Your child may be sadder than you think

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According to child development experts, it is perfectly normal for children to have mood fluctuations with occasional bouts of sadness. As they come into their own as individuals, kids struggle at times to process their emotions and regulate their behavior.

But when young children lack the self-awareness to describe how they're feeling, how does a parent or caregiver know when a dark disposition is more serious, possibly pointing to depression or some other mental health concern?

It's not always easy to determine, and can depend on a complex network of environmental factors, says Yuliya Kotelnikova, a professor and psychologist in the University of Alberta's School and Clinical Child Psychology Program.

To begin with, caregivers might interpret a child's behavior based on their own perceptions and frame of mind at the time. Or they might misread outward acts of worry, refusal and anger as an attempt to "get something"—such as acquiring material items—or "get out of something"—such as avoiding something they don't want to do, says Kotelnikova.

A caregiver might see a child as challenging the rules, she says, when actually the child feels helpless and frustrated and lacks the ability to express it verbally.

It is normal for children to experience variations in mood. But feeling sad, lonely, grouchy, angry or unhappy all day, every day for weeks and even months is not, and could be a sign of childhood depression, says Kotelnikova. Possible cues can be visible, expressed in outward behavior, or invisible, experienced by the child as thoughts, feelings or physical sensations.

Child psychologists often use the Cognitive Behavioral Model to understand how feelings, thoughts and behavior interact, recognizing that any change in one will cause changes in the others.

To help a struggling child, Kotelnikova advises keeping relationships between these components in mind while engaging in collaborative discussion with a child, encouraging them to identify and describe what they are thinking and feeling.

"When a caregiver takes this approach, they can shift seeing behaviors in children as a 'problem' to viewing their child as struggling because they lack the skills to manage their distress on their own," she says.

Here are some signs to watch for under each component of the Cognitive Behavioral Model.

Behavior

Changes in a child's typical behavior are often the first noticeable signs of depression, says Kotelnikova. That may include losing interest in activities a child normally enjoys, refusing to go to school, withdrawing from family and friends and disruptions in normal routines, like forgetting to brush teeth or bathe. Changes in eating habits, altered sleeping patterns, notably reduced ability to concentrate and a lack of enthusiasm for play or socializing may also indicate depression.

While such behaviors are the easiest signs indicating mental distress, they may also be "merely clues to what might be happening inside a child's mind," says Kotelnikova, who is a member of the Women and Children's Health Research Institute.

"Caregivers may need more information about a child's thoughts and feelings to fully understand what they are struggling with."

Thoughts

Especially as children become older and feel the need to meet societal expectations, they can become frustrated with themselves and engage in negative self-talk, a habit that can become reflexive for someone struggling with depression.

Frequent and persistent negative thoughts, such as, "I'm stupid," "I can't do this as well as my friends," or, "They don't like me," could be cause for concern, says Kotelnikova, as they may reinforce a child's sense of hopelessness and helplessness.

Conversations with a child about what's going on in their mind are crucial for determining the extent of negative self-talk and what steps may be necessary to address it. The best approach includes open-ended questions that require more elaboration than simple yes or no answers. Examples might include, "When you feel sad, what kinds of thoughts do you have about yourself?" or "How do you talk to yourself when you're frustrated and want to give up?"

Feelings and physical sensations

When a young child experiences negative emotions as sensations in the body—such as tummy aches, headaches, sore muscles, not feeling well or being too tired to play—it could be because they lack the words to articulate what's on their mind, says Kotelnikova. A caregiver can guide a child in understanding feelings as sources of physical sensations.

Together, the caregiver and child can develop a common language to describe feelings and physical sensations. Some examples of caregiver prompts might include, "What do you think your body is trying to say to you when your tummy feels upset before you meet new people?" or, "How does your body feel when you are sad? What about when you are angry? How is it different?"

The SAMPL research lab

Along with graduate students Amanda Santarossa, Kiranpreet Ghag and Kelsie Slater, Kotelnikova has established a lab called the Study of Assessment Methods and Psychopathology Across the Lifespan (SAMPL) in the Faculty of Education. They study caregivers' perceptions of their children's behaviors, thoughts and feelings as a way to better understand child temperament.

The lab also explores how a caregiver's relational sensitivity affects a child's reactions, emerging self-regulation and overall mental health, says Kotelnikova, stressing that parenting styles are strong predictors of healthy social-emotional adjustment.

"When caregivers work jointly with their children to understand how they respond to stressors," she says, "adults can help children find healthy coping strategies and develop adaptive self-regulation skills that foster a positive outcome, rather than avoiding, minimizing or neglecting difficulties."

Reactive or highly sensitive children who don't receive support and guidance from caregivers may experience more negative social-emotional developmental outcomes, Kotelnikova says, including strained interpersonal relationships, aggression and violence, dropping out of school, substance use and risky behavior.

To promote more positive outcomes, the SAMPL lab aims to understand the complex interplay between a child's temperament and their early caregiving environment, especially positive and negative parenting styles, says Kotelnikova.

In the best-case scenario, she adds that interplay can lead to positive interpersonal relationships, a sense of belonging, a strong moral compass and the child's future success in their career.

Provided by University of Alberta

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