Glean Information from School, Family, and Friends
For the most part, unless you have a toddler, your child will spend a majority of his time in a school setting. This is why you cannot overlook how he is doing at school and whether the school has noticed changes. Children who are quiet and cause little trouble in the classroom will go unnoticed but may be depressed. Some children are boisterous and mischievous, which can get them into trouble. Is this a child who enjoys the social aspects of school or is it a sign of something else? Children at the other extreme are labeled as troublemakers and are usually penalized in some way. But they may be depressed, too. Still others may have problems with learning and find it hard to concentrate or get motivated. This information is vital in getting the whole picture of how your child is doing.
Working with Teachers
While teachers will sometimes resist getting involved in this sort of thing, you have the right to at least demand participation. If you can't get it, don't be quick to overlook the possibility that your child's behavior is more than what meets the eye. If necessary, meet with the school's guidance counselor and enlist her aid. See Chapter 19 for more on school issues and depression.
A teacher needs to know if your child is taking medication, especially if a dosage will have to be administered during the school day. You will need to know your school's policy for handling medication and work with the appropriate persons to assure that your child gets his medicine on time. You won't know if your child's medicine is really working if you have no information about how he reacts to it during the school day.
Alert!
Unlike medical records, school records are not always confidential. Be prudent about how much information to share with teachers and the school. Children become known by a label or reputation, and it typically follows them from year to year. Ask your doctor if you are unsure what to share.
Get Information from Loved Ones
Getting information from family and friends is another way to get good information about your child. If you work and your child spends the afternoons with his grandmother, aunt, or babysitter, you have two choices. You can say nothing and see if they mention any marked changes in your child. However, they might be hesitant to do so for one reason or the other. So your second choice is to express your concerns. Explain that there is no reason for alarm, but that you are worried your child is exhibiting some signs of depression. Sometimes the less information provided the better, because it will help to keep their observations less biased. If family members are unclear as to what to look for, give them a simple list of symptoms such as the following:
Oppositional behavior
Acting-out behavior
Social withdrawal
Decreased concentration
Decreased interest in pleasurable activities
Increases in fears
Recurrent comments about death, suicide
Essential
Don't ask teachers and caregivers to look for only the symptoms you have noticed. Remember that these individuals may see different problematic behaviors that you need to know about. If they are looking out for only the few symptoms that you have mentioned, you might miss out on additional and essential pieces of the diagnostic puzzle.
The other reason why including others' observations of your child is so important is that you need to know if your child is experiencing the core symptoms of depression or something else. What if your child is having a problem at school with fighting but gets along perfectly well with his friends when not at school? He could be the target of a bully at school, or he may feel insecure to the point that he has to prove himself somehow. Likewise, a child may constantly act out and defy her parents at home but may be a perfect angel at school. This may indicate problems at home within the marriage, parenting style, and other environmental factors. Including important others in this process keeps it as objective as possible, which is helpful for an accurate diagnosis.
