Major Depressive Disorder
Major Depressive Disorder (MDD) is one of the most common mental disorders. When a child experiences a depressed mood over an extended period of time - two or more weeks - it may be a sign of MDD. Although ups and downs are quite common among children, major depression involves an extended period of sadness or irritability that is characterized by its impairment to functioning and its persistence. This is not a condition that someone can simply "wish away." Major depression has the ability to disrupt a child's life in multiple domains including behavior, appetite, energy level, sleep patterns, relationships, and academic performance. Children who are depressed tend to think very negatively about themselves and their circumstances. The child may be very judgmental towards themselves, feel hopeless, and withdraw from people they care about and from their typical interests and activities. In more severe cases, it may lead to drug usage, suicidal ideation, or patterns of self-harm.
Treatment
Behavioral treatment of major depression is well researched with several cognitive behavioral processes potentially playing an important role in clinical outcomes. At The Anxiety Center treatment typically involves teaching of coping and emotional regulation strategies such as cognitive reappraisal and acceptance as a means to address unhelpful thought patterns and intense feelings. A second component to treatment is called behavioral activation, which is a structured method for values, reinforcement, and activity monitoring. Drawing from applied behavioral analysis, the clinician will work with you to think about your behavior from a functional perspective - addressing what the behavior leads to - while determining which activities are in alignment with your values and most likely to increase your access to reinforcement. With children, this is always done in conjunction with parent training to ensure that the child has access to a validating environment that encourages more adaptive behaviors.