She cries for hours, and nothing works. Not the swaddle, not the bounce, not the car ride at midnight.
Or he is two, and the tantrums are not tantrums anymore. They are storms that last an hour and leave you both shaking.
Or maybe it is quieter than that. Your baby rarely looks at you. Rarely reaches. Seems far away.
And everyone keeps telling you it is a phase.
Sometimes it is. But sometimes a very young child is telling you something important in the only language they have.
The short answer: Yes, infants and toddlers can have emotional, relational and behavioral difficulties that deserve real attention. They show up through sleep, feeding, crying, sensory reactions, play and relationships rather than words. Specialists assess them with a diagnostic system built specifically for ages 0 to 5, called the DC:0-5, and early support works best while the brain is growing fastest.
The signals worth noticing
- Sleep struggles that persist despite good, consistent routines
- Feeding or latching aversion with no clear medical cause
- Crying that rarely settles, or a baby who seems unusually hard to soothe
- Strong reactions to sound, touch, textures or clothing
- Intense separation anxiety, or fearfulness in every new situation
- Persistent sadness, withdrawal, or loss of interest in play
- Aggression, very long meltdowns, or trouble with attention and activity level
- Differences in social communication, such as limited eye contact, pointing, or response to their name
One of these on a hard week is normal. A pattern that lasts, intensifies, or takes over family life deserves a closer look.
How do you evaluate a 14-month-old?
Not with adult criteria squeezed down to fit. The DC:0-5, the Diagnostic Classification of Mental Health and Developmental Disorders of Infancy and Early Childhood, uses developmentally specific criteria and looks closely at the caregiving relationships that hold a child. The University of Washington's Barnard Center notes it is recommended by CMS and SAMHSA.
A thoughtful evaluation watches your child in real routines, gathers developmental and medical history, considers sensory and developmental factors, and pays attention to how you and your child regulate each other.
A diagnosis is a description, not a life sentence
At this age, a diagnosis describes what is happening in your child's nervous system and relationships right now. Its job is to point toward support. It is not a label your child carries forever.
And you are part of the picture, not because you caused anything, but because your exhaustion matters too. The CDC reports that anxiety, behavior problems and depression are among the most commonly diagnosed mental health conditions in children. Early help changes trajectories.
How I care for little ones
At Dr. Joanne Psychiatry, children from birth to 5 are enrolled as patients in their own right through maternal-infant and early childhood mental health care. We meet by secure video, at home, where your child is most themselves. I do not prescribe medication to children under 4. The work is understanding what is driving the struggle, whether sensory, medical, relational or developmental, and coordinating with your pediatric provider.
Frequently asked questions
Can a baby really be depressed? Infants can show withdrawal, low engagement and poor responsiveness that deserve assessment, often alongside stress in the caregiving environment.
Will my toddler have to sit still on video? Never. Watching your child move, play and protest tells me what I need to know.
Do I need my pediatrician's referral? Not to book. Coordinating with your pediatric provider is part of good care.
Written by Dr. Joanne Patterson, DNP, MSN, PMHNP-BC, APHN-BC, board-certified Psychiatric Mental Health Nurse Practitioner. About Dr. Joanne
This article is educational and is not medical advice. If your child is in danger, call 911. For a mental health crisis, call or text 988.
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