As I said in an earlier blog entry, most of my childhood was blighted by clinical depression. After I was diagnosed at age 27, my parents told me that they knew something was wrong, but didn't know what. Not surprising, since I grew up in the 1960s and 70s, and depression in children wasn't even considered a possibility until the 1980s. But even today, years after the medical community acknowledged that children could be clinically depressed, it is not easy to recognize. 

There are a couple of reasons why this is the case. Although more and more people are becoming aware that clinical depression is not a mood but a disease, there are still plenty of people who don't realize that. So while they might be able to find reasons why an adult might be depressed (trouble with the person's job or marriage, financial difficulties, etc.) there are generally few reasons that a child might be displaying a sad demeanor, barring major loss of some kind or a dysfunctional home life.

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The consequences of depression can be devastating to the mother, her baby and her entire family, according to the report in the October issue of The American Journal of Psychiatry.

"The prevalence of women diagnosed with depression before, during and after pregnancy was pretty similar," said lead author Patricia Dietz, an epidemiologist at the U.S. Centers for Disease Control and Prevention's Division of Reproductive Health.

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Sometime in the mid-1990s my mother uncovered some photos of me as a child that I'd never seen before. I flipped through them and found one that fascinated me. It showed me at about nine months or so, crawling on the grass in Golden Gate Park. My tongue was sticking out of a corner of my mouth, and my chubby little face was beaming. I looked like I was having a great time.

I finally figured out, after a few days, what was so compelling about the picture. I had never seen a picture of myself as a child in which I had anything stronger than a half-smile on my face. In most photos I had a pensive expression on my face. School photos were the exception. In those I, always the good girl, obliged with a wide, if false, smile. So seeing a childhood photo in which I was genuinely beaming was new to me.

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Many employers view mental health coverage as a financial black hole, but the study shows that spending money on depression is a smart business move, said researcher Dr. Philip Wang. Wang works for the National Institute of Mental Health, which funded the study.

Employees who got the aggressive intervention worked on average about two weeks more during the yearlong study than those who got the usual care - advice to see their doctor or seek a mental health specialist.

Also, more workers in the intervention group were still employed by year's end - 93 percent vs. 88 percent - savings that helped employers avoid hiring and training costs, the researchers said.

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