The father noticed his 10-year-old son had been quieter than usual the past few weeks.

When the son interacted with the rest of the family, he tended to be irritable and get into arguments with his older sister. Then again, everyone had been feeling a bit on edge during the stay-at-home order.

His wife had observed the same behaviors but assumed her son was just missing his friends and all of the activities he had been involved in prior to the pandemic. Both parents felt it was likely just a phase that would lift as everyone could get outdoors and see friends.

Roughly, 3% of children in elementary school develop depression with rates doubling in middle and high school. These rates have likely increased with the pandemic as children experience increased stress and have fewer social contacts than usual.

Yet, it can be easy for parents to not recognize when their children are feeling depressed.

Parents want to help their children if they are depressed but many are not sure whether the behaviors they are seeing are just the typical ups and downs of childhood or something more serious. The hope is that the down mood is a temporary phase of normal development. As a result, treatment for depression in children is often delayed by months or even years.

Spotting depression in children is all the more difficult to spot as children often try to protect their parents. They see all of the stresses parents are under and do not want to make them worry more because they are feeling down. This can be particularly true if there are others in the family like a sibling with a disability or grandparent with health issues that take a lot of the parents' time already.

Children may also have tried to tell their parents they were feeling down but were not heard due to parents being distracted at the time. When this happens, children take away that parents do not want to hear about their problems and shut down. Parents can then feel that everything is ok and move on to other tasks when children are unwilling to disclose how they are feeling.

Another reason children may not want to tell their parents is that their parents will just try to fix them.

They do this by offering quick advice when children just want to be listened to about what they are experiencing. Parents may also dismiss children's disclosures by telling them to, "not worry so much" or that what they are experiencing will pass. Neither approach makes a child feel listened to and diminishes the odds children will say something again to their parents.

All of these factors are amplified during the current stay-at-home orders. Parents need to pay extra attention to when their children start to disclose their feelings and seem to want to talk about them. This usually occurs at inconvenient times for the parents like being in the middle of some task. Taking that time to listen and not try to fix can mean all the difference. This makes it more likely children will reach out again as they know they will be listened to.

If parents have concerns that their child has been down for a few weeks and does not seem to be getting better, it is important to consult with a mental health professional through the school or in clinical practice. Psychologists, counselors, and therapists can help the child work through the issue and give parents tools that they can use in the future.

Dan Florell, Ph.D., is an associate professor at Eastern Kentucky University and has a private practice, MindPsi (www.mindpsi.net). Praveena Salins, M.D., is a pediatrician at Madison Pediatric Associates (www.madisonpeds.com).

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