Depression and Anxiety: What to Look for in Kids with Heart Conditions (Part 1)

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Kids in magazines, on TV and even on hospital websites all tend to have one thing in common, no matter how ill they may be: They always have a smile and seem joyful.

Yet, parents know that for kids with chronic health conditions, life can be a struggle—a series of painful days and nights, scary doctors’ appointments and missed school. That’s not really anything to smile about.

Heart kiddos may end up feeling like they’re different from other kids and that they’re missing out on normal kid stuff. These experiences can lend themselves to depression and anxiety.


So it’s only natural that parents worry about depression and anxiety among heart kids. If he refuses to get out of the car at the doctor’s office, does he have anxiety? If she cries every time you leave for work, is she depressed?

Because this isn’t my area of expertise, I’ve asked Omaha Children’s Psychologist Dr. Sean Akers to weigh in. Dr. Akers sees patients every day who struggle with mental health issues as the result of chronic health conditions—everything from heart disease to cancer. He explains what these mental health issues are and symptoms that parents of heart kiddos can be on the lookout for.

What Are Depression and Anxiety?

Everyone gets sad, and everyone feels anxious at times, Dr. Akers says. That’s normal.

However, depression happens when you feel sadness, anger or loss for weeks at a time or longer. Anxiety, which can go hand-in-hand with depression, is a reaction to stress, according to the National Institute of Mental Health.

About 11% of American children will be diagnosed with depression by the time they hit 18, and 8% of kids age 13 to 18 have an anxiety disorder, says the National Institute of Mental Health.

Of course, some anxiety is good. It can be used as a motivator. But it becomes a problem when it leads to fear of everyday situations and inhibits your way of living.

Similarly, depression becomes a problem when your heart kiddo loses interest in activities she used to enjoy. She may not want to get out of bed in the morning, and her general sadness or apathy isn’t the result of any one thing—it’s just the way she is.

What Do Anxiety and Depression Look Like?

Noticing symptoms of anxiety or depression in your heart kid can certainly be scary, Dr. Akers says. You already spend so much time worrying about their physical health, now you have to be concerned for their mental health, too.


“Sometimes you’ll notice these things, and then your child is fine in a day. But when you start seeing patterns that go on for long periods, that’s when you should be concerned,” Dr. Akers says.

When Dr. Akers meets with heart kids, he first takes a mental health history to help figure out from where the depression or anxiety stems—genetics, specific situations (such as hospital stays), or a mix of the two.

“I want to empower parents. I ask them questions about changes they’re noticing, things they’re observing,” Dr. Akers says. “I’m the expert in anxiety and depression, but they’re the experts in their kids.”

That means you’ll likely be the one to spot symptoms before anyone else. So step one: Don’t wait for your child’s teacher or a friend to confirm your worries. Go with your gut. Talk to your medical team if you suspect an issue.

Want to learn about treatment options for depression and anxiety, and things parents can do to help their kids at home? Read part 2 of our series on Monday.

Barb Roessner

Hi, I'm Barb, and I'm a Physician Assistant and coordinator of the Heart Failure and Transplant Program at Children's Hospital & Medical Center in Omaha. I work with patients and families at every step of the journey, from diagnosing their child's heart condition to my favorite part—calling them to say "We have a heart."

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