Toddler Depression -- Real or a Phase?

A study of toddlers with depression finds problems may continue in grade school.

August 3, 2009, 3:25 PM

Aug. 3, 2009— -- Quieting a child's streaming tears on the playground might seem far easier than dealing with a sobbing adult. But what about a child who also doesn't enjoy playing anymore, who suffers from chronic stomach aches, or even threatens to kill herself?

While a number of studies in recent years have found toddlers -- and even babies -- can suffer from major depressive disorder, doctors have debated whether preschool depression was an isolated blip in a child's development or a sign of future problems.

But according to a new study published Monday in the Archives of General Psychiatry, preschoolers can suffer from major depression, and those children are likely to face depression again in elementary school.

Researchers at Washington University in St. Louis periodically interviewed the parents of 75 children aged 3 to 6 who were diagnosed with major depressive order. When compared to 146 non-depressed children, the preschoolers with depression were four times more likely to have depression one or two years later.

"These results underscore the clinical and public health importance of identification of depression as early as preschool," the authors wrote.

The authors pointed out that major depressive disorder in elementary school children is usually difficult to treat, making the need to catch depression early even more urgent.

"It takes quite a combination of risk factors, including genetic predisposition and environmental and familial factors, to depress a normally jubilant toddler," Rahil Briggs, a professor at Montefiore Medical Center in New York City, wrote to

"Children's early experiences become the lenses through which they later view the world. We must be very conscious of their well being during this formative time," Briggs wrote.

Importance of Studying Preschool Depression

But while many doctors enthusiastically backed the importance of the study, some questioned exactly what labeling a child as "depressed" actually shows.

"At this age especially, the focus should remain on the ongoing interactions between preschoolers and their significant caregivers -- parents, guardians, teachers, and sometimes older siblings," George Scarlett, an assistant professor of child development at Tufts University, wrote in an e-mail to

"The problem of depression is, in other words, a problem located within the relationships, not within children -- keeping this always in focus will lead to better solutions," he added.

No matter what doctors thought of the study, child psychiatrists warned against the urge to diagnose moody toddlers with depression.

"If you are concerned that your child isn't developing as your friends' children (or as your other children), make an appointment with your pediatrician and ask questions. If you still have concerns, go to a therapist," child psychiatrist Jennifer Hartstein, who has a private practice in New York City, wrote to

Hartstein recommended that parents keep in mind the "length of time of behavior" when deciding if a child's moods are just moods or a larger problem.

"If you know that the 'clingy' stage should be done by about age 3 or 4, and your child, at age 5, will not let you leave the house, isn't excited about spending time with friends or others, then you may have a clinically significant problem and should begin examining what it means," she wrote.

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