Just like us, children sometimes have good days and bad days. But childhood depression is more than feeling down and can affect your child’s mental and physical health.
WORDS DR NICOLA DAVIES
As the diagnosis and discussion of depression and other mental illnesses become more prevalent in society, it remains difficult to imagine that very young children could be experiencing the same struggles that adults or adolescents face. Can children as young as preschool age – three to five years old – have the same level of depression as their elders? While rare, recent studies have shed light on how very young children can indeed experience symptoms of depression. The key is how to determine whether a child is suffering from a true mental health condition (depression), or if they are just going through one of childhood’s most important phases: learning to regulate their emotions. There are many key differences, and if a child is diagnosed with depression, there are effective treatment options.
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What is Anhedonia?
One of the main symptoms of depression at any age is anhedonia, which can be described as a depression that does not improve, even in the face of happiness in life events. Anhedonia is not a natural state for very young children. That is why Dr Joan Luby, US psychiatrist, says it is a very important symptom in diagnosing early childhood depression. As she states in one of her papers, “The preschool period is characterised by the transition into more independent social functioning and greater emotional competence and, along with these emerging skills, joyful play exploration.” The absence of this joyfulness differentiates a true depression from normal childhood irritability or sadness.
While children can experience traumatic events such as
parental divorce or the death of a loved one, they can
also be resilient if given emotional support.
If a child is experiencing true depression, these emotional obstacles will be harder to overcome and could lead to weeks or even months of anhedonia.
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Other Red Flags
While anhedonia is an important component of diagnosing depression in young children, other symptoms that can be indicators include:
Even though these symptoms can occur at any time,
when they last a long time or are very intense,
they can seriously interfere with a child’s
quality of life and their emotional
and cognitive development.
They can also affect their ability to make and maintain friendships, their ability to focus on tasks and, if the depression persists into school age, eventually their grades and academic success.
There are also outside influences that can lead to early childhood depression, such as:
These precursors, while not always resulting in depression, are important factors in diagnosing a child at an early age.
Since traditional diagnosis can be challenging when dealing with a preschooler, these factors can go a long way in identifying a serious yet often treatable issue.
Early childhood depression does not always occur on its own. In many cases, the depression is associated with another condition that is affecting the child’s development, such as anxiety, Attention Deficit Hyperactivity Disorder (ADHD) or Oppositional Defiant Disorder (ODD). Indeed, about two-thirds of young people – children and adolescents – have depression combined with one other disorder and at least ten per cent are dealing with two or more disorders.
In preschoolers, the rate can be as high as three out of every four young children who have been diagnosed with depression. This correlation raises the question of whether depression in preschool children is actually similar to the types of depression that manifest in later stages of childhood, adolescence or adulthood, or whether it might be part of a greater pattern of behavioural or emotional challenges.
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