on the internet and on social media websites in particular, are we really any better educated on mental health than we were 30 years ago?

The National Institute of Mental Health (NIMH) reports that approximately 1 in 5 adults experiences mental illness annually, with approximately 1 in 25 experiencing mental illness that substantially interferes with or limits 1 or more major life activities. Based on data from the 2018 National Survey on Drug Use and Health, approximately 19% have an anxiety disorder, 2.8% live with bipolar disorder, and fewer than 1% have schizophrenia in the United States (US) adult population. In addition, 7.2% of adults have experienced at least 1 major depressive episode in the last year. Unfortunately, only about 43.3% of adults with a mental health condition received mental health services within the past year, and of those with a serious mental illness, only 64.1% received mental health services within the past year. Even the indirect costs of mental health have a significant impact. Serious mental illnesses have been estimated to cost over $193.2 billion in lost earnings per year in the US, and mental illness has been predicted to cost the global economy $16 trillion by 2030.

Much has changed in the treatment of mental illnesses in the past 30 years. Key treatments for depression, such as selective serotonin reuptake inhibitors (SSRIs) and newer serotonin-norepinephrine reuptake inhibitors (SNRIs), have mitigated some of the limitations of earlier antidepressants (e.g., drug-food interactions or select adverse effects). Even in the past year, novel approvals for treatment-resistant depression (TRD) and postpartum depression (PPD) have emerged. For those with schizophrenia, the availability of newer generation antipsychotics has significantly altered care as well. Although testing for genetic alterations to better identify the best medication choice for a patient is in its relative infancy, the role of pharmacogenomics is rapidly expanding, too. These advances offer promise for individuals with mental illness, but no medication is without risks, and a discussion with a licensed medical provider is essential to establish an appropriate treatment regimen. In addition to medications, the role of nonpharmacologic treatment has expanded in the past 30 years as well, with additional treatment modalities beyond the advancements in psychotherapy alone (e.g., modern cognitive behavioral therapy, interpersonal therapy). A more holistic approach, incorporating lifestyle changes (e.g., diet, exercise) and non-traditional medicine (e.g., meditation, acupuncture), is also gaining in popularity; however, it is critical to understand that herbal or “natural” treatments can have adverse or toxic effects and drug interactions. These should only be used in consultation with a healthcare provider.

Mental illness can contribute to the risks for suicide. Unfortunately, the Centers for Disease Control and Prevention (CDC) reports that suicide rates have increased by approximately 30% from 1999 to 2016. Notably, suicide is rarely caused by a single factor, and the National Alliance on Mental Illness (NAMI) reports that approximately 54% of those who die by suicide do not have a diagnosed mental health condition. Regardless, this leaves a significant portion of patients with known mental health conditions where intervention may have been helpful. Moreover, NAMI also reports that approximately 90% of those who die by suicide show symptoms of a mental health condition. The CDC includes several warning signs on their website and offers advice to several groups ranging from laypersons to the government to healthcare providers. One component the CDC emphasizes to healthcare systems is the need for affordable and effective mental and physical healthcare where people live. In addition, the Zero Suicide Institute provides a framework for continuous quality improvement in health and behavioral healthcare systems aiming to prevent suicide.

Of late, the public seems particularly concerned with the risk of violence in those with a mental illness. A 2006 survey found that 32% and 60% of Americans thought people with depression and schizophrenia, respectively, were likely to act violently toward someone else; however, research has demonstrated that there are several factors that contribute to violence, and that when accounting for these additional factors, the presence of a mental illness is only a modest contributor (at best) to violence. According to the 2018 National Survey on Drug Use and Health, approximately 19.4% of those over 12 years of age have used an illicit drug in the past year and 3% had at least 1 illicit drug use disorder. Additionally, 3.7% of adults reported dual diagnosis (both any mental illness and substance use disorder). Studies of patients with substance abuse or dual diagnosis have found higher correlations with violence compared to mental illness alone. Most importantly, adequate treatment has demonstrated improved outcomes.

With the discussion of mental health in the press and the plethora of inaccurate information on mental health online, it is difficult for the public to develop a truthful foundation on mental illness. While public access to information and scientific discovery have advanced in the past 30 years, the most critical component for the proper diagnosis, effective treatment, and safety of those with mental illness remains consultation with a healthcare provider and/or team.

If you or someone you know may be at risk for suicide, contact the free and confidential Suicide Prevention Lifeline at 1-800-273-TALK (8255). It is available to anyone 24 hours a day, 7 days a week.




Seasonal Affective Disorder

Some people experience a serious mood change during the winter months, when there is less natural sunlight. This condition is called seasonal affective disorder (SAD). SAD is a type of depression, and usually lifts during spring and summer. Seasonal affective disorder impacts those who live in specific geographical areas, typically those who live in northern or southern hemispheres but is extremely rare in people who live close to the equator.1

SAD symptoms
SAD is a fairly common form of depression that occurs in the winter. During the winter days are shorter. Shortened days increase the chances of someone to develop SAD due to the lack of natural sunlight.

Common symptoms may include:

  • Sad, anxious, or “empty” feelings
  • Feeling hopeless
  • Feeling guilty, worthless, or helpless
  • Irritability and restlessness
  • Loss of interest in activities
  • Loss of energy
  • Difficulty concentrating, remembering details and making decisions
  • Difficulty falling sleeping or oversleeping
  • Changes in weight
  • Thoughts of death or suicide

Seasonal changes in bipolar disorder
In some people with bipolar disorder, spring and summer can bring on symptoms of mania or a less intense form of mania (hypomania). This is known as reverse seasonal affective disorder. Signs and symptoms of reverse seasonal affective disorder include:

  • Persistently elevated mood
  • Hyperactivity
  • Agitation
  • Unbridled enthusiasm out of proportion to the situation
  • Rapid thoughts and speech

There are some measures you can take on your own that may help. You can make your environment brighter by sitting near windows and being exposed to more light. It is also helpful to get outdoors and be exposed to the sun and daylight. Regular exercise can help relieve the stress and anxiety brought on by SAD.

About 4 to 6 percent of people suffer from SAD and an additional 10 to 20 percent may suffer from mild SAD.2

Treatments SAD may be effectively treated with light therapy. But nearly half of people with SAD do not respond to light therapy alone. It is important to speak to your doctor about how you feel and determine the right treatment plan for you.

Here are a few tips on how you can manage SAD. Remember to speak with your doctor at any point about how you feel, and to determine the right treatment plan for you.

  • Get enough sleep and practice good sleep habits
  • Eat a healthy diet
  • Try to exercise more often and find activities that make you happy
  • Avoid alcohol and illegal drugs
  • Talk with family and friends
  • Stay active

When you are struggling with depression, talk about how you’re feeling to someone you trust. Try to be around people who are caring and positive. Volunteer or get involved in group activities.

People who have had repeated seasonal depression should talk to a mental health care professional about prevention methods. Starting treatment during the fall or early winter, before the symptoms of SAD begin, may be helpful.

For additional information, visit MagellanHealth.com/MYMH

1. www.mentalhealthamerica.net
2. American Family Physician, Seasonal Affective Disorder (www.aafp.org/afp/2000/0301/p1531.html) Source: National Alliance on Mental Health; National Alliance on Mental Illness (NAMI)

This document is for your information only. It is not meant to give medical advice. It should not be used to replace a visit with a provider. Magellan Health does not endorse other resources that may be mentioned here.




Reduce the Stress of Caregiving

Caring for a family member or friend who has a disability or a chronic illness can be rewarding. But it’s also demanding. One of the keys to being a successful caregiver is to manage stress by seeking support and taking care of yourself. Managing stress is especially important for a caregiver, because stress can weaken his or her immune system. A weak immune system makes the caregiver more likely to get sick.

Think about the kinds of caregiving tasks or situations that trigger stress for you. Then you can focus on one or two things you can do that will help the most to reduce stress. Here are some ideas:

Get support
Ask family members for help. Include them in caregiving decisions.

  • Ask family members for help. Include them in caregiving decisions.
  • Share the tasks. Make a list of weekly tasks, and share that list with your family. Ask for help with shopping, housecleaning, and errands. You don’t have to do all the work on your own.
  • Stay involved. Make time for social activities and friends, even if it’s only a phone call or coffee during the week.
  • Join a caregiver support group. Meeting other caregivers helps you know you’re not alone. And it gives you a chance to talk about your worries and concerns with others who understand.
  • Find respite care. Respite services provide someone who can stay with your family member while you get away for a few hours or days. Time away can help you manage your stress and be a better caretaker.
  • Look up caregiver resources in your community. Hospitals, churches, and other groups may provide transportation or other services that support caregiving tasks. You can reduce stress by planning ahead so you know who to call when you need extra help.

Take care of yourself

  • Put your own health first. Be sure to schedule and go to your medical checkups.
  • Eat a healthy diet, and get enough sleep. Taking care of yourself will help you deal with stressful situations.
  • Get regular exercise. Even a 10-minute walk can relieve stress.
  • Take a breath. Try stress reduction techniques like deep breathing and meditation.
  • Take a break. It’s important to take time off from caregiving once in a while. Spend some time doing things you enjoy or on things in your own life that need attention.

What to think about
Depression is common among caregivers. It’s emotionally draining to care for a loved one whose health is getting worse. Don’t dismiss your feelings as “just stress.” If you’re having trouble coping with your feelings, it may help to talk with a counselor. If you have symptoms of depression, such as a lack of interest in things you enjoy, a lack of energy, or trouble sleeping, talk with your doctor.

Help is available. For additional mental health information and resources, visit MagellanHealthcare.com.

Source: Healthwise




Depression in children and teens

What is depression in children and teens?

Depression is a serious mood disorder that can take the joy from a child’s life. It is normal for a child to be moody or sad from time to time. You can expect these feelings after the death of a pet or a move to a new city. But if these feelings last for weeks or months, they may be a sign of depression.

Experts used to think that only adults could get depression. Now we know that even a young child can have depression that needs treatment to improve. As many as 2 out of 100 young children and 8 out of 100 teens have serious depression.

Still, many children don’t get the treatment they need. This is partly because it can be hard to tell the difference between depression and normal moodiness. Also, depression may not look the same in a child as in an adult.

If you are worried about your child, learn more about the symptoms in children. Talk to your child to see how he or she is feeling. If you think your child is depressed, talk to your doctor or a counselor. The sooner a child gets treatment, the sooner he or she will start to feel better.

What are the symptoms?

A child may be depressed if he or she:

  • Is irritable, sad, withdrawn, or bored most of the time.
  • Does not take pleasure in things he or she used to enjoy.

A child who is depressed may also:

  • Lose or gain weight.
  • Sleep too much or too little.
  • Feel hopeless, worthless, or guilty.
  • Have trouble concentrating, thinking, or making decisions.
  • Think about death or suicide a lot.

The symptoms of depression are often overlooked at first. It can be hard to see that symptoms are all part of the same problem.

Also, the symptoms may be different depending on how old the child is.

  • Both very young children and grade-school children may lack energy and become withdrawn. They may show little emotion, seem to feel hopeless, and have trouble sleeping. Often they will lose interest in friends and activities they liked before. They may complain of headaches or stomachaches. A child may be more anxious or clingy with caregivers.
  • Teens may sleep a lot or move or speak more slowly than usual. Some teens and children with severe depression may see or hear things that aren’t there (hallucinate) or have false beliefs (delusions).

Depression can range from mild to severe. A child who feels a little “down” most of the time for a year or more may have a milder, ongoing form of depression called dysthymia (say “dis-THY-mee-uh”). In its most severe form, depression can cause a child to lose hope and want to die.

Whether depression is mild or severe, there are treatments that can help.

What causes depression?

Just what causes depression is not well understood. But it is linked to a problem with activity levels in certain parts of the brain as well as an imbalance of brain chemicals that affect mood. Things that may cause these problems include:

  • Stressful events, such as changing schools, going through a divorce, or losing a close family member or friend.
  • Some medicines, such as steroidsor opioids for pain relief.
  • Family history. In some children, depression seems to be inherited.

How is depression diagnosed?

To diagnose depression, a doctor may do a physical exam and ask questions about your child’s past health. You and your child may be asked to fill out a form about your child’s symptoms. The doctor may ask your child questions to learn more about how he or she thinks, acts, and feels.

Some diseases can cause symptoms that look like depression. So the child may have tests to help rule out physical problems, such as a low thyroid level or anemia.

It is common for children with depression to have other problems too, such as anxietyattention deficit hyperactivity disorder (ADHD), or an eating disorder. The doctor may ask questions about these problems to help your child get the right diagnosis and treatment.

How is it treated?

Usually one of the first steps in treating depression is education for the child and his or her family. Teaching both the child and the family about depression can be a big help. It makes them less likely to blame themselves for the problem. Sometimes it can help other family members see that they are also depressed.

Counseling may help the child feel better. The type of counseling will depend on the age of the child. For young children, play therapy may be best. Older children and teens may benefit from cognitive-behavioral therapy. This type of counseling can help them change negative thoughts that make them feel bad.

Medicine may be an option if the child is very depressed. Combining antidepressant medicine with counseling often works best. A child with severe depression may need to be treated in the hospital.

There are some things you can do at home to help your child start to feel better.

  • Encourage your child to get regular exercise, spend time with supportive friends, eat healthy foods, and get enough sleep.
  • See that your child takes any medicine as prescribed and goes to all follow-up appointments.
  • Make time to talk and listen to your child. Ask how he or she is feeling. Express your love and support.
  • Remind your child that things will get better in time.

What should you know about antidepressant medicines?

Antidepressant medicines often work well for children who are depressed. But there are some important things you should know about these medicines.

  • Children who take antidepressants should be watched closely. These medicines may increase the risk that a child will think about or try suicide, especially in the first few weeks of use. If your child takes an antidepressant, learn the warning signs of suicide, and get help right away if you see any of them. Common warning signs include:
    • Talking, drawing, or writing about death.
    • Giving away belongings.
    • Withdrawing from family and friends.
    • Having a plan, such as a gun or pills.
  • Your child may start to feel better after 1 to 3 weeks of taking antidepressant medicine. But it can take as many as 6 to 8 weeks to see more improvement. Make sure your child takes antidepressants as prescribed and keeps taking them so they have time to work.
  • A child may need to try several different antidepressants to find one that works. If you notice any warning signs or have concerns about the medicine, or if you do not notice any improvement by 3 weeks, talk to your child’s doctor.
  • Do not let a child suddenly stop taking antidepressants. This could be dangerous. Your doctor can help you taper off the dose slowly to prevent problems

Help is available. For additional information, visit MagellanHealth.com/MYMH

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