No parent wants to see their child suffer the consistent and pervasive sadness of depression. So just what are the treatment options available?
WORDS DR NICOLA DAVIES
When it comes to treating childhood depression, the very question many parents find themselves asking is to medicate or not to medicate. For most parents, the instinct is to avoid medication. Children have responded well to medications prescribed for disorders such as ADHD, but what is the general opinion about prescribing antidepressants for preschool children?
Dr Luby has noted that antidepressants are generally not very effective in treating preschool depression, possibly due to the developmental differences between very young children and the adolescents and adults who are usually prescribed such medication. She argues that because few studies exist that support the need or efficacy for antidepressants for young children and because children are at greater risk of side-effects, medication should be considered only as a last resort. If this last resort is needed, however, a child should not be denied it.
What are the Options for Treatment?
No parent wants to see their child suffer the consistent and pervasive sadness of depression.
In the rare instance that a very young child is diagnosed with depression, non-medicinal treatment options exist that can support the child while also involving parents in improving their emotional and behavioural well-being.
Cognitive Behavioural Therapy
One potential treatment option is Cognitive Behavioural Therapy (CBT).
CBT teaches coping strategies, such as how to turn
negative thoughts around and how to engage in
healthier thinking and behaviours.
However, there has been little research citing CBT as a truly effective response to early childhood depression. Indeed, research has shown that CBT only brings a modest level of improvement.
Parent Child Interaction Therapy
A better option might be a whole-family treatment, also known as Parent Child Interaction Therapy (PCIT). This type of therapy has been used in the treatment of other disorders such as ADHD and ODD, and a modified version geared towards emotional development (PCIT-ED) has shown promising results. This treatment has been described as a way to teach parents different ways to interact with their diagnosed child in an effort to enhance the quality of the parent-child relationship and help parents to set nurturing and effective limits with their child. In this way, the difficulty in providing clinical therapy to small children can be overcome by involving parents and caregivers in the treatment process.
Training parents in behavioural management with their children – Parent Management Training – has also been found to be effective in helping children with depression. Similar to PCIT-ED but with more of an emphasis on giving parents the tools they need, Parent Management Training differs in that it is not as time-intensive and offers the child a freer, more open-ended treatment option.
Early Intervention is Key
If there is one thing the literature on early childhood depression does agree on, it is that the earlier the intervention and treatment, the better. Dr Luby points to the greater capacity for very young brains to react to new experiences and events – otherwise known as neuroplasticity – as the main reason emotional and behavioural therapies are the best course of treatment. If addressed early, these strategies can continue to help as the child grows into their teenage years and adulthood.
If you are concerned that your child may be
experiencing depression, addressing these concerns
with a medical professional early can go a long way towards treating
the condition without having to resort to medication.
Some parents delay getting help through fear that they will be judged for their child’s depression. The sooner you act, the better chance your child has to recover and thrive.
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