Many kids are not in school, so they are missing out on live social contacts with peers and supportive teachers. They have often been restricted from seeing grandparents and other significant family members and have been spending more time in the house and without many outlets of sports or community activities. Many may have sustained significant loss due to the death or long-term hospitalization of a family member due to Covid. Additionally, children often mirror the feelings of their parents (no pressure here!). Parents may be moody and irritable due to their balancing of responsibilities of teaching their kids while working from home, lack of social contact and family support. There also has been much political upheaval recently and in the past year(s) that affects parents, and in turn, affects their children. 

Depression can be triggered in children as an understandable response to disruption in their relationships and routines. Short periods of sadness in response to difficult situations are common. However, if the depression lasts for longer periods of time and becomes severe, it is important to seek help for the child. Depression runs in families and can also come on for no apparent reason and become quite severe. 

Through the text and brilliant illustrations in his book, The Princess and the Fog, Lloyd Jones approaches this tough topic in an enjoyable and child-friendly manner. He lightens up the mood with many humorous illustrations. The "fog" and "black clouds" are used  as  metaphors for depression, which is tangible and easier for children to understand.

The book covers symptoms of depression, such as:
-Feeling alone
-slow(low energy), tired
-sadness
-trouble concentrating or doing the simplest things
-anhedonia, which is the loss of interest in the things a person loves to do

In addition to the symptoms addressed in the book, other symptoms of depression in children include: 
-withdrawal
-changes in appetite and/or sleep
-tearfulness
-low self-esteem
-irritability
-physical complaints, such as stomachaches and headaches. 

Many coping mechanisms are also presented in the book, which include:
-Talking to others
-Setting daily challenges
-doing things that make you happy
-therapy
-possible medication -in severe cases
​
The most important coping strategy prevalent throughout the book is the accessing of your support system, or as I call them, The Crown Jewels of Your Kingdom.

This book is appropriate for children ages 4-9 who are suffering from short periods of sadness or a more long-term issue with depression. The content would be helpful for kids who have a family member who experiences depression as a way to gain insight. The Princess and the Fog is also appropriate for all children to learn and recognize the signs and how to cope as "the fog" might enter their kingdom at some point. It provides insights for parents into the symptoms of depression in children and how to help them cope. Additionally, there is a guide for parents at the end of the book written by a psychologist with helpful information. 

This book is available for purchase on Amazon here. I have provided a related activity idea below to help children further explore this issue. 

After reading the book, discuss the symptoms of depression and inquire whether the child has ever felt that way. Talk about sad times they may have had in the past or present. Discuss what the princess did to feel better and who helped her. Name the support people or crown jewels in the princess' life. 

In this month's activity, we are going to explore THE CROWN JEWELS OF OUR KINGDOM. What do I mean by crown jewels? Crown jewels are those very special people in your life(or kingdom) that you know you can depend on. The people who are there for you when you need something. They are people that will listen when you talk to them and take what you say seriously. Who are the crown jewels of your kingdom? 

For the project today, we are going to make a crown with the jewels from our own kingdom! 
Materials needed: 
-Crown template - ​click here to access
-cardstock or heavier paper
-small pictures of support people-if available (optional)
-scissors
-glue (I mostly used silicone glue for faster and stronger hold)
-markers
-jewels, buttons or stickers

Why would we broach the subject of suicide with young children? It's very painful for us to accept that suicide touches lives of young children, but it does. They may have teenage or adult relatives or friends that die due to suicide. They may have suicidal thoughts themselves or may even have made attempts. Even though successful suicides are rare in children below age 10, children as young as 5 years old have successfully committed suicide. Suicidal thoughts at a young age are a major predictor of later successful suicide. Therefore, it is important to address coping with these feelings from a young age. Joanna Rowland, the author, approaches this intense topic in an age-appropriate and gentle manner. 

Her theme throughout the book stresses the power of friendship to help us through life's storms. The story helps children understand the importance of reaching out or accepting the help of others when their lives feel full of darkness. "Stay" is a repeated word throughout the dialogue.  "Stay" and allow me to care for you. Together we can conquer your hopeless, scared feelings. Tell me about your feelings, I will understand because I am human and I probably felt that way at one time or another too. This will end and we'll get to the other side of it together. If the feeling comes again, I will be here for you then too. This book is an example of humanity at its best. 

Through the illustrations, Lorian Tu, portrays hopefulness through vivid colors. The illustration of the fort on the cover and in the book supports the theme that you are safe and protected and can be helped through tough times. 

I highly recommend this book for all children, especially those who have been through or are going through dark and difficult times. This gentle, beautiful story provides coping skills, reassurance and hope to the youngest among us. 

Check out this author's website for excellent books on mental health and other topics for young children.  https://www.writerrowland.com/

Have a discussion with your child after reading the book. The following questions can help.  
1. If you were feeling really big feelings like sad, scared, confused, hopeless or worried, who would you want to be with you to help you(can be more than one person)?

2. How would that person(s) know you're having big feelings and that you want them to stay with you?  

3. What do you think that person can do with you to help you feel cared about and safe? 

4. Who do you think would want YOU with them if they were having really big feelings? 

After the discussion, make a fort/tent with the child and include their safe people inside the tent. 
Directions are below.

And... in the words of Mr. Rogers...

Brianna and the Blue Monster:
​A Cognitive Behavioral Story for Children with Depression
Written by Patience Domowski, LCSW

The rates of depression in children have been rising over the past several years. Most of us don't want to believe that children can suffer from depression, especially severe depression. However, it is a reality.  We are not talking about the minor day to day sadness and disappointments that all children experience. We are talking about clinical depression.  It is crucial to treat depression in children. Untreated depression can pose a risk of suicide at that time or later in life.  As shown through this book, Briana and the Blue Monster, depression can be treated effectively. 

Depression in children can be more difficult to recognize than in adults. As children have not yet mastered how to describe their feelings, they may have difficulty verbalizing their deep feelings of sadness and hopelessness. Below are signs of depression in children. All of these symptoms do not need to be present to meet the diagnosis. The symptoms need to be present for most days and the duration at least two weeks. If you suspect depression in your child, it is important to get therapeutic help as soon as possible. 

 Signs of Depression in Children:
1. Irritability and anger 
2. Loss of interest in activities that used to be fun for them
3. Physical/body symptoms including aches and pains, stomach aches, headaches
4. Restlessness or Fatigue
5. Difficulty separating from parents
6. Withdrawal from social activities
7. Difficulty concentrating
8. Talking about death/dying, giving away favorite possessions
9. Sleep increase or decrease 
10. Appetite/Weight changes
11. Low self-worth
12. Frequent crying and sadness for no apparent reason

In her book, Brianna and the Blue Monster, Patience Domowski presents the common thoughts and feelings of young children with clinical depression.  It is not a traditionally published storybook, but more of a tool for therapists and/or parents to use specifically for children suffering from depression. It explains the concept of depression in a manner that kids can understand and not feel so alone. The book appears appropriate for children ages 4-9.

Ms. Domowski does a great job showing how a child's feelings can manifest in the home and school environment. She does not shy away from the severe symptoms that some children can experience, such as the thought "...maybe I should never have been born." The book portrays understandable concern on the part of the parents and family and how they take action to help Brianna.  I especially like how Ms. Domowski describes, in a kid-friendly manner, the purpose of a therapist and the typical experience in a therapist's office.

The most important part of this book is the skillful way in which this author introduces cognitive-behavioral therapy at a level useful and fun for a young child. She describes negative self-talk as an imaginary monster in your head that tells you bad things about yourself.  She presents activities to help children defeat this lying monster.  It is a very creative approach to applying Cognitive-Behavioral Therapy to young children.  She also introduces role-playing techniques and other helpful activities to help children that are suffering from depression.  

The ending to this book is very hopeful.  There are questions and activities at the back of the book for further exploration and treatment.  I recommend Brianna and the Blue Monster and the presented activities for therapists to use in their practice with children suffering from depression.  I recommend it for parents as a way to help their child understand their problems with depression and to present the idea of going to a therapist.  This book should not be read independently by a child, but rather with a parent or therapist in a supportive manner.  

Even though there are many valuable activities presented in the book, I have added an additional activity in this post as an extension to the concepts in this book.  

Patience Domowski, LCSW, is a Clinical Social Worker practicing in Chester County, Pennsylvania.  She has written several books with mental health themes for children and a book on parenting.  Check out her website at patiencesbehaviortherapy.com. 

Materials Needed:
Poster board or large paper
markers/crayons 
scissors
glue