Depression is often described as the disease of the century. We tend to think that it manifests itself by a deep feeling of sadness, despair, isolation, a decrease in activities… But depression can take different forms depending on the age and the person. Knowing how to recognize the differences that it can take is to give yourself the means to understand yourself and to act to take care of yourself.
Young children have a more limited capacity for introspection, so it is more complicated for them to express what they feel and understand it. They tend to complain about somatic pain (“my stomach hurts”, “I have a lot of nightmares, I’m tired”) and to use phrases not directly related to a depressive state (“I’m afraid to go to school”, “I feel like crap”, “I’m not hungry”). Children may not be as involved in pleasurable activities, but it is rare to see total disinvestment with a consistently low mood. Children may have phases of enthusiasm when playing outside with friends and still experience depression. These moments are short-lived. Other signs include restlessness, insolence and oppositional or aggressive attitudes.
The older the child, the more the typical symptoms of depression resemble those of adults. The pre-adolescent acquires the ability to express what he or she is feeling. They will tend to talk about self-esteem issues, feelings of incompetence, and guilt.
Although rare, suicidal ideation may be present and should be carefully monitored.
In adolescence, the depressive picture is similar to that of adults. The presence of a feeling of sadness or despair is almost constant with a loss of investment in activities that were once pleasurable and a search for isolation. Difficulty concentrating, low self-esteem, and a pessimistic view of oneself, the world and one’s environment are also noted. Sleep, appetite and bowel problems are common. School results and investment are often in decline.
At this age, suicidal thoughts are frequent and should be considered even if they are not accompanied by hetero-aggressive acts (mutilation, scarification). In adolescents, depression can be accompanied and masked by the use of drugs (alcohol, cannabis).
Two types of depression:
-> Reactive depressive episode is a temporary reaction to a stressful situation that can last several months. The triggering events can be a divorce, a break-up, a bereavement…
-> The major depressive episode is rare and is defined as a disturbance of the individual’s entire functioning. All the previous symptoms are present and important. Somatic complaints are omnipotent.
Those phrases we hear that don’t help:
-> You complain constantly, there are worse things in life!
Your suffering is important, so you have the right to say that you are unwell. To quote Car Rogers: “The individual who speaks has value and is worth understanding; therefore he has value for having expressed something”. Perhaps you are not expressing yourself to people who can understand and help you through this process. Professionals are trained to listen to you and understand you, so don’t hesitate to change the person you are talking to!
-> Move, exercise, force yourself to go out and you’ll see you’ll feel better!
It’s a bit like wanting to row faster when there’s a hole in the kayak. Trying to treat the inactivity caused by depression with activity will not solve the depressive problems and the disorders will continue to exist. Moreover, forcing yourself to do an activity risks reinforcing the feeling of guilt for not succeeding despite these “tips” that seem easy. Taking care of yourself is already a complicated and energy-consuming task, depression is not a simple matter!
-> Think positive instead of brooding!
Depression leads to a “cognitive triad” (Beck, 1976). This triad is a dysfunction of the set of perceptions you have about yourself (“I’m useless”, “I suck”), about the world (“no one loves me”, “I’m their ball and chain”) and about the future (“I’ll never amount to anything”, “we’re all doomed to die”) This is a symptom of depression. These are automatic thoughts that come into your mind without your direct control. So no, it’s not so easy to think positive!
These phrases that can help, don’t forget:
-> Each suffering is unique and cannot be compared.
Feeling emotions, even intense ones, is a normal reaction to situations. Emotions are not the enemy, they help you to understand events and to better understand yourself. Sometimes they can overwhelm you, hurt you. And in spite of the suffering felt, some people will tell you that your emotions have no value because there are worse things. This is not true. Your way of living an emotion, a situation is unique, so is your suffering. Don’t let anyone tell you that your suffering has no reason to exist.
-> Kindness towards yourself.
Depression is by no means an easy time, and some situations can feel like a trial. Feelings of guilt and abandonment are sometimes very present and give you that sense of failure weighing on your life. Understanding that this is a symptom of depression will allow you to take a step back from these thoughts. Taking a step back does not mean putting aside your suffering but learning to preserve yourself while suffering.
-> Dare to direct the request for help and support.
There are many stereotypes that foster bad behaviour towards people with depression. That they are lazy, that they don’t make any effort, that getting better is easy. All this is false. Professionals are trained in these issues and can accompany you effectively. They can listen to your suffering and understand it. Several methods exist to get better (psychotherapy, medication…). The professionals adapt to your request and your needs. It is no longer up to you to adapt to others.
Miljkovitch, R. (2016). Developmental disorders. Université de Vincennes – Paris 8, p.34-38.