Parents struggle to differentiate between normal mood swings and signs of depression

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Telling the difference between a teen’s normal ups and downs and something bigger is among top challenges parents face in identifying youth depression, a new national poll suggests.

Though the majority of parents say they are confident they would recognize depression in their middle or high school aged child, two thirds acknowledge barriers to spotting specific signs and symptoms, according to the C.S. Mott Children’s Hospital National Poll on Children’s Health at the University of Michigan.

Forty percent of parents struggle to differentiate between normal mood swings and signs of depression, while 30% say their child is good at hiding feelings.

“In many families, the preteen and teen years bring dramatic changes both in youth behavior and in the dynamic between parents and children,” says poll co-director Sarah Clark.

“These transitions can make it particularly challenging to get a read on children’s emotional state and whether there is possible depression.”

Still, a third of parents polled said nothing would interfere with their ability to recognize signs of depression in their child.

“Some parents may be overestimating their ability to recognize depression in the mood and behavior of their own child,” Clark says.

“An overconfident parent may fail to pick up on the subtle signals that something is amiss.”

The poll also suggests that the topic of depression is all too familiar for middle and high school students. One in four parents say their child knows a peer or classmate with depression, and 1 in 10 say their child knows a peer or classmate who has died by suicide.

Indeed, rates of youth suicide continue to rise.

Among people ages 10 to 24 years old, the suicide rate climbed 56% between 2007 and 2017, according to the Centers for Disease Control and Prevention.

“Our report reinforces that depression is not an abstract concept for today’s teens and preteens, or their parents,” Clark says.

“This level of familiarity with depression and suicide is consistent with recent statistics showing a dramatic increase in suicide among U.S. youth over the past decade. Rising rates of suicide highlight the importance of recognizing depression in youth.”

Compared to the ratings of their own ability, parents polled were also less confident that their preteens or teens would recognize depression in themselves.

Clark says parents should stay vigilant on spotting any signs of potential depression in kids, which may vary from sadness and isolation to anger, irritability and acting out.

Parents might also talk with their preteen or teen about identifying a “go to” adult who can be a trusted source if they are feeling blue, Clark says.

Most parents also believe schools should play a role in identifying potential depression, with seven in 10 supporting depression screening starting in middle school.

“The good news is that parents view schools as a valuable partner in recognizing youth depression,” Clark says.

The bad news is that too few schools have adequate resources to screen students for depression, and to offer counseling to students who need it.”

Clark encourages parents to learn whether depression screening is taking place at their child’s school and whether counseling is available for students who screen positive.

Given the limited resources in many school districts, parents can be advocates of such efforts by talking to school administrators and school board members about the importance of offering mental health services in schools.

The nationally representative Mott Poll report is based on responses from 819 parents with at least one child in middle school, junior high, or high school.


There is a growing number of people with disabilities (including wheelchair users) who participate in regular physical activity/sports programs with ludic and rehabilitation purposes as well as with elite sport performance purposes (Bhambhani, 2002De Lira et al., 2010Lee and Uihlein, 2019).

Indeed, the participation of people with disabilities in sports is desirable, because it has a positive impact on social, psychological and physical aspects (Côté-Leclerc et al., 2017). Moreover, it is considered as a complementary strategy for physical, social and emotional rehabilitation, and consequently, could improve the quality of life (Blauwet and Willick, 2012Lee and Uihlein, 2019).

Furthermore, wheelchair sports consist a favorable opportunity for people with disabilities by increasing the possibility of social integration and physical, motor, psychological, and neurological rehabilitation (Lee and Uihlein, 2019).

Despite of indisputable benefits of exercise and sports for people with disabilities, there are some barriers that prevent the participation of people with disabilities (including wheelchair users) in adapted sports.

These barriers could be divided into psychological, physical, physiologic, and environmental factors (Côté-Leclerc et al., 2017). For instance, Côté-Leclerc et al. (2017) pointed that physical and mobility limitations might restrict opportunities to perform sports and physical activity, which may affect quality of life.

Regarding to psychological factors, in general, people with disabilities have low self-esteem and confidence, decreased motivation, increased depression and pain, and high stress level which affect negatively quality of life (Lee and Uihlein, 2019).

Previous meta-analysis showed that exercise can improve mental health (Ochentel et al., 2018Rodriguez-Ayllon et al., 2019) and quality of life (Conn et al., 2009Gillison et al., 2009Sweegers et al., 2018) in healthy and clinical population. For example, Schuch et al. (2018) showed that exercise can confer protection against the emergence of depression regardless of age and geographical region. Conn et al. (2009) conducted a meta-analysis to investigate the effects of interventions to increase physical activity among adults with chronic illness in quality of life outcomes and found that, despite considerable heterogeneity in the magnitude of the effect, participants improved quality of life from exposure to interventions designed to increase physical activity.

However, there are, so far as we are aware, few studies that investigated whether participation in adapted sports (particularly wheelchairs sports) affects the quality of life and emotional status of people with disabilities. For example, Muraki et al. (2000) demonstrated that sports activity can improve the psychological status in both tetraplegics and paraplegics with spinal cord injury, and the psychological benefits are emphasized by sports activity at high frequency.

Considering that about 10% of worldwide population (∼650 million people) have disabilities and that about 10% of people with disabilities require a wheelchair, studies that investigated the effects of exercise on mental health and quality of life of wheelchair are warranted (World Health Organization, 2011).

Thus, the aim of the present study was to compare the quality of life, depressive and anxiety symptoms, and profile of mood state between wheelchair users practicing sports or not. The research hypothesis is that people with disabilities, especially those wheelchair users that not practicing sports, would present poor levels of quality of life, anxiety and depressive symptoms, a negative profile of mood state as compared with wheelchair users practicing sports.


More information: Expert’s guide for parents on how to talk to children and teens about depression and suicide.

Provided by University of Michiga

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