Depression
Background
Diagnosing children as suffering from depression is a relatively new practice, this diagnosis was not used before the turn of the millennium. Unhappy children were earlier considered to have Adjustment Disorder with Depressive Symptoms, where “Adjustment Disorder” means a person suffering from symptoms triggered by their life experiences.
The diagnostic convention changed drastically around 2000, first in the USA but soon afterwards also in Europe. Child psychiatrists began to assign children the diagnosis of Major Depression, a category previously applied only to adults. This new label, which suggested that a child was suffering from a severe disturbance (rather than just an emotional reaction to something that had happened to them), was a welcome invention for two reasons. Firstly, it made securing reimbursement from insurance companies less complicated, and secondly, it justified treating children with medication rather than therapy.
An abundance of articles and research papers began appearing in professional journals. Proponents of the diagnosis maintained that childhood depression is a far more common disorder than generally assumed. It was even suggested that medical professionals often avoid assigning a Depression diagnosis because they, like most parents, find it difficult to admit that children can also suffer from this serious illness, which is common in adults.
A vague definition
In articles about childhood depression, the statement is often made that depression in children can take many forms and present via a wide variety of symptoms. The point is commonly made that when children are depressed, they are not necessarily sad, miserable or down (as adults usually are) but are either moody or irritated. With such a wide-ranging description, the definition of childhood depression has become so loose that only a tiny amount of imagination is required to allow it to be attached to any child who has emotional or psychological problems.
Diagnosing children as suffering from depression is a relatively new practice, this diagnosis was not used before the turn of the millennium. Unhappy children were earlier considered to have Adjustment Disorder with Depressive Symptoms, where “Adjustment Disorder” means a person suffering from symptoms triggered by their life experiences.
A dubious diagnosis
Within the last two decades, use of Depression as a diagnostic label for children has become widespread, with the obvious result that the number being prescribed antidepressant medication has skyrocketed. At the same time, psychiatric professionals have started to lose sight of the fact that, regardless of why children appear to be unhappy, there are many effective ways of helping them which do not involve labelling them as depressed and medicating them.
How did this happen?
The explanations provided here beg the question of why assigning a Depression diagnosis to children has become so commonplace. Proponents of the diagnosis will say it is because psychiatric professionals have finally opened their eyes to the ‘fact’ that both adults and children can suffer from depression, and that children therefore deserve to be treated accordingly. Critics argue that this drastic shift in diagnostic convention is nothing but a well–designed campaign massively funded by the pharmaceutical industry. The aim of this successful campaign has been to influence opinion and gain acceptance for the questionable concept that children’s psychological problems should be treated with the same potent neurochemical drugs as those widely used to treat adults.
Use natural language
When talking about children’s emotional and behavioural problems, I recommend that people avoid medical terminology whenever possible. This is because medical terminology – including most diagnostic categories – often implies that a problem is serious, is long-lasting, is difficult to treat successfully, and that only trained professionals have the qualifications to handle it.
Natural language is a wiser choice than medical jargon because it offers a wealth of words and expressions that encourage hope, and also because using it sends the clear message that everyone, not only professionals, has the qualifications required to help children overcome their problems.
Find an alternative word for depression
Depression can, for example, be replaced by natural language expressions such as ‘sad’, ‘down in the dumps’, ‘unhappy’, ‘heartbroken’, heavy-hearted’ or ‘feeling low’.
Joy Gone Hiding (JGH)
When I speak at conferences I often suggest that we should replace the term depression with the acronym JGH (Joy Gone Hiding) . This, more optimistic, ‘diagnosis’ conveys the idea that because something has happened in their life, a child has temporarily lost their ability to enjoy living. Treatment should, accordingly, not be medication, but helping the child recover their skill of experiencing joy in their lives – regardless of why they lost the skill in the first place.
Synopsis
If the child is unhappy, avoid medical terminology to describe the child’s condition and use words and expressions of natural language instead.
If there is a clear cause for the child’s unhappiness, support the child in overcoming the problem if possible. For example, if the child is bullied in school, read about what I have written about bullying in this app to find out how to help the child overcome the problem.
Think about depression in children as a sign that the child has temporarily lost their ability to enjoy life, and help the child by assisting the child to learn to experience joy again.
You can use Kids’ Skills to help the child relearn the ability to experience joy. The child can give the skill a name, nominate a number of supporters, pick a power creature, draw up a plan of how to celebrate once they have learned the skill, etc. You can help the child make a list of activities that the child has previously enjoyed and then invite the child’s supporters to do those activities with the child.

