Many people suffer depression in the winter months, and children are not immune. Some call it “Seasonal Adjustment Disorder”, a type of depression believed to be caused by the shortened days and a lack of sunshine. Others may be suffering from post-holiday stress. Any prolonged feelings of sadness, hopelessness or worthlessness should be treated by a health care professional.
Depression in Early Childhood
Prior to the 1980s, psychiatrists did not believe that depression could affect teenagers. They believed that teens were too “psychologically immature” to suffer from adult feelings of guilt and worthlessness. Now teenage depression is widely accepted. In the early 1990s some psychiatrists began to wonder if preschoolers could suffer depression, but it wasn’t until the Clinton Administration’s Conference on Early Childhood Development and Learning that interest in studying preschool depression increased.
The sad truth is that preschoolers can be clinically depressed. Depression is characterized by feeling sad. According to an article by the National Institute of Mental Health, “Children who are depressed may pretend to be sick, refuse to go to school or cling to a parent.” I’m thinking – “And how is this different from any normal three-year-old?” As a preschool teacher, I often saw young children cling to their parents in the morning. Some would cry or complain of stomach aches, and they didn’t want to go to preschool! Since I doubt they all were suffering from depression, how can parents tell the difference?
Whether a child is just feeling sad or suffering from depression is a matter of degree. The blues will pass after a few days or up to a week. The term depression is for extended periods of sadness lasting two weeks or more. Other symptoms of depression may include:
- Irritability or anger
- continual feelings of sadness or hopelessness
- social withdrawal
- increased sensitivity to rejection
- changes in appetite- increased or decreased
- changes in sleep – increased or decreased
- vocal outbursts and crying
- difficulty concentrating
- fatigue and low energy
- physical complaints – stomach ache, headache, that do not respond to treatment
- reduced ability to function during events, with friends and family
- feelings of worthlessness and guilt
- impaired thinking or concentration
- thoughts of death or suicide
Recognizing depression in preschoolers is much trickier than the older child or adult. Preschoolers are more naturally buoyant. Their moods swing frequently throughout the day, and they are unable to express their thoughts and feelings. Often, the depressed preschooler is the “good” child, the “wheel that doesn’t squeak”. One four-year-old, who was later diagnosed with depression, was that good child. He was empathetic and obedient, but he didn’t seem to find much enjoyment. He didn’t run around like other children. He didn’t get excited about going to Disney Land, and said, “Mickey lies. Dreams don’t come true.” He didn’t like to do anything if he couldn’t do it perfectly and got very upset when he made mistakes. He was often bored, and complained that nothing was fun. He was often draggy, super whiny, and seemed like he was in pain. Again, this is a matter of degree, as many preschoolers will have days like this!
Preschoolers can experience feelings of sadness, even though they may not yet understand emotions. Depression affects the degree to which this sadness is expressed. Imagine two young children trying to tie their shoes without success. One preschooler struggles, then asks a teacher for help. The other preschooler, frustrated, throws his shoe across the room. He may hit himself, or degrade himself, saying things like, “I’m stupid.”
Depressed preschoolers are often misdiagnosed. They may respond to depression differently than adults, becoming restless, hyperactive or irritable, and misdiagnosed with ADHD (attention deficit/hyperactivity disorder) or ODD (oppositional defiant disorder). The risk of depression in preschoolers is much higher if one or both parents are depressed.
Treatment for Depression in Preschoolers
Young children should NOT be given medication for depression. The drugs have not been tested for them. However, depression can have serious effects on their development if left untreated. A child with low self-esteem and low energy will not push himself to do well in school. Psychotherapy may be the best option. For preschoolers, this would be “play therapy”. Using toys and puppets, the mental health care professional can help the young child learn to express himself, and improve his negative emotions.
It is important to realize that no one is to blame. Parents cannot blame their child’s depression on something they did or did not do. Preschoolers are seldom depressed about bad things or stressful events. Depression is a mental disorder that is caused by a chemical imbalance in the brain. The causes of the chemical imbalance are not fully known, but can be linked to certain personality traits, medical conditions, and diet. Children who are obese, or deficient in vitamins B 12 and folic acid are more at risk for depression.
To depression-proof your child, help him to develop a positive self image. Teach him how to express his feelings, and reassure him that negative feelings are “okay”. Teach him how to deal with his feelings. Make sure he has a well-balanced diet that is high in fresh raw fruits and vegetables, and that he gets adequate exercise to prevent obesity. Teach him that it is okay to ask for help. And most of all, if you believe that you may be depressed, get the help you need now, before it affects your child.
* “Depression in Children”, www.Medicine.net, accessed January 5, 2011
* “Child Depression and Adolescent Depression,” The National Institute of Mental Health. Accessed January 6, 2011.
Tags: antidepressants for young children, depression, depression in young children, depression versus the blues, diagnosing depression in preschoolers, early childhood depression, Preschool depression, sadness