What Every Parent Needs to Know About Preschool Depression

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Babble is partnering with PACER Center to help readers better understand and navigate the needs of young children. This month, we’re talking about signs to recognize if your child is struggling with early forms of depression.

Google “depression” and you’ll get millions of hits. But chances are, most of the articles you’ll see will only pertain to adults. In reality, children as young as preschool-aged can become depressed, though it’s only been in recent years that the medical community has even begun to recognize that young children can experience depression, too.

Previously, child development experts believed that very young children weren’t emotionally or cognitively developed enough to feel depressed, or be able to express what they were feeling.

Although it is not common for a preschooler to become depressed, neither is it extremely rare. While data shows that older children and adolescents become depressed in far greater numbers, experts believe that somewhere from 1-3% of preschool children may experience depression at some point. But understanding that young children may be depressed means that it is easier for them to get the help they need.

According to Dr. Barry Garfinkel, a Minneapolis-based child and adolescent psychiatrist, “Preschool depression is rare enough that it is often mistaken for other problems.” One clue that a very young child is depressed, Garfinkel adds, “is when there is a real observable change in the child. They may appear more sluggish, withdrawn, apathetic, and their mood becomes much darker. It’s like the old cartoon with a black cloud hanging over the person; in this case, a young child.”

Of course, it’s very normal for any child to experience a dark mood. A child who is experiencing normal sadness will bounce back from an unhappy experience in a matter of hours or days. If a child is depressed, the sadness lingers for weeks or months.

“Symptoms of early childhood depression go beyond the ‘terrible twos’ and the ‘fearsome fours,’” Garfinkel says. “A child who was full of life, full of energy, seems almost lifeless. That sparkle in their eye, spring in their step is gone.”

Other symptoms can include regression, such as bathroom or nighttime accidents with a child who was previously toilet trained, or increased behavioral challenges such as tantrums or physical aggression.

Garfinkel advises concerned parents to watch their child closely, and seek the input of the child’s preschool teachers or daycare providers and other community members the child regularly interacts with, such as preschool sport coaches, Sunday school teachers, etc.

‘We don’t like to jump to pharmaceuticals. Most children respond to therapy and counseling.’
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Next steps might include a visit with the child’s pediatrician and, if warranted, a mental health expert. Garfinkel also recommends a child psychiatrist or PhD level psychologist.

“The best thing is multiple observations of child professionals who can use standardized and normed rating scales and observations to assist in forming clinical opinions,” he shares.

It’s important to seek treatment as soon as a parent recognizes a problem exists. Early treatment is key to a quicker and easier recovery.

“Lack of treatment can lead to academic and friendship difficulties when a child enters kindergarten or first grade,” Garfinkel says.

Childhood depression can usually be effectively treated with family counseling and individual therapy.

“We don’t like to jump to pharmaceuticals,” Garfinkel says. “Most children respond to therapy and counseling. Medication is very rarely necessary, and it is a last resort in young children who do not respond to other interventions.”

The good news about depression in very young children is that while it is a serious mental health issue, it is also a highly treatable one. Early intervention is key, and makes all the difference.

If you think your child may be at risk for depression, here are some common risk factors and symptoms to look out for:

Risk factors

• A recent loss (such as divorce or the loss of a parent)
• Family stress (loss of job, illness, moving)
• Having an anxiety, learning, emotional, behavioral, or attention-related disorder
• One or both parents experiencing or having experienced depression


• Loss of interest in favorite activities
• Low energy and boredom
• Lack of interest in playing with friends; being socially isolated
• Increased anger and irritability
• Change in sleeping patterns
• Regression in skills
• Complaining about physical symptoms• Reluctance to go to school or daycare
• Lack of concentration
• Self-destructive thoughts or actions
• Expressing hopelessness
• Displaying sadness; frequent crying
• Looking withdrawn, distracted or vacant
• Preoccupied with inner negative thoughts

Want to learn more about children’s mental health? Visit PACER’s Children’s Mental Health and Emotional or Behavioral Disorders Project.

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