Depression in Preschoolers: What You Need to Know
If you are a parent of a professional wanting to learn about preschool depression this page will serve as a jumping off point for you to learn more and a general overview.
When did we first learn depression in preschoolers existed?
Prior to the 1970s, depression was typically viewed as an adult disorder because children were seen as too immature to have this disorder. The Diagnostic and Statistical Manual of Mental Disorders (DSM) used by clinicians and psychiatrists to diagnose psychiatric illnesses did not begin to represent children until the 1980's. ( Charles and Fazeli 2017)
By the 1990's we began to first recognize and fully accept that depression existed in children under 10. In 1998 Joan Luby got the first grant from the National Institute of Mental Health to study preschool depression.
Many of us who work with depression know that our clients report being depressed as long as they can remember. Yet there is resistance to believing young children experience it. Over the last 20 years we have learned not only preschool depression exists, but also, what it looks like, how we can treat it, how it changes preschoolers brains, it's course, and what it is associated with.
Depression in Preschoolers: Signs
The symptom most specific preschool depression is anhedonia. This is defined as the inability to find pleasure or joy in previously enjoyed activities. In preschoolers this looks like NOT WANTING TO PLAY WITH THEIR TOYS or to do things that used to be fun.
- Sadness and irritability
- Changes in appetite and/or sleep problems
- Change in activity
- Low energy
- Low self esteem
- Trouble concentrating
- Easily giving up
- Negative Self statements
- Self Blame
- Somatic symptoms ( aches and pains)
- and expression of themes of death and suicide in play and with words.
Preschoolers who are depressed might cry and whine often and they also may be very irritable and angry.
Important facts about Depression in Preschoolers
Most preschool children with depression do not get accurately diagnosed because it is not accurately captured by the criteria in our manuals.
Programs that support early intervention help
Early intervention is key
- Children who have high maternal support during preschool period have have higher hippocampal volume and a higher growth trajectory later of their hippocampus but this is not seen during maternal support during the later elementary school years.The hippocampus is a part of the brain that performs functions specifically helpful to helping regulate depression. It appears that there is a sensitive time during preschool years where maternal support can help support the growth of this part of the brain.
- Caregiver ,support, nurturance, and attunement is key to the changes in the brain that are witnessed in children who suffer from depression. Although there is not one particular profile that a depressed preschooler fits, programs that support and foster preschoolers in the community and their caregiver may help mediate effects of depression.
Preschool Depression is Serious
Preschoolers do not grow out of depression.
- Depression is considered life long like OCD
- Children with Preschool Depression will often suffer recurrent depressive episodes
- New research shows that preschool children who are diagnosed with depression experience changes in their brains just as do adults. This new evidence is one of the pieces that finally convinced the scientific community that it was a real diagnosis in young children.
- The earlier the diagnosis the better the likelihood we can get help for a child and that may be associated with a more positive long term outcome, like it is for children with autism
- Specifically the experience of child depression is associated with the change in trajectory of cortical grey matter volume and cortical grey matter thickness
If your preschooler is depressed, you should get your child therapy
- Depressed preschoolers don't get better on their own
- Depression in preschoolers is a specific syndrome just like it is in adults
- Preschoolers with depression are four times as likely to have an anxiety disorder in later childhood
- Anhedonia (loss of interest in toys) is a unique marker of depression not associate with any other diagnosis
- Talk therapy is ineffective with children who are in preschool
- Play therapy although more effective than talk therapy does not have compelling evidence of long term effectiveness
- A mother's depression can impact a child's depression significantly, Moms should get their own help
- A therapist should always be involving you in you young children's therapy
- NEW promising therapy called PCIT ED is available.
Depression in Preschoolers Sources
Charles, J., & Fazeli, M. (2017). Depression in children. Australian Family Physician, 46(12), 901-907. Retrieved from http://nclive.org/cgi-bin/nclsm?url=http://search.proquest.com/docview/1976405179?accountid=13217
Fuhrmann, P., Equit, M., Schmidt, K., & von Gontard, A. (2014). Prevalence of depressive symptoms and associated developmental disorders in preschool children: A population-based study. European Child & Adolescent Psychiatry, 23(4), 219-224. doi:http://dx.doi.org/10.1007/s00787-013-0452-4
Paul, P. (2010, Aug 29). Can preschoolers be depressed? New York Times Magazine, , 48-55. Retrieved from http://nclive.org/cgi-bin/nclsm?url=http://search.proquest.com/docview/751055620?accountid=13217
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or suspect you have a problem, you should consult a healthcare provider.