Is Your Child's Mental Health On Track?

Refusing to take part in an activity. Throwing a temper tantrum. Ignoring directions or rules. Some behavior problems are a part of normal child development. But just like adults, children can have mental health disorders like anxiety or ADHD that interfere with the way they think, feel, and act.

Children's mental health is just as important as their physical health. When untreated, mental health disorders can lead to school failure, drug abuse, violence, and even suicide. Mental, behavioral, or emotional disorders can also affect your child’s future in less extreme ways that still impact their everyday lives – such as their personal relationships or work life – so it’s important to be proactive with your child's mental health.

Part of protecting your child’s mental health can include seeking the guidance of a behavioral health professional. But how do you know what signs to look for and what to do next? We answer parents’ most common questions about kids’ mental health below.

How do I know if my child's problems are serious?

Problems deserve attention when they are severe, lasting, or affect your child’s daily activities. Seek help if your child:

• 

  Is often sad, worried, or fearful

• Has major changes in appetite or sleep needs
• Experiences a marked change in weight or eating, either up or down
• Is spending most of his/her time alone instead of with friends or family
• Has lower grades or less interest in school
• Is hyperactive, impulsive, or has trouble focusing
• Is self-destructive or overly aggressive toward others
• Is intentionally harming animals

A child who is struggling might also spend more time on social media or alone, have trouble falling asleep, talk less, or make less eye contact than normal. If you notice persistent symptoms for more than two weeks, reach out for help right away.

Which mental disorders are often seen in children and teens?

• Anxiety disorders. These are the most common mental health problems in children and teens. They include panic disorder and generalized anxiety disorder. Over 7% of children have diagnosed anxiety.
• ADHD (attention-deficit/hyperactivity disorder). ADHD is the most common neurobehavioral disorder, affecting 7.2% of children. Symptoms include poor attention and focus. Children with ADHD are easily distracted and act on impulse.
• 

  Depression and other mood disorders. These disorders affect mood, energy, interests, sleep, appetite, and overall functioning. Symptoms are extreme and are seen most days of the week. They can greatly interfere with the ability to function at home or at school. 3.2% of children are diagnosed with depression. Only 60% of children with depression are currently receiving treatment.

• Eating disorders. Eating disorders include avoidant and restricted food intake, anorexia, bulimia, binge eating, and PICA (eating non-edible objects). About 5% of children struggle with eating disorders, particularly girls. Student athletes who have to have set weights for competition are also more susceptible.
• Autism spectrum disorder. Autism spectrum disorder impacts a child’s ability to make friends, participate in imaginative play, understand others’ emotions, handle changes in routines, use gestures, and process senses like loud sounds. Autism is estimated to affect 1 in 54 children. Children are often diagnosed around 4 to 5 years of age – though diagnosis can occur as early as 18 months.  

Where should I go for help?

First, schedule an appointment with your child’s primary healthcare provider or pediatrician. The doctor will first rule out any physical health conditions that could be causing the symptoms. They may also advise you to take your child to a psychiatrist, psychologist, licensed clinical social worker, or behavioral therapist.

If your child goes to school, the school's staff (counselors, school psychologists, and teachers) may become important members of their treatment team.

How are mental disorders diagnosed in young children?

A mental health provider will make the diagnosis. This includes taking a detailed family history, writing down your child's developmental history, and monitoring current symptoms. Standardized assessments, such as questionnaires or observations, may also be done.

A skilled mental health provider will then analyze all the information. If certain diagnostic criteria are met, they will make a diagnosis based on your child's age and personal reports from you as well as other caregivers or teachers.

How are children with mental health problems treated?

Sometimes psychotherapies, behavioral strategies, classroom strategies, and family support may be all a child needs. In other cases, medicines and family therapy are needed to help them cope. If medicine is prescribed, your child should be watched and assessed regularly. If family therapy is recommended, it's important to keep all appointments for the length of therapy suggested for your child.

If your child's mental health problems directly interfere with school performance, special laws will allow reasonable school accommodations for their needs, like preferential seating, reduced homework, and visual aids. These protective laws fall under the Americans with Disabilities Act (ADA) and Section 504 of the Civil Rights Act. Talk with your child's teacher and principal to see if these legal protections apply to them.

Most children who receive the right kind of help get better. They go on to live full and healthy lives as adults. Getting help early is key to a positive result.

What else can parents do to support?

Use these helpful tips from Dr. Michael Lucido, PhD, a clinical psychologist at Munson Healthcare Charlevoix Hospital:

Help your child build habits that support mood (as well as their physical health):

• Exercise. It’s recommended that children and adolescents get 60 minutes of moderate to vigorous exercise each day. Movement doesn’t only help our physical health. It can also help regulate mood, increase self-esteem, and improve concentration.
• Healthy foods. Encourage balanced meals, including fruits, vegetables, whole grains, and proteins. Don’t skip meals, including breakfast and snacks, and limit highly sugary foods and beverages.
• Sleep. School-aged children need 9-12 hours of sleep every night; teens need 8-10 hours. Encourage good sleep hygiene or bedtime routines that promote relaxation and rest. This may include a warm shower, limiting screen time, and a consistent bedtime.

Recent studies have linked greater screen time with anxiety and depression among children and teens. Socializing is a helpful and healthy behavior, but communicating by text or social media can make your child feel more cut off from others. Encourage face-to-face time with friends and family and consider creating a family media plan to help guide and promote healthful media use.

For anxiety:

Your child may have a hard time problem-solving when actively anxious, so when they are calm, encourage conversation. Seek to understand. Find out what is worrying your kids and help them make a plan.

You may need to reach out for help if you learn your child is being bullied or struggling with a major life event like a death in the family or a divorce. Help them identify and practice strategies to cope with more routine anxieties. The American Academy of Pediatrics recommends the following approaches:  

1. Practice deep breathing and muscle relaxation. Breathing in through the nose for four seconds, holding for two seconds, and exhaling for six seconds is a calming breathing technique.  You can find “Breathing Bubble” on YouTube that will track the timing for the breath.
2. Encourage positive self-talk (for example, "I can try this" instead of "I can't do this").
3. Think of a safe place, such as their bedroom or favorite place outdoors.
4. Gradually facing fears. Consider gradually exposing your child to feared objects or activities.
5. Praise and reward brave behavior: the goal is to cope, not avoid.

For depression:

1. Show empathy and compassion. Set aside some time each day to help your child talk through his/her feelings. Consider ending this time with a discussion of what your child is grateful for (such as a thing or event).
2. Educate yourself, other caregivers & other family members. A child who feels depressed is not making up their symptoms. What might look like laziness or irritability is a symptom of depression.
3. Let your child know that feelings of hopelessness are a symptom of depression – they are not permanent or an accurate picture of reality.
4. Focus on positivity and encourage your child. Rather than focusing on areas that need improving, praise the things they are good at and encourage them to enjoy those hobbies and activities. 

For behavioral disorders, like ADHD:

1. Keep a scheduled routine – kids both need and enjoy structure. Use a whiteboard to engage your child in each step.   
2. Make sure your child eats healthy and gets plenty of exercise. Avoid high-sugar diets. Artificial colors and flavorings have been linked to increased hyperactivity in children, so watch for these ingredients in packaged foods and avoid them as much as possible. Instead, make snacks with fruits and vegetables to reduce the risk of hyperactivity while improving healthy energy and attention. Finally, children with high energy often find it impossible to sit still. Try to do outdoor activities after school, like walking, playing sports, or going to the playground.  
3. Encourage and praise your child with five positive prosocial behaviors for every negative one. Try to focus more on celebrating what your child is doing right versus what he/she is doing wrong.
4. Provide a “1, 2, 3 stop” for problem behaviors. Parents often count to three without following up with consequences. The 1, 2, 3 stop (also called 123 Magic) works by calmly stating “That’s one,” followed by five (or so) seconds. Then, “That’s two,” followed by another five-ish seconds. Once you’ve reached three, immediately implement a consequence, such as a time-out. This allows your child time to redirect his/her behavior.
5. Give clear concise directions using eye contact and standing near your child. Avoid giving directions from other rooms or with the TV on. Ask, “[Name], pick up your shoes right now, please” versus “Would you pick up your things already?” Be business-like in tone without too much emotion.   
6. Time-in, cool down, sensory breaks, meditation, and calm time are all great ways to reset all of our behaviors. And don’t forget: As parents, we need these timeouts too! As a general rule wait until your child has calmed down.

The time your child needs varies, but it’s usually one minute for every year your child is in age (ex: a 5-year-old will need five minutes).  Try to remove items like electronics and make it a time to just sit with feelings. Find a safe place with them – like a special chair or room – and get their willingness to go there ahead of time.  At the end of the time-out, discuss what happened and what they can do next time to be more appropriate. Remember to offer times to cool off not just as a consequence for behaviors.

Help is Available

Mental health matters for people of all ages! And there are many resources available to you, including free help.

Are you, your child, or someone you know suicidal? The National Suicide Prevention Lifeline provides free, confidential, 24/7 emotional support to people in suicidal crisis or emotional distress. Call or text 988 and speak to a counselor today. Click here for our Mental Health Flowchart, a helpful resource to get support, no matter what mental health state you're in.

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Source: CDC