Severe Tantrums May Indicate Depression

According to Andrew Belden of Washington University's school of medicine, out-of-the-ordinary temper tantrums may indicate a risk of depression in toddlers.  While some tantrums are a normal part of development, and are to be expected, more severe or prolonged episodes can suggest other, more significant mental or mood disorders.

The article highlights five of what it calls "red flag meltdowns":

1. Aggressive
Consistent displays of aggression toward caregivers more than half of the time during the past 10 to 20 episodes. Violent, destructive behaviour. This is more common in children with disruptive disorders.

2. Self-destructive
Intentional self-injury is most common in children suffering from depression.

3. Frequent
Ten to 20 discrete tantrum episodes on separate days at home during a 30-day period is connected to both depression and disruptive disorders. More than five tantrums a day on multiple days while at school or outside the home suggests disruptive disorders.

4. Extended
Longer tantrum durations, lasting more than 25 minutes on average, may indicate both depression and disruptive disorders.

5. Unable to calm
Inability to calm themselves without help from a caregiver is more common among children with disruptive disorders.

The Globe And Mail also held a Q&A with Ross W. Greene, Ph.D., an associate clinical professor in the department of psychiatry at Harvard Medical School on this subject.  The first question asked was, interestingly enough, my gut reaction when I read about the study: what about the traditional argument that children throw tantrums because it works for them?  The response confirmed my interpretation of the study's findings: that while most (if not all) kids tantrum from time to time, if they are doing it practically every day, are unable to calm themselves, or exhibit the above indicators, then is the time to become concerned.  Unfortunately, this caveat is not made explicitly clear in the article (the five points are in a sidebar and not part of the regular content flow), and the Q&A is not linked to in the body.  (The article is linked to in the introduction to the Q&A.)

While the information that comes out of this study is enlightening and fascinating, it also underscores a trend in today's society to diagnose and subsequently label any behaviour that is even slightly outside the realm of normal.  True, improved diagnostic tools will enable psychiatrists and mental health professionals to identify individuals who suffer from actual disorders, but it will do so at the cost of worrying parents.

For a parent who has read this article blindly, every time their child has a tantrum that is particularly forceful they will wonder if they should bring their child in to be checked for depression.  Just as autism identification is an inexact science with a few well-known indicators that subsequently encourage armchair diagnostics from teachers and daycare workers, so too will this "bad tantrums might mean depression" argument be used to label kids.

I'm not saying that there's anything wrong with the study or its findings; I'm just saying that sometimes the results need to be presented with a larger grain of salt than they usually are.

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Comments

[Julie Pippert]

I'm glad you made the point about read and interpret critically, and also the point about quick to label. My concerns match yours. And to add to that, I'm concerned with the quick labeling of a physiological problem and a pill, with no support or therapy or behavior modification (of parents and children).

[kittenpie]

I think that far too many studies are reported like this - just an article reporting a link found between two things, but it is out of context, with no mention of other studies that may have shown different or inconclusive findings, no mention of how significant the results were, no mention of how long and how many other studies will be needed before the possible link can be explored and if viable, turned into actual treatment or diagnostic tool. I think it's irresponsible, to be honest, that the details can only be found in the actual study or medical journal, inaccessible to the average population who will hear the news story.