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9 year old, IS it depression or something else?

Posted by JILL on June 11, 1999 at 20:44:54
My 9 year old daughter is very bright and does above average work in school. She has never been diagnosed with ADD or anything like that. She has always been a tenderheart, and has never taken any kind of structural critisism very well. She has always been a very happy child until about a year and a half ago.
When she started 3rd grade she started a cough that sounded worse than croup. We had all kinds of tests done on her, and the MD concluded that it was a nervous tic, or attention getter.
My husband changed jobs which caused us to move out of state in the middle of the school year, which meant that she would have to change schools. She ended up getting a teacher that was not very sympathetic to her having to learn new routines and caused my daughter to hate school, when she has always loved it. Since she has been here she constantly complains of ailments like a sore arm or belly ache or if she gets a bruise or cut she cries like she is dying and goes completely out of control emotionally.
she cries at the drop of the hat at least 5-6 times a day,over anything, but sometimes she will start to cry and then start laughing uncontrollably over nothing. Her teacher actually told her she was a hypocondriac.( which infuriated me). One day after this incident she told me she wanted to kill herself. Could this be a sign of MAnic depression? If you have any ideas on what this may be I would appreciate it. I dont even know how to approach her pediatrician with this.. Thank you very much.

Posted by HFHS.MD-T.B. on June 14, 1999 at 16:02:10
Dear Jill, It sounds like your daughter is going through a difficult time and it is good that you want to help her.  I do not have enough information to be able to make an accurate diagnosis, although several things come to mind.  Manic-depression, a mood disorder, also known as Bipolar disorder, is typically characterized by periods of "ups" (mania) and "downs"(depression).  It can have an onset as early as ages 5 or 6, however the median age of onset is 30.  Suicidal thoughts can occur in Bipolar disorder, however they can occur in many other disorders as well.  Laughing and then crying or vice-versa does not mean that she has Bipolar disorder.  I would want to consider a depressive disorder with her history of crying spells and recent statement that she wanted to kill herself.  This seems the most likely diagnosis.  Depressive disorders can also present with multiple somatic(body) complaints that you mention.  
Although I do not know the specific circumstances of your daughter's symptoms, I would also want to consider separation-anxiety disorder, which involves excessive anxiety concerning separation from home or from those whom the individual is attached and can manifest in repetitive complaints of physical symptoms(headaches, stomachaches, etc.) when separation is anticipated.  I would also want to rule out a tic disorder, such as Tourette's disorder, with her history of the cough you describe, although this is less likely.  I would recommend that she see a mental health professional who can evaluate and treat her condition as needed.  Regarding approaching her pediatrician with this, I would do as you have done here, discuss her recent behaviors and symptoms- your pediatrician is there to help you and perhaps can make a good referral for a mental health professional.
I hope that this information has been helpful for you.  It is intended for educational purposes only, and should not replace consultation with a physician.  If you would like her to see a mental health professional at Henry Ford Hospital, please call 248-689-7476.

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