As a parent of a child whose moods are strong and sometimes swift or unrelenting, you’re faced with a situation that doesn’t always have a clear solution. In some cases, lifestyle changes may be sufficient to help your child manage their emotions. But in others, your child may need therapy, medication, or both.
“Healthy habits are important for children’s well-being, and even for improving their mood,” says Rebecca Baum, MD, chief of developmental and behavioral pediatrics at Nationwide Children’s Hospital. “Good nutrition, exercise, and meaningful relationships are often components of a treatment plan for anxiety or depression.”
And for good mental health, sleep is important. “Many kids aren’t getting enough sleep,” Dr. Baum points out. “Or their sleep is disturbed by electronics and lack of routine. So working on these lifestyle changes is key.”
If you haven’t already, there are some approaches you’ll want to try before turning to medication.
Look at Your Child’s Diet
Studies show that good nutrition can play an important role in alleviating mental health problems in children. One of the best ways to get started: Say goodbye to fast food. People who pull into the drive-thru are 40 percent more likely to develop depression than those who don’t, according to a study in Public Health Nutrition.
On the other hand, a Psychosomatic Medicine study with more than 45,000 participants revealed that healthier eating reduced symptoms of depression. While this research was done in adults, making sure your kid’s diet is filled with lots of fruits and vegetables might help with a reduction in symptoms.
Get Serious About Sleep
A good night’s sleep is one of the most important pieces of psychological health, especially for kids. Researchers at the University of Houston found that kids who skimp on sleep experience more negative emotions, less pleasure from positive activities, greater memory problems, and less impulse control—all of which play a part in their mental health.
While the amount of sleep is important, the quality of that sleep is too. Make sure your child’s bedroom is conducive to restful sleep. Ideally, it is quiet, dark, and cool. Also check in with them in the mornings to see if they feel rested or not.
Increase Physical Activity
If your child would rather spend the afternoon on the couch, encourage them to move more—go on a walk, dance, or take active breaks. Research finds that exercise can prevent or delay the symptoms and the onset of many mental health disorders. A study in Pediatrics, for example, showed that children who increased their physical activity over the span of two years showed fewer symptoms of depression.
Enlist Professional Help
Meeting with a clinician—a psychiatrist, psychologist, or licensed clinical social worker—can be an effective way for kids to understand their problems, change their behavior, and make positive changes in their lives.
“Therapy can be extremely helpful for developing coping skills, reducing stress, and ultimately changing the way kids think about facing challenges,” says Dr. Baum. “Cognitive behavioral therapy (CBT) has been shown to be effective for treating anxiety and depression in children. It helps kids identify thought patterns that contribute to feeling down or scared, and helps them try new behaviors that lead to different outcomes.”
There are many different kinds of therapy, which are usually keyed to a child’s developmental stage and particular issues. Younger children often do well with play therapy, while older kids may be more likely to respond to CBT, dialectical behavior therapy (DBT), or group therapy. Sometimes, the clinician will combine different types of therapy for the best outcome.
5 Steps to Take When Deciding Whether to Treat Your Child with Mental Health Medications
If you’ve tried the strategies above and your child is still struggling, it may be time to move on to the next phase of treatment: medication.
“Medication can be very helpful, and we often consider it when symptoms are interfering with a child’s functioning,” says Dr. Baum. “But because children’s brains are still developing, we don’t take prescribing these medications lightly.”
Thinking about medication for your child? Think carefully, says Dr. Baum. “Brain development continues into early adulthood, so it makes sense to be cautious about using medications in children. The available evidence suggests that these medications are safe for use in children and that they can potentially help kids who face significant problems with anxiety or depression.”
But before you make that decision, she says, know what to expect. Arm yourself with information—and ask all the questions you can. Here are five steps to take.
1. Start with Your Child’s Pediatrician or Family Doctor
Next to you, that’s the person who knows the most about your child’s health. Plus, the pediatrician is a professional who can spot behavioral health disorders.
“Pediatricians are trained to treat the whole child, and they can screen for psychological problems,” says Mark A. Stein, PhD, a psychologist at Seattle Children’s Hospital and a Genomind Scientific Advisory Board member. “Mental health problems don’t happen in isolation, and there are lots of physical issues, like sleep disorders and poor nutrition, that can contribute to behavioral issues.”
If your pediatrician or family doc discovers any complex mental health issues, they’ll know whether it’s time to call in a child psychiatrist or other mental health specialist. “Pediatricians have connections with behavioral specialists and keep lists of referrals at their fingertips,” says Dr. Stein.
Therapy can be another tool that is integrated into your child’s mental health journey. For some issues, like attention deficit hyperactivity disorder (ADHD), schizophrenia, and bipolar disorder, medication may be the first line of treatment with therapy as a very helpful addition.
For other conditions, like anxiety or depression, a combination of medication and therapy seems to be more effective. In milder cases, medication may not be needed.
2. Expect a Thorough Examination
Before the doctor prescribes medication, your child will probably be given a complete examination, including a thorough medical history. Starting a psychiatric medication is a big step. “We don’t take it lightly,” says Dr. Baum.
Some medications, like those used for bipolar disorder, may have risks of side effects that might affect your child’s cholesterol or glucose levels, or even their kidneys. That makes it important to assess your child’s health and track their height and weight. For those medications, your doctor might recommend lab tests or heart tests.
Medications like selective serotonin reuptake inhibitors (SSRIs), which are used to treat depression and anxiety in children, don’t usually require lab work.
The type of checkup your child gets will depend on the diagnosis and the prescription that’s being considered. Be sure to ask your doctor what type of evaluation is needed for your child, and about any tests they should get.
During this time, you may also want the clinician to perform pharmacogenetic (PGx) testing to help personalize your child’s mental health treatment. Genomind’s PGx test looks at 24 genes related to mental health treatment. It provides guidance across 10+ mental health conditions and 130+ medications to help your clinician determine:
- Which medications will likely be the most effective
- Which medications may have side effects
- How you metabolize medications for personalized dosing guidance
3. Ask Questions
You’ll likely have dozens of questions—and that’s good. It’s always important to have a discussion with the clinician about the potential benefits and risks of any medication you’re considering for your child. Go to the appointment prepared to ask away. Some of the things you may be wondering about include:
- What is the name of the medication? Is it ever called by different names?
- How will the medication help my child?
- How soon will it start to work?
- Is this medication addictive, or can it be abused?
- How often will you check my child’s progress?
- What side effects should I look out for?
- How long will my child need to take this medication?
- How can I reach you if I have a question or if my child has a problem with the medication?
Still feeling uneasy? If the clinician dismisses your questions or if you have any other reservations about treating your child with medication, remember that you can always seek a second opinion, which your insurance plan may cover.
4. Keep Your Child Involved
The more you can engage your child in the process, the better things are likely to go. “I like to involve the child in the decision because, in large part, we need to rely on how he or she is feeling after taking the medication,” Dr. Baum says. “Sometimes it’s good to make the decision in steps. I might say, ‘We can try counseling, and if that doesn’t work, then maybe we’ll try medication.’”
Often, after beginning medication, clinicians may use a questionnaire that a child completes to help monitor the drug’s effectiveness.
5. Continue Positive Lifestyle Changes
Even with medication that works well, a healthy diet, plenty of quality sleep, and regular exercise are all still important for your child’s physical and mental health. Keep up or start these healthy habits for optimal treatment.
Does Your Medication Work for You?
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