Ep. 163 | Is It Just a Bad Day or Childhood Depression? How to Tell the Difference

Karin Ryan (00:01.41)
Hello and welcome to another episode of Everyday Therapy. I am Dr. Karen Ryan here, and I am here with David. David Peraska. Yeah, and what is your license? What license do you have? I'm a licensed marriage and family therapist. What is a licensed marriage family therapist? Ooh, I mean that's a great question, right? Licensed marriage and family. well, I would say it's a it's a clinician who kind of specializes in

Marriages, family, the relationships in between, dealing a lot with systemic issues. Yeah. And a lot of family work and a lot of work with kids. yeah. And so that is why we have this fantastic guest with us today, David Praska, again, licensed marriage and family therapist, because today we're talking about recognizing depression and children. So really wanting to have a conversation about how can you tell when it's a bad day or just a hard day, simple sadness.

some general physical complaints versus something that's turning into something more. So today we really hope to talk a lot about kind of the nuances, what that looks like, give you some skills as the parent and for the kids, and just really talking about childhood depression and how to recognize that. And so David, will you start by telling everybody a little bit about why do you work with kids and what do you love about working with kids in therapy? I definitely think that there's a part of me that's a like

Like a young kid. Like my young, my my young self. My little David. I I think that I get to interact with him a lot when I work with kids. Yeah. And working with kids, working with families, like the the the work that goes into that, it it kind of has this like extra benefit for me where I get to

Interact with them if so like if interact with him in a way that's like, I didn't think about ever doing that. But I do get to interact with my young self. Yeah. From time to time. Yeah, and so that really it sounds like that helps you relate with them and understand and then you can offer them understanding, but at the same time you're gaining your own understanding and awareness all the time too. Yes. Yes. Yes. Kids are amazing at that, right? Like the amount we learn from children is incredible.

Karin Ryan (02:18.222)
So much. It's so incredible. It's so incredible. Yeah. And so we're talking about, you know, children when they're experiencing depression because you know that can be sometimes it can be missed and it can be hard to know what to do. And we know that childhood depression is common. And we know that when we can intervene early and we feel like we have skills and resources, that just dramatically improves kind of how they they have the ability to handle it and the trajectory, right? And so one of the things we want to talk about too is like validating the fear and helplessness that parents

Can experience when they notice a shift in their kids, right? I'm sure you experience that because as parents, like we love our children deeply. It's like part of our bodies lacking out in this world. And so I'm guessing you can validate, like, it is really hard as a parent when you notice something is off and not knowing what to do. Yes, I definitely can speak from personal experiences with my kids that it is very, very difficult to be in that space of I see something going on.

And I c I don't know what to do. Yeah. Yeah. Yeah, absolutely. And one of the things that's hard is even with kids is sometimes they don't have the words. So they don't have the words to be able to describe kind of sadness or depression or low motivation, the things that we do as adults. So I'm curious about kind of how that piece of when you experience kids who are going through a hard time, how do they tend to express distress or those kind of first signs of depression? What can that look like for kids?

I well there's a lot of the there's a lot of irritability. Like there's a thought that I remember somebody telling me of like you know kids are very primal creatures. And that I don't know why that thought kind of stood with me, but it really kind of has this notion of at our core we can when we're feeling upset

Anger is a very easy emotion to express. Yeah. And it is something that kids can do very intuitively. Yeah. And so like those complex feelings that come with depression, it's easy to express that through anger. And that looks like anger like irritability, yelling, screaming, hitting. It's it's kind of like those.

Karin Ryan (04:42.85)
Behaviors that can be that okay, there's they're trying to express something, trying to communicate something. And trying to get something to change too, right? Like I forget with it be when you feel like something needs to be different. So something feels off. Or like even as adults, there's a number of times I've in my own life been like something's off and I'm a therapist. And then like, after a few hours I'm like, yeah, I'm feeling that. And so yeah, when we feel off we can just be irritable and upset. Yeah.

and not know why we're upset. Yeah. Yeah. Yeah, totally. And is it true that like for some kids too that they might experience depression more physically within their body with some physical complaints? Is that something you see a lot of? headaches. Like tension headaches. Right? I I see that in my work with kids when talking about like somatic work, kind of things like that, it it's this, I get a lot of headaches

My my tummy feels weird, like like GI issues. Yeah. So that's like GI you're meaning like constipation, diarrhea. Yes. Feeling like you can't eat or yeah, huh, feeling off. Okay. Feeling off in that way. Yeah. That's what I by GI, yeah. Mm-hmm. Yeah, and it's amazing. Like, you know, think about it, like literally kind of having an awareness of your kids like bathroom movements is a helpful thing, right? And being able to talk about that and noticing that. Yes. I think one of the things that

surprises parents the most when I'm talking to them about kind of like depression in kids and things like that is when I start asking them about like, all right, how's their how are they doing with pooping? How are they doing with like their just their GI issues, their their body issues, like I think that kind of surprises parents a lot because it often when we're thinking about depression, we're thinking mentally, emotionally. Yes.

Yeah. And it surprises parents. And and we know this. We know there's this mind body connection. And I love the word that you said earlier of primal. And primal meaning just like all of our states to like help keep us safe. Yeah. And alive and function. Yep. And so when our body's off and we're experiencing depression or anxiety, that changes our digestion. It changes like our

Karin Ryan (07:01.966)
Hormones, it changes how our body processes things. So it does make sense when we really think about it, we go back to that primal. How are we designed to survive? If things feel off, our digestion changes to try and keep us safe. So it's a really is a really big thing. Yeah. What do you feel like in thinking about childhood depression when you think about some of the factors at play in our world today, you know, here

What are some of the things that are contributing to kids experiencing more depression? my goodness. I well, I think that if you were to compare today's time to say

eighties, nineties. We live in such a fast paced world right now compared to then. Yeah. And I think that c I think that just so many things online, phones, tablets, things like that, it there's this culture of I'm exposed to everything. Yeah. I see everything and I get so much input so fast. Yeah, you're right. And I think yes

We're like we're kind of going in that direction as a kind of just as a society, but there is this notion of what effects are is that having on kids. Yeah. And I think one of the things we see is their kids have a difficult time kind of understanding all the stuff that they're seeing if they're when they're young, we're talking about young kids. Yeah. Like having a difficult time if they're on, say like a tablet, right?

There's a game called Roblox. I'm sure everybody, all parents know this game. What? But the having that there's things on that that expose kids to certain elements. And it can have this effect on on a kid's like emotional well being. And I think that having

Karin Ryan (09:09.322)
having this kind of like societal norm of so yeah like kids are having tablets, kids are having phone access to phones, smart TVs, like there is the they have access to everything. Yes. And that can be one step towards some not great

Content and the consequences. Yeah, and as you're talking about that, I'm thinking about the things that we are exposed to and how there are algorithms designed to essentially prey upon our weaknesses or these air quotes areas of interest, right? Right. And so as a middle-aged woman, right, when I search certain things, I know that feed is gonna come my way. And so sometimes like I'm not saying all social media is bad.

But there are these pieces where if a teen or a kid searches for something once, now that's an area of vulnerability or a weakness in and now that is gonna be exploited. So now with self esteem, a huge part of depression, right? Like if I'm a girl and I search something about a body image, I'm gonna get flooded with that, most likely in a not helpful way. And it all starts

with something that is so pure, so genuine, so some so something that's so

Healthy within us, and that's just that that is a natural sense of curiosity. Yeah. And that curiosity then leading towards all the things that you said. Yes. It it's it's like exposed to all that stuff. But it it's just this what's can start is just this natural, I'm curious about something. Yeah. Yeah.

Karin Ryan (11:00.054)
And so this is a little bit off topic, but with it. So in regards to kind of social media and knowing how that can lead to like depression and other mental health things, do you have a few tips that will help parents? Okay, how do I help kind of have some boundaries with exposure and to content? Any tips that you have on that? man, it is first, I actually would say I actually have had parents come in with their tablets. No joke, no joke, Aaron. I've had parents come in and say, okay.

If you want to give this to your kid, right? If you want to give this to them, we need to understand how this works. We need to understand parental controls. We need to understand time frame. We need we have to have we have to have healthy boundaries around this item. Yeah. And while also at the same time, if you are wanting your kid to have this, because I definitely

I'm gonna give my kid a tablet 'cause I might have to go do something. Right. Yep. It's teaching them how to be on that tablet. How to if you are curious about something, what is the most appropriate way to go about that curiosity? Yeah. That's what I would that's what I would say to parents to help with that. Teaching them how to search, it sounds like and how to have problems with that. And then it sounds like it's intentional like downtime. So when do you take it away and how long do they have access for each day? Yeah.

Absolutely. Totally. Whole other segment left at you. Yeah. And so we talked a little bit about kind of some of the signs with depression. So what are some other things that you feel like are helpful for families to have on their mind when it's like it's more than just a a bad day or it's a hard day, right? 'Cause we all have hard days where we're feeling kinda down. We just kinda like need to sulf a little bit. How what are some red flags or some signs to watch for? Right. The

I definitely have the and I think a lot I well I think a lot of clinicians who work with families and kids will have this thought too is that the parents know the kid best. All right. And so it's this idea that I have an idea about how my kid functions. Yeah. And if I see anything that feels out of the norm, then I want to be curious about that. I want to see if they are if they're isolating.

Karin Ryan (13:28.002)
Right? And like I'm thinking older adults, right? Yeah. Or older kids. It's that if I see them kinda just hanging out in their room, right? That is a normalized behavior. Wanting some privacy. Wanting some privacy, total. And but if I see that also having these other consequences of they're not say they're not brushing their teeth. Mm-hmm. They're not

Doing appropriate self-care. Yep. Showering, hygiene, deodorant, shaking clothes. If I see low, if I see like them kind of having this low mood, this affect, right? And also kind of like slouching, kind of like kind of slow pace move. Yep. If I see what they used to do as fun, like go out, or like if they I'm really big soccer.

fan. So if like if they used to play soccer but then they're saying, I don't feel like doing that anymore, losing interest in things. Like that's when I would say there's something present. Yeah. More than just a normalized hard day. Yeah. So when yeah, I appreciate that 'cause as you say functioning, that's functioning in regards to like teeth brushing, showering, those sort of things. It's functioning socially. You still hang out with friends, you still chat with them.

Academically you still like doing homework and then are you still wanting to do sports, things like that. So it's it's all these areas you of check in on. Yeah, absolutely. Totally. And yeah, it's like if they if we see that and that's actually one of the things too that it's like when working with parents. Yeah. It's

wanting to encourage and I mentioned this word multiple times already because I really believe it's a really good thing is being curious. Yeah. It's if I see something and instead of just quickly going to judge it, I want to be curious about it. I want to go to my kid and lead with a sense of curiosity of like what's happening here? Like what's going like is like talking about something. Very

Karin Ryan (15:39.586)
very non threatening, non direct. Yeah. In a way that just communicates, I'm noticing something. Like Ho dude, when's the last time you showered? But not in that way, but it's this like, hey I noticed that we haven't showered. Yeah. And I'm curious as to what's happening, what's going on. Mm-hmm. Yeah, and I can see like as a as a parent, right, sometimes what's hard is to regulate your own fear or your own reaction. And so

I'm imagining that even for myself as a parent, when you're worried about something, you see it, you're like, what's wrong? Why haven't you called this person? I haven't seen you hang out with them. They're like, what do you you don't want to play soccer anymore? Like, you love soccer. And so I really appreciate your guidance of that curiosity and what that sounds like. Yeah. Yeah. And I'm curious for your thoughts on what is helpful for parents to remember when they notice their kid having a hard time, and that's hard for them.

What I mean by that is it can really activate, right? So like what are your thoughts about that? My I'll s I'll I could say it this way. Like, I how I conceptualize, right? How I can kind of how I treat it definitely comes from a standpoint of internal family systems. So IFS. Okay. And there is a phrase in IFS when it comes to

Specifically, they were talking about it for like relational, like married couples, but it also it also applies to relationships with like parent-child. And this phrase is courageous love. And really what that means is, and I'm not gonna go fully into it, but we want to stay grounded. We want to stay grounded as best we can when we see our kid.

struggling with something and it activates something inside. Yep. And it's normal if that activation leads to we're heightened. Maybe we're talking to them but maybe with a little bit of a higher tone, more of a direct tone. Yep. Like trying to lead with like I wanna help, I wanna help. Yes. But it's coming. But it's coming across as I'm nervous, I'm anxious about something. Absolutely.

Karin Ryan (18:06.574)
Courageous love is I want to stay grounded in the face of that. Is I want to find a place within me where I'm not coming from a place of anxiety. Yeah. I'm coming from a place of connection. I want to establish a connection with them when I see them struggling with something. Yeah. And that means I have to show courage to that part of me that wants to react in that way.

And I have to show bravery to myself. Yeah. While at the same time showing connection and curiosity towards my kid. Yeah. And offering that genuine love of I I love you. There's something that we gotta talk about. Yeah. Because I love you and because I love I love you and I care. And I appreciate the

validation of that part of you that is fearful and wants to respond this way, being able to validate that and say, and I know I can do this differently. Yeah. Yeah. In a way that is gonna serve me and my child better. It's it's it's it's I definitely think that there's research that supports this. For sure there's research that supports this. It's that w if we go kid

who is see who we see these like common signs of depression. Yeah. That when we go to them from a sense of connection and curiosity in that, that I feel like there's research to support that you're gonna have a better outcome. Yeah. You're gonna have a you're gonna have a better outcome in resolving what's currently happening. Than say that if we

come towards our kid with anxiety, stress, yes, and seeking control. Yeah. Well, because that sends the message of this is overwhelming and we don't know what to do and this is too much versus we can figure this out together. And if a little kid sees my parent is struggling with this. Yeah. How how am I supposed to struggle with how how am I supposed to deal with this? And so there's it's

Karin Ryan (20:28.462)
There's so much to how we come to kids when we're noticing these signs. And it's learning how to take care of how to do self-care. How to do self-care, how to do that. In addition, and and I know this is a really big thing for DPT. And approaching them with

Love, connection, curiosity, leading with that. Like if if if if we if we can do that, you're gonna we're gonna have a much better outcome. Yeah.

Absolutely. Yeah. Because everybody el everybody's gonna feel safer. Yeah. All parts of us are gonna feel safer. Yeah, absolutely. And so it sounds like your encouragement is kind of be thoughtful about when you're gonna talk to your kiddo about what you're noticing and coming together with kind of a plan of action. So that might be right if they're at home and at first like how do we have some routines and some sleep and some hygiene and physical movement and can we connect with this person? And so you kind of do some of those things first. And then what will be

you know your encouragement or advice when a parent feels like, all right, I feel like some professional help would be useful here, knowing that we are here and available, right? What are some ways that help make that happen, or some things that they might notice that say, let's let's make an appointment with a therapist? Yeah.

I wanna establish a like a a connection first with my kid. Yeah. Right. I mean that's the first thing that comes to my mind. Yeah. Is even before bringing that

Karin Ryan (22:19.64)
bringing that idea, bringing even before bringing that idea to a kid, is like, okay, I want to make sure that I have a connection with them, but they are really listening. Mm-hmm. And then I would say And hearing. And hearing, right? Listening and hearing. And and like they're they're like I've I've I've I'm connecting. And then I would say like hey, you know, there are these professional professionals. Yeah. There is there are

places that can help when we're seeing these things, when we're seeing these signs. Yes. And it's because you don't have to figure this out alone. And like we we don't have to figure this out on our own. Exactly.

We don't and I think just really normalizing mental health and I think kids today are so much better than my generation and for sure the generations before me where they really do talk more about mental health embedded within school. And so knowing as a parent too, like they already are gonna have some foundation of this. So as you normalize getting care. Right. Yeah, totally. Yeah. Like normalizing that it is what what you are experiencing, there is a degree of normalcy here.

Yeah. There's a degree of normalcy. Yep. And what you are experiencing is something that there are many other kids who are experiencing the same thing. Yes. And it's why let's let's maybe let's try going to a place where these all these kids can go. Mm-hmm. Like a mental health clinic. Yes. Of yeah, let's go and speak with someone who's

with kids. And these and people like you who absolutely love working with kids. I love Like you love it, right? And so it's gonna be a welcoming, warm and supportive and developmentally appropriate approach to mental health care. Yeah. Yeah. yeah. It's I like it would be going to them and saying, Hey, let's let's let's work on this together. Yeah. Let's work on this together.

Karin Ryan (24:30.938)
Mm-hmm. That's that and like more or less kind of like connecting and aligning with them. Yeah. Yeah. And so as we're wrapping up, hearing the themes of, you know, you are an expert on your kid and it's watching for those functional changes. And when you notice something leading with what is your phrase again? Courageous love. Courageous love. Right? And that we language of we're not alone.

Support and there are tremendous people out here ready to support you, and everybody deserves that care. Any last minute thoughts? You are like I said, you are the expert at your kid. Yeah. And it definitely there's times when like kids just want to avoid. Yeah. And it's avoid discomfort feel dis uncomfortable because it's new. Yes, yes, and and like that like

If maybe the kid is like, I don't want to go. And it's the normalizing that. But the the thing that I would definitely would say to kind of wrap up a little bit too is to parents is yes, we want to honor our kids' wishes and thoughts. But at the end of the day, you are parent. You have to do something to protect your kid if that means protecting them from themselves. Yeah. And it would be I have to do this because it's a responsibility as a parent.

to do this for my kid. Yeah, to give you this care. To give you this care that you deserve. I that's I would I would say that would be something that I would want parents to know. Yeah. Is that y you are the expert of your kid, but you will also have this responsibility for your kid. Yeah. That sounds really good.

Well, I so appreciate your time and everything that you shared with us. David Praska, thanks so much for being an awesome guest here on Everyday Therapy. And if you are interested or have any curiosity about the therapy services that we have for kids and teens, please check out our website, sagentbh.com, lots of information there, and you can see all the wonderful providers like David ready to help out kids and teens. Thanks so much. Thank you.