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Question
Posted by: Maria | 2011/09/25

Depression and anxiety in pre-schoolers

Hi CS

I was talking to an acquaintance yesterday who is extremely concerned about her 4 year old. He seems to be persistently sad, not enjoying the activities that kids his age typically find exuberant pleasure in, and extremely sensitive. His mother says that if e.g. another child said something nasty to him in the morning at creche he might still be very upset about this hours later. He cannot bounce back emotionally from seemingly insignificant events. This has been going on for more than a year. During that time his parents divorced, which of course always has a big impact, but his older sister has not shown any similar reaction and the divorce was quite amicable.

I know that the diagnosis and treatment of depression in young kids are contentious, and that one should be very careful of jumping to any conclusions. Could there be a purely physical reason for the anhedonia, which is the symptom she is most concerned about?

They don''t have medical aid or the financial resources to see different specialists privately. I''ve suggested that she should contact the psychiatric department at Tygerberg, our local teaching hospital. Do you have any other suggestions? Should she first have him checked out physically, perhaps by a gp?

Scratches to kitty!

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Our expert says:
Expert ImageCyberShrink

Its obvious to all of us that kids can get sad - it'd be abnormal not to. And, as in adults, our definition of an illness rather than a temporary reaction, would depend on the degree of the depression, its duration, and the extent to which it interferes with normal activities.
And experts who have studied the issue agree that some kids do get Depressed, even if 4 seems very young to do so. If the theories of chemical imbalances, ertc., imply that apurely chemical depression can arise, not dependent on obvious factors in external life, or on one's individual interpretation of whatever has happened to us ( which a 4 year-old might not be able to muster ) ; then presumably a Depression could arise even in a young child.
Ideally, one would want an assessment by a child psychologist or child psychiatrist.
No likely physical causes for this picture spring to mind. And non-shrinks can at times spend an awful lot of time and money trying to prove that every imaginable condition is not present, wven where there are no good reasons for supposing them to be there anyway.
I fully agree with your suggestion of seeking an arangement for the child to be seen at Tygerberg, where they have a very competent psych department fully able to assess him, and where the academic interest of the very question should help increase their interest in being helpful.
Kitty has banked the scratches for later, being currently fully occupied in lolling in the sunshine inside the window, idly toying with a curtain.

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Our users say:
Posted by: cybershrink | 2011/09/25

Its obvious to all of us that kids can get sad - it'd be abnormal not to. And, as in adults, our definition of an illness rather than a temporary reaction, would depend on the degree of the depression, its duration, and the extent to which it interferes with normal activities.
And experts who have studied the issue agree that some kids do get Depressed, even if 4 seems very young to do so. If the theories of chemical imbalances, ertc., imply that apurely chemical depression can arise, not dependent on obvious factors in external life, or on one's individual interpretation of whatever has happened to us ( which a 4 year-old might not be able to muster ) ; then presumably a Depression could arise even in a young child.
Ideally, one would want an assessment by a child psychologist or child psychiatrist.
No likely physical causes for this picture spring to mind. And non-shrinks can at times spend an awful lot of time and money trying to prove that every imaginable condition is not present, wven where there are no good reasons for supposing them to be there anyway.
I fully agree with your suggestion of seeking an arangement for the child to be seen at Tygerberg, where they have a very competent psych department fully able to assess him, and where the academic interest of the very question should help increase their interest in being helpful.
Kitty has banked the scratches for later, being currently fully occupied in lolling in the sunshine inside the window, idly toying with a curtain.

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