Juvenile Arthritis & Depression

Juvenile Arthritis & Depression

Worries about fitting in, getting sidelined from activities, having to take medication, living with unpredictable pain and feeling a loss of control over their bodies – these are some common reasons why children and teens with juvenile arthritis (JA) may experience depression. 

Spotting Signs of Depression

Depression is harder to diagnose in children than in adults, but parents’ gut feelings can often tell them when something is off.

Look for changes in mood or behaviour, including a loss or gain of appetite, changes in sleep patterns, a loss of interest in what used to be fun or new problems with concentration, friends or school.  

Here are some Depression signs to look for:

  • Irritability or anger
  • Mood swings or sadness
  • Persistent feelings of sadness or hopelessness
  • Social withdrawal or isolation, loss of interest in friends and or activities
  • Increased sensitivity to rejection
  • Poor school performance
  • Change in eating /sleeping
  • Tearfulness or temper tantrums
  • Extreme sensitivity to rejection / failure
  • Low self-esteem, feelings of worthlessness, hopelessness
  • Fatigue or low energy
  • Physical problems such as stomach-aches or headaches that don’t get better with treatment
  • Thoughts about death, self-destructive behaviour or suicide

If you notice any of these signs and they start to worry you, talk to your child’s Paediatric Rheumatologist or GP. 

How Parents Can Help

Identifying the root causes of mood problems can help. “For example, if it’s pain, then you want to help them get a handle on it so they’re the boss of their pain instead of their pain being the boss of them. If they are depressed because they can’t do their favourite activity, help them find a new one.

Parents can also help children work on coping strategies for every day and JIA related challenges.

The child’s behaviour may include acting out at school, withdrawing and somatization (an unconscious process where psychological distress is expressed as physical symptoms). In instances of somatization, the child may play sick, refuse to go to school or take meds. And by their teen years, they may turn to risky behaviours, like cutting themselves, or having an eating disorder as a way of acting out or coping.

Having open, honest discussions with children about their fears can also help. Don’t “sugarcoat” the pains of arthritis and its treatments, like telling them the needle won’t hurt. Instead, help them face their fears with positive coping mechanisms, like distraction (i.e., listening to music, meditating or watching their favourite show during shot time). Helping your kids manage stress, pain and fatigue and develop better sleeping habits may also stave off mood problems. 

Lastly, research suggests children with JIA who have higher ‘self-efficacy’ are less vulnerable to depression than kids who aren’t as confident.

‘Self-efficacy’ is the ability to feel confident that you can succeed at something. In general, children with higher levels of self-efficacy are more optimistic, and an optimistic outlook can help prevent depression and anxiety from becoming severe.

It is important for parents to let children take responsibility for tasks they’re mature enough to do successfully, which may include daily chores or, for older children, managing medications. Then give them praise, praise and more praise.

If you the parent is concerned about the child or teen, and have tried everything and nothing seems to work, it’s probably time to take you child to a Psychologist or Counsellor.