Children diagnosed with attention deficit hyperactivity disorder at an early age may be at greater risk of becoming depressed or suicidal as teenagers than children who don't have ADHD. That's not the kind of news any parent wants to hear, but ADHD experts say there's no reason to presume the worst will happen to your child.
"ADHD in young children is not something to be ignored," says Benjamin Lahey, an author of the study, which appeared in Archives of General Psychiatry, and a professor of epidemiology, psychiatry, and behavioral neuroscience at the University of Chicago. But he is concerned parents will hear about this new correlation and panic. Instead, he hopes the news will prompt parents to get advice from a mental health professional.
Earlier studies have found that children diagnosed with ADHD in childhood are more likely to have behavior problems as teens, and are more likely to be injured accidentally. This new study looked at 125 children in Chicago and Pittsburgh who were diagnosed with ADHD between the ages of 4 and 7, and 123 children of the same age range who did not have an ADHD diagnosis. When those children were re-evaluated between the ages of 9 and 18, the ADHD children were three times as likely to have made a suicide attempt by age 18 (18.4 percent compared to 5.7 percent), and four times as likely to be diagnosed with depression. The risk of suicide attempts and depression increased if the child had other mental health problems, like anxiety, or if the child's mother was depressed. Girls were at greater risk than boys for both depression and suicide attempts.
Concerned parents can consider these options:
- Make sure your child has been properly evaluated. Many children are "diagnosed" with ADHD by teachers, and those diagnoses may not be correct. A mental health professional who specializes in ADHD can evaluate a child to see if he or she meets the criteria for ADHD spelled out in the DSM-IV, the American Psychiatric Association's "bible" of mental health diagnoses.
- Find a counselor skilled in using cognitive behavioral therapy for ADHD. Cognitive behavioral therapy (CBT) is a short-term form of therapy that focuses on learning solutions to problems a person is having with everyday life; getting along with peers on the playground, for instance. It also helps people change their emotional responses, and has been used successfully to treat ADHD, depression, anxiety, and other mental health issues. Says Lahey: "That professional can get to know the child and family well, decide if the child actually has ADHD, and provide advice that is tailored to the family's specific circumstances."
- Get educated on the signs of suicide and depression in children and teens. A recent study in Pediatrics found that parents often missed the warning signs of suicide in teens. The American Academy of Pediatrics now recommends depression screening for all teens. Make sure your child gets screened with each annual physical.
- Ask yourself if you are depressed. Having a depressed mom increases the odds that a child will struggle with depression, and that's true not only for children with ADHD. Ask your doctor to screen you for depression, or take an online depression screening test.
Teenage depression and suicide are major health risks. The authors of the Archives study say that early intervention programs for young children diagnosed with ADHD could help reduce those risks. But such programs don't exist, so parents will have to be diligent. If you think your child may have ADHD, make sure that child gets a competent evaluation early on. And realize that protecting your child from the risk of suicide and depression may be part of your parental portfolio, just like making sure kids wear bike helmets and brush their teeth.