Depression, Anxiety, PTSD & Trauma, and Bipolar Disorders are complex and debilitating experiences for a child. They can often feel alone and misunderstood. 

Children with mood disturbances may lash out for no apparent reason, be short-tempered, and have difficulty sleeping. This experience of “disrespect” can all lead to parents over-disciplining behaviors that their child does not know how to manage on their own.

Major Depressive Disorder.

Depression is classified by a period of at least 2 weeks of sadness and low mood. Your child may be having changes in their sleeping or eating patterns, present as irritable, lose interest in activites they used to enjoy, have low self-esteem, be overly curious about death or dying, or even talk about or try to hurt themselves.

Depression can be due to a chemical imbalance in the brain or be situational. Often depressive symptoms occur with another mental illness. It is important the depression be treated early as continued symptoms can lead to suicidal ideation and self-mutilation behaviors.

To assess for depression a set of screeners are used to determine the severity and extent to which this disorder is impairing your child’s functioning. A diagnosis does not always require a full psychological evaluation, but can be very beneficial to improve prognosis of treatment.

Treatment for depression usual includes developing coping skills, behavioral training, and medication.

Generalized Anxiety Disorder.

Anxiety is a very common state of mind in America. Almost everyone is experiencing stress and it can often feel like a compitition to determine who can stay “busiest.” While anxiety can be harnessed to improve our productivity, it can also cause severe impairment when not properly managed.

For children anxiety can feel overwhelming and crippling. They often try to avoid any situation that can increase their anxiety such as school, making new friends, or leaving home. Children can have difficulty sleeping, be irritable, have difficulty concentrating, feel restless, and often spend a lot of time thinking about the thing that makes them anxious.

Since anxiety is so common, diagnosis for anxiety usually is not the focus of a psychological assessment. Any therapist can give this diagnosis based on the results of a few short screeners. An anxiety diagnose is usually found as a co-morbid disorder during the assessment process.

Treatment for anxiety included exposure therapy, behavior interventions, and medication.

Post-traumatic Stress Disorder (PTSD) & Other Traumas.

PTSD, or trauma, occurs due to witnessing, experiencing, or hearing about a near death experience. For children this can mean physical, emotional, or sexual abuse, neglect, or the threat of abuse or neglect. It could also mean a traumatic event like a car accident or being seperated from a caregiver.

Trauma shakes a child’s faith in the world and often is expressed through the mistrust of others. Children can relive the traumatic experience over and over in their minds. They tend to be easily triggered and can have flashbacks to the event, dreams about the event, or even act out the event through play and drawing.

Trauma itself can be assessed though a few screeers and a clinical interview with parents and the child. During a psychological assessment, the impact the trauma has on other aspects of the child’s functioning is evaluated. For example, trauma can lead to challenges in the academic setting such as behavioral outbursts, difficulty concentrating and learning, difficulty with memory, or social development. An assessment can also clarify if the trauma is co-occurring with another disorder such as anxiety, depression, ADHD, or a learning disability.

Treatment is usually long-term, though often not life-long. For children appropriate treatment modalities may include play therapy, behavioral support therapies like Cognitive Behavioral Therapy (CBT), and psychodynamic therapy. Medication is not commonly used to treat trauma, but can be helpful to treat sub-symptoms like anxiety and depression.

Bipolar Disorder in Childhood.

According to research, Juvenile Bipolar Disorder (JBD) has a slightly different presentation from Adult Bipolar Disorder. Unfortunately, there really is not a lot of research on JBD and the DSM-5 has not made a child specified disorder for psychologists to draw reference from. For this reason, I feel a diagnosis of Bipolar given to a child without a formal assessment is irresponsible.

First, there are 2 Bipolar disorder classifications. Bipolar I Disorder consists of alternating episodes of depression and mania, while Bipolar II Disorder consists of episodes of depression and hypomania, which is a less debilitating form of mania. 

Depressive symptoms are the same as written above under the heading Major Depressive Disorder, so I won’t go back into that.

Mania and hypomania are periods of elevated mood. Most notably a reduction in need for sleep, seeming super busy while not getting a lot of stuff done, and irrational behaviors such as believing that they’re better than other people without any proof that they are. Other behaviors may include shopping or gambling with money they don’t have, and increase in sexual behaviors, and an increase in aggression.

Assessment for JBD includes self-report and observation screeners from parents and teachers. Parents are also required to complete a 3-4 week mood tracker to measure fluctuations in mood symptoms. Similar diagnoses like Attention Deficit/Hyperactivity Disorder need to assessed for and ruled out— meaning it’s not another disorder or combination of other disorders.

Treatment is extremely challenging and requires a therapist well-versed in Bipolar Disorder in childhood. Parent and Family therapy is a common approach to support the child with this diagnosis. Medication is very commonly used to regulate mood.

How CDK can help.

Mood Disorders are often assessed after there has been little response to treatment to clarify diagnosis. If your child has been struggling in therapy or non-responsive to medication a psychological assessment can help. If you are looking for support services for your child’s education and you think their mood may be affecting their learning ability CALM DOWN KIDS can also help with that. Contact us today.


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