Contrary to the popular perception of toddlers as "carefree," a new study shows that chronic depression can affect children as young as three. Critics, however, worried that the findings will cause excessive use of antidepressants among toddlers.
Newser's Lindsey Tanner writes that although previous research indicated that about 2% of preschoolers suffer depression at some point, researchers didn't know if this depression could become chronic in kids so young. To determine this, the study followed 306 preschoolers, 75 of whom had major depression. They found that in 64% of children who were depressed at the start of the study, depression continued or recurred six months later. 40% were still suffering a full two years later. The findings are surprising because, as study author Dr. Joan Luby says, many psychologists thought "children under 6 were too emotionally immature to experience" depression.
The researchers found that toddlers were most likely to be depressed if they had depressed mothers, or if they had suffered abuse or the death of a parent. Psychiatrist Dr. Helen Egger says depression has different signs from ordinary toddler moodiness — kids seem sad even while playing, play death-themed games, throw especially violent tantrums, or become obsessively guilty over minor mistakes. However, it's not clear how clinicians should treat depressed toddlers. Some people are against prescribing drugs like Prozac to kids so young, but if left untreated, says psychiatry professor Dr. David Fassler, depression "can have a devastating and often lasting effect on a child's social and emotional development."
Early intervention may be helpful for a variety of mental illnesses, according to an article by researcher Mary E. Evans. For instance, cognitive behavioral therapy lowers the rate of depression in high-risk adolescents. But toddlers aren't teenagers, and it's not yet clear what kind of intervention might prevent their depression from becoming a lifelong problem. One thing's for sure — antidepressant use is on the rise across almost all American demographic groups, and might rise even more if more toddlers were diagnosed with depression.
Whether this is a good thing is up for debate. Many people get enormous relief from antidepressants, but the increase in their use hasn't corresponded with an overall improvement in American mental health. In fact, says Dr. Eric Caine, the suicide rate for middle-aged people in America is rising. Of course, that doesn't mean antidepressants aren't working — it could mean that life in America is just getting worse, or that the drugs aren't being prescribed to those who need them most. But since antidepressants can raise the risk of suicide in children, prescribing them to the very youngest kids isn't without its problems.
Still, depressed kids clearly need help, especially when depression starts before they even start school. Putting a face on this heart-wrenching illness is the HBO documentary Boy Interrupted (clip above), in which filmmakers Dana and Hart Perry chronicle the life of their son Evan. Evan first started talking about suicide in kindergarten, and was, according to Salon's Heather Havrilesky, "obsessed with jumping out a window." He killed himself at 15. Havrilesky calls the film "a smart, thoughtful and informative glimpse at a short life that sheds light on how tough it can be to recognize and effectively treat a kid." If Evan's life is any indication, it's a problem we still haven't solved.
Mental Illness Can Be Avoided In Youth [UPI]
Depression Affects Preschoolers [UPI]
U.S. Antidepressant Use Doubles In Decade [UPI]
Not Just A Cranky Toddler: Study Finds Depression In Children As Young As 3 [Newser]
Antidepressant Use Doubles In U.S., Study Finds [MSNBC]
Depressed Nation? [LA Times]
Critics' Picks [Salon]