Depression in children and adolescents with chronic illnesses
Summary
The onset of a chronic illness presents many challenges, especially during childhood or adolescence: changes in habits, daily difficulties, pain, doubts, and so on. This new situation can be overwhelming and emotionally affect the person experiencing it.
In most cases, children and adolescents adapt well to the changes involved in living with a chronic illness, but attention must be paid to emotional reactions to assess whether they are expected or if there is a possible risk of developing major depression.
In this article, we learn what warning signs may indicate difficulties in the emotional management of a chronic illness in order to offer children and adolescents good support.
People with chronic illnesses generally experience a lower quality of life (Megari, 2013). This is not only due to the physical problems they face, but also to the associated emotional distress and, in some cases, a greater risk of developing debilitating symptoms of anxiety and depression (Sziegethy et al., 2014).
This is especially relevant when illnesses occur during periods of heightened vulnerability, such as childhood and adolescence. Although most children, adolescents, and their families adapt to the challenges this presents , approximately 1 in 4 will develop a mental health disorder associated with the medical illness, usually in the realm of anxiety or depression (Shaw & DeMaso, 2020).
Emotional reactions to illness are normal (and in many cases, adaptive), expected, and variable responses. Here, we want to highlight sadness. This emotion will appear linked to the process of assimilating the illness, as the person understands its irreversibility and the associated losses. In this sense, several authors, drawing on the grief models of Klüber-Ross (1969) and Worden (2010), have proposed that the process of adapting to chronic illness is comparable to coping with multiple losses , primarily related to health, but also to independence, sense of control, privacy, body image, some interpersonal relationships, self-esteem, future plans, and family routines.
Distinguishing the symptoms of depression in children with chronic illnesses
It is important to distinguish between the normal and expected adaptation process, in which sadness in the face of illness may be present, and what would be considered major depression . For this reason, it is crucial to monitor the mood of children or adolescents with chronic illnesses in order to assess whether their response is expected, appropriate, and proportionate, or whether the distress they are experiencing is a risk indicator that will require intervention by a mental health specialist.
Some warning signs that may indicate difficulties in coping with the chronic illness process, and that the person may be developing major depression, would be the following:
- Sad and irritable mood most of the time.
- A feeling of deep emptiness and pain in the face of a situation that does not subside.
- Lack of interest in activities he previously enjoyed.
- Attitude of surrender to illness.
- Abandonment of treatments.
- Refusal to attend medical appointments.
Caring for the emotional health of families in the face of illness
A chronic illness presents a significant challenge for the child or adolescent who suffers from it . Although most manage to adapt well, sometimes the emotional distress is so intense, persistent, and difficult to manage that it causes significant symptoms of anxiety and depression.
However, chronic illness does not always have to be a traumatic experience. Therefore, it is essential to support and identify any signs of emotional distress that a child or adolescent may be experiencing in relation to their medical condition, in order to offer the necessary help and support to improve their quality of life, activate their strengths, and foster resilience in the face of the chronic illness .
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