Note: The research article referred to here appears in The Australian and New Zealand Journal of Psychiatry Volume 37 Issue 5 Page 563  - October 2003

From: http://www.theage.com.au/articles/2003/08/03/1059849277049.html

Disruptive children may have depression August 4 2003 By Amanda Dunn Health Reporter

A Melbourne study has found that children who have this depressive condition - known as dysthymic disorder - display the same symptoms as those with a type of ADHD, including inattentiveness, poor organisational skills and aggressive, contrary behaviour. They also are prone to extended bouts of feeling low and melancholy, and wild mood swings, which they display over a long period of time.

In a major breakthrough, a seven-year study of 300 children at the Alfred Hospital has shown that there is a biological reason for their depressive symptoms, as well as environmental factors that can trigger them. The finding is a controversial one, as doctors have long debated whether depressive illnesses have a biological root, and if children suffer from them. A child psychiatrist and researcher at the Alfred, Alasdair Vance, told The Age the study showed that children with dysthymic disorder had an overactive adrenaline system, and performed poorly on psychological function tests. Dr Vance said about 1 to 2 per cent of primary school children suffered from dysthymic disorder, while the same proportion were believed to have ADHD. A group of children identified in the study had both and displayed all the symptoms of the two disorders. Dr Vance said that as the children in the trial developed through puberty to their teenage years, dysthymic disorder was showing itself to be a significant predictor of depression later in life, with about 40 per cent or more going on to a major depressive disorder. While dysthymic disorder appeared to be equally prevalent in boys and girls - as opposed to ADHD, which is two to three times more common in boys - rates among girls skyrocketed when they reached puberty. "We must now look very carefully for depressive symptoms," Dr Vance said, "because it's a main driver for oppositional, defiant behaviour alone or in combination with ADHD." Dysthymic disorder was a treatable condition with a combination of medication and social support, Dr Vance said.

The findings of the study have been published in a number of international medical journals, with more planned. The research also found that medication used to treat children with ADHD was most effective when administered in conjunction with psychological methods to help children compensate for their difficulty with attention and behaviour. For example, Dr Vance said, that might involve setting up a child's bedroom or study area in a way that was conducive to concentrating. But most importantly, parents should allocate 30 minutes, three times a week, to spending time with their child - on the child's terms. That might mean playing a game, taking the dog for a walk or just watching television.

This segment is from a presentation to the Victorian Adult Literacy and Basic Education (VALBEC), Spring Forum, 22 September 2003 by Merv Edmunds, Project Manager avec esprit.

Now, while I am talking about a continuing state of arousal, let me mention something else. I use the term ‘deadly duo’ – stress and depression - both are problems arising from an inability to switch off the arousal state. Research by a Melbourne psychiatrist due for publication next month links depression (dysthymic disorder to be exact) with inattentiveness, poor organisational skills, aggressive, contrary, oppositional and defiant behaviour. It puzzled me, because when I thought of some young people displaying those behaviours, depression was not something that come to mind. I talked to Dr Vance, the guy who did the research, then I did some research of my own. This is what I found:

Depression is an emotion - a very strong emotion - and a depressive is someone who is highly emotionally aroused. The word ‘arousal’ may feel unfamiliar when linked with depression. While in the grip of any powerful emotion, we can be said to be in an emotionally driven trance state. Depression is no exception.

Joe Griffin and Ivan Tyrrell, Breaking the Cycle of Depression , European Therapy Studies Institute, 2002 p8.