Depression in the very young: Implication for the teenage years

What is depression? That seemingly simple question is in fact rather complex. To what extent is depression reactive, reflecting life experiences and the way we interpret them? To what extent is depression endogenous, reflecting a physiological process? Both factors are likely to be involved, to a greater or lesser extent, in every episode of depression. Understanding how these interact is crucial for our understanding of depression, how to identify it, how to manage it. Limited understanding in this area has, even in the fairly recent past, negatively affected our understanding of depression in early childhood, and thence our understanding of vulnerability to depression in the teenage years, and our understanding of how to provide effective intervention.

We tend to think of depression as primarily a problem in adolescence. Indeed, it is most commonly first diagnosed in the teenage years (Pile et al, 2020; RCPsych, 2022). But does depression really begin in adolescence – or are we under-diagnosing it in very young children? Increasingly, research suggests the latter.