Depression Among Preschool Children

Preschool children not only suffer with depression, their symptoms are often unnoticed and thus the condition goes undiagnosed. Recent findings on preschool depression indicate that it is not a temporary condition and that early detection is important.
Child psychiatrist and researcher Joan Luby from Washington University in St. Louis has published a new study in which she highlights depression in preschool children, the importance of early detection, and treatment strategies. Luby has been researching depression in preschool-age children for years. In August 2009, a study for which she was the lead author validated the existence of major depressive disorder in children as young as 3 years and showed that children with major depression at such a young age are nearly four times more likely than their peers to have depression two years later.
In 2003, Luby and her research team reported in the Journal of the American Academy of Child and Adolescent Psychiatry that a key symptom to identify depression in preschoolers is anhedonia, which is the inability to experience pleasure from activities and play. Luby noted they found “that depressed children just don’t derive pleasure from the same things as a typical 3- to 5-year-old child. They’re less joyful when they encounter the pleasures of daily life.”
In that study, Luby explained that because very young children cannot express their emotions in words, puppets and play schemes are used to identify them. They also reported that as in older depressed children and adults, depressed preschoolers tended to have more than one psychiatric disorder, with 42 percent also having attention deficit hyperactivity disorder (ADHD), 62 percent had oppositional defiant disorder (ODD), and 42 percent had both disorders.
In this newest study, Luby noted that depression in preschoolers tends to manifest as an inability to enjoy playtime. Parents tend to not notice preschool depression because the children may not be disruptive or obviously sad, and may function normally at times during the day. Age-appropriate interviews have shown that preschoolers do exhibit typical symptoms of depression, such as appearing less joyful, being prone to guilt, and experiencing changes in sleep habits.
The researchers also point out that because of the potentially long-lasting impact of preschool depression, as Luby demonstrated in an earlier study, early diagnosis and intervention are very important. The brains of young children are easily adaptable (“plastic”), which may explain why developmental interventions are more effective if they are initiated at an early age.
Luby notes that the side effects associated with the use of selective serotonin reuptake inhibitors are a concern, even though there is some evidence that these antidepressants may be effective in school-age children. For younger children, there may be another way.
Among depressed preschool children, a promising treatment based on Parent Child Interaction Therapy (PCIT) is being tested and has been modified to focus on a child’s emotional development (ED). Early changes in emotion skills may be an essential element to risk for depression, and it is possible PCIT-ED may help to correct those changes at a very early stage.

MySpace Campaign To Help Teen New Yorkers Cope Depression

Teenage visitors are encouraged to seek help for depression, drugs and dating violence.
The New York Health Department last week announced a new online campaign to engage teenagers grappling with depression, drugs, and violence, and to encourage them to seek help. NYC Teen Mindspace, posted on MySpace, is the agency’s first effort to promote health through Web-based social networking – a medium with great potential because of its popularity with young people. To see the campaign, visit here.
Mental health issues are common among teens. Nearly one-third of New York City high school students say they experience sadness that keeps them from daily activities (30%), and 8% report attempting suicide during the past year. In addition, some 11% say they experienced dating violence during the past year – up from 7% in 1999. About 15% of teens report binge drinking, and 12% say they smoke marijuana. (Both rates have fallen slightly in recent years.)
Though many teens experience mental health issues, they are often reluctant to acknowledge them and seek help. When asked who they are most likely to talk with when they feel sad, more than 20% of teens said they talk to no one, one-third said they would talk to a friend only (31%), and just one-third said they would talk to an adult (32%). The Mindspace page responds to these issues with interactive features that raise awareness and combat stigma by helping teens identify with peers and prompting them to seek help.
* Video blogs for teen characters. Mindspace features fictional, composite personalities, such as “Kyle,” “Nicole,” and “Stephanie,” who chronicle their struggles through video posts. Their stories about using drugs or suffering from depression unfold through updates. Any teen who visits the site can “friend” the characters and follow their stories. Additional characters will be added in coming weeks.
* Opportunities to reach out for help. By sending a confidential message to a mental health counselor from LifeNet, a service offered by the Mental Health Association of New York City, teens can get help and referrals to treatment. Mindspace does not offer live assistance, but it encourages teens who need support to call 800-LifeNet – where counselors are available 24 hours a day, seven days a week – or they can call 911 in an emergency.
* Quizzes, polls, games, and fact sheets. “Have you ever felt the need to harm yourself or others?” Teens can use questions like these to test their knowledge and compare their feelings with those of their peers. Fact sheets, quizzes, and games that focus on stress and abuse offer guidance and perspective – and they can be forwarded to friends.
* Music downloads. A standard piece of any popular page, this feature invites teens to express themselves by playing music to fit their moods.
“Social networking sites present a unique opportunity to help teenagers with mental health problems,” said Dr. David Rosin, Deputy Commissioner for Mental Hygiene. “By reaching out to young people where they socialize, in a style they can relate to, we make it easier for them to talk and seek help.”
Social networking has become a fact of teen life. Research from the Pew Research Center shows that 93% of U.S. teens use the Internet and 85% of them visit social networking sites, with half of them visiting their personal profiles daily to interact with a larger online community. These sites provide an opportunity not only to share information, but to shift social norms. Young people who visit Mindspace will see that the featured characters address their issues by talking to a counselor or calling LifeNet, and some will be inspired to reach out themselves.
“Many teens are reluctant to seek help,” said Dr. Myla Harrison, Assistant Commissioner for Child and Adolescent Services. “Engaging with these characters may help teens express their feelings, connect with others and realize that help is available. They may also realize that they don’t have to take risks and endanger themselves. Instead, they will see the characters think about how to direct their own lives in a safer, healthier way.”
The Health Department drew on data from the city’s biannual survey of public high school students in developing the focus areas for the campaign. The Department convened a teen advisory panel to guide the look and feel of the page and shape the profiles and experiences of the teen characters.

Biochemical link found between adversity, depression, and death

Researchers have used a unique way to determine a link between adverse life events that trigger stress and depression and lead to disease and increased risk of death. Interactions that occur between genes and the environment, in response to stress vary among individuals.
People with a rare form of the gene IL6 seem to be immune to dying from adverse life events and depression that can lead to poor health.
Steven Cole, a member of the UCLA Cousins Center for Psychoneuroimmunology and an associate professor of medicine in the division of hematology-oncology, and his colleagues used a computational model to discover that IL6, a gene that promotes inflammation, differs among individuals and changes the way adverse life events that trigger depression and misery affects individual health.
People who experience depression from adverse life events, whose IL6 gene activation pathway is blocked, seem to be immune from cardiovascular disease, neurodegeneration and some types of cancer that in other individuals produces depression that leads to disease and increased chances of death.
"The IL6 gene controls immune responses but can also serve as 'fertilizer' for cardiovascular disease and certain kinds of cancer," said Cole, who is also a member of UCLA's Jonsson Comprehensive Cancer Center and UCLA's Molecular Biology Institute. "Our studies were able to trace a biochemical pathway through which adverse life circumstances — fight-or-flight stress responses — can activate the IL6 gene.
We also identified the specific genetic sequence in this gene that serves as a target of that signaling pathway, and we discovered that a well-known variation in that sequence can block that path and disconnect IL6 responses from the effects of stress."
The scientists found that individuals who possess the most common IL6 gene were at higher risk of death for approximately eleven years from depression brought about by adverse life events.
The authors write, “This opens a new era in which we can begin to understand the influence of adversity on physical health by modeling the basic biology that allows the world outside us to influence the molecular processes going on inside our cells." Stress that lead to misery is now found to be linked to death from inflammation that promotes heart disease, some types of cancer, and neurodegenerative disease.
The IL6 gene varies among individuals. The researchers discovered through epidemiological studies and by using a computer model, that people with the rarer variant of the IL6 gene, were immune from the ill effects of adverse life events that leads to depression, misery and death.