“‘All of a sudden I don’t feel like the norm. I feel cold, not warm. My brain’s like a storm’… Lilly the dog wanted to help, but didn’t know what to do. She hated seeing Benny the bunny so blue.” — Bunny & Doggo: Friends Fight Depression, written by Matt Christensen and illustrated by Leilani “Ducky” Banayos
Benny, like a growing number of us, feels scared and uncertain, “stuck in the muck of [a] depressing black cloud.”
Depression and anxiety have doubled among young people during the pandemic. Literature suggests that 25% of children – 1 in 4 – are experiencing significant depressive symptoms.
“Since the pandemic started two years ago, there has been almost twice as many kids being treated for depression and anxiety,” says Dr. Emily Mudd, Ph.D., pediatric psychologist with Cleveland Clinic’s Children’s and mother of two.
“From a neurochemical standpoint, depression and anxiety are closely related. Underlying causes contribute to both. More often than not, if you have one, then you are likely to have the other.”
“Depression was previously more rare in younger children, but with stressors and the pandemic, we’ve seen a significant increase in ages 6 to 12, even younger.” She stresses the need for parent and teacher education, as “more younger children are visiting emergency rooms with increasing intensity and frequency of symptoms.”
Risk Factors
Some children are more vulnerable to the mental health effects of the pandemic. “Younger children experiencing more depressive symptoms often have risk factors,” she explains. “Biochemical reasons include family history and genetics, such as a parent or close relative with depression.”
“Early childhood trauma — which could include abuse, the loss of someone close to them, or bullying at school — can all make changes in the brain, leaving the child more susceptible to depression. Other risk factors include issues impacting self-esteem, peer problems, academic problems or kids who feel different from their peers.”
She says the pre-teen years are an especially sensitive time, when kids pick up on how they are different from peers. She advises watching for symptoms particularly in children with learning or other disabilities, ADHD or any chronic physical illness.
“Being in middle school is really hard,” Mudd says. “From a developmental standpoint, ages 10 to 12 is the hardest time to be alive. The social-emotional and cognitive brain is growing exponentially, and social challenges are really difficult. Leaving elementary school and coming back to middle school is a huge change. Acknowledge it is hard, validate their feelings, and make a connection.”
Warning Signs and Where to Turn
“Look for low self-esteem, withdrawing from family, changes in behavior and functioning, and changes in academic success,” Mudd says. “Is your child acting differently at home? For example, instead of coming home and having a snack, they go right to their room. We see a lot of physical symptoms at younger ages, as children often exhibit emotional stress through their bodies. Red flags include increased appetite or not eating, low energy, and chronic stomachaches or headaches that don’t go away.”
“Talk about harming oneself or suicide at any age must always be taken seriously. Get help,” she adds. “Text lines may be utilized by teenagers, but if you are worried about your child’s immediate safety, take them to an emergency room, where there is always a behavioral health professional who can do an evaluation.”
“I always tell families to start with their pediatrician, who can generally get kids in to see them sooner,” she says. She cautions parents not to wait months to see a mental health professional while things get worse. “Tell your pediatrician you need to get them evaluated. Your pediatrician knows your child and family and can refer you to therapy and/or medication management based on individual needs. It is good to have a medical home… [to] build your child’s health village.”
Engaging the School
An integral part of that village is school. “It’s often forgotten that children spend most of their time in school,” Mudd says. “Parents can be hesitant to get school involved, but if their mental health is impacting how they are functioning there, advocate for a 504 Plan, or at least tell your teachers what is going on.”
With a documented diagnosis of major depressive disorder or generalized anxiety disorder, a student may qualify for accommodations and support services. “Teachers can help advocate for the child and access emotional support from a school counselor,” she adds. “It is important your child is seen and supported in school.”
Matt Christensen is a first-grade and former seventh-grade teacher at Julie Billiart School Westlake, a school that nurtures and empowers students with learning differences and values, and encourages open parent-teacher communication.
“Teachers want to help, and I imagine most teachers want to help beyond academics,” Christensen says. “We have a unique insight into how students act and feel while existing in an environment that is both comforting and challenging. It’s also not uncommon for a parent to say their child behaves a certain way at home that’s different from how he or she behaves in school. And it’s through these observations that teachers and parents can collaborate and begin to put the puzzle together.
“If a child – especially a young child – is feeling unfamiliar emotions, he or she might have trouble expressing them clearly. Parents and teachers can be great resources for each other while trying to teach that skill,” he adds.
Facilitating Conversations
“Emotional support from family is the building block for relationships,” Mudd says. “Spending quality time is key, and can even be five minutes when you are not on your phone. Kids thrive on love and connection, so encourage open conversation, but let them guide it. Make sure they know you are open to listening, and validate their feelings.”
“For depression and anxiety to be treated, they have to be talked about,” Christensen says. “Little kids have big feelings. They’re unfiltered and intense, because they’re so unfamiliar. Imagine feeling scared, angry, or depressed for the first time in your life, and not knowing why. I believe that helping kids express their emotions accurately and comfortably is essential to their well-being, which is why I try to emphasize the importance of feelings whenever I can.”
Christensen knows how scary depression can be and wrote a story about it to help families approach mental health. His children’s book, “Bunny & Doggo: Friends Fight Depression,” is a tale of friendship, kindness and love inspired by the unique relationship between his bunny, Benny, and his sister’s dog, Lilly, during a brief period when they lived together.
Bunny & Doggo: Friends Fight Depression, written by Matt Christensen and illustrated by Leilani “Ducky” Banayos, is available on Barnes & Noble’s website, at your local bookseller, or from Westlake Porter Public Library.
Are you or your child experiencing a mental health crisis?
Contact your health provider, county crisis line or one of these free, confidential resources:
• Text “4HOPE” to 741741 to reach the Crisis Text Line in Ohio.
• Call 800-273-TALK (8255) to reach the National Suicide Prevention Lifeline, or use the Lifeline Chat web chat service online.
• Call 800-985-5990 to reach the Disaster Distress Helpline, which provides 24/7, 365-days-a-year crisis counseling and support to people experiencing emotional distress related to natural or human-caused disasters or traumatic events like the coronavirus.
