No parent wants to see their child in distress. Of course you want what’s best for them, and if they broke their arm or had a sore throat, you’d probably take them to get appropriate medical treatment right away. But what about kids’ mental health? How can parents tell the difference between “normal” children’s behavior and challenges, and something more serious? Scary Mommy spoke with Dr. Steven Jewell, the director of pediatric psychiatry and psychology at Akron Children’s Hospital to find out what parents should look for and when to get help.
We Need to Pay Attention to Kids’ Mental Health
Though we tend to associate mental illness with adults, the Centers for Disease Control (CDC) estimates that one in six children ages two to eight has a mental, behavioral, or developmental disorder. These figures don’t improve much once they hit adolescence either: according to Jewell, 20 percent of adolescents have mental illness severe enough to impair their functioning, but only one-fifth of them are diagnosed and treated during adolescence. In some cases, the mental illness is severe. In Ohio, for example, the Ohio Department of Health reported that suicide is now the leading cause of death for children ages 10 to 14.
When Jewell speaks with parents about mental illness and children, he starts by having them think about it like physical health. He asks parents how likely they think it is that their child will get sick between birth and their 18th birthday. Most are quick to say the chances are 100 percent. At this point, Jewell reminds parents that illnesses and health in general exist on a spectrum. For example, when it comes to physical health, kids can either have minor issues (like a common cold), conditions that take a few days and some treatment to clear up (like strep throat), and more serious and rare illnesses (like leukemia or heart disease). According to Jewell, parents should think about mental health in a similar way.
“First of all, 100 percent of kids will struggle with some form of mental illness,” Jewell tells Scary Mommy. “The vast [majority] will have something that is relatively time-limited and a normal part of childhood.”
Examples of this include anxiety over taking tests, or over an argument with a friend: things that can impact a child’s mental well-being, but that will also clear up on their own after the problem has passed. The important part in these challenging situations is to ensure that the child gets the support they need. On the other end of the spectrum, there are the more serious mental illnesses in children, like bipolar disorder and psychosis, which Jewell says can impact how a child functions on a regular basis.
It gets a little trickier with the middle category of mental illness in children. “If it’s identified early in and some intervention is brought to bear, it can be relatively short-lived — more severe anxiety, more severe depression, that kind of stuff. And if you catch it early on, you can, with just relatively minor interventions — counseling of some sort, support for the family, maybe even medication if necessary — make it time-limited with a relatively middle impact,” Jewell explains. “But if you miss it and you don’t intervene early, it can grow and become a much more serious problem.”
According to Jewell, the middle category of mental illness is most impacted by stigma. “You are stigmatized by being identified as having some characteristic that society thinks is a negative — in this case, a mental illness,” he explains. “And so the way to avoid stigma is to avoid the diagnosis. And the way to avoid the diagnosis is not to seek help. So if parents are worried about stigma, they often will not go and get help for their kid, even though they know their kid is struggling. And so the kid will go on with intensifying symptoms because they’re not getting any treatment and will often enter adulthood with a significant burden of disability that could have been avoided if early intervention had occurred.”
How to Identify Mental Illness in Children
Though every child and situation is different, here are seven warning signs than a child may have a mental illness, courtesy of Jewell and the doctors at Akron Children’s Hospital:
- Mood swings. Watch out for feelings of sadness or withdrawal that last for several weeks, or severe mood swings that affect relationships at home or school.
- Extreme feelings. Look for feelings of overwhelming fear or worry for no apparent reason, which may affect daily activities and interaction.
- Behavior changes. Be aware of drastic changes in behavior or personality, as well as out-of-control behavior, such as frequent fighting or arguing.
- Difficulty concentrating. Look for signs of trouble focusing or sitting still, which can lead to poor performance in school.
- Physical symptoms. Compared with adults, children with a mental health condition might develop headaches and stomachaches rather than sadness or anxiety.
- Physical harm. Sometimes a mental health condition leads to self-injury or self-harm, such as cutting or burning oneself. Children with a mental health condition also might develop suicidal thoughts or attempt suicide.
- Substance abuse. Look for signs of drug or alcohol use to try to cope with their feelings.
So how can parents tell the difference between typical kid mood swings and behavior changes, and something that might be a sign of mental illness or a mood disorder in your child? Jewell says that it’s important to look at their behavior through a developmental lens and what is appropriate for their age. In other words, if you have a toddler that gets easily upset and can pivot between wailing and giggling in a few seconds, chances are they do not have bipolar disorder — they are just being typical toddlers. If you’re unsure about a particular concern, ask your doctor.
“The pediatrician is the person who can really give you that developmental prescribed perspective because they work with kids of all ages and have a capacity for evaluating the appropriateness of this behavior at this time — especially those first-time parents who have their first kid and are understandably anxious,” Jewell explains. And once children enter school, their teachers are also a great resource for figuring out if their behavior is unusual for their age.
Of course, in serious and more immediate situations — like if a child threatens to take their own life — Jewell recommends that parents go straight to a mental health professional, like a psychiatrist, psychologist, social worker, or counselor. “Because [threatening suicide] is a severe and potentially life-threatening symptom of mental illness, it needs to be addressed in as timely fashion as possible,” he says. “But for the ones that are a little more iffy [and] it’s not entirely clear whether an intervention is needed and whether this is actually a symptom of mental illness, then I would say the pediatrician would be the logical first step.”
The bottom line is that parents need to be more aware of signs of a potential mental illness, while also being open to talking about it and having their child receive support, if necessary. The stigma surrounding mental illness hurts us all. Ignoring mental health challenges won’t make them go away — it will only keep your child from getting the treatment and coping skills they need.
For more information on children’s mental health, parents can contact the Association for Children’s Mental Health via their website or through their hotline, (888) ACMH-KID (226-4543).