Most medical professionals would tell you that the typical onset of clinical depression occurs during the storm and stress of the teenage years. And, certainly, that is typical. But some children, approximately 1-3 percent according to epidemiological studies, show symptoms even earlier.  Daniel Klein, a professor of clinical psychology at Stony Brook University, says that newer research suggests even preschoolers, children as young as 3 years of age, can meet the clinical criteria for major depressive disorder.

“This is something that surprises many people. Because of old psychological and developmental theories, most people thought that kids actually couldn’t get depressed before adolescence,” says Klein. “But several studies in the ’70s and ’80s showed that school-aged children could exhibit the same patterns of depressive symptoms that were seen in adolescents and adults. And as we started to investigate it more systematically, we saw that it was also present in a small percentage of preschool children.”

Signs & Symptoms of Depression in Children

The symptoms of preschool depression are identical to those seen in adolescents and adults: sadness, irritability, or the inability to feel joy. The groups even show similar patterns of brain activity. But since common wisdom suggested that young children couldn’t get depressed—and such young children are unable to accurately verbalize their feelings—parents often wanted to chalk up those symptoms to simple shyness or social anxiety.

“Certainly, these two things are often difficult to separate out. And depressed people are often anxious,” says Klein. “But an important way to distinguish between kids who are just shy or socially anxious is to ask yourself whether they are most anxious or withdrawn when exposed to new people or new situations. If they know the people around them well, or have had the chance to warm up, the shyness should largely disappear. But with kids who have depression, that withdrawal will be there even when they are with friends and family.”

Shyness in Children

Another thing to consider, Klein says, is whether or not a child is experiencing joy and fun in different situations. Most children, no matter their social comfort level, usually can’t resist giggles when presented with bubbles or other fun toys in a familiar setting.

“Even the shyest kids have activities and toys that they enjoy. That may be limited in new social situations but when they are with their parents or siblings, they can have fun and enjoy themselves,” says Klein. “Depressed kids, on the other hand, don’t get engaged or enthusiastic about much of anything. And that really is one of the bell-ringer symptoms you need to look out for.”

If you have concerns about your child and depression, even if they are as young as preschool age, Klein encourages you to take them for an evaluation with an accredited child mental health clinician. Because the earlier you act, the earlier they can be helped.

“If you think there may be something beyond just some shyness or irritability, don’t put off the evaluation,” he says. “Because being able to treat it early may make all the difference.”

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