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Depression Can Strike Preschoolers, Too

By Cynthia Haines, MD

A recent article in the New York Times Magazine captured my attention as both a mother of small children and a physician. The article focused on depression in very young children, and led off with the story of a St. Louis-area family whose child has seemed to be gripped with pervasive sadness for years despite his young age.

As the story made clear, depression in preschoolers is controversial and unsettling. But it could be affecting a child you know.
Even in adults, depression can be a confusing topic surrounded by myths. Some people think that depressed individuals should just shake it off and get over it. Some people are worried that taking antidepressants means they're "crazy." Some spend years in therapy, endlessly rehashing childhood memories. Many with depression remain inadequately treated.

When you start talking about depression in preschoolers, a lot of other highly emotional issues get mixed in. Parents worry about establishing a diagnosis for their kids that they might be saddled with into adulthood. They might feel guilty as if they're at fault. They may presume that this is just a phase that their kids will pass through quickly. Or they may look at the large numbers of kids taking medications for attention deficit disorder these days and wonder if the pharmaceutical industry is behind the scenes encouraging a new disorder to treat with drugs.

 But some kids do seem gripped with a deep-seated sadness at an early age. An article from 2006 in the journal Child and Adolescent Mental Health, co-authored by an expert quoted in the magazine story, cited research suggesting that 2.1 percent of kids ages two to five have a depressive disorder such as major depression or dysthymia (chronic, low mood with symptoms that aren't as severe as depression). Depression may be more common in 4- and 5-year-olds than toddlers.

Diagnosing depression in kids can be challenging. Small children often have trouble describing anything reliably, particularly complex concepts like their emotions. As a result, parents' input when discussing a child's mental health with experts is important. Symptoms that could point to possible depression in small children include:

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