Developing Anxiety and Depression

ZaraZara · Jan 9, 2016

Hi,

I have a few questions about both anxiety disorders and depression...I'll just list a few here, and if you can answer any of them, I'd be eternally grateful.

Anxiety and Social Anxiety
- Can you develop anxiety after a traumatic event, or traumatic prolonged circumstances? (Not PTSD though. Also, by circumstances I mean a traumatic separation from a caregiver as a child, dramatically changing surroundings, emotional neglect etc., but not combat/bombings/abuse.)
- Can you start to develop it at ~6-8 years old? If so, how does this come about? Would the child be aware that they are becoming more anxious?
- Is it realistic for a child with no symptoms of anxiety whatsoever to semi-suddenly start becoming more fretful and anxious, and for this to become a part of their personality?
- Do children aged ~6-8 realise that their anxiety is not normal? I know I was painfully aware of my own social anxiety from the time I was about three or four, but does this apply more to social anxiety than to generalised anxiety? Does it vary with individuals?

My character, as you might be able to tell, is a 6 year old who has been abruptly separated from the only parent they knew and thrust into a world with strangers and stress. I was wondering if anxiety disorders can develop in a child - as far as I know the onset is usually in adulthood or from birth. Also, I apologise for any misconceptions in the questions above; I truly mean no offence.

Depression
- How fast does depression usually develop?
- Can one event trigger depression? I know some people are predisposed to it.
- Do people that commit suicide usually have depression?
- If you have depression, would you feel uncomfortable about someone who doesn't have depression writing about a character that does? I have a character who is going to commit suicide. Before, the impact of her death was due to the fact that it was quite sudden, and has a strong impact on other characters. I hadn't really considered the intricacies of her mind. Now, I'm playing with the idea of writing chapters in her view, but then need to show a realistic transformation of her mental state. I plan to start telling her story when she is already almost moderately depressed, and show her from there. I'm worried about sort of...cheapening (maybe not the right word?) the suffering of people with actual depression. I don't want to use it as just a plot point - if I'm going to write her story, I do want it to be as true to experience as I can make it. If people who deal with depression don't think it is possible for someone who hasn't to adequately portray its complexities, please tell me what you think.

Thank you very, very much for any help you can give me.

Zara.

jaus tail · Jan 9, 2016

ZaraZara said:
Hi,

Anxiety and Social Anxiety
- Can you develop anxiety after a traumatic event, or traumatic prolonged circumstances? (Not PTSD though. Also, by circumstances I mean a traumatic separation from a caregiver as a child, dramatically changing surroundings, emotional neglect etc., but not combat/bombings/abuse.)

Yes. Anxiety is feeling uncomfortable times 100. Folks can get nervous at job interviews, school exams. If the new caretaker is angry or a bully then the child will have no support to cling to, end up being alone, get used to being alone. If suddenly the kid sees too many people around then he'd get anxious.

- Can you start to develop it at ~6-8 years old? If so, how does this come about? Would the child be aware that they are becoming more anxious?

I don't think the child would be aware that he's becoming more anxious until someone points it out to him. I didn't know of my depression until I saw the frown on my face in pictures.

- Is it realistic for a child with no symptoms of anxiety whatsoever to semi-suddenly start becoming more fretful and anxious, and for this to become a part of their personality?

Yes. If the child get beaten around by the new caretaker or the child gets super bullied at school, he'd be more nervous and scared.

- Do children aged ~6-8 realise that their anxiety is not normal? I know I was painfully aware of my own social anxiety from the time I was about three or four, but does this apply more to social anxiety than to generalised anxiety? Does it vary with individuals?

I don't think so.

Depression
- How fast does depression usually develop? In my case it was gradual. Like being around a depressed person, doing just nothing with my life. But I think depression can also be sudden, like if a person's family and friends wipe away by some tragedy.

- Can one event trigger depression? I know some people are predisposed to it. Yes.

- Do people that commit suicide usually have depression? Not sure about this. But suicide is the last resort.

- If you have depression, would you feel uncomfortable about someone who doesn't have depression writing about a character that does? I have a character who is going to commit suicide. Before, the impact of her death was due to the fact that it was quite sudden, and has a strong impact on other characters. I hadn't really considered the intricacies of her mind. Now, I'm playing with the idea of writing chapters in her view, but then need to show a realistic transformation of her mental state. I plan to start telling her story when she is already almost moderately depressed, and show her from there. I'm worried about sort of...cheapening (maybe not the right word?) the suffering of people with actual depression. I don't want to use it as just a plot point - if I'm going to write her story, I do want it to be as true to experience as I can make it. If people who deal with depression don't think it is possible for someone who hasn't to adequately portray its complexities, please tell me what you think. I've seen many tv shows that handle depression with someone giving advice and the person recovers. I just change the channel.

Thank you very, very much for any help you can give me.

Zara.

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ZaraZara · Jan 10, 2016

Thank you jaus tail! I appreciate your taking the time to respond.

Maryn · Jan 10, 2016

For one of our daughters, social anxiety disorder was evident by the time she was four. Her pediatricians inquired whether she had friends and was withdrawn around family, and on hearing "yes" and "no," were not terribly concerned. It worsened in middle school, when peer pressure grows so huge, and that's when we got an official diagnosis. But it was probably visible to someone who knew all the signs by the time she was fully verbal, two-and-a-half or three.

So the onset was not at all sudden.

I don't know if one experience helps, but you can add it to others, I hope.

LJD · Jan 10, 2016

ZaraZara said:
Depression
- How fast does depression usually develop?
- Can one event trigger depression? I know some people are predisposed to it.
- Do people that commit suicide usually have depression?
- If you have depression, would you feel uncomfortable about someone who doesn't have depression writing about a character that does? I have a character who is going to commit suicide. Before, the impact of her death was due to the fact that it was quite sudden, and has a strong impact on other characters. I hadn't really considered the intricacies of her mind. Now, I'm playing with the idea of writing chapters in her view, but then need to show a realistic transformation of her mental state. I plan to start telling her story when she is already almost moderately depressed, and show her from there. I'm worried about sort of...cheapening (maybe not the right word?) the suffering of people with actual depression. I don't want to use it as just a plot point - if I'm going to write her story, I do want it to be as true to experience as I can make it. If people who deal with depression don't think it is possible for someone who hasn't to adequately portray its complexities, please tell me what you think.

I only know about depression from personal experience; I have no medical background. So I don't think I can give good answers to your first few questions. I am just responding to say...that as someone with depression, I wouldn't discourage you from writing about it. But do your research, of course.

tbh, it's the idea of you writing about suicide that gives me pause. I lost my severely-depressed mother to suicide more than five years ago. Nearly everything I read about suicide sends me into some fit of rage. (Suicide is selfish, suicide is a permanent solution to a temporary problem, etc) In a way, I've been on both sides of suicide, having lost someone close to me, and having had suicidal thoughts on and off for my entire adult life. And this is a topic that is usually not dealt with sufficient compassion and understanding for me. But I recently read All My Puny Sorrows by Miriam Toews. I read it because I knew she'd lost both her father and her sister to suicide, so I was interested in her perspective. The book is very good, but I will continue to generally avoid books about suicide. However, this is a very personal issue for me, and I'm not saying that anything you write about suicide would be "wrong."

shadowwalker · Jan 10, 2016

I agree with LJD about the suicide issue. Most people speak of suicide from the "left behind" POV, which often means anger at the person who died. Kinda like family members of the terminally ill who refuse to let them get on with the business of dying, demanding they try yet another treatment, that they not "give up". And yes, depression is the typical reason for suicide - but there are other situations that end up that way, like terminal illnesses.

As to the onset of depression, it can be sudden, it can be gradual; it can be lifelong, it can be episodic, it can happen once and never come back. Stress of any sort can trigger it, including happy event stress.

As to someone without depression writing about it, I have no problem with that IF, as others said, the writer does their homework. Unfortunately, most writers don't. They make their characters into whiny weak complainers, instead of real people who struggle with an illness. Ignorance is why people claim depression when they're just having a stressful week, and why people get told they can't have depression because they actually have fun once in a while. Treat the character with respect, not as a stereotype.

wendymarlowe · Jan 11, 2016

Definitely find a critique partner or beta reader who's been treated for depression and can give you suggestions. So many people think depression is just "feeling sad all the time," and that's not it at ALL. For me, depression was mostly feeling *nothing.* What I did feel was muted. Depression --> suicide is also painfully overused, the same way gay --> effeminate or wheelchair user --> completely unable to walk is. SOME of people fall into both categories, but there are plenty of gay men who aren't effeminate, wheelchair users who only rely on their wheels part-time, and depressed people who have never had any suicide issues. It's frustrating to always see the same lazy shortcuts get used over and over again.

Cannuck · Jan 11, 2016

Three of my children have anxiety, each one different.

My oldest child is autistic (aspbergers syndrome) with general anxiety disorder. He was diagnosed at the age of 7 with autism and then when he was in grade 7 diagnosed with anxiety, for him I think it was always there to a degree and just got worse as he got older. Aspergers is largely a social disorder, so he struggled with social situations a lot through school, his anxiety is part of that not necessarily a result of that.

My second oldest has severe seperation anxiety. She always had signs of it. Right from infancy, she only wanted to be held by her father. If she couldn't see him she screamed. Forget about a babysitter, she didn't settle after Mom and Dad left she screamed the whole time. As she has gotten older she has internalized that anxiety as a way to function. For example when she is away from home at school and feels anxiety she pushes it down, and keeps pushing it down until she is home where she feels safe and secure. Then she explodes. It can be very trying...

Our third child never had anxiety until when she was 3 there was a situation where we were suddenly separated for a short duration of time (a few weeks). Prior to that she was a quiet, but well balanced child. Now she is very anxious and will work herself in to a fit over something we would typically find minuscule.

Our fourth child suffers from PTSD, which is completely different but caused by prolonged illness and too many traumatic medical procedures and surgeries. I mention this because even though you said you weren't looking at PTSD we have learned that some children are more susceptible to the development of anxieties and PTSD than others especially when their is a history of anxiety disorder in the family, as anxiety can be hereditary.

As for depression, I agree with others that as long as you stay away from the standard cliche's and paint (or write as the case may be) a true picture of the disorder I would take no offense. Suicide is a touchy subject in my opinion and there is no getting around it. Some people will avoid it because it is a very painful topic. Especially if you have lived it. I believe though that if it is written well some stories need to be told, even if they are hard to read.

Best of luck! I hope I've been of some help

LillithEve · Jan 11, 2016

ZaraZara said:
Hi,

I have a few questions about both anxiety disorders and depression...I'll just list a few here, and if you can answer any of them, I'd be eternally grateful.

Anxiety and Social Anxiety
- Can you develop anxiety after a traumatic event, or traumatic prolonged circumstances? (Not PTSD though. Also, by circumstances I mean a traumatic separation from a caregiver as a child, dramatically changing surroundings, emotional neglect etc., but not combat/bombings/abuse.)
- Can you start to develop it at ~6-8 years old? If so, how does this come about? Would the child be aware that they are becoming more anxious?
- Is it realistic for a child with no symptoms of anxiety whatsoever to semi-suddenly start becoming more fretful and anxious, and for this to become a part of their personality?
- Do children aged ~6-8 realise that their anxiety is not normal? I know I was painfully aware of my own social anxiety from the time I was about three or four, but does this apply more to social anxiety than to generalised anxiety? Does it vary with individuals?

My character, as you might be able to tell, is a 6 year old who has been abruptly separated from the only parent they knew and thrust into a world with strangers and stress. I was wondering if anxiety disorders can develop in a child - as far as I know the onset is usually in adulthood or from birth. Also, I apologise for any misconceptions in the questions above; I truly mean no offence.

Depression
- How fast does depression usually develop? I have double depression -- which means I have episodic major depressive spells, but I sort of live most my life with dhysthmia. I've had it so long, I can't remember when it developed.
- Can one event trigger depression? I know some people are predisposed to it Yes. I've had heaps of triggers for major episodes (am also predisposed).
- Do people that commit suicide usually have depress Yes, but there are obviously other reasons (this is not personal exp. I wrote a novel feat. suicide as a theme once and looked into this).
- If you have depression, would you feel uncomfortable about someone who doesn't have depression writing about a character that does? I have a character who is going to commit suicide. Before, the impact of her death was due to the fact that it was quite sudden, and has a strong impact on other characters. I hadn't really considered the intricacies of her mind not uncomfortable with people who don't have depression writing about it, but this strikes me as off. It can be romanticized and/or used as a life lesson to force growth for other characters (suicide) -- I'd steer clear of both of those tropes. Now, I'm playing with the idea of writing chapters in her view, but then need to show a realistic transformation of her mental state. I plan to start telling her story when she is already almost moderately depressed, and show her from there. I'm worried about sort of...cheapening (maybe not the right word?) the suffering of people with actual depression. I don't want to use it as just a plot point - if I'm going to write her story, I do want it to be as true to experience as I can make it. If people who deal with depression don't think it is possible for someone who hasn't to adequately portray its complexities, please tell me what you think.

Thank you very, very much for any help you can give me.

Zara.

I hope some of that was useful! Good luck! I have very little experience with anxiety, so I didn't deal with that part.

Snitchcat · Jan 14, 2016

I'll just echo the others here regarding respectful treatment of suicide and to avoid the stereotypical presentations of the illness.

ZaraZara said:
Depression
- How fast does depression usually develop?

Depends on the individual. Can be sudden or it take years.

- Can one event trigger depression? I know some people are predisposed to it.

Yes. In my experience, a prolonged event where the sufferer has to suppress or ignore the vast majority of emotions to survive has a high probability of triggering depression.

- Do people that commit suicide usually have depression?

Yes. Suicide, however, may not be successful in all attempts. When it isn't, it leaves the sufferer with deeper emotional scars and physical issues or disabilities ranging from mild to horrendous. When suicide is successful, those who know of it have to deal with the grief.

Suicide can be sudden, or it will be the ultimate culmination of a series of factors. But suicidal ideation may be present long before the act is ever committed; I recommend you research "suicidal ideation".

The thing that really infuriates me is when people say suicide is selfish, or useless, or anything else that disparages the sufferer or blames the sufferer for being who they are or weak. In point of fact, I see suicide as the final solution when the sufferer has tried every avenue of help open and accessible to them, and has no other path to take. It is a true dead end. There is no "A" or "B" or "Door 1" or "Door 2", and they cannot retrace their steps. Everything has collapsed around them. There is no more world, no more existence. And the sufferer is just very, very tired. All they want to do is rest forever.

By the way, suicide can be sudden or planned.

- If you have depression, would you feel uncomfortable about someone who doesn't have depression writing about a character that does?

Again, it's all about research, no matter how trivial it might seem at the time. Also, perhaps ask a beta reader who has depression to read through those parts for you, if they're up for it.

Depression is a complex subject. But the one thing I would note here is that depression is Not deterministic (the Theory of Determinism is something elese and interesting). From experience: when in the deepest grips of depression, the sufferer feels helpless, and has lost all hope. There is nothing but the endless chasm. What light is present, is deceptive and only serves to highlight and magnify the most negative thoughts, actions and beliefs of the sufferer. Ego disintegrates, objectivity never was, and "seeing the light at the end of the tunnel" is a proven myth.

There are, however, pockets of levity and happiness in the life of the depressed. This is normal.

Good luck!

CassandraW · Jan 14, 2016

I'll echo all those who say research depression -- research it well. There are so many common misconceptions about it. It's odd, really, since it is not an uncommon condition.

Can one event trigger depression? I know some people are predisposed to it.

And this question hits on one of the most common misconceptions.

It is normal to experience grief after a tragic or traumatic event. Everyone experiences this. And many tend to use the word "depression" to describe it. But depression, the condition, is not about that.

To paraphrase a comedian who suffers from depression (and now I'm forgetting who), depression isn't about feeling miserable when your life is going badly; it's about feeling miserable when things are going well. You feel hopeless, worthless, and empty when to every outside perspective, you've got no "reason" to feel that way. E.g., Robin Williams.

shadowwalker · Jan 14, 2016

CassandraW said:
I'll echo all those who say research depression -- research it well. There are so many common misconceptions about it. It's odd, really, since it is not an uncommon condition.

And this question hits on one of the most common misconceptions.

It is normal to experience grief after a tragic or traumatic event. Everyone experiences this. And many tend to use the word "depression" to describe it. But depression, the condition, is not about that.

To paraphrase a comedian who suffers from depression (and now I'm forgetting who), depression isn't about feeling miserable when your life is going badly; it's about feeling miserable when things are going well. You feel hopeless, worthless, and empty when to every outside perspective, you've got no "reason" to feel that way. E.g., Robin Williams.

I would add the caveat that a bad/traumatic event can trigger depression or a depressive episode - ie, the event creates a normal depressed feeling, but then clinical depression kicks in and you just don't come out it, at least not within a time frame considered "normal". I'm not sure if there's any research that indicates a predisposition to clinical depression in those circumstances or not.

CassandraW · Jan 14, 2016

shadowwalker said:
I would add the caveat that a bad/traumatic event can trigger depression or a depressive episode - ie, the event creates a normal depressed feeling, but then clinical depression kicks in and you just don't come out it, at least not within a time frame considered "normal".

Yes. Absolutely.

I just wanted to make the distinction between grieving over an event and a depressive episode, but absolutely the former can trigger the latter. You just don't necessarily need an event to trigger it.

Greene · Jan 14, 2016

ZaraZara said:
Anxiety and Social Anxiety
- Can you develop anxiety after a traumatic event, or traumatic prolonged circumstances? (Not PTSD though. Also, by circumstances I mean a traumatic separation from a caregiver as a child, dramatically changing surroundings, emotional neglect etc., but not combat/bombings/abuse.

I would say yes. My home environment was very unstable when I was a kid, due to my mother's mental illness. My siblings and I were finally sent off to live with our grandmother (very sweet, loving lady) because it wasn't safe to be at home anymore. Before that I'd been an outgoing, cheerful, happy-go-lucky kid, but I developed horrendous anxiety and OCD, culminating in being suicidal and almost unable to leave the house by age nine. I have a truly impressive family history of anxiety, and it's quite likely I would've developed it at some point anyway, but that unstable childhood & separation from parents (more specifically, my dad; he was the one I'd really bonded with) seemed to have triggered the tendency that was already there.

- Can you start to develop it at ~6-8 years old? If so, how does this come about? Would the child be aware that they are becoming more anxious?

Yes; I was around 5 or 6 when I started to develop anxiety. I can't say that I was particularly self-aware about it, at first; I just knew that I was scared all the time and hated being who I was and where I was. Not being old enough to have developed perspective, or know what anxiety was, I thought things would be that bad forever. I was drowning in fear, all the time, and all I really remember knowing was wanting it to stop.

Some of the symptoms I exhibited: I largely stopped sleeping. I sought reassurance constantly about things that scared me. (I'd repeat the same questions over and over and over, even if they'd already been answered, and even if I knew it was irrational. Like, "Is Daddy coming to see us this weekend? Is he okay?" Or, after I developed a phobia of storms: "What's the weather forecast? Is it supposed to storm? Is the sky clear? Are we safe here?" It nearly drove everyone nuts.)

- Is it realistic for a child with no symptoms of anxiety whatsoever to semi-suddenly start becoming more fretful and anxious, and for this to become a part of their personality?

That's pretty much what happened to me. Now granted, there's a family history, and I think the tendency must have been there already, but it didn't manifest until it was triggered. A brave, brash, confident kid turned into a nervous wreck who would barely talk or leave the house.

- Do children aged ~6-8 realise that their anxiety is not normal? I know I was painfully aware of my own social anxiety from the time I was about three or four, but does this apply more to social anxiety than to generalised anxiety? Does it vary with individuals?

I did know my anxiety wasn't normal. Partly because OCD involves intrusive thoughts that you know are irrational and wrong, but you still can't turn them off--it's genuinely horrible. And partly because everyone made it very clear that my anxiety wasn't normal and I needed to calm down, stop worrying and obsessing, and not be so strange. Which only made things worse, because then I developed anxiety about being anxious.

My character, as you might be able to tell, is a 6 year old who has been abruptly separated from the only parent they knew and thrust into a world with strangers and stress. I was wondering if anxiety disorders can develop in a child - as far as I know the onset is usually in adulthood or from birth. Also, I apologise for any misconceptions in the questions above; I truly mean no offence.

None taken; I think it's great that you're doing the research. It may be less common, and harder to diagnose, but anxiety disorders absolutely develop in children, and sometimes they are very severe. I'd guess it's usually a combination of genetics and circumstances, as it was for me.

Hope this helps. If you have any further questions please don't hesitate to contact me!

Also, if you're interested in childhood OCD at all, I recommend the book Don't Touch by Rachel M. Wilson. The protagonist is a teenager, but her early-onset OCD came on when she was 7 or 8, I think. It's an incredibly real portrayal of OCD by an author who has it.

Arianna Evelyn · Jan 22, 2016

I absolutely agree -- researching this is important, but you posted the question so you know that!

I have (unfortunately) a lot of experience with childhood anxiety. Most of my earliest memories are of panic attacks before I knew what was happening to me. I grew up dealing with anxiety on a daily basis, but it was usually confined to panic attacks and night terrors, mainly centring around house fires. Then when I was twelve a particular experience, combined with my age, triggered the development of some social anxiety. My family was also a foster home, and so I've played the older sister role to many frightened, emotionally traumatized children who were in situations similar to that which you describe... It's a tough topic, but I definitely feel like I can comment here!

There is a difference between a lifelong anxiety disorder (like mine) and the extreme stress and anxiety that any child would feel in the situation you're describing, which may or may not follow them forever. It all depends on the person, how the adults around them treat them, and the circumstances around the rest of their life. I think that being separated from your caregiver at six-eight years old is absolutely traumatic enough to be linked to an anxiety disorder. Combine it with emotional neglect, as you mentioned, and you may want to look into an attachment disorder as well. These can be hugely influential on one's life and sets in for most children after they have been taken away from their parents and not been able to bond properly with another caregiver. If your character is still a child this can manifest in ways that will conflict with social anxiety -- simplified, it tends to make kids overly affectionate and seem outgoing. This can be because they never feel settled or bonded with their current caregivers and feel an intense need for everyone, even complete strangers, to love them. It's kind of a philosophical point to argue whether we develop any anxiety disorder from trauma or whether some of us are predisposed and would have gotten that anxiety disorder even without the trauma. Kind of a chicken vs. egg conversation, because in my opinion none of us escape our childhoods completely unscathed.

Interestingly, many many children, even in happy homes, go through a 'fear stage' somewhere between the ages of four and six, some kids are later, obviously, and some earlier. Things like night terrors, nightmares, and being afraid of the dark are all perfectly normal at that age. Your character would very easily struggle with those types of things after such trauma. This is typically the stage when children start to understand that the world is big and there are things that they can't understand. This type of realization, while totally unconscious, causes a period where everything is scary for a little kid. Also at four-six years old you are also looking at school for the first time, bringing its own stress and fears!

I think that the majority of children are not self-aware enough of their emotions, let alone cataloging the emotions of those around, to realize that they are more/less anxious than they should be. The only place that this might not apply would be with social anxiety, where adults tend to call it out and make it worse, "oh, honey stop being so shy," "you can say hello, come on!" "why are you being silly?" etc. Most five and six year olds are cognitively unable to separate the sensation of fear from actual danger, while that ability will begin to develop in a seven or eight year old. So that's up to you, your character's age and how mature they are!

And I'm assuming that it's not your child character committing suicide, right? However sad and scared a young child gets it would not occur to them to purposefully end their own life, in this way some people argue that small children don't experience depression the way that even a twelve or thirteen year old might...

Depression is a difficult one to talk about. My experience is that clinical depression creeps up on people until they're suddenly at a breaking point for what feels like no reason. And like others have said the grief that is triggered by a traumatic event is an entirely different beast than clinical depression. However, yes, if someone struggles with depression/anxiety events, even small ones, can send them on roller coasters. I don't think that someone with a healthy outlook would be suicidal immediately after a single event, but the grief from a significant event could, and does for many, snowball into real depression. I heard from a therapist once that if a patient is experiencing the symptoms of depression more than three months after a significant trauma without any perceptible improvement then they may recommend looking at it as depression instead of as grief -- I don't know how scientifically accurate that is, however! If you don't misrepresent it then there's nothing to be upset about, so doing your research and then being sure to find trustworthy betas who can comment on the accuracy of the emotion is your best bet! The concern that you are already showing in asking these questions is evidence to me that you'll be able to get it right!

A related side note (that I'm too passionate about not to mention): I don't know the setting/situation of your story, but I would like to mention that as authors we need to be aware that the perception of fostering, foster homes and foster families is really really awful in all media right now, and it is really unfair. I grew up 'in the system' and have known many many fostering families. It does NOT pay enough money to be something that ill-intentioned people would do, there are rounds and rounds (continuing for years) of home studies to ensure the safest possible places for children. Social workers legitimately care about children, and 99.9% of foster parents really just want to offer solace and safety to hurting children. Not sure if this applies to your story, but if it's necessary to write about an awful foster home, please address the idea that most families are NOT like that (emotionally neglectful, for example) and that this is an exception. Also, accusations from children, even the suggestion that they are unhappy in their situation are usually taken very very seriously. If your character moves into an average foster family part of their required training where I grew up in Canada is in child psychology and these caregivers should understand anxiety, attachment and the stresses of the situation and age of the character. *steps off soap box*

Hope that my perspective can help a little! Sorry I'm so painfully long-winded! xD

Bolero · Jan 28, 2016

To second Arianna's comment on fostering - I know two people who have fostered kids and speaking as an outsider (as in not resident in the house) - it wasn't about money. Both had a reasonable income, would broadly classify as professional/middle class, had nice houses and it was one kid, not a houseful. One went on to adopt the fostered kid.

tlustoprd · Jan 30, 2016

A lot has already been said, but still...

After years of living with myself and writing stuff, I think that everything is possible. You just have to make it believable. The symptoms and causes and development of anxiety and depression differ from person to person, so I don't think that you can go wrong as long as you stick to imagination + common sense + etc... People are wildly different and react differently to stuff. Someone might not even notice when they experience a traumatic event, someone might be deeply impacted, someone might be sensitive, someone might be resilient... all the little things shape us might lead us to a completely different personality in the long run -> someone might become anxious, someone might cope with it and be okay. The possibilities are limitless.

- Can you develop anxiety after a traumatic event, or traumatic prolonged circumstances? (Not PTSD though. Also, by circumstances I mean a traumatic separation from a caregiver as a child, dramatically changing surroundings, emotional neglect etc., but not combat/bombings/abuse.)

Yes. Definitely. It also depends on a lot of things. You could be genetically predisposed for these things, for example.

- Can you start to develop it at ~6-8 years old? If so, how does this come about? Would the child be aware that they are becoming more anxious?

Definitely. Let's say I'm naturally shy and I think it's written in my genes to be anxious. Question is, to what degree. In my early childhood, there was a string of events and circumstances that impacted me deeply in a negative way. One of them, and probably the strongest, happened when I was around 6 and lasted for an extended period of time. I don't want to go into details, but I think it fits "traumatic event or traumatic prolonged circumstances" (definitely the latter). I was anxious and shy in kindergarten by nature, though not that much, but it certainly worsened after those events.

How does it come about? I don't remember everything from my childhood, but from what I do, I think I could compare it to the bite of a venomous snake. The fangs sink deep, so you become aware of the trauma and feel it. The poison then works its way in and you're dealing with the echoes. Gradually, the poison creeps over the brain and changes you. It becomes a subconscious thing. This is individual though. I imagine the development is different for many people. What others do is also important -- is it treated? does someone notice? does someone try to help you? There are so many variables that change the development.

Was I aware of becoming anxious? Hard to answer. I'd say no. But I think this is a matter of education and other people's behaviour towards you. In my case, nobody really bothered/noticed/identified it as anxiety (and depression). I had no idea back then what 'anxiety' was, but I knew I was "different" and I knew I "had problems", but I didn't realize what it was. In fact, due to my surroundings, I was led to believe it was something wrong that I had to hide and somehow push out. It had no name, though. In my mind, it wasn't anxiety. But like I said, it depends on a lot. You can construct a story where the child knows precisely what it is.

Is it realistic for a child with no symptoms of anxiety whatsoever to semi-suddenly start becoming more fretful and anxious, and for this to become a part of their personality?

It is. Some people might be "ticking bombs". Some (I think 'most' is more appropriate) people can also be pushed over the edge. I think there even have been similar researches into that. Can't quite remember, but there was an unethical one about stammer. I don't remember what was the aim of the research, but it involved telling perfectly confident and normal children that they stammer. They became self-conscious, trying to correct themselves, while the remarks continued. As a result, they became very anxious, depressed. It even ruined lives of some, if I remember right.

- Do children aged ~6-8 realise that their anxiety is not normal? I know I was painfully aware of my own social anxiety from the time I was about three or four, but does this apply more to social anxiety than to generalised anxiety? Does it vary with individuals?

Like I said before, I believe this varies. Children with social/general anxiety may be aware or may not. Also the level of general and social anxiety might be different, they might overlap, etc.

Depression
- How fast does depression usually develop?
Depends (usually on one's personality). It can develop remarkably fast if you're predisposed for it. Or stressed, in a bad mood, etc. I imagine that everyone can be broken, though if you take a very happy laid-back person, it will generally take some time. Though I can imagine a scenario where a perfectly normal and strong person can be driven to depression in a matter of a week (especially a child). Separation, which you mentioned earlier, can serve as a great example.

- Can one event trigger depression? I know some people are predisposed to it.
Yes. Even if people aren't predisposed to it.

- Do people that commit suicide usually have depression?
I think yes, but not always. There are many cases of suicide committed without depression. The human mind is a very delicate thing and I think there's a lot of leeway in this aspect. For example, I had this rational, almost robotic thought--"Okay, let's try this and this and this and if it doesn't work out, then that means I failed and suicide is the only viable option." I wasn't depressed, it simply "was". But of course, depression is quite a motivation in this aspect. It might often drive a person to commit suicide on impulse.

- If you have depression, would you feel uncomfortable about someone who doesn't have depression writing about a character that does? I have a character who is going to commit suicide. Before, the impact of her death was due to the fact that it was quite sudden, and has a strong impact on other characters. I hadn't really considered the intricacies of her mind. Now, I'm playing with the idea of writing chapters in her view, but then need to show a realistic transformation of her mental state. I plan to start telling her story when she is already almost moderately depressed, and show her from there. I'm worried about sort of...cheapening (maybe not the right word?) the suffering of people with actual depression. I don't want to use it as just a plot point - if I'm going to write her story, I do want it to be as true to experience as I can make it. If people who deal with depression don't think it is possible for someone who hasn't to adequately portray its complexities, please tell me what you think.
No, I wouldn't feel uncomfortable. I think this is such a broad topic that you can pull a character and their depression out of nowhere and still make it believable. The question is, will the reader feel it? Will it have impact on them?

Roxxsmom · Jan 30, 2016

Completely anecdotal story:

A memory I have of separation anxiety around the age of four was when my folks enrolled me in a nursery school. My mother (who was my primary caregiver, as my dad was a postdoc at the University of Chicago at that time) took me to this large, sunny room filled with toys and other kids (all of whom were a bit younger than me, though I didn't notice this at the time), and I played with them while my mom talked to this really nice lady. "Would you like to come back here every day?" I was asked.

"Why yes, yes I would!"

The next time we came, my mom dropped me off and LEFT ME THERE!

Wait. This wasn't part of the bargain. I'd assumed she be there every day when they brought me.

And to make things worse, I was not shuttled to the large, sunny, toy-filled room with friendly, slightly-younger children, but to a smaller, darker room with tables and kids who were mostly older than me (only a few months older, but they felt ages older). I had no idea at this time, but my December birthday meant I'd squeaked into the "grasshopper" group instead of the younger "crickets," which meant we were sort of pre-kindergarden instead of nursery school curriculum.

And my teacher wasn't the nice lady, but a scary older lady named "K," who had a bun on top of her head and cat glasses with a chain (maybe Gary Larson had a similar experience, because years later, that woman in his cartoons reminded me of her). She hated me from the start. Called me a baby for crying, splashed water in my face, and threatened to throw the whole bucket over me if I wouldn't stop crying. I was ashamed, because I knew crying was bad, so I didn't tell my mom when she came to get me. I got in trouble sometimes if I cried at home. No one likes a crybaby.

Soon, my mom was putting me on a school bus each afternoon to go to this place (why my folks thought this was a good idea when I was only 4 and we lived in Chicago, I don't know, but my folks had only one car back then, and my dad worked long days and often left early and got back late). The driver was a nice man named Bud who talked to me on the way, so I never cried until I got to the school. And I couldn't tell my parents how mean K was, because I knew I was supposed to be a big girl and not cry like a baby. Grownups knew everything anyway, so if K was being mean to me, my parents must know and approve. My parents were mean sometimes when I was bad too, so K was mean because I was doing something wrong, even though I couldn't help it.

There were two other kids she hated and teased too, both boys.

But I cried every day after I arrived, even though I knew tears were bad and babyish. I missed my mommy (sorry dad, but I was used to you going away and leaving every day) and hated this place. K made fun of me, called me a crybaby. I spilled my milk during snack time one day, and she got the other kids to tease me and told me I couldn't have snacks again. I got really upset (I remember feeling how unjust this was, because other kids spilled milk sometimes too) and cried harder than usual, so she made me go sit in a dark closet by myself. I think I must have gotten hysterical, because I cried so hard I peed my pants (more shame, as I had very good bladder control usually and never bed wet or anything). I still remember sitting in the dark in a warm puddle that got colder and colder, and finally the nice lady came and helped me clean up and put me in dry clothes to go home.

I guess she sent a note home with me that day saying I'd had an accident. That's when my folks began to suspect something was wrong (I didn't know this at the time, but they told me later). Also, Bud the bus driver had told them that he thought this school was a bad place. My mom brought me the next time, because she wanted to talk to the teacher (I learned this many years later when I told her what I remembered), and ran into the cloakroom and tried to hide in a coat locker.

So they pulled me out and put me in a different nursery school (the Ancona school, which was a brand new Montessori school not too far from where we lived that had just opened there, and is flourishing to this day). I loved it and my teachers and the other kids there, and no more tears or anxiety until we moved to CA two years later and I had to deal with its very different public school system (school was no longer very fun).

However, I've always been inclined (especially as a child, but even as an adult) to bond strongly with my nearest and dearest, to be shy with new people, and to blame myself when people are angry at me or treat me badly. I've been prone to depression, and have suffered from it off and on in my adult life.

I don't know how much of my strangeness has been because of my internal wiring/genetics, and how much might have been triggered by this odd experience with that nursery school. My mom says the whole period was only two weeks, start to finish. She's probably right and remembers better than I do, but it felt like an eternity at the time. Kids really do live in the moment when they're little.

The thing I've taken with me from this very early memory, and something I'd try to integrate into anything I might write about younger kids, is how much they trust their main caregivers and internalize the lessons they're taught (crying is bad. People are mean when you're bad). And that horrible feeling that something is wrong, unfair, and terrifying, but you can't articulate it, and if you try, the grown ups don't understand (because it's not important or real, maybe), or they dismiss it, or they insist that whatever is wrong is your fault. And that odd blind faith that something you're doing is bad, even if you can't help it, because the grownups SAY it is.

WhitePawn · Feb 1, 2016

There's a difference between "reactions" and "syndromes". Say someone close to you dies...standard operating procedure says 1-2 years for "grief reaction", and it's fine, so long as it's functional (maintain job, personal hygiene bills....this does not include wanting to start anything new like classes, a trip, social events, etc). If it goes beyond 2 yrs then it goes into syndrome territory. There's a galvanizing event, but the coping mechanisms haven't asserted so help is now needed. An example would be going to the doc due to grief anxiety and getting a script for a sleep aid, standard for a newbie being 6 pills. Your diagnosis would be something like "grief reaction" which is not stigmatizing in any way. Now if you're a repeat customer and this has been going on for a prolonged length of time, you'll be referred to psychiatry.

This is Registered Nurse perspective/teaching. While I didn't have questions on my actual boards, had several on this with the NCLEX prep tests. The right answer is always includes a 2yr "normal" grief time.

Funny thing is, you ask the standard layman and they'll say 6 months and done or it's abby normal. Which is wrong. More distanced people do take a 6 month perspective though so the griever will have a drop-off of support at the 6 month mark. I have to wonder if this backing off by friends and family doesn't extend the process, as it's not uncommon to see grievers take regressive steps in their process around the 6 month mark.

Grieving is the best post response I can come up with that isn't PTSD. Now for the child thing, that is complex and varied and I don't have a better answer for you that won't involve politics and heated debate.

nemaara · Feb 4, 2016

ZaraZara said:
Depression
- How fast does depression usually develop?
- Do people that commit suicide usually have depression?

Sorry if this is a bit late, but maybe here are some reasonable answers:

Depression isn't something well defined to begin with. It differs depending on the person and can be triggered by many different things. It probably isn't something that develops very rapidly, but maybe the realization can be very sudden. It's probably a state of mind that someone can be in for a period of time, but one day, that person might wake up and suddenly realize that he/she is depressed. (A friend may realize this about said person too).

From experience, the people I know who have committed suicide have had some sort of traumatic experience, but whether or not this can be classified as "depression" is another matter. It's hard to generalize, but maybe people who are committing suicide do have some sort of mental instability or have had something bad happen.

fitzdiaz · Feb 6, 2016

I'm a little late in, and not a mental health professional. BUT, I have had experience w/ the issues, w/ my own child and working with other kids.

-yes, kids develop depression, anxiety and even PTSD after a traumatic event. PTSD can develop from traumatic non-combat events, and generally includes a lot of anxiety and depression.

-yes, kids that age can develop depression

-they may or may not realize their anxiety is not normal compared to their peers.

Depression and anxiety in kids may present as anger, aggression and acting out.

Depression and anxiety can be normal adaptive reactions - they're not always things that are somehow hardwired into a person. A kid w/ cancer, spending lots of time in the hospital w/ punishing therapies and an uncertain outcome, may understandably be depressed and anxious. The depression and anxiety may resolve as they recover, but it might not. They might develop PTSD, or have lasting mental health consequences from something so traumatic. Kids separated from their parents - especially if they don't know for how long or why - may also be pretty anxious. A child's world gets turned upside-down and depression and anxiety are normal, understandable responses.

Tottie Scone · Feb 15, 2016

Have you checked out online forums? There are a lot of forums on the subject of various mental health issues, and you can get a really good feel for what it's actually like to suffer from something by reading people's personal accounts. I would definitely do this as well as thoroughly researching the clinical side.

For a good intro to common mental health problems, check out the Wise Counsel podcast on iTunes. It's not being made any more but the old episodes are still up and I have found this helpful and fascinating in the past.

One thing to bear in mind about any issue like anxiety or depression is that if you have had it chronically and for as long as you can remember, you may not be aware that it is unusual.

For example, I had post natal depression. I knew that wasn't normal because it came on within a short period of time and was different to how I felt before (although it was damped a bit because, in my experience, a bout of depression screws up perspective so that you feel like you've always felt that way - they're easier to spot if they are cyclic, because when you're out of it, you can clearly see the difference).

But I also suffer from chronic anxiety, and it's taken me years to realise that sweaty palms and thumping heart when picking up the phone to call the doctor or car mechanic is not normal. Whatever is inside your head seems normal to you - it's all you know. You don't get to look inside other people's heads and compare.

Developing Anxiety and Depression

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