A recent study conducted to estimate the prevalence of depression among adolescents has shown that there is high prevalence. Results indicate that there is a 10% young population with depression which amounted to approximately 550,000 adolescents. These children were treated by psychiatrists using pharmacotherapy and indicates a growing need for having approved treatments in adolescents with depression in Japan. Globally, too there is a growing incline in major depressive disorder in children and as many as 8% of adolescents who have been diagnosed with MDD have suicided by adulthood making it one of the leading causes of suicide.

Grief and sadness is part of life when facing negative experiences, but such feelings are normally short-lived. When there is continuous feeling of intense sadness, this may be due to clinical depression, which can impact both mood and behavior, decreasing one’s quality of life. Currently Japan has no approved antidepressant treatments for paediatrics patients having depression. A recent study conducted to estimate the prevalence of depression among adolescents has shown that there is high prevalence. Results indicate that there is a 10% young population with depression which amounted to approximately 550,000 adolescents. These children were treated by psychiatrists using pharmacotherapy and indicates a growing need for having approved treatments in adolescents with depression in Japan. Globally, too there is a growing incline in major depressive disorder in children and as many as 8% of adolescents who have been diagnosed with MDD have suicided by adulthood making it one of the leading causes of suicide. Paediatric MDD is not well diagnosed and the condition becomes a chronic, recurrent and debilitating disease impacting social functioning. The present Covid-19 pandemic has further aggravated mental health conditions in both children and adults.

Symptoms of Major Depressive Disorder: Paediatric patients experience episodes of depression and teens who have this condition usually have symptoms lasting for at least 14 days. Some of the common symptoms which can be identified are.

·     Children lose their interest in studies

·     Social withdrawal is noticed with less engagement with friends and family

·     Decline in interest to carry out hobbies

·     Difficulty sleeping

·     Weight loss and appetite issues

·     Feeling of being misunderstood

·     Unexplained crying and fear

·     Thoughts of self-harm

·     Fatigue and low energy

In addition, children may look stressed out and show anxiety with unexplained physical complaints. MDD can be present in children as young as 10 years, which makes up approximately 2% to 3% cases and this rate increases to 5% to 8% when in their teens. Following puberty, girls have twice the chance of having this condition than boys. It is important that children with this condition are evaluated and medical treatment is sought. It will help to stop recurrent episodes of depression. Researchers feel that early identification and treatment helps to bring improved outcomes in the short and long term. This helps to improve self-esteem, school performance and social development. In addition, children with depression have a high tendency to involve in substance misuse which is another factor to increase the risk of suicide.

Diagnosis of Major Depressive Disorder: If symptoms of depression has lasted for more than a fortnight, then it’s important to have your child checked by a mental health care professional who specialises in children. The doctor will want to speak to the child alone and evaluate using interviews as well as other psychological testing. Feedback from teachers, siblings and friends can be important to understand if the child has a marked change from previous behavior. Personal information, questionnaires and mental health screens are used by paediatricians to diagnose childhood depression. Mental health conditions are usually associated with misconceptions which ultimately leads to high social stigma. This negative stigma associated with the disease can make parents feel embarrassed to take their children for a medical evaluation. Children too fear being shamed or being labelled a ‘basket case’ and about how they could cope with what society thinks about them. This usually prevents seeking help early.

Effects of the pandemic on Major Depressive Disorder: Covid-19 has brought in complex issues with high uncertainty levels, social isolation and frustration among parents too. This has had a severe negative impact on the mental health of children. Predictability of life has been disrupted and children face anxiety due to uncertainty. With parents facing many challenges to make ends meet, it has become difficult to address the emotional needs of children. During a recent online survey performed during the pandemic in China, it was seen that 22% youth faced clinical depression. The data was gathered from 359 children and 3254 adolescents. Evaluation was done using depression and anxiety scales.

Treatment Methods for Major Depressive Disorder: Psychotherapy is the first line of therapy for major depressive disorder in children. Two of the most used psychotherapeutic approaches include the Cognitive Behavioural Therapy (CBT) and Interpersonal Therapy (IPT). These therapies are administered by licenced therapists who are specialised in handling depressed paediatric patients. In CBT, the patients are taught to identify wrong patterns of reasoning and correct it with constructive thoughts. IPT focus on building relationships and communication skills which is used to treat children with MDD. Two of the FDA-approved drugs currently used include selective serotonin re-uptake inhibitors. These include fluoxetine and escitalopram. These drugs have helped in preventing depression symptoms and brought about a greater prevalence of remission. 

Tips to Improve Mental Health: Empowering and being there for your children is important. Some ways you can help to improve your child’s emotional wellbeing are:

·     Being aware of your child’s overall actions and behavior: When children have a problem, it is shown in their behavior than words they speak.

·     Encouraging Creativity: Help your child to build relationships through sports, art, writing and music.

·     Build Trust: The relationship you share with kids play an important role in building their mental health. Thus, it’s important to build trust and establish a safe and secure atmosphere for children. This can be done by working on the emotional needs of your children.

·     Teach Stress Management: As parents, it is important to teach children on how to cope with stress and teach them ways to build their mental health.

·     Establish Healthy Habits: Train children to have a healthy lifestyle with a healthy diet, plenty of exercise and a good night’s sleep. This is essential in building positive mental health. Mindfulness and gratitude help to improve your family’s overall mental health.

We at 3H are committed towards building a healthy future generation and helps to find novel solutions through clinical trials to address the issues of major depressive disorder in children.

To know more about 3H disease awareness approach, please contact imran@3h-ms.co.jp