Depression can start as early as kindergarten and so be "aware of red flags that trigger child depression", according to doctors.

In the wake of children returning to schools, doctors warn parents that though school grounds are meant to be a safe heaven for kids, they can also be a nightmare.

Dr Hussein Nasser Matlik, consultant - pediatric neurology, Burjeel Hospital, said: "Depression is not rare in children, and it often starts from school because bullying continues to be a problem in schools."

He noted that depression among children is so common that a US study found that it can start in children as young as three to five.

"The study revealed that depression is in 0.5 per cent in children ages 3-5 years and 1.5 per cent in children ages 6-12, and 3.5 per cent from 12-17 years. It is common in both male and female, but usually more common in female by almost double the number after puberty, but pre-puberty it is exactly the opposite."

Dr Matlik pointed out that there are risk factors that families and teachers must look out for.

"There's a lot of risk factors, including family history of anxiety, family disruption and exposure to early abuse or neglect, which is common.

"However, the most important factor now-a-days is combating bullying, because children suffering form chronic illnesses are more at risk than others, and it's the parent's and teacher's job to insure they are protected.

"Schools should be aware of this and should monitor the child - especially, if he or she is already suffering from disability, diseases like cancer or epilepsy - and they have to be treated as normal. Depression is common in both boys and girls, but usually more common in females by almost double the number after puberty, but pre-puberty it is exactly the opposite," Dr Matlik added.

Most importantly, Dr Matlik said parents should consult the teachers if their child is being bullied in school. "If the bullying is not stopped, it will lead to depression."

Dr Matlik said other risk factors include substance abuse, psychiatric diseases, autism, and any history of trauma to the brain.

"Adults should look out for any sudden changes in the child's mood, such as feeling down, or sudden diminished interest, less interaction, and any sudden changes in the appetite - either increased or decreased."

He said sleep disturbance, such as difficulty falling asleep, sleep walking, or waking-up early and unable to return to sleep, are also warning signs.

"These signs all suggest that their child might be starting depression."

He noted that parents should consult a child psychologist if they notice rapid changes, because ignoring the signs may lead to detrimental consequences.

"Depending on the severity of the condition, there will be medical or psychotherapy intervention. Depression in children can be controlled, but there is a high risk of relapse."

Naser Al Riyami, hypnotherapist and psychologist, said: "Clinical depression in children is usually the result of complex interactions and children as young as six are put on medication to fight depression. Most children should not be treated with medication, but rather by fixing their environments and talking to them."

"Today, more children are being diagnosed with depression or anxiety, but the main diagnoses with children remains as learning disorders and attention deficit hyperactivity disorder (ADHD)."

Al Riyami said that feeling sad and anxious are core morbidities with the common diagnosis, adding that a healthy way of combating this among children ages 0-12 is for the parents to apply the sleep-talk programme on a nightly basis for at least three months. "Depression in children is one of those things that parents will say: 'You are not old enough to be depressed.' But the truth is, as long as you are alive, you are at risk of being depressed."

jasmine@khaleejtimes.com

Sleep-talk programme

Don't misinterpret this with children talking out aloud during their sleep. This is a therapy to put the child to sleep but don't leave them alone in bed. Talk to them things that boost their self-image and confidence as they fall in sleep. Bedtime stories are also another option for children fighting depression. Read out to them instead of putting them on an electronic device to listen to a story.

Warning signs

> Sudden changes in mood such as feeling down

> Diminished interest, less interaction

> Changes in appetite - either increased or decreased

> Sleep disturbance, such as difficulty falling asleep, sleep walking

> Waking-up early and unable to return to sleep

Source: Khaleej Times