Children and Mental Health
I was first diagnosed with Major Depression at the age of 12. My mum became concerned when I suddenly started making excuses and faking physical illness so that I couldn’t go to school. I was trying to avoid going to school because it made me sad and anxious. Looking back, my depression had started much earlier in my childhood, but had gone unnoticed and undiagnosed until I subconsciously forced my mum’s hand into getting me to a healthcare professional. In my case there is no sad story, no trauma or abuse to blame. It’s simply a genetic predisposition passed down through my parents.
Mental health used to be a hushed up, not-talked-about subject. No one wanted to admit that they or anyone in their family had “issues”. Thankfully, this is no longer the case and as a society we are more aware and more empathetic to mental health, the effects it has on people and the treatments available.
It is a sad reality that many mental health disorders are present in early childhood, and some symptoms even start manifesting as early as age 3. And I think that as parents we are vigilant to certain behaviours at certain stages in our children’s development. We know that tantrums up until age 3 are normal and just your toddler’s way of trying to assert independence. And we know that at age 12 to 14 our preteens are starting to have hormonal changes which can cause changes in behaviour.
We expect our child to be sad when a loved one or a pet has just died. We anticipate a change in behaviour when we move home or change schools. But we may not pay attention to behavioural changes that fall outside of this “normal behaviour”.
Mental health is an important part of children’s overall health and well-being. Mental health includes children’s mental, emotional, and behavioural well-being. It affects how children think, feel, and act. It also plays a role in how children handle stress, relate to others, and make healthy choices.
Mental disorders among children are described as serious changes in the way children typically learn, behave, or handle their emotions, causing distress and problems getting through the day. Among the more common mental disorders that can be diagnosed in childhood are:
Anxiety disorders: Anxiety disorders in children are persistent fears, worries or anxiety that disrupt their ability to participate in play, school or typical age-appropriate social situations. Diagnoses include social anxiety, generalised anxiety and obsessive-compulsive disorders.
Attention-deficit/hyperactivity disorder (ADHD): Compared with most children of the same age, children with ADHD have difficulty with attention, impulsive behaviours, hyperactivity or some combination of these problems.
Autism spectrum disorder (ASD): Autism spectrum disorder is a neurological condition that appears in early childhood — usually before age 3. Although the severity of ASD varies, a child with this disorder has difficulty communicating and interacting with others.
Eating disorders: Eating disorders are defined as a preoccupation with an ideal body type, disordered thinking about weight and weight loss, and unsafe eating and dieting habits. Eating disorders — such as anorexia nervosa, bulimia nervosa and binge (eating disorder) can result in emotional and social dysfunction and life-threatening physical complications.
Depression and other mood disorders: Depression is persistent feelings of sadness and loss of interest that disrupt a child’s ability to function in school and interact with others. Bipolar disorder results in extreme mood swings between depression and extreme emotional or behavioural highs that may be unguarded, risky or unsafe.
Mental illness in children can be hard for parents to identify. As a result, many children who could benefit from treatment don’t get the help they need. Understand how to recognise warning signs of mental illness in children and how you can help your child.
So, if you notice some behavioural changes in your child that are unexpected and not covered in the regular parenting guidelines; here are some of the warning signs of mental illness in children to look out for and if you notice any of these signs in your child, and the signs go on for more than a few weeks, it’s important to talk with your child and then get professional help.
Emotional and behaviour signs
Your child:
Doesn’t seem to enjoy things the way they used to
As repeated tantrums or consistently behaves in a defiant or aggressive way
Seems sad or unhappy, or cries a lot
Is afraid or worried a lot
Gets very upset about being separated from you, or avoids social situations
Starts behaving in ways that they’ve outgrown, like sucking their thumb or wetting the bed
Has trouble paying attention, can’t sit still or is restless.
Physical signs
Your child:
Isn’t sleeping well or oversleeps
Has difficulty getting out of bed
Has trouble eating or overeats
Has lost or gained a lot of weight
Has physical pain that doesn’t have a clear medical cause – for example, headaches, stomach aches, nausea or other physical pains.
School and social signs
If your child is at school, you might also notice your child:
Isn’t doing as well as usual at school
Is having problems fitting in at school or getting along with other children
Doesn’t want to go to school
Isn’t doing what their teacher asks
Has withdrawn from their friends
Doesn’t want to go to social events like birthday parties or usual activities like sport. It’s important to get professional help as soon as possible if the changes in your child’s mood or behaviour:
Last for more than a few weeks
Are distressing your child
Are affecting their relationships with family and friends
Are affecting your child’s ability to do everyday activities and enjoy life.
There are various professional support options, including:
Your child’s teacher at preschool or school, or a school counsellor
Your child’s GP or pediatrician
A psychologist who is trained to work with children and families
A mental health social worker
Your local children’s health or community health center
Your local mental health service.
When you take your child to a health care professional for support and a diagnosis, describe the behaviours that concern you. Talk to your child’s teacher, close friends, relatives or other caregivers to see if they’ve noticed changes in your child’s behaviour. Share this information with your child’s health care provider.
How do health care professionals diagnose mental illness in children?
Mental health conditions in children are diagnosed and treated based on signs and symptoms and how the condition affects a child’s daily life. To make a diagnosis, your child’s health care provider might recommend that your child be evaluated by a specialist, such as a psychiatrist, psychologist, clinical social worker, psychiatric nurse or other mental health care professional. The evaluation might include:
Complete medical exam
Medical history
History of physical or emotional trauma
Family history of physical and mental health
Review of symptoms and general concerns with parents
Timeline of child’s developmental progress
Academic history
Interview with parents
Conversations with and observations of the child
Standardised assessments and questionnaires for child and parents
Diagnosing mental illness in children can take time because young children may have trouble understanding or expressing their feelings, and normal development varies. Your child’s health care provider may change or refine a diagnosis over time.
How is mental illness in children treated?
Common treatment options for children who have mental health conditions include:
Psychotherapy: Psychotherapy is also known as talk therapy or behaviour therapy. Psychotherapy is a way to address mental health concerns by talking with a psychologist or other mental health professional. With young children, psychotherapy may include play time or games, as well as talk about what happens while playing. During psychotherapy, children and adolescents learn how to talk about thoughts and feelings, how to respond to them, and how to learn new behaviors and coping skills.
Medication: Your child’s health care provider or mental health professional may recommend a medication — such as a stimulant, antidepressant, anti-anxiety medication, antipsychotic or mood stabiliser — as part of the treatment plan. Your child’s provider will explain risks, side effects and benefits of drug treatments. Some practical tips on engaging with your child about their mental health: If you notice a sudden change in your child’s mood or behaviour, encourage your child to talk with you about their feelings, and really listen to what they’re saying. Listening and showing that you care can comfort your child if something is bothering them. And this might be all the help they need. Tell your child that you’ve noticed they seem sad and you want to help. Your child is more likely to talk openly with you about their feelings if you’re accepting and don’t judge or over-react to what they tell you. Tell your child that it’s not unusual for children and adults to feel worried, stressed or sad sometimes.
Tell your child that opening up about personal thoughts and feelings can be scary but talking about a problem with an adult they trust might help. Let your child know that you care for them and you’re ready to listen whenever your child wants to talk. Ask your child what they think might help them feel better. This can help you give or get your child the right support.
How can I help my child cope with mental illness?
You will play an important role in supporting your child’s treatment plan. To care for yourself and your child:
Learn about the illness.
Consider family counseling that treats all members as partners in the treatment plan.
Ask your child’s mental health professional for advice on how to respond to your child and handle difficult behaviour.
Enroll in parent training programs, particularly those designed for parents of children with a mental illness.
Explore stress management techniques to help you respond calmly.
Seek ways to relax and have fun with your child.
Praise your child’s strengths and abilities.
Work with your child’s school to secure necessary support.
