Down syndrome & Depression

Transitioning to life after high school is a major adjustment for anyone. An individual’s relationships, including with caregivers, teachers, staff, friends, and peers, are significantly changing. In addition, daily schedules, routines, and activities are frequently influx. However, for individuals with Down syndrome, this transition may be even more challenging. This time period tends to be the first major life transition regarding individuals’ schedules, especially if they have stayed in the public school system through the age of 21. Major life transitions can sometimes serve as a precursor to depression.

Children and adolescents with Down syndrome tend to display more externalizing behaviors, such as aggression or inattention difficulties, that move to more internalizing symptoms, such as depression and loneliness, as they become young adults (Vitsootsak, 2007). Individuals with Down syndrome are at a higher risk than the general population of developing comorbid mental health concerns, such as depression. In individuals with Down syndrome, depressive symptoms may present more as biological differences versus cognitive changes (Prasher & Bansal, 2017). Common symptoms of depression include feeling sad, empty or hopeless, loss of interest or pleasure in previously desirable activities, significant changes in weight, difficulties with sleep, psychomotor agitation, fatigue or loss of energy, feelings of worthlessness or guilt, and diminished ability to think or concentrate. Depression may also present as a decline in adaptive skills and irritability. Any underlying medical concerns should be ruled out.

The following are ways to assist individuals in making this transition as smooth as possible and in reducing depression-related symptoms:

  • Start early. Start planning and talking about the upcoming transition well in advance. Start talking about daily changes that will occur, new people that will be met, what new routines will look like, and so forth. If possible, make visits to any new settings or environments to start establishing a sense of familiarity.
  • Establish new routines. While an individuals’ routines may have been consistent for a number of years, they may now have more unstructured time on their hands. Even small routines can provide a sense of comfort and security. Things as simple as morning routines for daily living tasks, meal preparation, and engaging in social relationships can provide a sense of structure.
  • Be conscious of relationships. While individuals are not consistently interacting with friends and peers in an educational environment on a daily basis, consider other opportunities for them to engage. Are there extracurricular activities they can participate in together? Are there other opportunities for social engagement? If logistical issues make it impossible for meeting in person, consider other technology options such as Skype or FaceTime. Even regular meetings can assist individuals in feeling connected.
  • Help them find purpose. While their days of schooling have changed, individuals still need to feel purpose and that they are contributing and engaging with those around them. Is there an organization they can volunteer with? Are there employment opportunities? How can they contribute to their household or family?
  • Identify and reduce stress. Ensure that individuals are getting sufficient sleep, eating an adequate diet, and have some form of movement within their day. Also, help individuals identify opportunities to engage in preferred activities and hobbies of interest.

If, after environmental modifications have been made, an individual requires further assistance addressing depression-related symptoms, caregivers may wish to seek out counseling or therapy services. In addition, medication management may be an appropriate avenue to consider. Discuss with the individual’s primary care physician or a psychiatrist about the appropriateness of a medication trial.

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