Running Head: DEPRESSION IN CHRONICALLY ILL CHILDREN 1

Depression in Chronically Ill Children

A Review of the Literature

Taelyr Czech

Edina High School

Authors Note

This paper was prepared for Pre-AP English 10 taught by Mrs. Taylor, Hour 4
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Depression in Chronically Ill Children

A Review of the Literature

Introduction

According to Fine (2001), The incidence of major depression in chronically ill patients ranges

from 25% to 77% (Para. 2). A huge problem facing America today is depression, more

specifically, in chronically ill children. If nothing is done to stop this mental disease, quality of

life for those living with these illnesses will only worsen. Constant sadness and negativity

amongst patients is heart-rendering and can lead to a worsening of either disease. It is of the

utmost importance to inform my community and to advocate for an increase in government

funding, so we can research and learn more about the link between these two diseases and what

more we can do to help solve the problem.

Background

Childhood depression

In chronically ill children, depression is a devastating reality for a lot of patients. Depression is a

very common but life threatening disease that has many effects on how chronically ill patients

feel in their everyday lives. It alters your mood and the way you think. It can have a dramatic

effect on your daily activities, like sleeping, eating and working. Depression is a disorder that

must be present for two or more weeks to be diagnosed. Different forms of depression may

emerge under certain situations (Depression, 2016, para.1). Although depression has no single

cause, genetics and the environment play a large role. Depression in children can be provoked by

medical illnesses, stressful situations or the loss of a family member/relative. Children with

behavioral issues or anxiety are more likely to develop depression (Frequently Asked Questions,
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n.d., para.1). Dysthymic disorder is a type of depressive disorder that usually arises in children or

adolescence. It's a chronic disease but has fewer symptoms and is much milder. With this type of

depression, they are depressed daily for a minimum of one year. Due to the average duration of

the disorder (4 years), these children are used to the feeling of depression so they might not

recognize themselves as depressed. Major depressive episodes are common with people with

Dysthymic disorder. Almost three-quarters of adolescents or children experience a major

depressive episode in their lifetime. (Mental Health and Illness, n.d., para. 9) When Children are

depressed, they may begin to lose close friends and family members. They may fall behind at

school, and start loosing control on their grades. Depressed children are also more likely to

experiment with drugs and other harmful substances. Untreated depression in adolescents can

often lead to suicide. Once someone is diagnosed with depression, they have a higher chance of

having the disease again in the future (Frequently Asked Questions, n.d., Para.3).

Chronically Ill children

Epidemiologic studies suggest that as many as 1 out of 4 children in the U.S., or 15 to 18

million children age 17 years and younger, suffer from a chronic health problem (Compas,

Jaser, Dunn, Rodriguez, 2011, para.7). It is also the leading cause of death in the US,

accounting for 70% of all deaths (About Chronic Disease, n.d., para.1). A chronic illness is

defined as a human health condition or disease that is persistent or otherwise long-lasting in its

effects of disease that comes with time. The term chronic is often applied when the course of the

disease lasts for more than three months(Chronic condition, 2016, para.1). Examples of this

disease include, cancer, asthma, diabetes, COPD, arthritis, hepatitis C, and HIV/AIDS (Chronic

condition, 2016, para.1). There are many common risk factors for chronic diseases. Most of these
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consist of your lifestyle/dietary lifestyle. Certain conditions may be averted by eating healthy,

daily physical activity and by quitting unhealthy habits, such as smoking. Another risk factor has

to do with social factors (education level, race/ethnicity and socioeconomic status). Lack of

understanding and heath care can have a huge impact on your health in the future and increases

the likeliness of developing a chronic condition (Chronic Conditions, 2016, para.3). Although

there is no definite prevention for chronic conditions, early detection results in a less severe

result. Often times, preventative services often include screening or predisposition. Public health

programs are crucial in raising awareness and promoting healthy lifestyle. Studies have shown

that public health programs are effective in reducing mortality rates associated to cardiovascular

disease, diabetes and cancer, but the results are somewhat heterogeneous depending on the type

of condition and the type of programs involved (Chronic Conditions, 2016, para.4).

Link Between Chronic Illness and Depression

Chronic illness is often associated with an increased occurrence of depressive symptoms.

Compared to those without depression, patients with chronic illnesses displayed and experienced

a decline in their daily standard of life (Simon, 2001, para.2). Depression in chronically ill

children not only affects their mood and output on life, it can also worsen the chronic illness.

The interaction between depression and chronic medical illness may be mediated by either

biologic or behavioral mechanisms. For example, depression may affect the course of ischemic

heart disease through increased platelet activation or of diabetes through decreased glucose

tolerance. It may also affect these diseases by decreasing treatment adherence and physical

activity... (Simon, 2001, para.3). Chronic disease and depressive disorders are recognizably

growing as an obstruction to health. The appearance of depression varies in different chronic

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illnesses. 21% of cancer patients suffer from depression. Depression has been greatly associated

with a desire for a quick death in cancer patients, which can ultimately make them make

decisions that they will not be able to take back. Increased symptoms of depression have also

been found to be inversely related to the survival rate of patients. However, it was found that

cancer patients who have endured chemotherapy have increased hemoglobin levels, which has

been found to decrease symptoms of depression (The Vital Link Between Chronic Disease and

Depressive Disorders, n.d., para.10).

Current Actions and Potential Solutions

Finally starting to understand the importance of the issue is very important in increasing

government spending. Even though there is increasing knowledge about the importance of

depressive disorders in those living with chronic diseases, little review has been done to help

solve the issue. While raising important concerns, previous reviews were deliberately limited in

scope and did not generally address disease-specific variables potentially underlying the

associations between depressive disorders and a number of chronic diseases(The Vital Link

Between Chronic Disease and Depressive Disorders, n.d., para.6). Currently, the CDC is

examining the direct relationships between depressive disorders and specific chronic illnesses,

which will hopefully help to better address the issue and find direct influences and causes which

will eventually lead to solutions (The Vital Link Between Chronic Disease and Depressive

Disorders, n.d., para.6). Currently, the National Institute of Mental Health is conducting clinical

and laboratory research. Clinical research helps to get a better understanding of a specific topic

by enrolling people with or without disorders, depending on the needs of the trial, to be studied

using tests. This helps to find possible new ways of preventing, detecting, or treating a disease.
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Clinical research trials are at the heart of all medical advances (Clinical Trials -

Participants,n.d., para.1) The Clinical trials conducted at NIMH are federally and privately

funded. Increasing funding will help to increase the number of clinical trials funded by the

federal government (Clinical Trials - Participants,n.d., para.1). An issue that is contributing to

the worsening link of these two diseases is that, 99% of disease management is in the hands of

individuals and their families(Addressing Health Challenges on a Global Scale, n.d., para.1).

Doctors and researchers need to be more familiar with the subject so that they can contribute to

helping the families and individuals of those coping with the diseases. Talking to congress or

sending an email persuading them to increase research budgets will help to inform people about

the link between chronic illness and depression in children. Another contributing factor to

chronic illness in children is obesity. Obesity can lead to a variety of different chronic illnesses

such as diabetes, cardiovascular disease and cancers. Obesity also results in significant health

care spending and indirect costs, as illustrated by a recent study from the Texas comptroller

reporting that obesity alone cost Texas businesses an extra $9.5 billion in 2009, including more

than $4 billion for health care, $5 billion for lost productivity and absenteeism, and $321 million

for disability(Chronic Condition, 2016, para.6) By decreasing the number of children with

obesity, the percentage of children with chronic illness will decrease causing spending to

decrease as well. With spending on obesity decreasing, once again, more money could be put

into researching the link between chronic illness and depressive disorders to help grow

understanding.

Conclusion
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The problem of depression in chronically ill children is a devastating one. Young children who

are already facing a potentially fatal disease have to also deal with constant sadness and

negativity. Innocent children, who should be running around with no care in the world, are

instead living their everyday lives in constant misery. Increasing the amount of government

funding for research on the link between depression and chronic illness in children, will help to

decrease depression in these patients. No child should have to face these problems. They should

be able to live normal, happy lives and should not have to worry about living to see tomorrow.

By eliminating or decreasing the severity of the depression, they are able to focus their energy on

fighting the chronic illness and are more likely to overcome the disease.
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