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Does My Child Need Help?

What To Know About Children’s Mental, Behavioral, & Emotional Well-Being

While it’s normal for children to occasionally feel stressed or undergo a season of sadness, persistent emotional distress should never be ignored. Here is what every parent should know about their child’s mental, behavioral, and emotional well-being.

Children and Mental Health: A Snapshot

Childhood. It’s the most carefree time of life. It’s a time free of the worries and burdens that plague us as adults, right?

Not always. According to the National Alliance of Mental Illness, about 1 in 5 young people aged 13-18 years has a diagnosable mental illness. One in 10 has a mental health problem severe enough to interfere with their everyday life.

“A common myth is that childhood has no problems. It’s the happiest time of life,” says Dr. Susan McGuire, adolescent and child psychiatrist and medical director at Parkridge Valley Child and Adolescent Campus. “But when we idealize childhood, we minimize the reality that many children suffer.”

child's hands holding alphabet magnets spelling HELP

Mental health disorders encompass a large spectrum of conditions impacting how we feel, think, and act. Among children, some of the most common are anxiety disorders, depression, and ADHD. Of these, the most common is anxiety.

Bringing Issues to Light

When a child has a physical problem like an infection or a broken bone, no one hesitates to call the doctor. However, when a child has an emotional problem like ongoing anxiety or depression, people are less likely to seek professional help. Research shows an estimated 79% of youths between 6 and 17 years old with a mental health issue never receive services.

Unfortunately, neglecting to address an issue can have serious consequences. “The immediate consequences of untreated childhood mental disorders include school struggles, academic failure, drug abuse and other self-medicating behaviors, and even suicide,” says Dr. Kenneth Pittman, pediatric psychiatrist with Agape Youth Behavioral Health.

If left untreated, childhood mental disorders will, in all likelihood, continue into adulthood. And like other chronic diseases, the longer a mental illness goes untreated, the worse it gets. Half of all lifetime cases of mental illness begin by age 14. An estimated 75% begin by age 24.

The good news is, children with emotional issues don’t have to have such grave outcomes. Recognizing a mental illness early in life can change its course. “We know early detection and intervention can mitigate the symptoms of mental illness later in life,” says Donna Maddox, executive director of Johnson Mental Health Center – a division of Volunteer Behavioral Health Care System.

Dr. McGuire agrees. “By treating kids earlier, we can help them have a less difficult road and a better chance at a full life. Early intervention can even prevent some of these lifelong disorders.”

Spotting Red Flags

As parents, how can we tell the difference between normal developmental changes and warning signs of mental illness? Local mental health professionals point to a few important red flags.

The first is persistent changes in behavior. “If your child continues to withdraw from peers and family, shows decreased interest in activities, or shows a significant change in personality, something could be off,” says Dr. Pittman.

Dr. Shelley Salter, Children and Youth IST Program Coordinator at Helen Ross McNabb Center, points to a few warning signs. “Red flags include mood swings, hypersensitivity, persistent sadness, changes in interests, severe anger outbursts, and changes in eating and sleeping patterns,” she says.

The second is severe, or extreme, behavioral changes. If your child’s symptoms begin to affect their ability to function in daily life and/or interact with others, it could be time to get help.

“For example, if a youth who was once outgoing, friendly, and talkative suddenly becomes withdrawn and isolated, it could be part of his or her development. But, if it continues and gets worse, it might be time to talk with a professional,” Maddox says.

Just a “Phase”?

If you think your child or teenager may struggle with a mental illness, initiate a sincere and open discussion. Tell your child what you have observed that is worrying you, and focus on listening without judgement.

Ask if there is anything new going on in his or her life. Share your own insecurities and stories from adolescence to convey your love and commitment.

If your child can’t or won’t disclose more, consider meeting with a trusted second party. Your child’s teachers, coaches, friends, or family members may be able to offer valuable insight. List your concerns and note when problems first began.

If you still aren’t sure whether your child’s symptoms warrant professional help, trust your gut. “I often tell families that they are the best historians. They know their child better than anyone,” says Dr. McGuire.

Be wary of labeling a change as a “phase” or ignoring it. It’s far better to check something out. Go with your intuition and observations, and err on the side of caution. A health professional can relieve your own anxiety and help put your concerns into perspective.

Stay alert to any language that suggests a desire to self-harm and/or any behavior that may endanger your child’s safety. “If your child says things such as ‘I don’t want to live’ or ‘I wish I was dead,’ take them seriously and seek immediate care,” says Dr. Salter. “If they write letters or post on social media about suicide, don’t ignore it.”

Getting the Care You Need

Parents who notice signs or symptoms should begin by taking their child to a trusted pediatrician for an evaluation. Take the opportunity to discuss any disconcerting behaviors and share your observations. Your pediatrician is trained to identify mental health issues, and understands the difference between normal developmental changes and a concern worth pursuing. Your doctor can also search your child’s history for trauma or other conditions that may explain his or her behavior.

In some cases, a pediatrician will give guidance or direct treatment. However, depending on the nature and severity of your child’s concern, he or she may also refer you to a therapist or a specialist (such as a child psychiatrist) for an evaluation.

Mental health concerns can be tricky to diagnose, so don’t be afraid to seek a second opinion. “Many diagnoses can look alike, so it can be helpful to seek help from someone who specializes in children’s mental health. Sometimes a medication for a certain mental health condition can exacerbate symptoms of a different one,” says Dr. Salter.

What are the most common psychiatric disorders in childhood?

Anxiety Disorders

Children with anxiety disorders respond to certain things or situations with fear and dread, as well as with physical signs of anxiety, such as a rapid heartbeat and sweating. Median age of onset is age 6.

Mood Disorders

Children with mood disorders may have persistent feelings of sadness and/or rapidly changing moods. Median age of onset is age 13.

ADHD and Behavior Disorders

Children with ADHD and/or behavioral disorders may have difficulty focusing and controlling impulsive behaviors. Median age of onset is age 11.

Combating Myths and Misconceptions

Myths and misconceptions abound that can keep parents from seeking the care they need. As community members, we must all rally to combat these to safeguard the health of our children.

For example, one damaging and inaccurate assumption is that mental illness in children is all about parenting. “While today’s culture has room for improved parenting, the assumption that children’s behaviors are due to poor parenting is often false,” says Dr. Pittman. “Society needs a better understanding of the role biology plays in children’s mental health conditions.”

Maddox agrees. “Mental illnesses, like other chronic diseases, have multiple causal factors, including heredity and environmental influences. Assuming that it is all about parenting is not only inaccurate, but can be damaging.”

Another myth is that children who see a doctor for mental illness will always be put on a medication. This simply isn’t true.

“Medication plays a role in some situations, but even when needed, the best course of treatment is combined therapy and medication,” says Maddox. “Support for the child and family is crucial. This may include case managers or behavioral intervention specialists working with the family in the home and community.”

Advocating for Youth

Boosting awareness for mental health concerns takes a village, and it’s never too late to start advocating for children. To learn more about mental health in children, consider taking a class in Youth Mental Health First Aid. Youth Mental Health First Aid USA is an eight-hour public education program available at locations across the U.S. and throughout our area. The course introduces common mental health challenges for youth, reviews typical adolescent development, and teaches a 5-step action plan for how to help young people in both crisis and non-crisis situations. “It gives the community tools to support our children and youth and provide opportunities for intervention,” says Maddox.

Don’t wait. Visit mentalhealthfirstaid.org to sign up today!

Good Questions to Ask:

  • Are my child’s problems interfering with his or her ability to function normally in everyday life?
  • Is my child having a hard time in situations where they used to be OK?
  • Do my child’s problems seem to be getting worse?
  • Is my child often distressed and cannot be soothed or comforted?

Dr. Susan McGuire

Medical Director, Parkridge Valley Child and Adolescent Campus

Dr. Kenneth Pittman

Pediatric Psychiatrist, Agape Youth Behavioral Health

Dr. Shelley Salter

Children and Youth IST Program Coordinator, Helen Ross McNabb Center

Donna Maddox

Executive Director, Johnson Mental Health Center - a division of Volunteer Behavioral Health Care System

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