THE COURSE OF DEPRESSION IN THE YOUNG
That depression should not just be treated, but prevented, in children is clear from an alarming discovery: Even mild episodes of depression in a child can augur more severe episodes later in life.26 This challenges the old assumption that depression in childhood does not matter in the long run, since children supposedly "grow out of it." Of course, every child gets sad from time to time; childhood and adolescence are, like adulthood, times of occasional disappointments and losses large and small with the attendant grief. The need for prevention is not for these times, but for those children for whom sadness spirals downward into a gloom that leaves them despairing, irritable, and withdrawn—a far more severe melancholy.
Among children whose depression was severe enough that they were referred for treatment, three quarters had a subsequent episode of severe depression, according to data collected by Maria Kovacs, a psychologist at Western Psychiatric Institute and Clinic in Pittsburgh.27 .Kovacs studied children diagnosed with depression when they were as young as eight years old, assessing them every few years until some were as old as twenty-four.
The children with major depression had episodes lasting about eleven months on average, though in one in six of them it persisted for as long as eighteen months. Mild depression, which began as early as age five in some children, was less incapacitating but lasted far longer—an average of about four years. And, Kovacs found, children who have a minor depression are more likely to have it intensify into major depression—a so-called double depression. Those who develop double depression are much more prone to suffer recurring episodes as the years go on. As children who had an episode of depression grew into adolescence and early adulthood, they suffered from depression or manic-depressive disorder, on average, one year in three.
The cost to children goes beyond the suffering caused by depression itself. Kovacs told me, "Kids learn social skills in their peer relations—for example, what to do if you want something and aren't getting it, seeing how other children handle the situation and then trying it yourself. But depressed kids are likely to be among the neglected children in a school, the ones other kids don't play with much."28
The sullenness or sadness such children feel leads them to avoid initiating social contacts, or to look away when another child is trying to engage them—a social signal the other child only takes as a rebuff; the end result is that depressed children end up rejected or neglected on the playground. This lacuna in their interpersonal experience means they miss out on what they would normally learn in the rough-and-tumble of play, and so can leave them social and emotional laggards, with much catching up to do after the depression lifts.29 Indeed, when depressed children have been compared to those without depression, they have been found to be more socially inept, to have fewer friends, to be less preferred than others as playmates, to be less liked, and to have more troubled relationships with other children.
|
|
|
Another cost to these children is doing poorly in school; depression interferes with their memory and concentration, making it harder to pay attention in class and retain what is taught. A child who feels no joy in anything will find it hard to marshal the energy to master challenging lessons, let alone experience flow in learning. Understandably, the longer children in Kovacs's study were depressed, the more their grades dropped and the poorer they did on achievement tests, so that they were more likely to be held back in school. In fact, there was a direct correlation between the length of time a child had been depressed and his grade-point average, with a steady plummet over the course of the episode. All of this academic rough going, of course, compounds the depression. As Kovacs observes, "Imagine you're already feeling depressed, and you start flunking out of school, and you sit home by yourself instead of playing with other kids."
Дата добавления: 2018-02-28; просмотров: 361; Мы поможем в написании вашей работы! |
Мы поможем в написании ваших работ!