Metro Saving Children Experts at JWF seminar tell how to detect childhood depression. RONELLE GRIER Special to the Jewish News A ll children experience mood swings, but when should par- ents become concerned? How do you tell the difference between nor- mal adolescent angst and actual depres- sion? When should parents seek profes- sional help? What about medication? These issues and more were tackled by professionals at a Jan. 21 seminar sponsored by the Jewish Women's Foundation (JWF) of the Jewish Federation of Metropolitan Detroit at the Henry Ford Medical Center in West Bloomfield. About 65 women attended the semi- nar, titled "Understanding Your Child's Behavior: From Moodiness to Depression." Dr. C. Edward Coffey, chair of psy- chiatry and vice president of Behavioral Health Services for the Henry Ford Health System, moderated the program that featured three Ford professionals. Dr. Cathy Frank, director of outpa- tient services, psychiatric education and forensic psychiatry departments for Henry Ford Health System, surprised the audience with these statistics: • 21 percent of children ages 9-17 have been diagnosed with some type of mental illness. • 1 in 10 of these children have symptoms that are severe enough to impair them socially and/or academically. • Only 1 out of 5 receive treatment. There are three criteria for determin- ing when to seek professional help, she said. They are when the child's symp- toms are severe, persistent and affect daily functioning at school, with friends or within the family. Some symptoms to watch for are a drop in grades or change in school performance, excessive worry or anxi- ety, persistent nightmares, change in eating or sleeping habits, extreme moodiness and, in teenagers, drug or alcohol abuse and inappropriate sexual behavior. "All children experience negative thoughts, feelings and reactions," said Dr. Wiley C. Rasbury, "but if the fre- quency, duration and intensity of these reactions increase, if kids don't snap back easily from minor disappoint- ments, then professional help might be needed." Dr. Rasbury said a case of "the blahs" *When To Seek Help Parents should seek professional help if one or more of these symptoms are severe, persistent or impair aca- demic and-or social functioning on a daily basis. • Frequent sadness, crying • Feelings of hopelessness • Increased irritability, anger or hostility • Difficulty with relationships, loss of friends • Low energy, loss of interest in things previously enjoyed • Numerous complaints about physical symptoms such as headaches or stomachaches • Major changes in eating or sleeping habits 2/ 3 2005 26 • Drop in grades or school performance • Thoughts or expressions of suicide or other self-destructive behavior • Recurring nightmares • Excessive worry or anxiety • Drug or alcohol abuse • Sexual acting out • Threats or efforts to run away . The Washington, D.C.-based American. Academy of Child & Adolescent Psychiatry has a Web site with information dedicated to helping families understand develop- mental, behavioral, emotional and mental disorders affecting children and adolescents: ww-w.aacap.org or call (202) 966-7300. Drs. C. Edward Coffey, Olu Osoba, Wiley Rasbury and Cathy Frank, all of Henry Ford Behavioral Health Services, with Francee Ford, Jewish Women's Foundation event chair, and Beverly Liss, JWF president. could be a sign of depression, as can persistent anger and irritability. "Often kids who act out are diag- nosed as being oppositional, when often they're depressed," he said. "A child's behavior relates to his perception of himself, other people and the world in general." Parents Have Great Impact Dr. Rasbury emphasized that parents aren't automatically the cause of their children's problems, but that they can be very powerful agents for change. Childhood depression can have a genetic basis; it can also be brought on by other factors such as major stress or trauma. "How we help our children handle trauma and stress is important; our overall behavior as parents has a great impact," he continued. "Keep in mind that children general- ly will do as well as they can. They are not out to get you, even though it may seem that way at times." He added that it is important that children who have a lot of difficulty with school have other activities in their lives that can make them feel suc- cessful. "Parents who are concerned should talk first to the child, then to his teachers and the family pediatrician," he said. "Expert help is available if you need it. Knowing how your child thinks, feels and believes is the key to under- standing. "Medication can be helpful, but it shouldn't be the sole source of treat- ment, it doesn't teach us to think or develop better coping skills," he added. According to Dr. Olu Osoba, once there is a diagnosis of depression, treatment options include therapy — particularly cognitive behavioral thera- py — medication, or a combination of the two. "Sometimes if there are no real risk factors, we take no initial action other than monitoring the child," he said. If therapy is recommended, Dr. Osoba advised parents to ask questions, such as what type of therapy will be used, how long it will last and what results the family can expect. Addressing the recent publicity fol- lowing the FDA warning that antide- pressants could increase the risk of suicide for teenagers, Dr. Osoba said that untreated depression carries a higher risk of suicide than the use of medication. "The potential benefit must be greater than the potential risk," he said, "but medication should be used very carefully with children because they can't always describe their symptoms if they have an adverse reaction." He added that side effects are gener- ally fewer and milder in children because they tend to break down drugs faster than adults do, due to healthier kidneys and livers. The audience left with a folder of handouts and a lot of food for thought. "I have three teenagers; and I thought I'd been exposed to this topic before, but this went several steps fur- ther," said Ann Mandelbaum-Mann of Franklin. "It was a great program." "This was much more comprehensive than any program I've ever attended; there was a lot of valuable information for parents of young children," said Florence Binder of Beverly Hills, a retired teacher. Francee Ford, a JWF trustee, chaired the program. JWF chair Beverly Liss introduced the speakers. The JWF was established in 1999 by Federation as a grant-making and educational organization dedicated to expanding opportunities for Jewish women and girls. Its goal is to empower women as philanthropists, decision-makers and leaders.