Beyond Blue

Beyond Blue

Preschool Depression Is Real

It’s official. Depression is real among kids as young as three.

In a study lead by Dr. Joan Luby, a psychiatrist at Washington University in St. Louis, researchers found that preschoolers with depression had a 4 times greater likelihood of major depressive disorder one or two years later than preschoolers who didn’t have depression. The study was funded by the National Institute of Mental Health and just published in the August issue of “Archives of General Psychiatry.”


I know what most people are thinking, or at least I think I do because I heard plenty of opinions back when my son was exhibiting troublesome behavior in preschool, which felt like the terrible twos, threes, fours, and fives … “Oh God, here we go again … trying to fit the kids somewhere into the DSM-IV (shrink’s Bible) so Big Pharma can get its greedy hands all over that innocent child.

I chose to exhaust the behavioral therapies that we, as a family, could learn, not because I don’t believe that there is a place for medicine–friends of mine have put their kids on drugs and I think that was absolutely the best solution for them–but that David responded to a few adjustments in how we run the house, and to more structure. I’m aware of the lack of research available today on treating kids, and so I think if your kid can learn adopt some helpful cognitive behavioral techniques and behavioral modifications, then start there. But that doesn’t work for everyone. Some kids need the medication to assist them with the other stuff. Thank God we have it for them.


Ultimately, I am glad this study was published and is getting some publicity. Not to scare all the moms out there with three-year-olds whose tantrums lasts an hour. But as a gentle prodding to pay careful attention to symptoms of overwhelming guilt, chronic sadness, persistent weepiness, extreme irritability, and temper tantrums that involve biting, kicking, or hitting.

I’m not saying parents should, upon recognizing these symptoms, lace their kids’ peanut butter and jelly sandwiches with 5 milligrams of Prozac. But I do think it’s worth investigating some behavioral strategies to relieve some of the sadness and anxiety.

I wish my mom had done that for me.

Not that I fault her for not taking me to a shrink when I was 4 or 5. Get real! I was 4! But the signs were very much there, from the beginning: insidious rituals, like praying four rosaries before breakfast, that I had to perform or else I would go to hell; nightmares that had me shrieking in the middle of the night; chronic crying; extreme separation anxiety; and guilt … oh man, don’t get me started on guilt. Over the stupidest things! Like accidentally plucking a blade of grass from my neighbor’s lawn. Had I been taught–through some cognitive behavioral strategies–to manage my emotions, then maybe, just maybe, I might have dodged the serious mood disorder I have today.


One theory of depression suggests that any major disruption early in life, like trauma, abuse, or neglect, may contribute to permanent changes in the brain that lead to an overproduction of cotropin-releasing factor (CRF), which in turn stimulates the pituitary gland to release hormones that cause depression. According to psychiatric geneticist James Potash, M.D., stress can trigger a cascade of steroid hormones that likely alters the hippocampus–belonging to the brain’s limbic system, the seat of human emotions–and retard its new growth.

That’s why it’s so important to treat depression at a young age. So that the tender brain doesn’t start form under that stress, and predict a life of depression.


Dr. David Fassler, a University of Vermont psychiatry professor says that depression in the very young is still pretty rare, but without treatment “can have a devastating and often lasting effect on a child’s social and emotional development.”

I can provide proof of that.

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  • Lee

    Great post – thanks. Your point of view is really well-balanced and spot on. Be aware, react to the signs (resorting to meds IF ultimately necessary) but keep things in perspective. It’s a rocky road, parenting but the more we know, the better we do.

  • Mark

    There is another quite fascinating area of psychotherapeutic research, that could explain early childhood depression (or adult depression for that matter) not as being based on biology (changes in the brain), but from the trauma of birth itself or even from deeper transpersonal roots such as past “life experiences”, “karma” or even generational family pathology (not biologically based). I know this sounds quite mind bending to some, but if you’re interested in exploring some new frontiers in deep psychology take a look at the work done by psychiatrist Stanislav Grof (recommended start could be his book “Psychology of the Future: Lessons from Modern Consciousness Research” or YouTube videos by the same). Good luck! Great blog!

  • Leeann

    Great post Therese, I have a problem with my 9 year old boy. Last year in school I was told over and over again by his teacher as well as the guidence couselor that he has a focusing problem and thought he should be evaluated. Well my husband and I discussed it and I told him that even though “he has negitive feelings about therapy we would not doing our job as parents if we did not at least have him tested”. He agreed and then when I went to make the appointment he fought with me over it. Needless to say my son has got no help and now he has become very arrogant, no empathy, angry and is acting like my husband and I am very worried. I need your help to help me to get the help he needs before it gets any worse. Just an example his teacher he had last year told me he reached his grade level in reading but he needed to keep reading over the summer, well guess what he has not read and he will be going backk to school in a few weeks he also needs to do an assignment about the facts of the state we live in and as well has not done that and my husband will not back me up. My husband is putting it back onto me and blaming me when my son does not want to do anything with me his life revolves around his father and wants his father to do it with him and my husband has yet to do it. As you have probably figured out by now that my husband and I are having problems. When he was in preschool he was evaluated for ADD so the daycare claims he showed signs but he passed with flying colors. I don’t know what to do if you please email me back with any advice please do I know you are very busy but I don’t know how much more I can take it is making my mental illness even worse when I have been stuggling and have finally I beilve found a med that works.
    Thank You and God Bless you and your family

  • Mary

    For Leeann: if your husband won’t go to family counseling with you, go by yourself if at all possible. I have been in the situation with a husband who refused to acknowledge and address the extent of our family’s problems and my children suffered more because as parents we did not work together for their best interest. A book I found very helpful is The Bipolar Child, by Dimitri F. Papolos M.D. and Janice Papolos. Even if bipolar disorder is not your child’s problem, there is a lot of helpful information on everything from diagnosis, medication, dealing with school officials, family issues, and perhaps as important as anything else, reassurance that you are not alone. Whatever you do, don’t give up on getting help for your son and yourself.

  • Jenn

    Thanks so much for this post. I am currently turning my Reiki healing practice into a Spiritual Life Coaching for Children practice. I believe that the lack of spiritual balance in our children’s lives is a large portion of what is happening with them emotionally, behaviourally and socially. I have seen many children who are full of potential become stuck in a fog because of medications their teachers thought they should be on and parents without any other information or knowledge of alternative treatments go with that recommendation.
    Thank you for your sincerity and honesty with your blog posts. They are great to read!

  • WahSupDoc

    Let’s just hope the solution doesn’t include throwing more pharmaceuticals at the problem as first line course of action! Our ‘quick fix’ society, where culture advocates taking a pill to fix any problem, ie, anxiety, obesity, sleeplessness, etc.

  • Andrea

    Not all that surprising that a chemical imbalance in the brain would show up in toddlers since other illnesses also appear early. I honestly don’t remember a time when I was not mildly depressed. It started well before I started kindergarten. I’m really not sure how much of my personality is “me” and how much was shaped by the dysthymia. My mother had nicknamed me “Oscartina” for Oscar the Grouch when I was little and I look serious and pensive in a lot of my photographs as a small child.
    I suspect that all types of depression are present in young children, not just the bipolar or OCD or major depression like in the symptoms they’re describing in the study.

  • Andrea

    I’d add that I don’t think medication should be automatically ruled out for little kids, if you combine it with behavioral therapy. I also don’t think medicating kids necessarily creates the problems. Most of the time the problems were already there in the first place. I cover schools and educational issues for the paper I write for and from what I’ve seen, medication is often a good idea that can help a kid fit in at school, concentrate on homework, make friends, feel good enough to develop normally.
    There was no trauma to speak of in my early childhood that made me depressed, no real reason other than genetic vulnerability. I had two loving parents who are still married to each other, a lot of attention from them and my grandparents, and one fairly serious infection that involved hospitalization for 10 days when I was a toddler, followed a few years later by an autoimmune illness at age 5 that prevented me from walking for six weeks. If I were to guess at a physical cause, I’d say that infection might have started things going a little haywire in my brain, maybe affected the serotonin flow. Who knows? But I hope people won’t automatically assume that children without abuse or trauma can’t become depressed very early too. They should keep an eye out for depression as a possible complication of other physical illesses.

  • Leeann

    Thank You Mary for your comment and I will check the book out. I do myself have Bipolar/depression and I think I have had it since I was a child but they say that children usually do not show any signs until their teens or later. I disagree with that. I pray all the time that my husband will turn around but I don’t see it happening as sad as that is and he obsessed with my son and Lord knows what he would do if I went a head and did it, I am in a rock and a hard place. Thank you again and I will keep you in my prayers and please say a prayer for my family.

  • Sara

    I am a single mom of a 4 year old boy. I know my son is having issues with the seperation from his dad. My son has aggression and sometimes hit’s himself. I find htat if I talk with him, one on one, face to face and at eye level, it helps him… relieves him of his anger. I explain to him that he is upset and it’s ok to be upset so let’s talk about it. Sometimes i would ask him if he misses daddy and he says “NO!” sometimes, he says “yes!”. however, i always empathize with my son and I strongly believe it helps. I think we just need to spend more one on one time with our kids and talk with them just like we would want one of our parents to talk with us. I know at 4 my son understands a lot better then most think. Like I say, they are people with feelings and it is our place to help them learn how to deal with them…I don’t believe in these depression meds expecially for children. I do believe there is always a way to make them better it’s just up to us to figure that out. pay attention to your child and find out what he/she really needs. I’m sure that YOU are the only one who can give that to them.

  • Lisa

    I feel there are a lot more environmental toxins that can disrupt healthy brain chemistry in today’s children. We (and our parents) did not grow up laden in pesticides (which are neurotoxins by the way), antimony (very toxic flame retardant in bedding, pjs, carpets, upholstery) everything fragranced with chemicals, an overabundance of chemical laden processed foods and mercury laden high fructose corn syrup and genetically modified foods.
    Our children today are paying the price for letting “better living though chemistry” get out of hand.
    It is much easier to medicate symptoms, than to detox a child and his home and food.

  • Janet

    AMEN GIRL! I AGREE, FOOD and yes all the other stuff, that is why I home make alot of stuff, plus no fabric softners here or harsh chemicals for clothing, I use baking soda which is suppose to help remove toxins as such from clothing. I try to eat as much as possible in organics, and I avoid all perfumes etc at home. I also avoid as many shots as possible except of course the ones that are benefits out weighs risk. Milk I buy hormone free and antibiotics. Try to get farmer fresh veggies and grow my own alot of the time too. DIET plays a HUGE HUGE PART OF todays society. I don’t believe in medication, I am sorry, but I just don’t. I have been to rock bottom and back, and nothing the LORD couldn’t get me through. However, if it works for some, then I am not against for your use. I just can’t seem to wrap my brian around the thought of it for myself and children, ESPECIALLY a CHILD! Dicipline and structure and healthy BED TIMES is another huge problem with today’s childern. I do believe all the processed food is a HUGE part. I have read different very convincing studies about fake sugars and processed food actually making lab rabs CRAZY LITERALLY loosing their well being when fed and watched. It is scary, however, I don’t want to offend anyone, I do believe there is need for everthing and everything has a place, just be wise, I think today everyone thinks a problem can be solved with a dr’s PILL!
    However, that said I am sure there are some people who need medication to be well, and that is FINE!

  • Adolescent Psychology

    It might be suggested that adolescent psychology is nearly non-existent, because a person requires a functioning mind in order for the term “psychology” to apply. However, Dr. Phil types and Big Pharma have stuff to sell – so there develops the industry of adolescent psychology. Recently, studies were published that purports depression in preschool students. That’s right – preschool students are depressed. (If Spongebob and Shrek are persons’ biggest role model and life revolves around where their Hot Wheels are at…Freud does not apply.) There are already child safe doses of depression medications and Ritalin – perhaps it’s unhealthy for adolescent psychology for parents to spend an installment loan on anti-depressants for children, as they are bad enough for adults.

  • Your Name

    Hi I’m writing to see what you guys would think my sister has a 3 year old daughter and she has been in pre-school since august and she was having fun. All of a sudden she had a couple of reports (I believe about 2 or 3) saying that she punched another child in about two weeks. The teacher said that one incident she came in the room and she turned on the lights and another student said that it wasn’t her turn to turn on the lights she got mad and punched her in the face. My question is why she just suddenly changed? My sister has 3 children all girls a 3 year old, a 2 year old,and 1 year old. And might it be because of lack of attention?

  • Lizzy

    I agree with chemiclas harming us!! I had depression growing up and I ate the typical American diet, and purchased all the chemical filed products. Once I read Baby Matters by Linda Folden Palmer, DC I discovered food and the important role it plays in every aspect of our lives. I was on Prozac and Cymbalta, now I am free of all of it. I watch a preschooler that was also fed large amounts of sugar and processed foods daily becuase he is in a split home. His mother allows him to eat it because he enjoyes it. We noticed when he would stay with us for a week his symptoms improved. He used to cry all the time, hit himself, get very aggresive, and was very small for his age. His change of diet has lessen his behavioral issues. I strongly feel he would be cured if his mother agreed. But she does not. Check out SCD diet and the link between bad food and autism. Kids can eat well and not have to eat sugar(use honey instead) limit grains, and avoid dairy unless it has been fermented. We eat fresh fruits daily and fruit and vegetables with every meal. The only thing I worry about is the children going to school. Our schools feed the children highly processed food and lots of sugar. I find it horrible but many people do not care to learn how harmful this food is. Food is our life. It can make us or break us. I cook homemade food daily and my little guy is very big for his age and loves life. I’m glad I read Baby Matters when he was having colic after he was born. Food is what caused it and food is what made it go away-not doctors, not surgury. And it can also help you and your little ones.

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