Young Families INSIGHTS
May 2002
Linda Swann, NAMI NC Young Families Program Coordinator, Editor
Linda Buzard, Layout Manager

At 2, I called my son my "Whirling Dervish."  Around age 18 - 24 months, he began picking at the fur of his favorite teddy. I kept taking teddy to pediatricians asking if this was normal.  Every doctor disregarded my question and brushed it aside saying that picking and eating teddy's fur wouldn't kill him. Teddy and my son became inseparable.

Over the years, teddy's fur has been loved off.  I realize now that this was an anxiety reliever for him. At this age, my son was in day care for two mornings a week.  To my horror, he bit children! When I picked him, he was often so sweaty that his hair stuck to his head. This behavior was puzzling, because our family is not chaotic or dysfunctional.

My son was very bright and interested in several projects at home, so we looked forward to preschool. For months leaving him was a sideshow of clinging to my legs and hysterical crying. He played under the tables. They insisted he was a slow learner because he would not cooperate with their milestone testing. To prove otherwise, I brought in a pre-med anatomy workbook that my son had spent hours coloring in by letters to learn his alphabet.

Together we had read every dinosaur book in our library. The tantrums when I dropped him off got to the point that the director took me into her office to ask what was wrong at home. She persisted that separation anxiety is a result of child or spousal abuse.  As I said, we do not have a dysfunctional family. I felt so bewildered that anyone would even think that of us. I cried all the way home.  Months later, the director told me that she thought our "little talk" went well and that she had made progress.

At home, I read countless books on effective parenting and took parenting seminars. "Time out" at our house was more like a tornado. I persisted that "time out" just angered my son more. The "pros" said that I wasn't doing it right. Any unexpected change in our routine, such as a friend dropping over unannounced, sent my son into a tizzy.  Getting the child to fall asleep meant an hour of patting his head and countless calls for "Mom" from the bed.  Everyone had advice for me. I was trying and trying and nothing was working.

Boy, did I feel like loser mother of the decade. I knew that my son was bright and loving, I must have been doing everything wrong. We went to our local therapist for a behavioral assessment. We spent months in play therapy and took more parenting classes. Every afternoon at the playground I coached him on how to get along with the other kids. After about 6 months the psychiatrist diagnosed him with ADHD.   

It was time to begin kindergarten. The doctor advised us to let him try being in the classroom without medication his first day. She advised not to talk to the teacher about our concerns before hand. She was concerned about pre-labeling him. We wanted to see if the play therapy and coaching was enough to help him.  

I vividly remember the churning stomach and anxious hopefulness as he eagerly began his first day of kindergarten. Two hours later, I was waiting hopefully in the schoolyard. The teacher led him firmly by the hand and said something like this in front of all the other parents: "This young man needs to learn a thing or two.  Your son would not stop talking!  He ran around the room and wouldn't listen!" The tears welled up in my eyes. I told her all that we had been through to prepare him for his first big day. I think that she felt horrible because her face softened. The next day we began medicine. From that point on, the teacher was very supportive.  

Now my son is almost 10 years old. He is still diagnosed ADHD. However, now we have another diagnosis. He has early onset Bipolar Disorder and symptoms of Obsessive Compulsive Disorder. All the pieces of the puzzles from his very early years make sense now.

• Displaying very little emotion
• No interest in sights, sounds, or touch
• Rejecting or avoiding being held; avoiding playing with others
• Unusually difficult to comfort or console
• Unable to comfort or calm self
• Extremely fearful or on-guard
• Failing or refusing to turn to familiar adults for comfort or help
• Exhibiting any sudden behavior changes

• Refusing to play with others or toys
• Inadequate language/communication skills
• Frequent fights with others
• Appearing very sad
• Extreme mood swings
• Unusually fearful
• Withdrawn
• Unusual responses to situations – laughing when most would cry
• Extremely active
• Losing skills previously acquired – some regression
• Very accident prone
• Destructive to self, others, objects
• Extremely immature

(Source "Early Childhood Mental Health – Building blocks for success," The Early Childhood Mental Health Initiative, Child and Family Services Section of MH/DD/SAS, Susan E. Robinson, M.Ed. and Susan Lynn Roehrig, MSW)

Susan Dubuque, co-author (with son, Nicholas) of Kid Power Tactics for Dealing with Depression and A Parent’s Survival Guide to Childhood Depression, recently presented a workshop on depression in children. Those in attendance came away with new insight and some terrific, practical ideas. Here is some of what we learned.

What causes depression in children? Susan began by reviewing the causes. First we looked at genetics. If one parent has depression, the child has a 30% chance of developing it. If both parents have depression, the child has a whopping 70% chance. Other factors include: a biochemical imbalance in the child’s brain, how the child looks at the world (cognitive), and environment as in what loss the child may have experienced. She said the environment at home and at school have very little affect on depression. When it comes to cognition, a child can learn to "reframe" how she/he feels or thinks about the world. This can help fight depression.

Why is childhood depression such a mystery today? Depression in children is difficult to recognize because depression in children does not look the same as it does in adults. Children are more likely to be irritable than sad. Susan said that quite often boys appear to be aggressive. She calls them "Dragons." They act out often and get a lot of the teacher’s attention. Girls, however, often present as "Turtles," very quiet and compliant.

What are the symptoms? Irritability rates number one. Children with depression also may exhibit violent behavior when playing, like cutting off the heads of dolls. They may appear to be bored, unable to concentrate. They may have frequent physical complaints and be absent a lot from school or perform poorly in class. They may spend a significant amount of time alone. The big thing to look for is a change in behavior.

The biggest asset in dealing with childhood depression is empowerment – empowerment for caregivers and for the child. Having some control, some say in what happens, goes a long way toward dealing successfully with depression.

• Get a thorough evaluation by a trained mental health professional.
• Make the most of therapy. Focus on the child’s, not the parents, goals.
• Show children how medication for depression works. Visit a pharmacist.
• Deal with the anger. Try to find what sets it off.
• Reduce stress. Take a power break. Exercise is good!
• Problems making and keeping friends? These children are often better playing "up or down." In other words, find playmates a little older or younger. And keep playtime structured and short.
• Make sure children get plenty of sleep and eat well.
• Parents should pick their battles. Prioritize what is important enough to make it an issue.
• Teachers and parents need to help children develop a vocabulary that helps them express their feelings. There is almost something magical about being able to express oneself.
• Help children learn impulse control. "Stop, drop, and roll!"
• Fight the stigma of mental illness/brain disorders. Teachers can integrate mental health into their curriculum. They can point out famous people in history who had depression but still managed to be creative and contribute to the world.

We cannot possibly cover all of Susan’s tips here. She has wonderful ideas for teachers to use in the classroom as well as tips on advocating for children. Her books are terrific resources for parents and children. She even offers a free Childhood Depression Awareness Day Kit. For more information, contact her at 804-783-8140 or e-mail her at sdubuque@NeathawkDubuque.com.

"Educator’s Guide to Learning Differences," was written and published this year by Schwab Learning, a service of the Charles and Helen Schwab Foundation. Check it out at www.SchwabLearning.org. In part 5, "The Power of Collaboration: Working with Families and the Community," the authors list what parents say they appreciate most from educators:

• Communication without jargon
• Conferences scheduled at convenient times
• Copies of any reports about their child
• Frequent progress reports and informal feedback
• Information about their child’s social and academic skills
• Advice on how to manage problems or reinforce skills
• Recommendations and referrals for information, support
• Information on their rights and responsibilities in special education
• A genuine attitude of caring and cooperation

The guide also includes ways parents can reinforce skills at home, even how to help with homework. Learning disabilities, including ADHD, are covered plus "What a General Education Teacher Can Do."

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