Depressed Children

Can Preschoolers Be Depressed?” asked the title of a long article in last week’s New York Times Magazine. “Good grief,” I thought. “I know where this is headed.” So I set the article aside. But it kept calling to me, so I read the first page. It was about a four-year old named Kiran who, among other things, spent a day at a children’s museum but couldn’t remember anything fun that he’d done. His life seemed to be awash in that kind of feeling. And so I had another reason not to read the article—I was not drawn to reading about children in that kind of emotional pain. But still it called.

The day before I picked up the article I fixed a gas wall heater. In the course of doing the work, I got a blast of propane gas—pretty nasty stuff. I took some homeopathic and flower essence remedies to help my body recover, but still I had a slight headache into the evening. The next morning I woke up with a mild vertigo, mild nausea, and a feeling of despair. The three are typical signs when I’m getting sick. I took some more flower essences and a different homeopathic remedy. But this isn’t about being slopping with toxins. Nor is it about non-invasive remedies for the consequences of such mistakes. It’s about how emotions are signals your body sends in order to get you to attend to it.

I didn’t connect these two things until the next day. I had guessed that the Times article would talk a lot about psychotherapeutic diagnosis and treatment, medicalizing the emotional suffering of children because conventional practitioners too often don’t know what else to do. I guessed that it would say nothing about environmental effects on their emotional life. And I was right on both counts.

To their credit, the practitioners and researchers interviewed for the article are rejecting the efforts of pharmaceutical companies working to get into this “emerging market.” On the other hand, their approach was narrowly focused on coming up with a diagnosis for depression in preschoolers and identifying suitable treatments. That dynamic channels the rich, albeit unhappy experience of the child into one thing: depression.

But is depression the same thing as despair, helplessness, morose, melancholy, sad, sullen? These are all different emotions. If they’re all reduced to “depression,” doesn’t that impoverish what we know? Doesn’t that impoverish who we are? Doesn’t that impoverish the child’s experience and our understanding of the child?

The question “Can Preschoolers Be Depressed?” is a trick question. It’s not about the child, it’s about what we call the child. Of course, what you call a child will shape how that child adapts to adversity and who that child becomes.

Going back to my propane experience and my emotional reaction to it, what happened to me was quite simple: my body was communicating with me. I was sick. My body wanted me to stop so it could heal. Despair is a feeling of not wanting to go on. Environmental exposure leads to physiological response leads to emotional response that affects the actions of the organism: me.

I turned to Environmental Health Perspectives, one of the major scientific journals in the field. First I did a search on depression. There were 133 articles. Then I did a search on depression and children. There were 37 articles. And those are only the articles published in the last four years in one journal.

The researchers and practitioners interviewed for the Times article are trying to find ways to comfort children who feel badly about themselves. In most cases, they work with the parents who struggle daily to give their child the happiness he or she deserves. Although noble, they are doing so in a dualistic universe where emotions are one kind of thing and toxins are another. Because what’s wrong presents itself as emotional, it stays in the emotional silo, separate from the physical silo. Of course, there are no silos. The child and we adults too are a unity of the emotional and physical.

So the researchers and practitioners simply don’t ask what environmental exposures prompt the “depression” let along the nuanced emotions that children are actually experiencing, whether they can name them or not. What is the toxin that the child is or was exposed to that caused his little body to make him feel like he doesn’t want to go on, that nothing will make him happy, that, to quote little boy, “now I’m really sad,” that, to quote another, “I am a bad boy. I don’t think you love me now.”

“Can Preschoolers Be Depressed?” If we say so, they can. If we tell them so, they can. But should we? Should we grasp at the relief offered by a diagnosis and psychotherapeutic treatment, perhaps including drugs, confined to the emotional silo? Or should we help those suffering children understand the meaning of what they’re actually feeling while we look for the environmental exposures that harm them, the exposures that make them feel so badly?