Depressed preschoolers?

Researchers discovering new insights about this disorder in young children

Depression is the most common mental health problem in the U.S., affecting about 17 million people.  But it doesn't just affect adults. Child Psychiatrist Dr. Joan Luby has been studying depression in preschool children for more than 20 years.

"Children as young as age 3 can get clinical depression," explained Luby, Professor of Psychiatry (Child), Director of the Early Emotional Development Program, Washington University School of Medicine.

In a recent imaging study, Luby's group found depressed preschoolers had elevated activity in an area of the brain called the amygdala.

"We can see changes in the structure and volume of several key brain regions that are known to be involved in emotion processing," Luby said.

The study was the first to show these changes in children so young.

"We believe that the earlier you can identify the disorder, the more effective treatment will be," Luby added.

Researchers believe as many as one in every 33 children may have depression. Children with depression are often withdrawn, highly sensitive, have a difficult time dealing with negative emotions, and are preoccupied with feelings of guilt. The symptoms often go unnoticed.

"Most people don't pick up on depression in their young children. Mostly parents pick up on what we call disruptive symptoms in children," Luby said.

However, if you do spot the symptoms, getting help could make all the difference.

In very young children, Luby says a strategy called "parent child interaction therapy— emotion development" is helpful. It works on strengthening the parent-child relationship and helps the parent serve as an "emotional coach" for their depressed child.

There are several treatments for older children with depression. Anti-depressants are considered generally safe for children older than seven, but the FDA has placed a "black box" warning on these drugs because of the increased risk of suicidal thinking.

Additional Information:

Depression is the most common mental health problem in the United States.  Every year it affects 17 million people of all ages, economic background, and races.  Researchers used to believe that depression could only happen to adults.  Now, researchers believe as many as one in every 33 children may have depression; and in teens, that number could be as high as one in eight.  (Source:

TYPES:  Types of depression include: adjustment disorder with depressed mood, seasonal affective disorder, major depression, dysthymia, and bipolar disorder or manic depression.  All of which can affect children.  Major depression is characterized by persistent sad mood, feelings of worthlessness or guilt, and the inability to feel pressure or happiness. A child with major depression feels depressed almost every day.  Dysthymia could be diagnosed if sadness or irritability is not as severe, but continues for a year or longer.  Kids with dysthymia can feel hopeless, have low self-esteem, and even have problems eating and sleeping. Bipolar disorder is characterized by episodes of low-energy depression and high-energy mania.  It may affect as many as one to two percent of kids.  Experts believe that kids and teenagers with bipolar disorder can experience problems like ADD, oppositional, behavior disorders, anxiety, and irritability. (Source: and

TREATMENT:  Depression can be successfully treated in more than 80 percent of the people who become depressed.  Counseling may help the child feel better.  The type of counseling depends on the age of the child.  For young children, play therapy may be best.  Older children and teenagers may benefit from cognitive-behavioral therapy.  This type can help them change negative thoughts that make them feel bad.  Dr. Luby recommends Parent Child Interaction Therapy— Emotion Development (PCIT-ED), which is a form of play therapy between parents and their children.  Parent-child interaction therapy has been used successfully to treat hyperactivity and disruptive disorders.  Researchers at Washington University School of Medicine in St. Louis adapted it by adding a focus on emotional development to test whether it could help parents teach their children how to regulate negative emotions, like guilt and sadness. "The original form of parent-child interaction therapy had two components," lead author Shannon N. Lenze, PhD, an instructor in the Department of Psychiatry, was quoted as saying.  "One was a child-directed interaction, and the other was parent-directed. The first encourages the parent to use effective praising techniques, to play games the child wants to play, to get down on the child's level and be enthusiastic. The second component teaches the parent about effective discipline using a very specific ‘time out' to help the child learn to obey parent commands."  The third component, which was developed for the study, involves emotions and helps parents learn to help their child more effectively regulate them.  (Source: and