Brain scans of preschoolers show the earliest evidence of depression in young children, according to Washington University researchers.
To measure the early differences in brain function linked to depression, researchers studied more than 50 local children ages 4 to 6. About half of the group had been diagnosed with depression. None had taken any anti-depressant medications. The depressed and healthy brains, when scanned with magnetic imaging, showed differences in the part of the brain that regulates emotions that are also seen in scans of older children and adults with depression.
Young children with depression had increased blood flow to the part of the brain called the amygdala, which regulates emotions, when shown pictures of faces with different expressions.
Researchers at Washington University have studied early childhood depression since the late 1980s. Many adults who suffer from depression report having those feelings for as long as they can remember. The new brain scan findings add physiological evidence that depression in preschoolers is a real phenomenon and that they need therapy to deal with their symptoms, said lead author and assistant professor of psychiatry Michael Gaffrey.
While few statistics are available on clinical depression in preschool children, it is not believed to be common. Parents should be aware of behavior changes in children, particularly those who have family members with mental illness.
Tamar Chansky, a child psychologist in Philadelphia, treats children as young as 3 at the Children’s and Adult Center for OCD and Anxiety. She has written tips for parents on recognizing normal vs. problematic anxieties in preschoolers. Separation anxiety is normal and healthy in this age range and should improve by the time the child reaches kindergarten. It is also normal for young children to worry about monsters, ghosts and scary characters they encounter in books. These concerns can lead to fears of closets, basements, under the bed and a general fear of the dark.
But Chansky says parents should become concerned when the typical fears of early childhood prevent children from fully participating in social and family activities. These children can complain of ongoing headaches and stomach aches. They may have trouble sleeping and seek constant reassurance with little benefit. Illogical pessimistic thinking is another red flag in preschoolers.
The goal of treatment is not to get children on anti-depressant or other psychiatric drugs, Gaffrey said. Treatments for depression in young children start with behavioral and family therapy to help the kids better regulate their emotions and to teach parents how to coach them.
Scientists at Washington University’s Early Emotional Development Program have studied depression in young children for years, but this was the first time they had scanned the brains of preschoolers. The kids first tried staying as still as possible in a fake scanner before the real images were taken. A mirror on a helmet worn by the children reflected pictures of people with different facial expressions including happy, sad, scared and neutral. All of the different faces elicited increased activity in the brains of children with depression.
The same method is used to measure brain activity in adults with depression. In these previous studies, brain activity increased mainly when adults saw faces that expressed negative emotions.
Gaffrey speculated that depression can exaggerate the children’s reactions to all types of emotions. Parents said their children with depression in the study had trouble controlling and understanding their emotions.
“We can’t say these children were born with this, but more that these kids who have developed depression do show some brain differences as seen in older depressed groups,” Gaffrey said.
The evidence that children can experience changes in their brains linked to depression should lessen societal skepticism that young children can be clinically sad.
“The notion of a preschooler who isn’t happy is off-putting, and we can completely understand that,” Gaffrey said. “That’s what drives us to try and help these children, ultimately we want to get them back to happy and engaged.” 