Our expert says:
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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