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Depression Affects Kids as Young as 3

When Preschoolers Are Depressed, Play Therapy, Not Medication, Is in Order, Researchers Say

Depression in Preschoolers: Seeking Help

Where should worried parents turn for help? "You could go to the pediatrician, but you might have to educate your pediatrician a bit," Luby says, noting that not all are aware that depression can strike as young as age 3.

Parents might also seek help from a mental health provider, she says.

Although antidepressant medication is a mainstay of treating adult depression, it should never be given to preschoolers, she says. "Absolutely not to medication," she tells parents. It's not been tested in young children.

''Psychotherapy is recommended," she says, "in the kids' case, play therapy."

Luby is in the process of testing a modified version of a treatment called Parent-Child Interaction Therapy or PCIT that was originally designed for children with a conduct disorder.

In PCIT, parents of children with conduct disorders are taught to work with the child to improve pro-social behavior and reduce negative behavior. Luby is testing a version that focuses on teaching parents to enhance a child's emotional development. The thought is that early changes in emotional development skills could help with the depression.

She is hoping that early intervention will prove more effective than waiting and that the gains will be sustained in later childhood. She is studying the approach with 300 children, including some with depression, some with other mental health issues, and some healthy comparison children.

Depression in Preschoolers: More Perspective

Early intervention for depression in preschoolers is crucial, says Bernadette Melnyk, PhD, RN, dean and Distinguished Foundation Professor in Nursing at Arizona State University, Phoenix, and an advocate for teens' and children's mental health. She reviewed the update for WebMD.

Parents should be aware that some young children with depression are initially misdiagnosed, she says. "Because young children with mood disorders can get restless, hyperactive, and irritable when depressed, misdiagnosis -- for example, ADHD -- is common," she says.

The risk of depression in preschoolers is higher, when parents have a history of depression, she says.

Ignoring or denying depression at any age is hazardous, Melnyk says. "It is critical to assess for and identify depression in children of all ages so that early interventions can be implemented."

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