Major Depression in Preschool Children?

First, I want to announce that I have an article in the new (October, 2009) issue of Psychology Today magazine. It’s called “Secondhand Blues,” and presents some of the key points from my new book, Depression is Contagious, which will be released next month from The Free Press, a division of Simon & Schuster. (You can click on the book announcement elsewhere on this blog page and it will take you to Amazon where there's a brief video clip you can watch of me describing the book.) Both the article and book counter the prevailing myth that depression is all about biology run amok. Instead, I draw attention to the social side of depression, the many ways our relationships with others can trigger and exacerbate depression. I hope you’ll read both the magazine article as well as the book.

Earlier this month, in an article published in the Archives of General Psychiatry, researchers concluded that major depressive disorder (MDD) occurs in children as young as 3 years old. The younger the child affected by depression, the more likely depression was an unwelcome companion for life. Lead author Joan Luby, M.D, from Washington School of Medicine in St. Louis, Missouri, presented the evidence that depressed preschoolers are likely to grow into depressed children, adolescents, and adults. (For the details of how symptoms were assessed, how the family’s psychiatric history was evaluated, and so forth, I’d suggest you see the full publication.)

For anyone who evaluates and works with kids, “discovering” that very young children can manifest depression is hardly news. In fact, children are the fastest growing group of depression sufferers. Yet, up until relatively recently, there was no diagnostic category for childhood depression. The prevailing “wisdom,” based on elaborate and widely accepted (but incorrect) developmental theories, was that children simply didn’t have sufficient personality development to experience “true” depression. Thus, instead of recognizing long ago that not only can kids get depressed, even very young ones, the profession overlooked children altogether. Consequently, the scientific literature on kids’ depression is woefully underdeveloped. Theory trumped common sense for much too long. When I wrote Hand-Me-Down Blues in 1999 about kids depression, I was shocked by how little literature there was to go on. That was only a decade ago!

The child of a depressed parent is anywhere from 3 to 6 times more likely to suffer depression than the child of a non-depressed parent. Just having a depressed parent is a very strong risk factor and, as we now know, it isn’t because of a “depression gene.” There isn’t one. Particularly compelling, in my view, is the researcher’s finding that early depression stays with one. Depressive episodes may come and go, but the likelihood of recurrence is much too great, especially when no treatment is provided. If you are the parent of young children, or you are a therapist working with young children, it is critically important that you tune into a child’s mood state and outlook. I’d also suggest reading Martin Seligman’s book, The Optimistic Child, as a way to learn to recognize opportunities to teach the skills to kids that can not only reduce depression, but even prevent it. Depression’s rate is rising among young people, and only aggressive education and prevention can slow the rising tide of suffering.