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Children with Chronic Illness: Dealing with Emotional Problems and Depression

Feelings of sadness, depression, or being overwhelmed may come and go for both you and your child. This is normal and healthy. As tumultuous as these times can be, most youngsters and their families emerge with few if any long-term behavioral problems or lasting psychological scars. In fact, the majority of children really do manage their situation well, despite riding an emotional roller coaster on occasion. Researchers believe that the likelihood of emo­tional and behavioral problems associated with chronic illness has been de­creasing recently because parents, school staffs, and health-care providers are learning more effective ways to help children and their parents meet their psy­chological needs.

Nevertheless, children who have a chronic illness or condition often feel "different," socially isolated, and restricted in their activities. They may have school problems and feel overprotected. They may experience recurrent fear and pain. When these emotional difficulties are not dealt with, they can lead to anxiety, sadness, withdrawal, rebelliousness, or a decreased interest in school.

School-age children rarely state that they are sad or depressed. Instead, they may withdraw from friends and family or exhibit rebellious or angry be­havior. They may do poorly in school. They may interfere with their medical treatments, perhaps by refusing to take medication as scheduled. They might experiment with alcohol, drugs, or early sexual activity. Or they may run away from home or contemplate suicide.

Make an ongoing effort to discuss with your child what he is experiencing. Do you think he is displaying signs of despair and hopelessness related to his illness and future? Encourage him to talk about these feelings with you or with another trusted adult. Because your child may not even be aware of his feel­ings, try beginning these conversations with statements like "If I were you, I think I would be feeling..." or "I have read that many kids with this condition feel lonely and sad. How do you feel?"

Some parents are hesitant to discuss feelings about the disease with their child, in an effort to protect the youngster from emotional hurt. Most experts, however, disagree with that point of view. Children can usually adjust much better to an unpleasant truth than to the perception that their parents are up­set and hiding something from them. If parents and children do not talk openly, the opportunities for misinterpretation are high. A youngster's imagi­nation can run wild, and fears may emerge or be exaggerated.

Thus, it is best to make a commitment to be as communicative as possible. Remind your child that he is not going through this alone and that you will re­main a constant source of love and support. Many studies show that the key to a child's resilience is a relationship with a caring, loving, accessible adult—someone the child can count on and trust.

If you are concerned about your child's coping with these stresses, talk to your physician. If your youngster is exhibiting destructive or unusual behav­ior, if he refuses to take his medication, if he is severely withdrawn or if his schoolwork has deteriorated, your doctor might recommend some counseling for the child or the entire family.

Last Updated
Caring for Your School-Age Child: Ages 5 to 12 (Copyright © 2004 American Academy of Pediatrics)
The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.
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