Depression is a disorder that affects the way one feels, and perceives the world. According to the American Psychiatric Association (2013), 7% of individuals between 18 and 29-year-olds suffer from Major Depressive Disorder (MDD). Another subset of the population that suffers from depression are children and adolescents, according to the National Institute of Mental Health, 12.5% of population between 12 to 17 suffer from this disorder.
To get a better understanding of childhood and adolescent depression is like, I have interviewed Maria, her daughter Abrielle was present during the interview to help translate the questions. The interviewee and child come from a Latin background. Maria is a single-parent, who raised her daughter alone without the help of the biological father. She has always worked two jobs to raise her daughter. The daughter is now a 23-year-old in college, who is still managing her depression. For the purpose of this paper I have changed the name of the person interviewed and of their child.
Prior research done by Corona and colleagues (2012), examine the relationship of mothers and child depression among Mexican American families. Maria came to the U.S. from Mexico at a very young age, the study done by Corona and colleagues (2012) can help to better understand why Abrielle was at risk for depression. The study found that family is main cause for stress among Latino youth, parenting also play a role in the risk of developing depression. The mothers who report little to support from family showed to be more depressed, which could have resulted in modeling (Corona et al., 2012). In Abrielle’s case, it could be that Maria did not have a good relationship with her own family, Abrielle could have imitated what she was doing and not really on her for support. In the study, it was also mentioned that the relationship between the child and parent is affected by poor parenting quality (Corona et al., 2012). Although it was not intentional, Maria explained that when Abrielle was younger she would not spend enough time with Abrielle and believes that it was poor parenting. From the research done in this article, in Latino families “family” is very important. The fact that Maria admitted to not having a good relationship her family, it could mean that she herself had symptoms of depression or had depression. It gives a better understanding that Abrielle developing depression may have been due to genetics, modeling, and environment.
Maria noticed early symptoms of depression when Abrielle was 13. Abrielle would lock herself in her room and would not come out for hours, she ate very little or nothing at all, she would sleep in very late during the weekends and would get upset if woken up, and she would not spend time with her friends like a child her age. The DSM-5 requires the patient to present five or more symptoms in a two-week period. Abrielle at that age was not meeting all the required criteria for depression. Maria believed that Abrielle had an anxiety disorder rather than depression, but it was explained to her that sometimes the symptoms could be similar and cause a child to be misdiagnosed. And although she was not sure at the time, depression and anxiety are known to be comorbid disorders. According to Hirschfeld (2001), there are four different types of depression and anxiety comorbidity. The first, is when an individual has a full diagnosis of anxiety but few depressive symptoms. Second, when there is a full major depressive diagnosis and few anxiety symptoms. The third, the individual will be diagnosed with both disorders. And lastly, there are symptoms of both disorders but do not meet the criteria to be diagnosed. Nonetheless, a figure presented in Hirschfeld’s research showed that patients who have been diagnosed with major depressive disorder 8.2% will have an anxiety disorder comorbidity (2001).
Even though Maria did not think Abrielle was suffering from a disorder Maria did know that something was not right with her daughter. Maria did not know that Abrielle’s depression was severe until she was in high school and sought out for treatment without her acknowledgement. At the beginning, she was meeting with the school psychologist, and receiving counseling alone. However, after she was diagnosed with major depressive disorder therapist asked for Maria to join the treatment. Family counseling is an effective treatment, problems within the family influence behaviors and moods (Crethar, Snow, & Carlson, 2004). In this treatment, rather than trying to fix the child, there is a focus in fixing the parent-child interaction. The treatment goals during the first phase is to build stronger relationships, listening to each member view point, assessing depression within family, medicine and suicide history, and family history. During the second phase, it is important to educate the families about the disorder, find effective ways to cope, and improve parent-child interaction. In the final phase, the family will show what they have learned, the progress that has been made, preventing relapse, and the counselor helps the family cope with the absence of guidance (Crethar et al., 2004). Its assumed that Maria and Abrielle did not do this exact family treatment but rather a similar one. Maria learned to deal with Abrielle’s depressed or sad moods, engage in positive behaviors and activities that would encourage positive moods and thoughts, build a stronger relationship, and develop effective problem solving strategies for life stressors associated with depression.
Even though family treatments usually involve both parents, Abrielle had a special family treatment. In her treatment, she included her aunt. Her aunt played as a big social support, and someone who could relate to her. Corona and colleagues (2012), mentioned that in Latino culture family is important to lower the risk of developing depression. When Maria’s family found out about Abrielle’s disorder, her family came around to give support. It was easier for both Maria and her daughter to cope with the disorder. During the first phase of the treatment, the therapist usually asks about family history (Crethar et al., 2014). Although during this time Maria’s daughter was done with treatment, members of the extended family sought out treatment because it was believed that depression ran in the family. It was then concluded that Both of Maria’s parents suffer of a different but interrelated disorders.
The full diagnosis given to Abrielle was major depressive disorder with generalized anxiety symptoms. This diagnosis is explained by Hirschfeld (2001), where the person has full blown depressive diagnosis with symptoms of anxiety. Abrielle had constant worry about what would happen to her mother when they were not together. Abrielle would also worry that something extremely bad would happen to her if she did not stay home. Although it was family treatment, during the second phase it was suggested that there are effective coping skills (Crethar et al., 2004). Abrielle was taught to use relaxation skills when confronted with situations where her mother had to leave.
Other than family life, Maria believes that Abrielle’s depression influenced her academics. As Abrielle started her sophomore year in high school, she began to refuse school, she began to skip classes and staying home, and her grades began to drop. According to Petersen et al. (1993), grades decline over time for both genders. However, the decline in academics is usually seen in boy and not girls (Petersen et al., 1993). Assumptions were made that since this is an older article, there was still no research on academics and girls with depression. And it could have been possible that Abrielle had a severe depression that caused for her grades and school motivation to decline. In addition to academics declining, having little to no friends can have an influence on depression (Petersen et al., 1993). However, from background knowledge sometimes children who are depressed do not engage in social conversations. And other times children who do not suffer from depression do not approach children with depressive symptoms. This was the case with Abrielle, she had friends in middle school, in high school she lost contact with the few friends she had because she thought that other would also become sad. Petersen and colleagues (1993) suggest that it is not always the case that children do not have friends. In fact they suggest that there are cases where the relationships with parents are not absent, close friends fill that void for children.
There are many factors that play in a child developing depression and managing through it. This interview has helped in viewing the disorder from a different prospective. It helps with knowing that it is not easy being a parent and not knowing what your own child is going through or feels. At times a child’s disorder causes family to fall apart but in few cases like Abrielle’s it causes family to become closer. And the interview was happening, it was something that I could relate because I have also dealt with my own disorders and that I am not the only one who has gone through hard times. Maria included that although this is focused during childhood and adolescence, even now as an adult Abrielle still struggles with dealing with her depression and suggest that parents should not be afraid of a disorder but rather stand by the child and help them become successful.