If your daughter is showing symptoms of depression, she’s not alone. As the teen years approach, girls report depressive feelings at twice the rate boys do. Children and teens of both genders are receiving more medication for depression, with antidepressant prescription rates for kids skyrocketing over the past 10 years from 50,000 to an estimated 2.5 million.
Although experts urge parents to move quickly when their daughter is depressed, they also urge caution before turning to medication. “We should help girls deal with environmental and cultural factors that can cause depression rather than first treating them biologically,” says John Sommers-Flanagan, a clinical psychologist and co-author with counselor wife Rita of Problem Child or Quirky Kid: A Commonsense Guide. In recent months, regulators in the United States and the United Kingdom have warned against the use of widely prescribed antidepressants such as Paxil and Effexor by youth because of the suicidal and hostile behavior that can sometimes result. Many are also concerned about withdrawal symptoms including anxiety and sleeplessness when antidepressants are discontinued.
While antidepressants are under scrutiny, however, other methods for treating depression in girls are receiving high marks. One five-year program funded by the National Institutes of Mental Health focuses on teaching coping skills to 9- to 13-year-old girls and their parents. First-year results show that 87 percent of the middle-school girls diagnosed as depressed had recovered. “We’re very pleased, because if girls can learn these skills early on, they’re much more likely to avoid depression as adults,” says project director and University of Texas psychology professor Kevin Stark.
Better yet, parents can help their daughters learn depression-busting basics from an early age. “Many girls who develop depressive disorders tend to use a ruminative, internally focused style of coping with stress, rather than an active coping style that enables them to obtain relief through distractions and problem solving,” Stark explains. Parents can help their daughter do what girls in the NIMH project learn with the acronym ACTION: Always do something better. Catch the positive. Think of obstacles as problems to be solved. Inspect the situation. Open yourself to the positive. Never get stuck in the negative muck.
Parents can model ACTION-inspired behavior, while boning up on parenting skills to deal with the withdrawal and anger that often accompany depression in depressed girls. For starters, they can help their daughter adopt a more healthy and realistic view of her problems. “People who are depressed often see their situation in an unrealistically negative way,” notes Stark.
Just as critically, parents must talk with their daughters about the pressures facing all girls, such as the cultural expectations to be model-thin and attract boys, and to be “nice” or silent in the face of unfairness. “Girls get some very destructive messages, and they need help in recognizing and dealing with them,” says Rita Sommers-Flanagan. Parents can talk with girls about these pressures and help them chart changes in their feelings that may be linked with certain situations or expectations.
When parents and girls work together to analyze the sources of a girl’s depression, they may find some fairly easy fixes. Sometimes girls are simply overwhelmed by high parental expectations or exhausting schedules. In this case, basics can help a lot, such as making sure she gets enough sleep and down time, eats well, and finds ways to relax. When peer relationships depress her, take the situation seriously and seek help from school counselors. And while you’re talking to them, suggest they start an ACTION-style group at your daughter’s school. If the source of a girl’s depression is family upheavals such as divorce or moving, parents should seek counseling to lessen the strain on the entire family.
Counseling is definitely needed when a girl’s depression continues beyond the occasional bad mood or sadness. If a girl repeatedly says she can’t cope, has persistent stress-related symptoms such as headaches and stomachaches, or if her behavior keeps her from functioning, seek help, advises Sommers-Flanagan. Ask trusted friends to find the best professional, and be prepared to insist on therapy if medication alone is prescribed. Ask lots of questions about any suggested drugs. (And if your daughter is on antidepressants and you are considering stopping them, be sure to first consult with a medical professional because of the possibility of withdrawal symptoms.) “A pill is not a skill,” says Sommers-Flanagan. “Most kids improve after at least eight sessions of learning coping skills and stress reduction.”
Helen Cordes is a nationally published parenting writer and the executive editor of New Moon Girls magazine.
Treating Depressed Children: Therapist Manual for Taking Action by Kevin Stark and Philip C. Kendall
Problem Child or Quirky Kid by John and Rita Sommers-Flanagan