In the spirit of Mental Health Awareness Month we asked a leading child and adolescent psychiatrist for some guidance on what to look out for and what to do in the case of depressed and suicidal children. pic:

Adults often think that children are not mature enough to experience the emotions that constitute depression, but a respected child and adolescent psychiatrist said children respond to stressful situations like we do.

In the spirit of Mental Health Awareness Month we asked Johannesburg-based, Dr Helen Clark, for some guidance on what to look out for and what to do.


1.Seeing a change in the child - the child may appear sad, irritable, cry more often, start having tantrums, start withdrawing, isolating themselves OR become agitated and behave badly and become aggressive The key is the change in behaviour from before.

“Talk to your child that you have noticed he's not the same as before. Is there something worrying him? How is he feeling? Suggest emotions and explain them to help him describe them. Encourage him to talk. This may be all he needs -to know that you know and are going to help him. You can also start watching him to elicit other signs of depression at which time you should seek professional help.”

2.The child is no longer interested in future activities - not looking forward to a birthday party or their birthday.

“The most important intervention in all of these factors is to talk to your child which so many parents just don't do. Why don't you want to go to the party - as there may be a very valid and real reason or the child may just not feel like it, not have the energy, say no one likes me. One must remember that one of the features of depression is a poor sense of self worth. Again look for other signs of depression and seek help if indicated.”

3.Change in sleep or appetite. These are what are called neurovegetative features. Sleep is often disturbed with difficulty getting to sleep (lie awake thinking sad thoughts or worrying), may wake at night and not be able to get back to sleep or wake early in the morning. Watch for sudden onset of nightmares representing subconscious presentation of distress.

“Monitor. Settle child at night, sit with the child at night while falls asleep and try to address their worries. Try to provide food they like. Again look at other symptoms of depression and act accordingly.”

4.Starts complaining of physical complaints eg headaches, stomach ache, dizziness but there is nothing physically wrong (when taken to GP)

“Once there is a suspicion of depression, phhysical problems should be addressed symptomatically as parent would normally do and referred to the GP or primary health care clinic if there is concern. The caregiver may realise that there is, there may be multiple visits over a short period of time. A good practitioner will suspect depression at this point Once there is a suspicion of depression referral should be considered.”

5. "It would be better if I was dead".

“This is a reason for severe concern. Check for other signs of depression but immediately refer for assistance.”

The procedure of referral for psychiatric /psychologically help is:

  • If have contact with psychiatrist /psychologist, consult directly.
  • Consult GP or primary healthcare clinic or hospital paediatric casualty
  • They will refer you to a psychiatrist/psychologist/or medical practitioner who can assist you. (Your GP may be able to assist you directly)
  • Suicidality is a child psychiatric emergency - if there is a child psychiatric ward, with a bed available, the child should ideally be admitted. These children need treatment and very close observation.
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