To many parents, diagnosing a child with depression as young as 2-years-old sound unconscionable. Many ask, what child doesn’t cry or become irritable? What toddler doesn’t become bored or unhappy at times?
But, in fact, the diagnosis is becoming more and more common. It has even has a name now, “preschool depression”. It’s estimated as many as 84,000 of America’s 6 million preschoolers, kids ages 2-5 years old, are clinically depressed.
“For preschoolers, really the hallmark of depression across the age range is really a lack of pleasure in the day to day activities,” says Dr. Stuart Goldman, the director of the Mood Disorder Clinic at Children’s Hospital Boston, “these kids are just not happy. They don’t enjoy life the way ordinary kids do.” Goldman says it is the type of sadness that goes beyond having a bad day.
SIGNS OF PRESCHOOL DEPRESSION
While there’s no doubt, kids as young as 2-years-old can have significant behavioral and emotional issues, some health care professionals are concerned with the actual label preschool depression. Dr. Lisa Cosgrove is a research lab fellow in the Edmond J. Sapher Center for Ethics at Harvard University.
Cosgrove warns by collapsing children’s issues under one name and labeling it as depression, we may be inadvertently deflecting our attention away from the other issues the child may be suffering from. “They could be the result of a number of factors, such as abuse, trauma, attachment difficulties, poverty, a number of situation and stressors and traumas can certainly cause those kinds of behavioral and emotional difficulties,” Cosgrove says.
There’s also the issue of medication. Cosgrove’s research looks at the influence of pharmaceutical companies over the medical community. The FDA doesn’t approve a drug, unless there’s an identifiable condition for it to treat, and Cosgrove wonders if there was a rush to put a label on preschool depression, “I think there are many well-intentioned, very good researchers addressing the issue of preschool depression. I think we need to be careful that none is playing hand maiden to the drug companies’ desire to make profits be expanding the market of what would be treatable.” One of Cosgrove’s concerns is the younger the patient, the larger big pharma’s customer base becomes. “So the concern would be what would the early intervention look like? Would it amount predominantly to medication?,” asks Cosgrove.
For now, there is no standard course of treatment for preschool depression. Much of it depends on the severity of the case, and family history of mental illness. Medication, according to Dr. Goldman, are used by most doctors as a late resort, “I think most child psychologists are not excited about prescribing powerful meds to 3 to 5-year olds, on the other hand, they don’t want kids to be suicidal and end up in the hospital either. For those who doubt the diagnosis, Dr. Goldman gives the example in a painting done by one of his patients, a little girl who tried to commit suicide at just 3-years-old. “She said there’s a little girl behind the rock and nobody knows where she is, and he mommy doesn’t know and she’s hungry and she’s cold and even Santa Claus, and it’s right around Christmas, is not going to find her,” Goldman says.