The road to recovery
Sofia Wright’s journey back from panic came step-by-step. Driving with her mother to school she practiced relaxation techniques with a handheld biofeedback device, imagining situations that might make her anxious and visualizing how she would handle them. Sofia still feels nervous in some situations, her mother says, but she visits her friends at their homes and recently got on a subway for a class field trip.
“She made a remarkable transformation,” Joyce says. She’s feeling much stronger and has a sense of accomplishment for everything she was able to do. She continues to visualize and problem-solve on the way to school, only now she does it without the biofeedback device. They returned it to Yeaton a few months ago.
Helping kids cope without antidepressants
A growing number of alternative practitioners employ a wide array of techniques to help children suffering from depression and anxiety problems. Here is a quick guide to some of the key approaches these practitioners use to help troubled kids.
First: Assess the problem
The first step in working with a depressed or anxious child is to do a thorough assessment, says Michael Cantwell, MD, a pediatrician at the Institute for Health and Healing at California Pacific Medical Center in San Francisco. He gets detailed information from both children and parents about what the child eats, when and how much he or she sleeps, what’s going on in the family and at school, and when his or her symptoms seem to manifest themselves. “These elements of a child’s life can be critical factors contributing to depression or anxiety but often get overlooked because theyre so basic,” Cantwell says. A lot of kids these days are overscheduled and theyre tired. Thats another cause for depression; some kids just dont get enough sleep.
Diet: Check it, then change it
When assessing diet, one of the first things Cantwell looks at is a child’s protein intake. “While most Americans consume more than enough protein, many kids dont get enough,” he says, “especially in the morning when they need it most.” Inadequate protein can contribute to depression because neurotransmitters are made of amino acids, the primary in-gredient of protein necessary to make these mood-enhancing chemicals. One tip-off that children may not be getting enough protein is if they are sleepy by mid-morning and crabby or very tired in the afternoon, Cantwell says.
Unfortunately, the worst kind of breakfast in terms of triggering depression is also perhaps the most common: one with lots of sugar or highly refined carbohydrates–such as donuts, bagels and muffins–and little or no protein. Cantwell says there is mounting evidence that a high-sugar, low-protein diet can boost insulin levels and deplete serotonin, a virtual recipe for depression in many people.
The general rule of thumb is that growing children need about one gram of protein for every two pounds of body weight. To treat depression, Cantwell suggests as much as double that amount, with one-third to one-half of a child’s protein intake coming at breakfast. Easy sources of protein at breakfast include milk (1 cup provides 8 grams of protein), eggs (1 egg contains 6 grams of protein) and yogurt (8 ounces provides nearly 11 grams of protein).
Cantwell suggests making small changes to a depressed child’s diet, especially at breakfast, by incrementally boosting his or her protein consumption. If necessary, he says, keep a diary of what your child is eating along with notes on his or her mood and behavior. You may notice patterns, and youll be able to review these notes with a practitioner.
Exercise: Get kids moving
There’s plenty of evidence that exercise can ease depression in adults, but exercise scarcely has been studied as an intervention for depressed children. Still many experts believe it is likely to produce the same effect on kids. That exercise has a beneficial effect on mental health for children as well as adults is an attractive, intuitive and widely held notion, write Theodore Ganley and Carl Sherman in a 2000 article in the journal The Physician and Sports Medicine.
What’s the mechanism by which exercise could affect mood and ease depression or anxiety? James Gordon, MD, a psychiatrist and director of the Center for Mind-Body Medicine in Washington, D.C., says that there is good evidence, again in adults, that exercise can cut cortisol levels and boost levels of serotonin.
For these reasons, many alternative and mainstream practitioners will try to get kids to indulge in regular physical exercise. “We always try to get kids on an organized exercise program of some kind as opposed to being really sedentary, which a lot of them tend to be when theyre depressed,” says Tim Culbert, MD, a behavioral/developmental pediatrician and medical director of the integrative medicine program at Children’s Hospital and Clinics of Minnesota in Minneapolis.
Omega-3 fatty acids
Adults who don’t get enough omega-3 fatty acids, found mostly in cold-water fish, are at higher risk of depression. One study of hospitalized depressed patients found they had especially low levels of omega-3s and that their ratio of omega-3s to omega-6s was too low. Why shouldnt the same be true of children, alternative practitioners ask. I almost always recommend omega-3s for both children and adults because its really deficient in our current diet, Cantwell says.
That being said, clear guidelines on dosages of omega-3s have not been established for children. Cantwell recommends that kids under 6 take supplements containing 500 mg of omega-3s a day, in the form known as docosahexaenoic acid or DHA; children over 6, like adults, can take 1,000 mg per day, he says. Culbert also generally recommends omega-3s for depressed children; he advocates 1,000 to 2,000 mg per day. But see your child’s healthcare provider for the dosage best for your child.