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How to Spot Mental Health Issues in Children: A Guide for Parents

father sitting with daughter crying on bed

No parent wants to witness their child suffering—for any reason. But mental illness can be exponentially more difficult to watch because you can’t see or comprehend the source as you could with a fever, for instance.

Plus, it’s tough to tell if your little one is on the mend or still suffering in silence.

Mental disorders among teens and young adults have been rising steadily for the past decade. The reasons could be environ – mental (i.e., family, school, and social media), situational (i.e., a traumatic event), physical (i.e., hormones and genetics), or a combination of these. While science tries to pinpoint the causes, consider this: About 17 percent of children and teenagers have a mental health disorder, according to JAMA Pediatrics.

Now some good news: Early detection and intervention can save years of hassle and heartbreak. So it’s important that parents know how to recognize the stealthy signs of mental illness.

Where to begin? Right here.

How to Determine If Your Child Needs Mental Health Help

One of the biggest challenges for parents is recognizing the difference between a psychological issue and the normal developmental changes that happen during these formative years, says Mark A. Stein, PhD, a psychologist at Seattle Children’s Hospital and a Genomind Scientific Advisory Board member.

Parents often either overinterpret a supposed sign and conclude there’s a problem, or dismiss a change in behavior as “a bad week.”

To be a good mental health first responder for your child, Dr. Stein suggests looking at his or her behavior in three areas: home, school, and social groups. Consider the following to help you determine whether you should seek help.

Family Functioning

It’s normal for family members to squabble and for kids to push back against parental rules. But if your child is suddenly getting into frequent or escalating conflicts with family members that don’t get resolved, that’s a warning sign of a potential problem. For example, the dual-diagnosis of anxiety and OCD in children has been associated with higher levels of family conflict.

Academic Functioning

School is a major portion of any child’s life, so significant changes in grades or attitude about class or homework that are out of the ordinary should raise a red flag. Teacher input is often a helpful first step.

Social Functioning

Is your child struggling to get along with friends and classmates? Has she withdrawn from or become reluctant to participate in social activities? If yes, those are all warning signs.

If your child is having issues in any of these areas, seek help. This is especially true if their behavior doesn’t match their development level. For example, it’s normal for a 3-year-old to have frequent tantrums, but not an 11-year-old.

Common Symptoms of Mental Illness in Children

Psychological and psychiatric problems can largely be divided into two areas: externalizing or internalizing, says Dr. Stein.

As you might guess, externalized behavior problems are easier to spot because signs include things you can see: behavioral changes, fighting, hyperactivity, destructive behavior. Internalized problems are often emotional, such as depression, and thus much more difficult to spot.

Here are six symptoms to watch for.

Mood Changes

All children are prone to mood swings. But pay attention if your child’s mood dips to the point where she seems very sad for a week or does not look forward to things she used to enjoy.

Intense Feelings of Anxiety

Be alert for a child who’s overly anxious, especially if it leads to physical symptoms like a racing heart. While a little bit of anxiety is normal and can be a good thing—if it motivates your child to study or practice, for instance—“too much impairs performance, and children really suffer,” says Dr. Stein. Two easily overlooked physical signs: unexplained headaches or stomachaches.

Difficulty Concentrating

A teacher might report that your child is having unusual trouble sitting still or paying attention, or you may notice this problem at home.

Changes in Eating or Sleeping Habits

If your child is suddenly suffering from insomnia—or, conversely, tries to sleep all day—it could be a sign of depression. Same goes for a loss of appetite.

Quick Weight Loss

A noticeable lack of appetite or quick weight loss could point to an eating disorder, particularly in teens.

Experimentation with Illicit Substances

Many teens try cigarettes, alcohol, and drugs. If this behavior coincides with declining grades or a change in peer group, it’s cause for alarm, says Dr. Stein.

When to Worry About Suicide

“There’s been a marked increase in suicide attempts and suicides among children and youth,” says Dr. Stein.

In fact, suicide is now the second-leading cause of death for Americans between the ages of 10 and 24, according to the Centers for Disease Control and Prevention.

The biggest red flag for parents: changes in mood or behavior, such as becoming increasingly isolated and withdrawn, or expressing feelings of hopelessness. Kids’ behavior changes like the weather, but watch for drastic shifts—like a calm kid suddenly getting into fights or being unusually disruptive at school.

If the behavior includes the use of or a preoccupation with weapons, or any threat of harm to themselves or others, call your doctor right away. Likewise, if you are concerned that your child may harm themselves, call 911 or go to the emergency room immediately, says Dr. Stein.

“Be even more aware if you know your child is prone to impulsivity,” Dr. Stein says. In addition, watch carefully if there have been publicized cases of suicide near you, as it’s not uncommon for young people contemplating self-harm to be pushed closer when they hear of other cases.

What to Do If You Suspect a Mental Health Problem

If you believe your child is struggling with anxiety, depression, or another psychological issue, make an appointment with your pediatrician or family doctor first, says Dr. Stein.

“This is someone who knows your child, has a sense of them over time, and also knows your family,” he says.

Your doctor will help you decide if you should seek an evaluation from a mental health professional, such as a psychologist, psychiatrist, or neurodevelopment expert.

“A diagnostic evaluation is important for understanding how to treat any psychiatric disorder,” says Dr. Stein. “The first step in treatment is a diagnostic evaluation, which should identify appropriate, personalized targets for treatment and an evaluation strategy. We’re constantly striving to develop more precise ways of diagnosing individuals to really guide our treatment.”

Dealing with a child who may have a mental illness is challenging, but there are good options for both therapy and medication. And remember, seeking help sooner rather than later is more likely to lead to a successful outcome for your child and family.

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