Is My Five Year Old Depressed?   Frank Barnhill M.D.

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Most parents don’t think about kids in this age group being depressed. They just can’t imagine what could occur that would cause depression in a five year old. After all, don’t five year olds just run around playing, eating, and having a good time all the time? I’ve seen really bad stress ulcers in dozens of five year olds that were supposed to be doing those things. And since they weren’t doing those things in a normal way, that brings us to a discussion of what you would notice if your five year old is getting depressed?

The signs of depression in this age group can occur so slowly as to be unnoticeable or so rapidly as to make a parent think their child has some terrible disease. Here are the most common.

Loss of appetite. A five year old eats just about everything he or she wants when they want and where they want. If not, then they truly become irritable and can make your life miserable. Appetite loss in this age group is not normal if it lasts more than two to three days and there is no other illness. This is especially true when it comes to favorite foods such as candy, ice cream or pizza. About 15 % of the time, a depressed child’s appetite will go up when they are stressed and they’ll gain a lot of weight. It’s sort of like adults who pig out on chocolates trying to make themselves feel better.

Complaining of stomach aches. Stress in a five year old usually shows itself as a stomachache. In children older than ten or twelve, they may complain of headaches, but rarely so in five year olds. They associate a stomachache as “feeling bad’. Typically the stomachache occurs early in the day, while being stressed or just before bed. If it happens after eating or is associated with vomiting, then something else is wrong. I’ve seen lots of depressed kids show up with ulcers that were probably caused by stress. Their ulcers showed up on X-ray and there was no infection to cause them. By the way, those children’s ulcers didn’t get better until the source of their stress went away.

Changes in sleep. When your child wants to sleep all the time or doesn’t sleep well at night, it can be disrupting to the whole family. You may have a hard time getting them out of bed or if they’re not sleeping at night, they may be drowsy all day. You have to look at your child’s sleep habits and surroundings before deciding their problem is emotional. It could be they’re having nightmares and really not sleeping well. I saw a child in the 1980’s who fell into this group of poor sleepers. She awoke almost every night screaming and crying with nightmares. Since she couldn’t tell her mom and dad what was scaring her, they assumed she was having emotional problems.

On the second office visit, she finally started crying and told me she was scared of the dog. It was obvious she was upset about this. Her parents told me she had mentioned this before, but because they had no dog and she never played with a dog, they had dismissed it altogether. Eventually we discovered that there was a dog in her bedroom every night. When she barely awoke at midnight, she saw it on the wall in front of her bed. To find out what was going on, I had mom sleep with the child. If the sleep problems were emotional, then having mom around would probably help. Just on time at midnight, the child awoke, screamed about the dog, and pointed at the wall. Since mom was there and no lights were turned on, she was amazed to see a dog on the bedroom wall. Now everything was clear! Mom had hung an ornament in the window above her little girls bed last year. About the time nightmares started, dad had installed a pole light in the back yard to help with nighttime security. You guessed it! It cast the shadow of a dog on the wall.

Changes in energy level. When a mom brings her child in and tells me they normally are so hyper they run around like a proverbial headless chicken and now they don’t do anything but sit and watch television or play video games, I know something’s wrong. Mom does too, or she wouldn’t be asking for help. When children don’t feel well for any reason, they’ll have times of low energy levels. Typically what I hear is “He complains of feeling bad and wants to lay around most of the day, until his friends or cousins come over.” “Then, he’s ready to go out and play.” Kids are sort of like little adults, in that they can find a little energy to do what they wish when they think the activity will make them feel better. So, these up and down energy levels shouldn’t surprise us. If the change lasts more than a few days, look for a reason.

Anger. When five year olds are stressed or blue, they can get angry. They don’t know why they’re angry; they just know their insides don’t feel right.

They become angry over little things that normally wouldn’t matter. Parents sometimes relate their child has become oppositional for no reason. He or she may refuse to take a bath or get in the car to go to the store. These are signs the child feels things are out of his control and feels threatened. Therefore, the child reacts in a typical childhood fashion by displaying anger and feelings of need for control.

Now that we know the most common signs of depression or stress in a five year old, let’s take a look at possible causes. The most common causes of stress and depression in children involve their perceived loss of security. We all have needs that must be fulfilled in order for us to feel good about surroundings and ourselves. There are basic needs for food, water, shelter, but there are also needs for the love of others and knowing that we are cared for and will be cared for in the future. When anything happens that threatens or causes those needs to go unfulfilled, then emotional stress or distress occurs. Events such as divorce, constant parental fights, recurrent sibling fights, a parent losing a job, a death in the family, mom or dad having a bad car wreck, the death of a close pet, having to move to a new town, starting a new school, being physically or verbally abused, and a multitude of other happenings can lead to stress and depression in this age group. Since these kids are too young to understand what’s going on, they may become confused and probably won’t ask questions. This just tends to make the stress worse and sets up cycles of hurt, confusion, frustration, feelings of insecurity, and depression.

Self-help treatments for these age groups don’t work well. If you suspect depression in your child, it is best to seek medical help as soon as feasible. Some children respond well just to talking about their problems and changes in living environments. Others may require medications such as antidepressants. And of course, some may need treatment for ulcers and their stomach pains.

Let’s all work together to help your five year old grow without unneeded stress.

Dr. Frank

These health tips are offered for your common sense use and are not intended to take the place of a visit to your doctor.  Your use of the materials implies your understanding that nothing herein contained represents individual medical advice.

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