Childs and teens mental health

Question 1

Website for depression and other mental heatlh problems in children and teens - read and make notes on for revision

Answer 1

https://www.mindedforfamilies.org.uk/young-people/search-results/?searchTerm=depression

Question 2

What can cause a child to be upset?

Answer 2

Life changes, stresses and losses can cause upset, both big and small eg
Lower marks, not being chosen for a team, parental dispute or separation
Breakup of key friendship or firat relationship
Death or serious illness of close relatice or freind

Question 3

Presentation of child being upset

Answer 3

Look down in the dumps
Seem very caught up in themselves
Be preoccupied
Be tearful or seem to want to be alone, and they may avoid other

Question 4

Cycle of clinical depression

Answer 4

Thought, feelings, experiences, behaviours

Question 5

Thoughts and feelinfs in clinical depression

Answer 5

Slow thinking or movements, difficulty staying focused
Guilt, that is not rational, but is painful, worthlessness, or low self-esteem
Ideas of life not being worthwhile
Ideas of harming oneself or ending ones life
Voices and other hallucinations or strange thinking (usually more severe cases can be signs of psychosis)
Feelings: Depression of mood or low mood
Irritable

Question 6

Physical experiences in depression

Answer 6

Loss of interest or loss of pleasure in things
Loss of energy or get up and go
Changes of appetite, generally marked decrease, sometimes inappropriate overeating or weight changes
Sleep problems with lack of sleep especially early morning waking
Mood being very low first thing, but getting much better as the day goes by

Question 6

Physical experiences and behaciours in clinical depression

Answer 6

Loss of interest or loss of pleasure in things
Loss of energy or get up and go
Changes of appetite, generally marked decrease, sometimes inappropriate overeating or weight changes
Sleep problems with lack of sleep especially early morning waking
Mood being very low first thing, but getting much better as the day goes by
Beahviours - Irritability
Tetchiness

Question 7

What does a child or young person need for a diagnosis of depression?

Answer 7

At least 4 symptoms with sufficient severeity, persistence and negative impact on everyday life
With one of:
Sadness or a sad-irritability
Undue touchiness or edginess
Snappiness

Question 8

How long symptoms need to be present for a diagnposis of clinicla depression in children?

Answer 8

-at least 2 weeks in a row at least 50% of the time
-Impairment of ADLs

Question 9

What can develop from depression that are red flags?

Answer 9

Slf harm/suicide
Pyshcotic symptoms

Question 10

How does depression manifest in the day to day?

Answer 10

Worrying more than usual
‘Giving up’ and ‘giving in’ on tasks much sooner than is usual for that young person’s character
Behaviours and or ideas linked to ending life, suicidal behaviours
Increasing sense of fragility
Tearful
Decreased get up and go, with a sense of the young person having very low ‘batteries’ as if they have lost all their ‘umph’
Increasing isolation from friends, school, social activities and family
Excessive boredom
Decreasing school performance including:
Poor concentration
Stopping before finishing
Losing track during class
Not understanding things clearly said to them
Being unable to make decisions around learning, or in tests
Becoming edgy, like ‘walking on egg shells’, prone to ‘disintegrate or fall apart easily’ or ‘flying off the handle’
Acting out of character

Question 11

What is there a link with in depression in ypung people?

Answer 11

Risk taking behaviours much more likely eg
-Smoke reguarly 11-16 years
Drink at least twice a week
Used hard drugs
Selg harmed - self reported
No friends
Excluded from school

Question 12

How much does childhood depression increase risk of having significant mental health issues in adult life?

Answer 12

Depression returns in 50% of young people over 5 years, 75% over 18 years or more

Question 13

What % of adults with depression have experience it before the afe of 21? What are they at higher rusk of?

Answer 13

25%
Adult psychiatric disorders eg anxiety, substance musude

Question 14

Principles for helping depression in young people

Answer 14

Listen
Empathetic
Problem solve tovether
Reconnect
Support positive experieicnes
Support good life habits, exercise etc
Deal with life stresses
COnsent and confidentiality
Develop an idea that they are supported and importnat

Question 15

How to manage mild cases of depression in children

Answer 15

Support, watch and eait
If dont improve in 1-2 motnhs refer to next level of sercice or provision
-GP
-Local area children or young persons team
Local child and adolescent mental health service

Question 16

When to refer as priority - alarm bell or emergency to GP/local specialist adolescent mental heatlh service for young people with depression?

Answer 16

Moderate cases:
o Five or more symptoms with moderate impairment
* Severe cases:
o Seven or more symptoms with high impairment
* Any with increased risk due to:
o Ideas of suicide
o Risk related behaviours or thoughts
o Possible psychosis (voices and strange thoughts)

Question 17

Where to refer in a red flag situation/crisis?

Answer 17

due to high risk, self-harm or risk to others, call the GP or refer to the A&E department and the on-call specialist child and adolescent mental health service immediately.

Question 18

When are medications considered in childhood depression?

Answer 18

After talking therapies have been considered and with careful supervision by doctors to manage risks