Childhood Depression: Signs in Preschoolers, Kids & Teens Michele Borba

Parenting tips to help you understand what depression looks like age by age

REALITY CHECK: Here is what’s not true about your child and depression: “She’s too young to be depressed.” “Don’t worry. It’s only a phase.” “Real depression is something only teens or adults get.” “He’ll outgrow it.” Beware that depression is now diagnosed in even toddlers! The sooner our children get the right diagnosis and the right treatment, the better the prognosis.

The Kid Are Not All Right, Folks!

The sobering reality is that depression does strike kids–and it hits hard.

Clinical depression is not a phase or a normal stage of development, nor something kids can shrug off. It is a serious and sometimes life-threatening disease, and the long-term consequences are just too severe to ignore.

Here are just a few troubling stats about depression and kids today:

A child today is ten times more likely to be seriously depressed compared to a child born in the first third of this century.

Almost one-third of thirteen-year olds have marked depressive symptoms.

By the time they finish high school almost 15 percent have had an episode of major depression.

Since it is frequently overlooked, some leading experts predict that almost one in four youngsters will experience a serious episode of depression before their high school graduation.

Yale Medical School study found that depressed youngsters are almost four times more likely to have drug or alcohol problems by their mid-20s.

Nearly one in ten kids who develop major depression prior to their puberty commit suicide.

Suicide rates for kids and teens have tripled in three decades.

But even more sobering news: research shows that depression is hitting kids as young as three. See my blog and the report I gave on The Doctors on this new and troubling trend: Depression in Young Children.

Depression Hits Kids At Younger Ages

The rates of childhood depression are not only increasing but are also impacting younger kids. In a recent Journal of the Association for Psychological Science, Current Directions in Psychological Science , child psychiatrist and researcher, Joan Luby from Washington University in St. Louis reports recent findings examining depression in preschool-age children.

Luby pointed out that depression in children as young as three years of age is real and not just a passing grumpy mood. The researcher states that until fairly recently, “people really haven’t paid much attention to depression disorders in children under the age of six because children under six were too emotionally immature to experience it.” New studies now counter that view.

One thing most child development researchers agree is that when depression is diagnosed early and properly treated, kids almost always can be helped and feel better. And the earlier you seek treatment the better.

The problem is that signs of depression in younger children do not always look the same as it does in older kids and adults and that is one reason why researchers feel depression has been largely overlooked in children as younger as preschool age. It is also why parents and child providers must learn the signs of depression in children by stages and ages.

What Depression Looks Like in Different Ages

Here are what to expect by stages in ages of children from my book, The Big Book of Parenting Solutions: 101 Answers to Your Everyday Challenges and Wildest Worries. More specific recommendations, up-to-date research and parenting solutions are provided in the chapter on Depression.

Child and adolescent psychiatrist, David Fassler, MD, offers these signs of childhood depression in his must-read book, “Help Me, I’m Sad!”

Depression in a Preschooler

Verbal skills are limited so will have trouble describing feelings. Look for loss of pleasure in play (or inability to enjoy playtime) as well as frequent and unexplained stomachaches, headaches, and fatigue; overactive and excessive restlessness; irritability or low tolerance for frustration; frequent sadness.

Typical preschool behaviors (such as separation anxiety, whining, tantrums, nightmares) are more intense and last several weeks though usually not at steady intervals.

Depression in a School Age Child

In addition to preschooler signs watch for:

Sleep pattern changes, significant weight loss or gain, tearfulness, excessive worrying and low self-esteem, unprovoked hostility or aggression, drop in grades, refusal or reluctance to attend school, loss of interest in playing with peers, feelings of unworthiness: “Nobody likes me.” “I’m no good.” “I can’t do anything right.”

Depression in Adolescents

In addition to school age signs look for:

Sleeping longer, feeling hopeless, abusing drugs, alcohol or smoking, conduct problems in school, fatigue, loss of enjoyment of previously enjoyable activities, self-destructive behavior, difficulty with relationships, eating-related problems, social isolation, doesn’t attend to appearance, extreme sensitivity to rejection or failure, physical slowness or agitation, morbid or suicidal thoughts.

When Should You Worry About Your Child? Use the “Too Index”

So when do you get help? I always suggest parents use the “TOO Index:”

Whenever your child’s behavior becomes TOO different from his normal, typical behavior

Whenever your worries and his behavior lasts TOO long (especially every day for at least TWO weeks)

Whenever your child’s problems start to “spill over” into TOO many other areas (school, friends, activities, home)

Whenever your own instinct says something is not right.. my child’s behavior is “Too” different and “Too” much of a concern.

Why second guess something so critical? Get the help of a licensed mental health professional. The two words I hear most from parents that are just too sad: “IF only…”

Please don’t wait! Depression is treatable.

Dr. Michele Borba, Parenting Expert

I am an educational psychologist, parenting expert, TODAY show contributor and author of 22 books.

You can also refer to my daily blog, Dr. Borba’s Reality Check for ongoing parenting solutions and late-breaking news about child development

Follow me on twitter @MicheleBorba

Additional Resources

The Big Book of Parenting Solutions: 101 Answers to Your Everyday Challenges and Wildest Worries, by Michele Borba, Jossey Bass Publishers, 2010, (chapter on depression)

Signs of depressions preschool, school-age, tweens: D. Fassler, “Symptoms to Be Aware Of, By Age,” USA Today, Nov. 30, 1999, p. 8D.

Three to five year olds show less pleasure in play: Joan Luby of Washington University School of Medicine identified depression through play by having preschoolers watch two puppets discussion their emotions then asking kids to point to the one that sounded most like them. C. Kalb, “Troubled Souls,” Newsweek, Sept 22, 2003, p. 69.

M. E. P. Seligman: The Optimistic Child, by New York: Houghton Mifflin, 1995.

One third of 13 year olds marked depressive symptoms; 15 percent episode of major depression by time they finish high school: P. Lewinsohn, P. Rohde, J. Seeley, and S. Fischer “Age-Cohort Changes in the Lifetime Occurrence of Depression and other Mental Disorders,” Journal of Abnormal Psychology, 102, 1993, 110-120; C. Garrison, C. Addy, J. Jackson, et al. “Major Depressive Disorder and Dysthymia in Young Adolescents, American Journal Of Epidemiology,1992, 135, 792-802

When treated early almost all children can be helped: W. R. Beardless and Stuart Goldman, “Living Beyond Sadness,” Newsweek, Sept. 22, 2003, p. 70.