Given the fact that depression can begin in early childhood, concerned parents often wonder if there are warning signs of depression to watch for in their own children.
According to a 2009 study in the Journal of Clinical Child and Adolescent Psychology, different emotional reactions were seen in preschool children who were depressed or at-risk for internalizing symptoms, and children who were not.
Internalizing symptoms, like extreme shyness and unexplained physical complaints, are associated with depressive symptoms in some children.
In their study of 3- to 5-year-olds, they found that depressed and at-risk boys showed more anger than any other study group, and that depressed and at-risk girls showed more sadness overall.
This finding suggests that early emotional warning signs may be present in the course of childhood depression. Furthermore, it shows that these emotional reactions differ between boys and girls.
Additional Warning Signs of Depression
Parents should be aware of additional signs of depression that may appear in young children. Young children are less likely to be able to express what they are feeling than are older children or adults. Instead, they may cling to a parent and refuse to be separated for fear of something bad happening, consistently complain of vague physical ailments that have no underlying medical cause, or refuse to attend school or leave home.
Parents, teachers or caregivers may report that a child "does not seem like herself."
Unlike adults, where a depressed mood and anhedonia are the primary factors for making a diagnosis of depression, irritability is an important symptom of depression in children, and is actually a factor in the diagnosis of childhood depression, according to the DSM-IV. Irritability may come in the form of angry outbursts, inappropriate reactions, or simply a negative mood.
Anhedonia, or the inability to experience pleasure, is highly associated with depression, and can be clearly identified by age 3. For children, anhedonia is marked by the inability to experience pleasure from age-appropriate play.
What to Do If You Are Concerned
If you think that your young child has symptoms of depression, visit her pediatrician first. A physician can rule out any physical illness that may be causing her symptoms.
Once physical illness has been ruled out, have your child evaluated by a mental health professional who is trained in working with children and mood disorders. The specialist will evaluate your child and determine an appropriate diagnosis and, if necessary, treatment.
The early identification of depression is extremely important especially for children. Effective treatment can reduce the severity of a child's course of depression.
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision. Washington, DC: American Psychiatric Association; 2000.
Depression and Suicide in Children and Adolescents. Surgeon General's Health Report. Accessed: April 01, 2011. http://mentalhealth.about.com/library/sg/chapter3/blsec5.htm
Joan L. Luby, M.D., Marilyn J. Essex, Ph.D., Jeffrey M. Armstrong, M.S., Marjorie H. Klein, Ph.D., Carolyn Aahn-Waxler, Ph.D., Jill P. Sullivan, M.S., and H. Hill Goldsmith, Ph.D. Gender Differences in Emotional Reactivity and AT Risk Preschoolers: Implications for Gender Specific Manifestations of Preschool Depression. The Journal of Clinical Child and Adolescent Psychology. July 2009. 38(4): 525-537.
Joan L. Luby. "Preschool Depression: The Importance of Identification of Depression Early in Development." Current Trends in Psychological Science, August 2010; 19(4).