Early Childhood Depression
The first article is from the ADAA website, which is the Anxiety and Depression Association of America. This association was founded in 1979. It focuses on helping people with these disorders of all ages. They also educate others on how these disorders can affect them or their loved ones. “ADAA strives to improve patient care by promoting implementation of evidence-based treatments and best practices across disciplines through continuing education and trainings and accelerating dissemination of research into practice” (Bhatia). There goal is to eventually be able to prevent and cure disorders like anxiety and depression. What’s great is that their “passion” is to help people understand these disorders instead of being uncomfortable around them and not talking about them. ADAA is helping to get the conversation started and steering it in the right direction. They started as The Phobia Society of America then expanded to “anxiety disorders, mood disorders, depression, OCD and PTSD” (Bhatia). They have worked very hard over the years to expand the scientific understanding of these disorders in order to better treat them and help educate others about them.
The second article is from NCBI (National Center for Biotechnology Information) website and under the PMC (PubMed Central). NCBI is an organization whose mission is “uncovering new knowledge” (Luby). It was founded in 1988 for the purpose of providing biomedical information so more people can understand the “fundamental molecular and genetic processes that control health and disease” (Luby). This happens to include anxiety and depression because these disorders are often linked to an imbalance of hormones or other environmental causes. They try to gather as much information as possible “nationally and internationally” to help build a bigger understanding in the medical community (Luby). They conduct their own research, collaborate with other institutions, sponsor workshops and lectures, support training in the research field, provide a large variety of sources for people, and promote standards for databases (Luby).
How it works
The first article from the ADAA is about childhood depression. Many people do not catch childhood depression because they assume that it is just the kids being kids, but the rate of childhood depression has gone up in recent years. Depression is real, and it is definitely real in kids. It has “biological, psychological, and social underpinnings” meaning that these are mostly what causes depression in humans of any age (Bhatia). Children and teenagers are more likely to have depression if a family member has it, but this is only based on probability. Most children with depression go unnoticed. If more parents know the signals to look for they could save their child’s life. Children are more likely to have physical symptoms when depressed but there are other symptoms such as; “loss of interest in fun activities, withdrawal from social or usual pleasurable activities, difficulties with concentration, running away from home, talk about death or dying, sleep increase or decrease, appetite or weight changes, new onset agitation or aggression, and comments indication hopelessness or low self-worth” (Bhatia). They may not have all the symptoms, but they only need to occur on most days for at least 2 weeks for it to be considered depression. Before arriving to the conclusion of it being depression, though, the best thing to do is to rule out any other medical conditions that can cause depression. For example, hypothyroidism, anemia, or a Vitamin D deficiency (Bhatia). It could also be another psychiatric disorder that can also result in depressive symptoms like ADHD. Treatment is important because, if left untreated, it could lead to loss of life for the child. Most treatment involves an assessment, then a referral to a psychiatrist or a psychotherapist, and there could also be some medication involved. Treatment varies on the child, their age, and the degree of their depression. SSRI’s or other antidepressants can be helpful but there is a risk when treating younger children with these. They can increase thoughts of suicide, but my monitoring them and changing the dose as needed as decreased this risk (Bhatia). Treatment will vary if the depression is a symptom of another condition like anxiety or ADHD. Other than their symptoms going unnoticed, many children and teens with depression are simply ignored because of the stigma against mental illnesses. “Research shows that stigma and embarrassment were the top reasons why people with mental illnesses did not engage in medication adherence, such as self-care, therapy, and medication compliance” (Bhatia). If these young children do not get the help they need soon, their illnesses could follow them into their teenage years into high school and on. ADAA is partnered with Bring Change to Mind to encourage people to talk more about mental health and raising awareness about it.
The second article from NCBI is also about early childhood depression. The study of depression in children younger than 6 is fairly new, but research over the past few years has proven against the thought that children of this age are “too immature” to have depressive symptoms (Luby). Researchers have also realized that children of these ages are more mature and intellectual than they thought. They are able to experience the depressive symptoms like guilt and shame. Studies have also shown that they show “alterations in the hypothalamic-pituitary-adrenal axis” just like in adult depression (Luby). Whether depression from this age continues on or reoccurs is still in question. There was a study done on a 4-year-old girl who showed depressive symptoms. She showed “extreme irritability, periods of social withdrawal, negativity, and periods of decreased appetite” (Luby). Her parents noticed these symptoms and their increasing over a period of time and decided to bring her to a mental health clinic. She was uninterested in play or like negative play themes. She was in the right stage of development for her motor and language skills, but she did not enjoy play like someone at her age should (Luby). Diagnosing depression in children of such a young age can be difficult because their depressive symptoms could be associated with another disorder. There is still work to be done to educate parents and others about the signs and symptoms of depression that way one can distinguish if there is really another problem going on. Since this is still so new in the medical community, there are no specific set treatments for depression in preschool children. Psychotherapy has been known to be effective as well as CBT (Cognitive Behavioral Therapy). Tests are being done and they seem promising for future researchers and others to be more informed. PCIT-ED (Parent Child Interaction Therapy-Emotional Development) has also been known to be effective. It is designed to target the child’s emotional development through the use of emotional education. The parent is trained to respond whenever the child has an episode and to coach them through it (Luby). This particular therapy, however; is still in its testing phases. Early intervention is also something that can be tried when treating children of this age. The goal is to teach them how to use their emotions properly and how to recognize them. Early intervention has been known to help in many cases that are not just mental illnesses but also disorders. Children are more likely to suffer from depression if a parent or other relatives has suffered or is suffering from it. Treatment that targets the child is necessary in this situation because emotion development is unavailable (Luby). The use of antidepressants on preschool children is not recommended because of the effects. This would require family members to fully comply with the treatment plan.
Take Home Points
I did not realize that children so young could actually have depression. I, like many others I’m sure, did not think that they had the mental capacity for these emotions yet. But the studies and the information provided by these two articles has proven me wrong. I learned that children of this age need to be monitored more closely when it comes to their emotions because if they go unnoticed, it could be fatal in the future. I also learned that the study of early childhood depression is very rare and that even though the rates of childhood depression are growing, the means to prevent it or treat it are not. Many people are not educated enough on this topic and should realize that it is a real thing that it physically wrong with the person it is affecting. Many children are just brushed off when it comes to their feelings because “kids will be kids”. But this can no longer be used as an excuse to ignore the symptoms of depression in a child. I think that there should be more studies done and more research going on about this topic so that more parents of the world can be educated and learn to recognize the signs so that they can prevent it or treat it. Treatments for teens and adults with depression are so common these days, but no one seems to be thinking that a 5-year-old child can be depressed, too. This is something that the psychological community should be teaching us, not only so we can be more informed about the situation, but so that the stigma against mental illnesses can be removed all together.
Bhatia, Richa, n.d., Childhood Depression, Retrieved from https://adaa.org/learn-from-us/from-the-experts/blog-posts/consumer/childhood-depression
Luby, Joan L., n.d., Early Childhood Depression, Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3184299/