Depression in an 8 year old girl

[YaYa23453]

I have custody of  my grandaughter. She is 8 and she has lived with me for 6 years. She is in the gifted class in school, a very bright,creative child. She stared having a drop in grades, primarily due to careless errrors, rushing through her work etc. She is in counseling so I decided it might be a good idea to have her tested for ADHD. The results were inconclusive for ADHD (borderline), however the testing indicated that she is depressed. Since she has been in counseling for 3 years primarily as an outlet due to living situation and to prevent any issues going forward. It has been recommended that we consider medication for her since she has been in counseling already. I just have concerns that medication is the first response due to the results of a test. We understand that she has many struggles in her life but I feel that a different approach in counseling should be tried in addition to family counseling bringing in her parents and stepparents as this is where some of the saddness and frustration is coming from. Can anyone give me some sound advice on this? I do have to also consider the wishes of the parents and the relationship between the adults is strained and stressful. Thanks for any help.

[specialmom]

My son was diagnosed at 4 and we've been doing occupational therapy ever since.  It in all honesty was difficult for me to accept that he has this delay.  But once I did, we embraced it and have worked hard to help him.  

It is interesting how his sensory affects him.  It has created some anxiety in different areas and he is quite quirky at times.  Socially, we work hard as his senory has made that difficult for him.  He's fortunate to be pretty strong and athletic naturally, so he does do sports but then will struggle with things like focus and pushing through when it is tough. In school, well, things surface from time to time.  Anything speed related is a challenge.  As soon as he hears it is a timed test (as in doing 100 math problems in 5 minutes as they do in second grade/last year)---  he freezes.  He processes a bit slowly so that is just very difficult.  Same with words per minute reading.  These are benchmark tests in our state and our school is reluctant to give him any sort of IEP for that because overall he has done alright academically.   So, that is tough.  My son works on self esteem issues due to his sensory.  He needs a lot of movement to stay on top of things.  And he needs to be more flexible as he can be quite rigid in thought and what he wants to do.  

We have a sensory integration disorder forum now that I'm the CL for .  I'd love to have you come and join us.  

[YaYa23453]

Hi, so your son has sensory integration disorder.  That's something I have a lot of experience with so I can certainly see where your empathy comes from.  I actually have custody of two of my granddaugters (sisters).  The sister of the child I have been communicating about also has sensory integration disorder which I picked up on when she was very young.  I have a professional background in this area so I was thankful I knew where to go for help.  So many struggle to find help for their children who have sensory issues because unfortunately this diagnosis is still not understood and most often is mistaken for ADHD.  

My granddaughter with sensory disorder is 7 and has also been diagnosed with ADHD as a result of a school evaluation I requested.  She struggles with learning and retaining information and was at risk of being retained this past year (1st grade).  I work with her at home daily and felt she may have a learning disability.  Fortunately she does not, but she does qualify for special ed services and will have an IEP this school year due to the ADHD diagnosis.

What things does your son struggle with, and how long has he had this diagnosis?  Do you have a good support sytem?

Oh, to answer your question about my granddaughter I originally wrote about, she was actually tested for ADHD and that was the test that gave us the diagnosis of depression and inconclusive for ADHD.  

[specialmom]

Hi,  well, it is actually not uncommon for gifted kids to have trouble in the regular classroom with their work.  I would discuss this with the gifted teacher as you are planning on and then perhaps another meeting can bet set up with her teacher for next school year in the regular classroom.

Yes, do follow up with an appt. with a clinical psychologists.  They have that extra extra in identifying the mental health issues that might be hindering our kids.

I have an 8 year old as well and he is a quirky kid.  (he's got sensory integration disorder which can look like add/adhd involving the nervous system).  Because things can be harder for him but he is also quite intelligent, he also struggles with perfectionism.  Perfectionism is a rough way to go for kids (and adults----  many depressed adults have perfectionism as a side issue).  Being perfect is impossible and a standard that sets one up for failure their whole life and in everything.  So, try to help her with it,

Here are some age appropriate things to do with an 8 year old.  Without her really realizing it, in front of her, make a big mistake and handle it with grace.  Do this a few times.  Grandma isn't perfect and here is how SHE feels about herself when she messes up and how she handles it.  Pick things that fall under creative, work, and around the house.  And kind of role play/talk out loud.  Start talking about things that are not end point, success oriented.  If she draws a picture---  don't say "that is a great dog", say "I love the colors you chose".  Have a scribble session.  Both just scribble and draw nothing and talk about the colors and how they go together.  I'd ease up on the school work if you can.  You think she may get bored probably, but most likely she won't.  More relaxing time with nothing expected is great to recenter perfectionism.

so, you say you are having her evaluated for add/adhd?

[YaYa23453]

Thank you for your very helpful suggestions.  I also am very concerned that a diagnosis of depression was the outcome of a test vs. an observation of her therapist.  I had some concerns that my granddaughter held everything in, and she made a comment that she wished she could go to sleep and not wake up when she made some errors on her homework on one occasion about a year ago.  I addressed this with her therapist and after their session it did not appear that she wanted to die, but she was very upset that her work was not perfect.  She did however document that as 1 episosde of major depression.  I am not comfortable with this whole process because had I not requested testing to rule out ADHD the depression diagnosis would not be there and this would not even be a discussion.  I do think an evaluation with a clinical psychologist who specializes in depression in children is the best way to address this.  I also think a conference with her gifted teacher is appropriate as she is in a cluster program at her regular school and is pulled out of class by the gifted teacher on certain days.  The rest of the time she is in regular classes with the teacher she is assigned to at the school and that is where she is having problems, not with the gifted teacher.  I'm sorry for being so lengthy, but you really gave me a lot to consider.  Thank you so much for your help, and God Bless You for helping us.

[YaYa23453]

Thank you so much for your input.  It was so nice just to hear from someone completely neutral.  I had not considered your comment about her "relaxing her self- imposed perfectionism...".It makes perfect sense.  I do feel it may be time for a change in therapists.  This child is just beginning to ask the difficult questions and she will need someone that can help her and me to navigate through the very difficult answers.  I just don't want her to take a pill and make it go away.  I would do that for her if I could.  I want her to grow up and know that she was a survivor before she was even born so she can make it through anything.  Thank you again for taking the time to make a difference in our lives.

[specialmom]

Oh, a couple of other things.  Is she a perfectionist?  

If she is highly gifted, these kids can often have trouble with actual school work believe it or not.  They have many quirks and the gifted teacher can possibly make some accomadations for her to be successful.  

[specialmom]

I would also consider adding in beyond the counseling she is getting another field of psychologist, a clinical psychologist for children that deals with depression.  Ask your doctor for a referrel to someone that specializes in this.  I think that if you are not ready for her to take medication and I don't blame you as she is only 8 and this is a new diagnosis (and is it official, a medical diagnosis has now been given to her?)------  a clinical psychologist can try to work other avenues to help her.  OR if her therapist is already a clinical psychologist, then speak to them about this new data.  Interesting that her therapist never picked up on depression.  That worries me.  

I agree with anniebrooke that you are in charge.  You've had her for a long time and her parents will have to adjust to decisions you make in her best interest.  good luck and bless you for saving her.  

[AnnieBrooke]

You say "She is 8 and she has lived with me for 6 years;" if you have had the custody of this child since she was 2 years old, what do her biological parents have to say about anything?  To all intents and purposes, you are her parent, and having some inadequate bio-relatives around who fight with each other would be enough to daunt anyone, much less an 8-year-old.  Can you not make some rules for the people in the strained relationship so this does not play out in front of the child?

I would discuss the counselor's approach with him or her, and your dislike of medication being given as an immediate response to one test, and see where you get.  There is no law against changing counselors if you don't like the approach being taken.  That said, some kids do OK on medication.  It sounds like she's been a high achiever in response to her life, maybe part of it is that she's trying to make things better that way.  Maybe relaxing her self-imposed perfectionism is actually a sign that she is no longer indulging in magical thinking about her behavior being able to make everything all right, so maybe it's not so bad.

Find a counselor whose approach you like, and take his or her advice on the medication suggestion.