Depression in very young kids

[elise1mds]

How does one help a depressed 5-, almost 6-year-old? Her symptoms are not affecting her academics, and she isn't suicidal, though her pdoc has given me a list of med options to consider and told me to call him the second we choose/want/need one. So I'm not quite up to starting a medication with her yet. Part of my reluctance there is that I know if we start down the med road and she is bipolar (there is a history there that strongly suggests this possibility), she may never be off of them again, and I hate that idea. She has flat-out told me she won't talk to a therapist (and proven it when we visited the pdoc and all she did was glared and grunted at him), and I'm not sure how helpful it would be for me to go to a therapist by myself, though I'm open to the possibility. Mostly I just want to be able to talk to my baby girl so that she can hear me. Any ideas? Books? Anything? Thanks :)

[PeterPan]

Have you looked for physical causes of the depression? EMF from power lines, allergies (environmental or food), low thyroid, etc.? Also, the symptoms of being low stim from an OT perspective LOOK like you're depressed, but really it's an SPD thing. So the practitioner you go to would affect the diagnosis you get, kwim? And for the low stim, doing OT stuff *dramatically* affects it. Do you send her outside to play every day?

 

I'm not trying to discount what you're saying, just suggesting some avenues to research, things we've dealt with that have given us similar symptoms.

[elise1mds]

Allergies are minimal unless there's ragweed; her brother has much larger allergy issues than she has. EMF is out, too... we live in the country and aren't near any cell towers or other potential sources of EMF radiation. I'll ask about her thyroid at her well-child visit in April. That's a good idea. She is a big girl. She's outside TONS and is a sensory seeker. We have a huge yard, and she never asks for TV but begs to go outside. She rode her bike for about 30 minutes today, till she scratched her leg, which caused a 45-minute crying session. The depression is new since December. From March to September of last year, she was manic. Hence the potential bipolar diagnosis (right now we're working under a mood disorder NOS diagnosis). I appreciate the ideas :)

[Mergath]

She might say now that she won't talk to anyone, but a good therapist will be able to draw her out over time and earn her trust, so I would definitely ask around and find a good one. With depression, if you don't want to medicate, therapy is going to be essential. Your dd might not say a word for the first five sessions, but eventually she'll open up.

 

You'll benefit from seeing a therapist, too. A therapist will be able to help you find ways to help her, and to deal with your own feelings about what's going on, too. I would strongly encourage both of you to go, separately and as a family.

 

I have clinical depression, anxiety disorder, and borderline personality disorder, so I've been there, though not quite that young. And you might have to go through one or two therapists, but when you find the right one, he or she will make a world of difference.

[gingersmom]

My daughter saw a therapist at that age and its not like an adult seeing a therapist. She did not sit in a chair for 45 minutes and discuss what was bugging her.

 

They played games and did art projects and chatted. My daughter loved going to see her therapist.

 

I would use medication as a last resort.

[Guest jessanerissa]

Is there any ongoing conflict in the family or between parents?

 

I agree with Mergath, a good therapist will be able to draw her out over time and earn her trust. A child can't determine or may not know what bothers her but with the frequent visitation to the therapist she will learn to trust and share her concerns. You need to take the lead and notice changes in her.

 

If you do not have success with this, get help from someone your child can trust. This may be a relative or a friend. Your child may also not show obvious sadness but can show reduced pleasure in activities that were once joyful to her. Some depressed kids will show signs that is present in teen depression such as disrupted patterns of sleep and poor quality of sleep.

 

Many depressed children become depressed adolescents and it is a bigger risk, so it is better to solve the problem as early. Keep talking to her and listen to every word she says. Do not quiz her, or ask 'why'. She may not know 'why', but she may know how she feel and she may know what she want to be different. Help your child find ways to express sad feelings and make sure that she knows you love her.

Edited March 11, 2011 by jessanerissa

[elise1mds]

Thanks for the advice. DS saw a psychologist for a while, and while she was excellent for him (and me at the time), I don't think she and DD would have the same rapport. I will ask DD's pdoc for a list of names.

 

Everything at home is fine and stable. Everything at school is, too. There's no outside reason for her to be depressed, unless it's a thyroid issue like OhElizabeth suggested, but she definitely isn't the happy child I know. She does have the sleep problems, she doesn't play with her toys (she clings to me 24/7; she also has a separation anxiety/GAD diagnosis), and she cries about everything at the drop of a hat. She will talk to my MIL if she "has to," and that's some relief, but I'd rather her talk to a therapist instead. My MIL can shoot her mouth off at times, and I am often the root of all evil. The other day I patted her hair like I do probably a dozen times a day and received a note stating "Behave yourself mommy. Ph.Ph. [That's a raspberry being blown at me.] Hmph! Lov, DD. Lov, the end."

 

Again, thanks for the tips. I appreciate the thoughts :)

[elizam]

this site might be of interest...I have one bipolar child and am worried about my youngest as well.

 

http://www.bpkids.org

 

 

and this one: http://www.kristen-mcclure-therapist.com/

[elise1mds]

Elizam, I'm on the BP site and in one of their support groups. I just like to come here for ideas sometimes, too. It has been amazing and wonderful. Thanks for the other link as well!

[Terabith]

I have a five year old who will be six in April, who has severe anxiety. I am bipolar. The developmental pediatrician was really pushing me to medicate her, but I was VERY reluctant to do so, both because of her age and because of the bipolar risk factors.

 

We went to a child psychologist, and it was good, but there wasn't that much of an impact on the anxiety. Finally I decided that we would try it. It was so extreme it was affecting every aspect of her life (including academics and social skills) and of our lives.

 

It was one of the best decisions I ever made. I still shudder at the fact I am giving celexa to my five year old, but it has really transformed things for her. She still is anxious, but it's something we can deal with now. It's a TINY dose. She doesn't look like an Aspie anymore; she never quite qualified, because she passed the A-DOS with flying colors, but everyone (OT, ST, dev ped, psychologist) thought she had it. The anxiety was just interfering with the social skills to that degree.

 

I'm not saying that you should give her the antidepressant. It's not something to do lightly. I still think it's sort of playing with fire, in terms of the bipolar issue. I feel like we may have dodged the bullet, but she's only been on the meds for four months.

 

I just wanted to let you know that I understand, and that for us, it turned out well.

[Ottakee]

You could also check her Vitamin D levels and try some good Omega 3s.

 

That said, treating bipolar, earlier rather than later can be VERY helpful. Our neuropsych said that there is more and more research showing that the earlier you treat it, the easier it is to control.

 

You do though need a doctor very experienced in young kids and meds.

 

The fact that she is depressed now in the winter months and you said she was manic in spring/summer, tends to lend towards bipolar.

[BlueTaelon]

If you are open to a non drug option we have found amazing success with the TrueHope program http://www.truehope.com We just hit 6 months on it for myself and my 10 yr old who has BP1, we never found stability on meds and after 2 years decided to try the TH. My only regret is that we didn't find them before going on psych meds.

 

ps: I promise I'm not a spammer even though this is my 1st post, I came here looking for curriculum recs that might be a better fit for my dd and saw your post:)

[Ottakee]

We did the True Hope for a while. It is expensive---unless it has come down some now. It did not work well here but my daughter has 3 mito issues, seizures and the bipolar. I know our psychiatrist said that she has a few patients on it that have done well though.

 

One positive though of trying it was that we went off all meds (under close doctor superivision) and it did help us fine tune what we needed meds for, what was side effects of the meds, etc.

[BlueTaelon]

We did the True Hope for a while. It is expensive---unless it has come down some now. It did not work well here but my daughter has 3 mito issues, seizures and the bipolar. I know our psychiatrist said that she has a few patients on it that have done well though.

 

One positive though of trying it was that we went off all meds (under close doctor superivision) and it did help us fine tune what we needed meds for, what was side effects of the meds, etc.

 

 

Its still expensive but they have a wellness program to help cover the cost for those who can not afford it. How long did you try the program? You really need to give it a year which seems like forever at first, I know 6 months ago I couldn't even picture today much less 1 year. The 1st I dunno, 2-3 months? Were really hard since the withdrawals off the meds were horrid but were mostly past that now. dd was doing really good until I enrolled her in public school. The stress of school made her go manic and its been a nightmare since. When she's been home for the day she's fine but when she gets home from school ugh! I've had enough and I'm bringing her back home.

 

Just a thought, the meds used to treat the seizures could be messing with her moods and could be incompatible with the empower, I know lamictal and is a nightmare coming off of and is not at all compatible.

[elise1mds]

She is on omega-3s, but they don't do much for her. She likes taking them, though, and they do help DS, so I figure they're not hurting her, either. Her pdoc suggested folic acid, so I'm going to see if I can find and add it. It sure can't hurt.

 

Ottakee, I've read somewhere that there are brain changes caused by or at least linked to bipolar that can actually be prevented by early treatment, so there is definitely that to consider. Thanks for reminding me. Terabith, I'm glad to hear another story. I remember putting DS on medication (also at 5) for ADHD and the heartache that went with it. For some reason, this decision seems tougher. His medication was temporary, till we got him home and got the anxiety under control, and he's been off of all meds for a year and a half; with her, putting her on something just seems so final. BlueTaelon, I'll check out that link; thanks.

 

Seriously, thanks again for all the extra info and tips. I'm so grateful. Mood disorders are a whole different ballgame when compared to autism disorders, and I'm just now learning the rules (basically, the only predictable thing is how unpredictable they are).