Depression is a debilitating condition that impacts all aspects of a child’s life. The effects also ripple out through the family. One of the most overlooked parts of the condition is the body sensations, or somatic symptoms, that children with depression complain about.
It can be a key way we look at treating depression differently.
Somatic symptoms are mentioned in a great majority of depressed patients, particularly somatic anxiety and fatigue, which was documented in up to 80% of people suffering from major depression. This study confirmed that depressive disorders with body based symptoms were the most common form of depression, both in inpatient and outpatient care. They even found that somatic symptoms significantly correlated to a person’s risk regarding suicide.
Hippocampus: The hippocampus, which is involved in memory formation and emotional regulation, tends to be smaller in people with depression. Chronic stress associated with depression can lead to the loss of neurons in this region.
Prefrontal Cortex: This area, responsible for decision-making, self-control, and regulating emotions, often shows reduced volume and activity in individuals with depression. This reduction can affect executive functioning and emotional regulation.
Amygdala: The amygdala, which processes emotions such as fear and pleasure, often becomes overactive. This heightened activity can contribute to the intense emotional responses typical of depression.
Neurotransmitter Imbalances: Levels of neurotransmitters like serotonin, dopamine, and norepinephrine are often dysregulated in depression. These chemicals play critical roles in mood regulation, motivation, and pleasure.
Neuroplasticity: Depression can impair neuroplasticity, the brain’s ability to adapt and form new connections. This impairment can hinder the brain’s ability to recover from stressful events and adapt to new information or experiences.
The nervous system of a person with depression has significant differences compared to a typical nervous system, including ANS imbalance, HPA axis dysfunction, and neurotransmitter imbalances. These changes often result in various physical symptoms like chronic pain, fatigue, sleep disturbances, and altered stress responses.
Understanding the ways depression impacts the body can help in more comprehensive treatment plans that better address both the mental and physical impacts depression makes in the lives of children.
Autonomic Nervous System (ANS) Imbalance: The ANS, which regulates involuntary bodily functions like heart rate, digestion, and respiratory rate, is often dysregulated in people with depression.
Hypothalamic-Pituitary-Adrenal (HPA) Axis Dysfunction: The HPA axis controls the body’s response to stress. In depression, this axis often becomes dysregulated.
Neurotransmitter Imbalances: Neurotransmitters like serotonin, norepinephrine, and dopamine are critical for mood regulation. In depression, these neurotransmitters are often imbalanced, affecting not only mood but also bodily functions such as appetite, sleep, and energy levels.
Chronic Pain and Somatic Symptoms: Individuals with depression often experience chronic pain and somatic symptoms such as headaches, muscle aches, joint pain, and gastrointestinal issues.
Fatigue and Low Energy: Persistent fatigue and low energy levels are common. Even with adequate rest, people with depression may feel physically exhausted, making it difficult to engage in daily activities.
Sleep Disturbances: Insomnia or hypersomnia (excessive sleeping) can occur. Sleep patterns are often disrupted, leading to difficulty falling asleep, staying asleep, or waking up early.
Appetite and Weight Changes: Depression can cause changes in appetite, leading to significant weight loss or gain. Some individuals may experience a lack of interest in food, while others may turn to overeating as a coping mechanism.
Reduced Physical Sensation: Some individuals report a feeling of numbness or a reduced ability to feel physical sensations, which can contribute to a sense of detachment from their bodies.
Altered Stress Response: The fight/flight response can be blunted or exaggerated in depression. Some individuals may have a heightened response to minor stressors, while others may feel an inability to respond to significant stress.
Chronic Hyperarousal: An overactive SNS can lead to chronic hyperarousal, where the body is in a constant state of heightened alertness. This can result in symptoms like increased heart rate, rapid breathing, sweating, and tension.
Hypoarousal and Apathy: On the flip side, some individuals may experience hypoarousal, where the body’s stress response is diminished. This can manifest as a lack of motivation, emotional numbness, and a sense of disconnection from the environment.
Difficulty Regulating Emotions: Due to the imbalance between the SNS and PNS, people with depression may struggle to regulate their emotions effectively. They might experience rapid mood swings, irritability, or prolonged periods of sadness and despair.
Negative Thinking Patterns: People with depression often experience pervasive negative thoughts about themselves, the world, and the future. This negative cognitive triad can dominate their mindset, leading to feelings of hopelessness and worthlessness.
Anhedonia: Anhedonia, or the inability to experience pleasure, is a common symptom. Activities that once brought joy and satisfaction may no longer provide the same positive feelings, contributing to a sense of emptiness and disinterest.
Emotional Dysregulation: Individuals with depression often struggle to regulate their emotions. They may feel overwhelming sadness, irritability, or numbness, and small stressors can trigger intense emotional reactions.
Cognitive Impairments: Depression can affect cognitive functions such as memory, attention, and decision-making. This can manifest as forgetfulness, difficulty concentrating, and indecisiveness, making daily tasks more challenging.
Physical Symptoms: Depression is not just a mental condition; it also has physical manifestations. Individuals may experience fatigue, changes in appetite and sleep patterns, and unexplained aches and pains.
Social Withdrawal: People with depression often withdraw from social interactions. They may feel isolated, misunderstood, or unable to engage in social activities, which can further exacerbate feelings of loneliness and depression.
When somatic symptoms, particularly painful physical conditions, accompany the already debilitating psychiatric and behavioral symptoms of depression, the course of the illness may be more severe. That can imply higher risks of early relapse, suicide, or mortality due to other natural causes.
The family’s quality of life may be lowered dramatically.
By focusing on the somatic symptoms in depression, parents may be able to guide children into more promising treatment approaches.
In somatic therapy, we educate clients about what body awareness is, and how to cultivate body awareness in and around your body. This is a prerequisite to creating change on a cellular level. We begin by identifying areas of tension and areas of constriction, as well as thoughts, feelings and behaviors that promote a feeling of calm and safety, and bring these to conscious awareness. We may practice something small such as softening a “hunched” back to a more straightened posture, to begin working towards body alignment.
By focusing on, and amplifying the sensations in your body, you begin to deepen your brain and body connection, which can allow for a more embodied experience in those feeling numb from depression.
Grounding refers to our ability to experience our full selves as connected and “embodied”.
The concept of grounding is at the root of mind-body focused interventions. Alexander Lowen, developer of bioenergetics, introduced grounding as a concept in which we can live life, fully experiencing ourselves- connected in the world around us. We use grounding tools to help calm and regulate our nervous systems when we are feeling overly activated or triggered, as grounding helps sooth and settle.
An easy way to remember this is to use the 4 Elements Exercise where you encourage children to get in touch with the elements around us; earth, air, water and fire. Think running cold water over your hands or rubbing them until they feel warm.
Somatic approaches focus on getting curious and descriptive, while staying close to the experience that’s happening in and around your body. That’s because tension, anxiety and traumatic memories get processed as long as you can track, contact, describe and allow the experience to move through you.
Here is an easy illustration; you’re angry at something that’s happened, but you don’t want to stay angry and irritated. A somatic approach reminds you to get descriptive about your body experience because that would help you move through it.
You may begin with something like: “It feels like a raging fiery feeling welling up in my chest….”. As you stay with the physical sensations, and follow what happens next, you’ll notice the anger moves, and how it slowly shifts as you focus on the descriptive body sensation instead of the details of the upsetting event. This distancing helps with the mental processing while the body begins to work through the retained stress of that trauma.
You can encourage children to use descriptive language about physical sensations as a method to deepen their brain body connection! Some descriptive words are: warmth, cold, tingly, sharp sensation, numb, dull pressure, ease, spinning, lifting, swirling, or calming.
CREATE uses a family first approach that focuses on building connection between parent and child. We combine that with a body centered framework that aims to build a child’s capability to identify, sit with and process strong feelings.
Contact us to work with our therapist if you are interested in addressing your child’s specific needs with our approach. We offer one-on-one therapy, homework and school support, activities focused on improving the family and more.