Since the beginning of the COVID-19 pandemic, mental health has been in the spotlight more than ever. We have seen the impacts of changing routines, limiting activities, and avoiding socialization, and this is especially true in children. As things begin to get back on track, it’s important to keep kids’ positive mental health as a priority so that the next generation can thrive.
What is mental health, really?
Mental health is usually in the news in a negative light, but it’s really just an aspect of a person’s overall health and isn’t always bad. Mental health includes your emotional well-being and influences your behavior, good and bad. In children, it also is closely tied to their development – how they cope with new experiences and feelings, developing healthy coping skills and the ability to make healthy choices. ¹
The Centers for Disease Control and Prevention (CDC) report that most children, from toddlers to older teenagers, regularly display signs of positive mental health. The indicators that are monitored shift with age. For instance, the markers for positive mental health in children ages 3-5 years can include: ²
Resilience (ability to recover quickly)
In children ages 6-17 years, the markers observed include: ²
Mental disorders, meanwhile, are when there is a serious change to that development, affecting their ability to learn, behave, interact with others, cope with feelings, and even just get through the day. Some common disorders include: ³
Conduct Disorder (CD)
Attention-Deficit/Hyperactivity Disorder (ADHD)
Obsessive-Compulsive Disorder (OCD)
Post-traumatic Stress Disorder (PTSD)
ADHD, anxiety, behavior disorders, and depression are the most diagnosed disorders in children; these disorders can often occur simultaneously in a child, and the occurrences of them (or at least the diagnosis of them) as increased over time. Depression in children is most likely to be addressed with treatment, while other disorders are more likely to go untreated. There is also a wide variance in when a child is most likely to be diagnosed, by age. Depression, for instance, is more often diagnosed in teenagers, while behavior disorders are usually diagnosed when between 6 and 11 years old. ²
When is it growing pains and when is it something else?
It’s important to remember that it’s normal for children to experience anxiety, sadness, anger, or stress, and those feelings don’t necessarily mean that there is a disorder in play. Kids have big feelings and it takes some time to learn how to cope with them; there are also a lot of external influences that can rightly cause stress – being away from parents in a new space, an illness of a close family member, or even little things like not being able to find a favorite pair of socks. Healthy mental development will mean that these stressors will be short-term, and the child will outgrow most of those fears, feelings, and reactions.
While extreme emotional swings and periods of acting out are part of the growing pains of childhood, they can also be signals of something else.
As a rule of thumb, you should consider seeking help for your child if their changes in behavior or emotions last more than a few weeks or is getting in the way of day-to-day life at work or at home. If you or your child are worried sooner than that, there’s nothing wrong with seeking help before the two or three week mark; in fact, some situations call for immediate action. If your child is talking about harming themselves or others, get a professional involved right away. ⁴
Different mental disorders have different warning signs, though there is overlap. It’s important to pay attention to your child’s actions and emotions so that you are aware if they shift outside of the norm.
Anxiety & Related Disorders
Anxiety is a common reaction to something that we see as dangerous or generally negative for us. The concern is when the feeling of anxiety doesn’t match up with the reality of the danger. Consider seeking help for your child if they: ⁵
Worry about being separated from parents or other family members
Extreme fear of very specific things, such as spiders or the dentist’s office
Fear social activities (school, a crowded playground) or going to new places
Have a hard time functioning because extreme worry makes it hard to function
Think that repeating certain thoughts or actions will stop something bad from happening
Signs of anxiety can go unnoticed easily, as many children may keep their worries to themselves. They can also manifest as a physical symptom, like a headache or trouble sleeping. ⁶
Being sad or unmotivated is part of life – being depressed is not. Depression is long-term feelings of sadness or hopelessness, and it can lead to a person no longer enjoying things that used to bring happiness.
Consider taking action if your child is experiencing: ⁵
Long-lasting mood changes or swift shifts in mood. Depression in adults often shows as sadness, but children are more likely to show symptoms by being irritable.
Changes in sleeping habits. This could be difficulty falling or staying asleep, but it’s more often sleeping too much.
Changes in appetite
Lowered energy or self-esteem
Thoughts or talk of self-harm
Depression can go unnoticed or misdiagnosed because children often don’t seem sad like a depressed adult may be. The changes in mood and activity can lead to a child being thought of as a troublemaker or as lazy instead of getting the help they need. ⁶
Behavior Disorders ⁷
Unlike depression and anxiety that are mostly internalized, behavior disorders are considered externalizing disorders because the child is generally acting out toward others. These disorders are generally diagnosed as a child (before the teenage years) and are often most visible to people close to them, as those are the people most likely to experience the disruptions, defiance, or bad conduct.
Some behaviors that could indicate a disorder include a child often:
Being angry or losing their temper
Arguing with or pushing back at rules or requests made of them
Being spiteful, resentful, or aggressive – especially aggression that causes harm to others
Purposely annoying others around them
Blaming other people for their mistakes or actions
Breaking serious rules
Purposely lying, stealing, or damaging others’ things
What should I do if I think my child has a mental disorder?
The first step to take if your child is showing symptoms of a mental disorder is to talk to their healthcare provider. If your child is diagnosed with a disorder, there are generally two avenues to take for treatment: psychotherapy and medication.
Psychotherapy can help children process what they’re feeling and address concerns by talking with a psychologist or other mental health professional. This could also include playing games or doing activities while they talk. This process can help kids learn to recognize their feelings and develop healthy ways to respond to and cope with them. ⁸ Therapy doesn’t look at the feelings on their own – external factors can influence mental health, so looking at social, cognitive, and biological identity alongside culture, language, and more is essential at forming a well-rounded picture. ⁹
Looking to find a psychologist for your child? Psychologists for children are in touch with hospitals, pediatricians, and adult psychologists, but you can also often find options by contacting your school or a community health center. ⁹
Like mental conditions in adults, medication can provide stability to a child experiencing a mental disorder. The medication recommended will vary with the diagnosis, and many mental health medications can take some trial and error to find the right fit for you. Some common types of medication for mental disorders include:
There are risks and side effects that go along with the benefits of medication, so be sure to talk everything through with your child’s healthcare provider so you know what to expect and what concerns to watch for.
What YOU can do to help your child.
Your child can’t take care of their mental health alone. Having support at home is essential for improving your child’s mental health. Some steps you can take to care for your child (and for yourself!) include:
Learn about the illness. It’s hard to help when you don’t understand what’s going on with your child and know symptoms to watch for.
Get counseling. Treatment is stressful for everyone involved, but family counseling can help support and guide you all on the journey.
Get help. Whether it’s advice on handling difficult behavior or training on appropriate responses, there’s nothing wrong with reaching out to people who are experienced in this area. This also means knowing when your child may need more help than what you can give.
Don’t just focus on the disorder. Take time to have fun with your child, and make sure they know their strengths. It’s easy to focus on the negative, but make sure everyone sees the positive, too.
Your child can’t have positive overall health without positive mental health – though many disorders are out of anyone’s control, many others are preventable. It all starts with being observant, taking warning signs seriously, and making sure you have a great support team (like your local pharmacy!) that knows you and is available to help.