We had a few rough years. I’m hearing from a lot of friends and patients’ parents that they are burned out and overloaded. Many have seen signs of this same exhaustion and crankiness in their kids as well — maybe you have too.
So what does depression (or the lighter version of it called “dysphoria”) look like in kids? Is it permanent or reversible? When should you worry?
First, it’s worth remembering that children all respond to stress in different ways. Some act out, scream and cry, try to control everything, or use their bodies to communicate their inner distress (in other words, hit, kick, and shove). Some children turn inwards, seeming to “shut down” and wanting to be alone. Whatever their style of reacting to stress, kids who are feeling depressed may care less about things that usually make them happy, may refuse to try new things, may blame others a lot, or may say negative things about themselves. All of these — plus changes in sleep, appetite, concentration, and social skills — are signs that their mood is off.
Second, it’s also important to know that kids are really resilient. It’s why I became a pediatrician: kids get better with treatment! Play therapy is actually one way that children get in touch with their feelings, or build more positive relationships with their parents. Here are a few of the crucial ingredients of play that help foster these changes:
4 Ways Play Can Help Kids Get in Touch With Their Feelings
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Sit back and let them take the lead.
One of the things parents tend to do when their kids get grumpy or defiant is to micro-manage more. Play, on the other hand, lets your child feel more in control, and lets you just observe. Turn off digital distractions, bring out whatever your child is in the mood to play with (crayons, blocks, action figures, whatever!) and don’t direct the play. It’s ok to ask questions, or say things like, “Oh that’s cool!” or “What can I draw?” but try to notice when you want to jump in and control things, and resist that urge.
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Find activities that bring out the smiles.
One of the best things about play is the natural joy that can come from being silly together, popping bubbles, chasing and tickling, or telling jokes. You don’t need to demand that your child join you — you can start without them and let them choose to join in (this way, they feel in more control). Studies show that playing in “synchrony” with your kids — such as taking turns popping bubbles, dancing to the same songs, or doing funny faces in the mirror — is great for their emotional development
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Make identifying emotions a game.
When I’m seeing a child in developmental behavioral pediatrics clinic, I sometimes draw out a grid with 4 circles that I will turn into faces with different emotions. I let them help me draw the faces, identify the feelings, and list a few things that make them feel that way. We also talk about what they do to feel better when that happens, and how they get back to the “green” zone. I ask questions about how their favorite book or cartoon characters might be feeling, and I recommend shows like Daniel Tiger’s Neighborhood that have songs about emotional problem-solving. Emotions don’t need to be scary — like Mister Rogers said, we need to teach kids that they are mentionable and manageable.
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Keep your bodies moving.
When kids were sitting in the same spot every day for virtual school and were confined to their homes, a lot of us saw more moodiness in them. This makes sense, because body movemetn and time in nature are crucial for kids' wellbeing. Occupational therapists know that stretching the joints, bouncing around, swinging, or other sensory/motor activities can really help kids feel alert and more positive. Look around your yard or neighborhood to see what could make into a daily body-moving routine.
Play is a powerful way to get inside your child’s mind a bit and give them a sense of control and mastery over life. Coming out of such a stressful, disorienting year, our kids will need help with their mood and emotions just as much as we do. If you’re at the point where it’s hard to get your child to do anything than be on screens, you are arguing all the time, or you feel helpless in parenting them, that’s OK. Finding a therapist who can help you and your child recover from a difficult time actually helps build skills that will last a lifetime — I’ve been there!
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