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Depression Guide

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Depression is more than just feeling down or having a bad day. When a sad mood lasts for a long time and affects your child’s normal, everyday functioning, they may be struggling with depression. It’s important for you and your child to know that depression is not a weakness or character flaw. It is a medical condition that needs treatment – and treatment is available.

Signs and symptoms of depression:

  • Feeling sad or anxious often or all the time
  • Not wanting to do activities that used to be fun
  • Being irritable, easily frustrated or restless
  • Having trouble sleeping or sleeping too much
  • Eating more or less than usual or having no appetite
  • Aches, pains, headaches or stomach problems that don‘t go away
  • Trouble concentrating or making decisions
  • Being forgetful
  • Feeling tired or having less energy
  • Feeling guilty, worthless or helpless
  • Dark or negative thoughts
  • Thoughts about self-harm, suicide or death*

*If your child is in crisis or at risk of hurting themselves, immediately call or text 9-8-8 to reach the 988 Suicide & Crisis Lifeline. The line provides 24/7, free and confidential support for people in suicidal crisis or emotional distress.

You may also call the Sunshine Health Behavioral Health Crisis Line any day, any time at 1-866-799-5321 (TTY 1-800-955-8770).

Types of depression

  • Persistent Depressive Disorder: A mild but long-term form of depression that causes a sad or dark mood most of the time for two years or more. Also called Dysthymia.
  • Major Depressive Episode/Disorder: A more intense form of depression that causes a constant feeling of sadness that interferes with daily life. Also called Major Depression.
  • Premenstrual Dysphoric Disorder (PMDD): A form of depression related to the menstrual cycle that causes severe PMS symptoms in the week or two before menstruation (bleeding) starts. The symptoms, which can include anxiety, depression and extreme mood changes, usually go away two or three days after bleeding starts.
  • Disruptive Mood Dysregulation Disorder: This is a childhood condition that causes ongoing anger and irritability. It often include severe temper tantrums and outbursts, and it can lead to other mental health conditions if not treated.
  • Bipolar Disorder: A mental health condition that causes extreme mood swings, including emotional highs, known as mania, and emotional lows, known as depression. Formerly called Manic Depression.

Note: The above lists do not include all signs, symptoms and types of depression. Talk to your child’s doctor if you have questions. Read more about depression and other mental health conditions from the Centers for Disease Control and Prevention.

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  • Educate yourself. Read up on the signs and symptoms of depression if you think your child may be struggling. You can also reach out to your child’s Care Manager for help finding resources and services.
  • Check in with your child. Talk to your child often. Ask about their worries and let them know you are there to listen. Tell them you understand their feelings and do what you can to make them feel safe. Ask how you can help them feel less sad or afraid. Explain that there are doctors who can help, too.
  • Keep routine. Depression may make your child want to withdraw from things they used to enjoy, like playing with friends or going to school. Try to keep their routine as normal as possible, and make sure they continue to see loved ones even if they don’t feel up for it.
  • Talk to your child’s doctor. Your child’s doctor can help you understand depression and how it affects your child. They can answer your questions and explain treatment options.

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  • Therapy: A therapist can help your child learn healthy ways to cope with depression. They can offer support and give your child tips to work through sad feelings. There are different types of therapy. Some services may be available at your child’s school. Call their doctor or Care Manager with questions.
  • Medications: If therapy doesn’t work for your child, or if their depression is severe, antidepressant medication may be an option. Talk to your child’s doctor for more information.
  • Healthy diet: Make sure your child gets plenty of fruits, vegetables and protein. Limit sugar and caffeine, which can trigger depression symptoms. It’s important for your child to drink plenty of water as dehydration can affect mood.
  • Exercise: Exercise is proven to help with depression symptoms. Your child can start with small goals, like taking short walks or riding a bike a few times a week.
  • Rest: Getting enough sleep will help your child manage depression. Try stretching or taking deep breaths together to wind down before bed. Try the 4-4-4 breathing exercise:
    • Breathe in for 4 seconds
    • Hold for 4 seconds
    • Exhale for 4 seconds

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Benefits

  • Behavioral Health Assessment Services: Services used to detect or diagnose mental illnesses and behavioral health disorders. Includes one initial assessment and one reassessment per year, and up to 150 minutes of behavioral health status assessments. Covered as medically necessary.
  • Family Therapy Services: Covered as medically necessary.
  • Group Therapy Services: Covered as medically necessary.
  • Individual Therapy Services: Covered as medically necessary.
  • Medication Management Services: Services to help you make the best choices for taking medication. Covered as medically necessary.
  • Mental Health Targeted Case Management: Services to get medical and behavioral health care for people with mental illness. Covered as medically necessary.
  • Family Training and Counseling for Child Development: Services and support to your family during your child’s mental health treatment. Covered as medically necessary and recommended by CMS Health Plan.
  • Mental Health Partial Hospitalization Program Services: Treatment provided for more than 3 hours a day, several days a week, for people recovering for from mental illness. Covered as medically necessary and recommended by CMS Health Plan. Prior authorization required.
  • Mobile Crisis Assessment and Intervention Services: A team of healthcare workers who provide emergency mental health services, usually in people’s homes. Covered as medically necessary.
  • Multi-Systemic Therapy Services: An intensive service focused on the family for children at risk of residential mental health treatment. Covered as medically necessary and recommended by CMS Health Plan. Prior authorization required.
  • Psychiatric Specialty Hospital Services: Emergency mental health services that are performed in a facility that is not a regular hospital. Up to 15 days per month. Prior authorization required for voluntary admissions and after three days of involuntary admission.
  • Therapeutic Behavioral On-Site Services: Services by a team to prevent children 0-20 with mental illness or behavioral health conditions from being placed in a hospital or other facility. Covered as medically necessary.
  • Swimming Lessons: Get up to $200 a year for swimming lessons.
  • Equine Therapy*: Therapy that involves activities with horses.
  • Pet Therapy*: Therapy that involves activities with trained animals.
  • Art Therapy*: Therapy that involves art activities with a behavioral health clinician with an art therapy certification.

Learn more about your child’s CMS Health Plan benefits.

*Through EPSDT (Early and Periodic Screening, Diagnostic and Treatment).

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  • Brave Health: Free, fully virtual therapy and psychiatry for CMS Health Plan members 13 and older. Get one-on-one or group therapy, talk about medication and connect with community supports. Text or call 1-305-902-6347, email start@bebravehealth.com.
  • Charlie Health: Virtual intensive outpatient services (IOP) for a wide range of complex mental health conditions, including depression and anxiety. A personalized, evidenced-based approach to mental health care. Available to members ages 11 and up. Reach the Admissions Team 24/7 at 1-866-491-5196 or email admissions@charliehealth.com.
  • IMPOWER: Florida’s first and most experienced telehealth provider for behavioral health. Services include assessments, individual and family therapy, medication management, and psychiatric evaluation and treatment. Visit impowerfl.org to make a referral for your child. Fill out the online form and you will be contacted within 72 hours. You can also call 1-407-215-0095 or email referrals@impowerfl.org.
  • We’re In This Together by Erika’s Lighthouse: Find tools and resources to connect with your child about their mental health. Browse family guides for talking about mental health and getting help when needed.
  • Parent Support Workshops by Mending Hearts Family Counseling Center, Inc.: Free, online workshops that teach the principles of Parent-Child Interaction Therapy. Learn to use bonding and behavior management skills to connect with your child through difficult emotions, like anxiety and anger. Email welcome2@mendinghearts.love or call 1-909-787-1968.
  • Services by 7 Cups of Tea: Anonymous online chat with trained volunteers that provide free empathetic listening 24/7. Connect with the first available listener or search for one who shares your background or specializes in certain topics. Some listeners work only with teens 13-17.
  • Boys Town National Hotline by Boys Town: Free, one-on-one support from trained counselors through phone, text or email. Available 24/7 to children and teens who are experiencing challenges like anxiety, depression, trauma, abuse and more. Spanish-speaking counselors are available, as well as translation services for more than 100 languages. Call 1-800-448-3000, email hotline@boystown.org.
  • Youth Resilience Program by Florida State University: Free telehealth and texting therapy for teens 14 to 17 years old. Call 1-850-794-8002.
  • Visit the Krames Health Library to access thousands of health sheets on medications, conditions and more. Visit the Community Resource Database to get connected with programs and supports in your area that can help with food shelter, education, jobs and more.
  • CMS Health Plan Behavioral Crisis Line: We are available 24/7, including weekends and holidays, to help members in mental or emotional crisis. Call at 1-866-799-5321 (TTY 1-800-955-8770) to be connected.
  • NAMI HelpLine: Call, text or chat online with a trained specialist through the National Alliance on Mental Illness HelpLine. It’s a free peer-support service that connects you with someone who can offer support and help you find resources for your child. Available 10 a.m. to 10 p.m. Eastern, Monday through Friday. Text “HelpLine” to 62640. Call the HelpLine at 1-800-950-6264. Email helpline@NAMI.org or visit NAMI.org/help to use the online chat option.

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Contact your child’s Care Manager for more information about any of these resources. You can also call Member Services at 1-866-799-5321 (TTY 1-800-955-8770), Monday through Friday, 8 a.m. to 8 p.m. Eastern.