Is there anything sadder than a depressed preschooler?Friday, August 27, 2010
If there's anything sadder than the idea of clinically depressed 3-year-olds, I can't think of it on this gloriously sunny Friday afternoon. Preschool, after all, is when the world is supposed to be at its most magical, full of wonder and possibility and after-school snacks.
But researchers say "preschool depression" exists and can affect children as young as 2 or 3. Detailed in a New York Times' Sunday magazine piece by Pamela Paul published Friday, preschool depression is the latest face of the "name game" played in pediatric diagnosis -- whether it will follow in the footsteps of A.D.H.D. (attention deficit hyperactivity disorder) and O.D.D. (oppositional defiance disorder) remains to be seen.
The diagnosis is understandably controversial. It's been long thought that kids' brains just aren't developed enough to get depressed. Sure, kids are sad when a friend goes on vacation or when their favorite blanket doesn't make it through the spin cycle, but to be truly zapped of joy, teetering on the edge of existential emptiness? Seems a little much to ask of kids still working on potty-training.
The problem is, that's what the medical establishment thought about teenagers just a few decades ago: that they were too young to be depressed. Then all evidence pointed otherwise, and the age threshold for depression has inched steadily downward:
First adolescents, then grade-school children were considered too psychologically immature to be depressed. Stigma was a major fear. "There was this big worry that once you labeled it, you actually had it," explains Neal Ryan, a professor of child and adolescent psychiatry at the University of Pittsburgh. By the early 1990s psychiatrists had come to recognize that depression occurs in children of 8, 9 and 10.
Paul leaves us with another cautionary note. Things like "he'll grow out of it" or "it's just a phrase" are commonplace among parents of youngsters for a reason: They're often true. What are the consequences of saddling a young child with a clinical diagnosis when maybe it really is just a phase? There's certainly less stigma around depression than there once was, but it still exists, and the rush to overdiagnose serves neither the child nor the diagnosis.
But for cases of true depression among youngsters -- and the article provides plenty that will break your heart -- there is one bright spot. Children, because of their still rapidly developing brains, may actually be more receptive to treatments than adults, in whom depression is notoriously hard to cure. The lessons learned from autism over the past decade -- that early intervention can make a huge difference -- may apply similarly to preschool depression, experts say.