WK5 NRNP 6665 ASSIGN

WEEK 5: Mood and Anxiety Disorders in Children and Adolescents

Alexandra Louis-Jeune

College of Nursing- PMHNP, Walden University

NRNP 6665- PMHNP Across the Lifespan I

Megan Shelton

January 3, 2022

A GUIDE ON PERSISTENT DEPRESSIVE DISORDER IN CHILDREN AND ADOLESCENTS

WHAT IS PERSISTANT DEPRESSIVE DISORDER?

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A child or adolescent with persistent depressive disorder will experience a depressed or irritable mood on most days for at least 1 year. The body, emotions, and thoughts of a child are all affected by the depression. It's not the same as being gloomy or down in the dumps. It's also not an indication of immaturity. It is not something that can be hoped or commanded away. Children that are depressed are unable to pull themselves together and improve on their own. Treatment is frequently required.

Symptoms may include the following:  Lasting feelings of sadness  Irritability and aggression  Despair  Helplessness  Low self-esteem  Sleep problems  Changes in appetite and weight  Low energy  Problems focusing  Suicidal thoughts or attempts  Running away or threats of running away from home  Disinterest in normal activities

CAUSES OF PERSISTENT DEPRESSIVE DISORDER:

There is no single cause for persistent depressive disorder. It frequently occurs in the context of other mental health issues, such as substance misuse or anxiety. There are unique risk factors for a chronic depressive disorder that include but are not limited to genetics, epigenetics, prior mental illness, high anxiety states, trauma, life stresses, and other social health indicators (Patel, & Rose, 2021).

Common risk factors for depression include the following:  Family history of depression  High level of stress  Abuse or neglect  Physical or emotional trauma  Other mental health problems  Loss of a parent, caregiver, or other loved one  Loss of a relationship  Other long-term health problems  Developmental or learning problems

DIAGNOSIS OF PERSISTENT DEPRESSIVE DISORDER IN A CHILDREN AND ADOLESCENTS

This disorder is frequently diagnosed by a mental health professional. A thorough mental health examination will be performed. F amily members, instructors, and carers may be consulted. Any psychiatric interview, especially one for diagnostic purposes, requires a thorough history. The accurate diagnosis is determined by investigating symptoms, severity, and sequential progression. Symptoms cannot be absent for greater than 2 months.

In addition to depressed/irritable mood, at least 1 one of the following symptoms must be present.

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 Poor appetite or overeating  Insomnia or hypersomnia  Low energy/fatigue  Low self-esteem  Poor concentration/decision making  Hopelessness

The symptoms must cause significant distress and impairment in vital areas of functioning for diagnosis.

TREATMENT OF PERSISTENT DEPRESSIVE DISORDER IN CHILDREN AND ADOLESCENTS

A combination of pharmacotherapy and psychotherapy is more effective than either treatment independently (Das, Salam, Lassi, Khan, Mahmood, Patel, & Bhutta, 2016). If antidepressant therapy is indicated, a selective serotonin reuptake inhibitor is the first line typically given the overall efficacy and tolerability of the class. Cognitive behavioral therapy and interpersonal therapy are most studied for the treatment of depression. Treatment will depend on your child’s symptoms, age, and general health. It will also depend on how severe the condition is. This disorder can be treated.

COMMUNITY RESOURCES FOR PERSISTENT DEPRESSIVE DISORDER IN CHILDREN AND ADOLESCENTS

1. Your child/adolescent’s care team may include counselors, therapists, social workers, psychologists, and psychiatrists, depending on their needs and seriousness of their depression.

2. Pediatric clinicians may refer patients to outside resources for higher-acuity cases or those who require more specialized care.

3. Care coordination is the process of organizing patient care activities, which is often aided by information sharing among doctors participating in a patient's care. This ensures that services delivered across locations are well planned.

4. Music, dancing, singing, theater, and visual arts are examples of community- based creative activities that have a good impact on behavioral changes, self- confidence, self-esteem, knowledge, and physical exercise.

5. Children and adolescents with complicated and long-term mental health difficulties benefit from mental health rehabilitation treatments. Inpatient programs and community teams that provide clinical input to clients in community-based settings (Dalton-Locke, Marston, McPherson, & Killaspy, 2021).

6. If your child's depression makes it difficult to succeed in school, special protections, and accommodations under the Americans with Disabilities Act (ADA) or Section 504 of the Civil Rights Act may be provided. Discuss how to obtain more information with your child's teacher or school principal.

Seek help right away if your child:

 Feels extreme depression, fear, anxiety, or anger toward himself or herself or others

 Feels out of control  Hears voices that others don’t hear  Sees things that others don’t see  Can’t sleep or eat for 3 days in a row

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 Shows behavior that concerns friends, family, or teachers, and others express concern about your child’s behavior and ask you to get help

Call 911 if your child has suicidal thoughts, a suicide plan, and the means to carry out the plan.

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REFRENCES

Dalton-Locke, C., Marston, L., McPherson, P., & Killaspy, H. (2021). The Effectiveness of Mental

Health Rehabilitation Services: A Systematic Review and Narrative Synthesis. Frontiers in

psychiatry, 11, 607933. https://doi.org/10.3389/fpsyt.2020.607933

Das, J. K., Salam, R. A., Lassi, Z. S., Khan, M. N., Mahmood, W., Patel, V., & Bhutta, Z. A. (2016).

Interventions for Adolescent Mental Health: An Overview of Systematic Reviews. The

Journal of adolescent health : official publication of the Society for Adolescent Medicine,

59(4S), S49–S60. https://doi.org/10.1016/j.jadohealth.2016.06.020

Patel R.K., Rose G.M., (2021) Persistent Depressive Disorder. Treasure Island, FL: StatPearls

Publishing; Available from: https://www.ncbi.nlm.nih.gov/books/NBK541052/

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