Dr. Henry Paul, MD

Psychiatrist, Author and Educator

Tag Archives: depression in children

YOUNG CHILDREN AND GENDER IDENTITY (GENDER DSYPHORIA)

May 12th, 2015

“People who have gender dysphoria feel strongly that they are not the gender they physically appear to be.

For example, a person who has a penis and all other physical traits of a male might feel instead that he is actually a female. That person would have an intense desire to have a female body and to be accepted by others as a female. Or, someone with the physical characteristics of a female would feel her true identity is male.

Feeling that your body does not reflect your true gender can cause severe distress, anxiety, and depression. “Dysphoria” is a feeling of dissatisfaction, anxiety, and restlessness. With gender dysphoria, the discomfort with your male or female body can be so intense that it can interfere with the way you function in normal life, for instance at school or work or during social activities.” (WEDMD, 2015)

Gender dysphoria is another term for Gender Identity Disorder. Whether-or-not young children who express transgender issues can really be believed is a hotly debated issue right now. Is this ever just a phase? How do you respond when your toddler daughter’s first sentence is that she’s a boy and she says it over-and-over, day-after-day? What do you do when your three-year-old son insists on wearing nail polish like mommy, and a dress to pre-school?

21423515_sHow young is too young to know? In March 2015, a Medscape study looked at the usual patterns for development of gender identity. According to the study, “Several studies by Milton Diamond of the University of Hawaii indicate that gender development reaches a critical point during childhood, after which it becomes extremely difficult to modify in most individuals. While there may be a number of children who do not clearly fit into a neat binary model of gender in which the polar extremes of behavior are reserved for those with clear sex and gender congruence, it is increasingly clear that gender identity is at the very least an intrinsic characteristic that emerges during early development.”

For parents, dealing with a child’s gender identity issues can be overwhelming. It also brings on a flood of questions. What causes it? What treatment will help? What should parents do or not do?

The first thing is not to panic. Love your child. Talk with your child’s pediatrician and seek out a child psychiatrist, if necessary. Many very young children express gender dysphoria and turn out not to be transgender when older. Thus, it is considered risky to support any permanent changes (name, gender reassignment surgery,etc.) until a child is older.  Also, with gender identity there are usually underlying conditions, known as co-morbidities, which need to be addressed. These co-morbidities include such things as depression, anxiety and suicidal tendencies. Remember, that supportive parenting practices are key to strengthening a child’s self-esteem. Listen, learn and keep the communication open. Those are the first steps!

Disclaimer
This blog is intended for educational purposes only. It is not intended as medical or psychiatric advice for individual conditions or treatment and does not substitute for a medical or psychiatric examination. A psychiatrist must make a determination about any treatment or prescription. Dr. Paul does not assume any responsibility or risk for the use of any information contained within this blog.

SCREENING PRESCHOOLERS FOR DEPRESSION IS A GOOD IDEA

August 22nd, 2014

Depression can strike at any age, even among preschoolers, researchers report. CBS News

A very interesting study came out this month that looked at depression in preschoolers. The study found that preschoolers who are depressed are two and a half times more likely to continue to experience symptoms in elementary and middle school.

The study, published recently in the American Journal of Psychiatry, was done at Washington University by a team headed by Dr. Joan Luby, who directs the university’s Early Emotional Development Program. It included 246 preschool children, ranging from three to five years of age. Luby’s team evaluated the children for depression and other psychiatric conditions over time.

At the onset of the study, 74 of the children were diagnosed with depression. Six years later, 79 of the children met the criteria for clinical depression, including about half of the 74 children diagnosed with depression when the study began. Of the 172 children who were not depressed as preschoolers just 24 percent of them went on to develop depression later.

The study identified a higher risk of depression for children whose mothers had suffered from depression, and those who were diagnosed with a conduct disorder while in preschool.

When I was in training, we were taught that young children could not suffer from depression because they were not old enough to have a superego — a mental structure described by Sigmund Freud that develops at about eight years old. This theory, which denied the obvious, which was that we often saw depressed young children, flew in the face of reality and caused depressed children to be left untreated up until the last few decades.

Today, we know that people of all ages can suffer from depression, especially young children who grow up in stressful circumstances. If untreated, this depression can lead to severe consequences including further depression, educational slowing, behavior disorders and other syndromes.

I agree with the researchers that children as early as three years old should be screened. Childhood depression can be treated, and there are a host of interventions that help including psychotherapy, family therapy, and medication.

DISCLAIMER
Information contained in this blog is intended for educational purposes only. It is not intended as medical or psychiatric advice for individual conditions or treatment and does not substitute for a medical or psychiatric examination. A psychiatrist must make a determination about any treatment or prescription. Dr. Paul does not assume any responsibility or risk for the use of any information contained within this blog.