Recognizing Childhood Depression and Anxiety

Depression in children is an increasingly recognized problem. Learn the symptoms of childhood depression.

Sometimes kids get sad. They may act depressed. Most kids get over the worst of these symptoms in a couple of days. Some don't.

Parents, if they know to look, can tell the difference, says Marilyn B. Benoit, MD, immediate past president of the American Academy of Child and Adolescent Psychiatry and clinical professor at Georgetown University, in Washington.

"Parents know in their heart of hearts something has changed in their child and it is not going away," Benoit tells WebMD. "A child who is unhappy about a friend who treated them badly, they normally will get over that in a couple of days. But parents know when something is sticking and not going away. Most kids bounce back from an adverse experience in just a few days. Depressed children are still sad after a couple of weeks."

Childhood Depression

Can school-aged children -- even toddlers -- be depressed?

"Absolutely: In preschool and in school years, children suffer from depression," Benoit says.

"There really is clinical depression in toddlers, preschoolers, and school-aged children," Jeffrey Dolgan, PhD, chief of psychology at The Children's Hospital, in Denver, tells WebMD. "It is something a few years ago we weren't recognizing."

How common is it? That depends on your definition. Benoit and Dolgan note that most children with depressive disorders also suffer from anxiety. Some experts, however, see the anxiety as the underlying problem for the vast majority of these kids. One of them is Harold S. Koplewicz, MD, founder and director of the New York University Child Study Center, and director of child and adolescent psychiatry at NYU/Belleview Hospital Center.

Koplewicz, Benoit, and Dolgan agree that childhood depression is -- like adult depression -- a brain disorder brought on by changes in the chemistry of the brain. These changes often have their roots in the hormonal changes of the teen and young adult years. 

"Depression in preteen children is a rare phenomenon," Koplewicz tells WebMD. "They don't have the right chemical or anatomical changes that put you at risk."

Even so, genuine depression is by no means unknown in preteens.

"As rare as it is, there is a group of school-aged kids -- and even a few preschoolers -- who do experience full-blown depressive episodes," Koplewicz says. "It is one of those times where it is not a parent or an environment that has done this. It is a predisposition, the same way some kids have autism or learning disabilities or a full-blown gift for music at age 5 or 6. It is purely a DNA blip."

Childhood Depression, Childhood Anxiety

Whether a child suffers from true depression or a kind of anxiety, the condition is serious.

Prior to puberty the equivalent of depression in children is anxiety, Koplewicz says. "When kids are anxious they most probably have similar biochemical issues to teenagers. ... So these anxiety disorders are most likely, in prepuberty, the predisposition to depression."