Children can and do suffer from depression, however, even very small children can suffer from depression a new study has found. The researchers discovered that preschoolers who suffer from depression are also likely to experience a recurrence of their depressive symptoms throughout childhood.
Most childhood depression studies carried out to date have focussed on school age children of around 6 years old and older. Now, according to this recent study by L. Luby et al, from the Department of Psychiatry, Washington University School of Medicine, even 3 year olds can show signs of suffering from major depression.
The study published in the American Journal of Psychiatry involved around 250 preschool children between the ages of 3 and 5 who were regularly assessed for signs of depression over a period of 6 years.
Of the 74 children diagnosed with depression at the start of the trial, around 50 percent went on to meet the criteria for depression 6 years later compared to only 24 percent of those who were not depressed at the start of the study.
The study also involved evaluating the relationship between the child and their parents/caregivers through two way mirrors and asking the children’s’ parents/caregivers questions on the child’s moods, emotions, playtime activities, and appetite and sleep patterns.
Children whose mother’s suffered from depression were more likely to suffer from depression themselves later on. However, the biggest risk for suffering from depression in childhood was being diagnosed with depression as a preschool child.
“Preschool depression predicted school-age depression over and above any of the other well-established risk factors” Luby said.
“Those children appear to be on a trajectory for depression that’s independent of other psychosocial variables.”
Difficult and Challenging
However, diagnosing depression in very young children is a lot more difficult and challenging than diagnosing depression in older children or adults, mainly because very young children either cannot articulate exactly how they are feeling or they find it difficult to find the words to express themselves accurately. Diagnosing depression is extremely important though because the earlier it is identified the more successful the treatment.
The biggest challenge with childhood depression is really recognising it in the first place. This is because not all children who are suffering from depression appear sad and unhappy and not all children who are sad and unhappy are suffering from depression. The symptoms may also differ depending on the age of the child and whether the child is able to speak or not.
Symptoms of depression in older children
Although it is still challenging diagnosing depression in older children, it is still easier than recognising it in very young children. The following is not an exhaustive list but these symptoms can be an indication of depression.
- Poor performance at school
- Self depreciating and feeling unworthy
- Think they are unlovable and unloved
- May speak of or be preoccupied with themes of death or dying
- May intentionally hurt themselves
- Frequent bouts of unexplained illness
- Low moods and appears sad most of the time
- No longer enjoying activities they used to
- Sensitivity to criticism
- Anxiety and excessive worrying
- Emotional outbursts and crying frequently
- Permanently bored
- Defiant behaviour
- Poor conduct
- Major changes to appetite with weight gain or weight loss
- Major changes to sleep patterns with sleeping to much or too little
Symptoms of depression in preschool children
This is much more difficult, not just to correctly diagnose depression but also because a lot of mental health professionals don’t acknowledge that depression can exist in a very young child as it still isn’t accepted in mainstream psychiatric circles. According to Luby it definitely does exist although she recognises that it isn’t common at about 1 or 2 percent.
Luby says an exceptionally ‘good’ child may actually be a depressed child as kids as young as this “are not disruptive in their environment” and she described them as “the wheel that’s not squeaky.”
A young child who is suffering from depression may also look sad and generally unhappy and show an inability to enjoy activities that most other preschool children are able to enjoy.
Guilt is another indicator, in that if something goes wrong, the child feels as though they are somehow to blame and it is their fault.
If these sorts of symptoms persist for longer than a week or two, then it is time to seek help says Luby.
Treatment for preschool depression
Medication combined with cognitive therapy is the standard treatment for children and adults suffering from major depression, however, this isn’t the case for very young children. Luby recommends psychotherapy in the form of play therapy and she is currently developing a treatment that will involve parent/child interaction therapy.
Medication is absolutely not the way forward she says as the drugs given to older children haven’t been tested in very young children.