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Depression: Children Not Immune

Parents often mistake depression in children for moodiness.

Signs Your Child Is Depressed continued...

"You know your child. You know when things have changed. When you get that red flag, do something. Don't ignore it," Benoit says.

"Go with your gut feelings. If you have a worry, let's get it checked out," Dolgan says. "Good parents are tuned in to their kids, but they don't always know what the signals mean."

Most parents begin by taking their child to a pediatrician, although some go directly to a child psychologist or child psychiatrist.

But beware of an immediate jump to treatment. Benoit, Dolgan, and Koplewicz each stress that the most important first step is to get a proper diagnosis.

The Key: Diagnosis

"In real estate they say the most important three things are location, location, and location. In the depressed child it is diagnosis, diagnosis, and diagnosis," Koplewicz says. "Before we treat a child who has a sad demeanor or a demoralized state, we want to make sure that child really has depression. The way to do that is to ask your pediatrician or psychiatrist or psychologist, 'What is my child's diagnosis? Explain it so I can understand, and tell me what are my treatment options.'"

Most parents first take their child to a pediatrician. Unfortunately, many pediatricians lack the specific training needed to correctly tell when a child is depressed or anxious.

"I think there is a public health problem," Koplewicz says. "You have 16,000 child psychiatrists and 8,000 child psychologists, and 8 million children and teens who need help. We have to decide whether to train pediatricians and nurses and counselors in the diagnosis of this disorder so we can get this properly diagnosed."

Koplewicz believes that the heart of the problem is that insurance companies are less willing to pay for mental health care than for physical health care.

"As a nation we don't treat psychiatric illness as we do physical illness," he says. "There are not enough experts. We have to demand from insurance companies to get parity, and pediatricians must get sufficient time to see kids to make this decision. It is a matter of whether we get training so the diagnosis can be made. Learning all your diagnostic skills from the pharmaceutical representative is a problem."

Children younger than 5 years old can get depressed. But their depression most often reflects the mental state of their primary caregiver -- usually their mother, Benoit says.

"Very often, in that preschool group, the child's affective state is highly connected to the mother's state," she says. "I could give you many cases of that, where the mother is the primary agent of what is happening with the child. If anyone does not take a look and do an evaluation of the primary caregiver, I think they would be missing a tremendous amount."

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