depressed preschool child holding a teddy bear
Child Therapy

Guest Blog: Mental Health of Preschoolers

Signs of Depression and Anxiety in Young Children

Therapy? For a 3-year-old? They are so young.

What could they possibly be depressed or anxious about?

I often get these questions from friends and family who find out that I work with young children. The reality is that kids as young as 3 are being diagnosed with serious mental health conditions, including anxiety and depression. Current research estimates about 2% of preschoolers meet criteria for depression or anxiety. 

While symptoms may be present before age 3, practitioners refrain from giving an official diagnosis until at least age 3 due to the fact that enough research exists at that age for practitioners to better distinguish behavior outside the norm. Even then, an official diagnosis is not often given until the child reaches school age and more diagnostic tools are available.

An official diagnosis can possibly be avoided if the symptoms are caught early and treated. 

It’s imperative to not wait for a child to “grow out of” certain behaviors if they can be indicative of underlying mental health issues.

The longer a disorder goes untreated, the harder it is to treat.

We now know that untreated symptoms of depression and anxiety in preschoolers is a predictor of children meeting full-blown depression and anxiety criteria later on in life. 

Who Is At Risk

Current research suggests the following factors increase a preschooler’s risk of developing depression or anxiety disorders: 

  • Having an immediate family member(s) with a history of depression or other mood disorders
  • Having a chronic or severe medical condition
  • Early stressful life event(s)

When To Consider Help

Like the rest of us, preschoolers often experience life changes (i.e. divorce, loss, moving) that may bring up intense feelings and take some time to adjust to. Usually, changes in behavior due to such an adjustment will subside fairly quickly.

If symptoms persist past 1-2 months and/or are causing chronic trouble at school or home, it may be time to reach out to your pediatrician or a child therapist.

Either of those professionals can help you decide if treatment is needed. They can also help you navigate the difficult period. 

Symptoms To Pay Attention To

Note that one symptom is not usually a cause for concern. It would be the presence of several symptoms and their impact on the child’s ability to function at home, school and/or in social situations. 

Depression in Preschoolers

  • A regression in skills: wetting bed again (if potty trained), thumb sucking, “baby talk”
  • Loses interest in playing 
  • Sleep is schedule off – possibly napping more
  • *Expression of excessive guilt – apologizing for things they did not do, continuing to apologize long after event 
  • Changes in weight or appetite
  • *Frequent irritability,  “tantrums” or “meltdowns” (A hard one to decipher between what’s age appropriate and what’s outside the norm!)

*Seen together are stronger indicators

Anxiety in Preschoolers

anxious preschooler bitting his nails

  • Trouble falling and staying asleep 
  • Excessive worrying
  • School refusal 
  • Frequent urination
  • Complaints of a stomach ache
  • Frequent irritability
  • Frequent “tantrums” or “meltdowns” (A hard one to decipher between what’s age appropriate and what’s outside the norm!)
  • Body-Focused Repetitive Behaviors (BFRBs): Recurring behaviors often seen in those aiming to reduce anxiety. Some common ones being skin picking, pulling hair out or nail biting

This list is not exhaustive, nor are the symptoms limited to anxiety and depression. However, being aware of them and having an open dialogue with your pediatrician is key. Catching preschool onset of depression and anxiety disorders can prevent years of further suffering. There are several evidence-based therapeutic interventions that could be implemented to prevent the prolongment and severity of symptoms. 


About The Author

Brittany LaFleur, Child therapist

Brittany LaFleur is a Licensed Clinical Professional Counselor (LCPC) in Chevy Chase, MD and founder of Your Best Self Therapy. Brittany obtained her Bachelor’s degree in Psychology with a minor in Family Sciences from the University of Maryland. She then went on to earn her Masters of Science in School Counseling from Johns Hopkins University. After practicing as a school counselor for a few years, she went back to Johns Hopkins to earn her Certificate in Mental Health Counseling. In private practice, her interest and expertise lies in treating young children through play, as a  Registered Play Therapist (R-PT). She also works with teens and young adults navigating life transitions, anxiety, depression and/or trauma integration. She is a Certified Child and Adolescent Trauma Therapist. 

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