When something just doesn’t seem right with your child, your first reaction is most likely to check to see if there’s something physically wrong. But once you’ve ruled out, or taken care of, any obvious physical reason for your child behaving markedly different, you may wonder if there’s a psychological cause. While there’s usually another explanation for why your child is acting odd, sometimes there may be something more to it. If you suspect mental illness, it’s important to recognize the signs that may indicate a problem.
Prevalence of Mental Illness in Children
While it is normal to worry that something’s wrong with your child, and what parent doesn’t, the fact is that only about 10 percent of children and young adults suffer from a mental health problem. Of those, only a small percentage will have a severe mental illness. In order to best handle these childhood disorders, it’s important for parents and caregivers to recognize potential signs of mental illness and to seek treatment for the child as soon as possible if the situation requires it.
Signs of Mental Illness
Mental health professionals advise that parents not become overly concerned if their child displays one of the following signs. But the presence of two or more may warrant consultation with a psychiatrist, psychologist or mental health professional to determine if, in fact, there is a mental illness. These signs are not all-inclusive, and represent some of the more common signs of bipolar disorder, schizophrenia, depression, and anxiety disorder.
Thought or Perception Problems – One of the aspects of mental illness is that the individual has difficulty with one or more of the following:
- Inability to concentrate
- Easily distracted
- Difficulty remembering
- Processes information slowly
- Acts confused
- Problem-solving takes a great deal of effort
- Inability to grasp abstract concepts
- Perceptual difficulties – such as seeing unusually bright colors or hearing loud sounds, hearing voices, believing there are hidden messages in the TV, radio or other public forms of address, reacts to old situations as if they are completely new
Signs of Anxiety – It is normal for children to feel anxious in unfamiliar situations, but when they display one or more of the following signs on a regular basis, there may be cause for concern:
- Worries about everything – even minor things
- Highly anxious in almost every situation
- Fearful – of anything and everything
- Acts as if he or she is constantly on guard, hyper alert, vigilant
- Engages in rituals and/or compulsive, repetitive behavior
- Acts uncomfortable around people
- Has frequent upsetting memories of past events or nightmares
- Resists or avoids doing normal activities
Definition and Signs of Bipolar Mania – Bipolar disorder is defined as a disorder of the brain characterized by outs of extreme and impairing changes in energy, mood, behavior and thinking. Symptoms of bipolar disorder may emerge suddenly or gradually during childhood, adolescence, or adulthood. Bipolar disorder cannot yet be cured, but it is treatable. A child (or adult) with bipolar mania and depression may exhibit one or more of the following:
- Extreme mood swings without any provocation – one minute the individual is exultant, jubilant, and without warning, turns morose, weepy, or angry, confrontational
- Irritability – not occasional, but most of the time
- Hyper-energetic
- Requires little sleep
- Becomes easily angered
- Disruptive to and with others
- Euphoric, excited
- Overconfident about abilities, talents, or looks
- Speaks rapidly and is difficult to interrupt
- Bipolar depression includes mood swings that range from low to high (manic) and back down again
Definition and Signs of Depression – Depressive disorder is defined as a disease that affects mood, behavior and thoughts. Without treatment, symptoms can last for weeks, months or years. Clinical depression differs from bipolar depression in that in clinical depression, the mood swings are in one direction – down. Normal periods separated by a steady drop in mood, which progressively goes down. Signs of depression include one or more of the following symptoms:
- Feelings of hopelessness, worthlessness, and helplessness
- Loses interest and pleasure in most things – as if he or she is just going through the motions, robotic-like
- Frequent thoughts of suicide and/or death
- Difficulty sleeping, sleeping too much, interrupted sleep
- Loss of appetite, weight loss, or weight gain
- Fatigue, loss of energy
- Persistent feelings or sadness, crying spells
- Agitation
- Drop in grades
- Inability to make decisions, follow-through, or concentrate
- Minor things cause unwarranted feelings of guilt
Socialization Problems – How your child interacts with others is another important area to examine, especially if he or she shows one or more of the following:
- Becomes physically or verbally abusive to others – including siblings, friends, strangers
- Has few friends or few that are close
- Prefers to be alone
- When he or she is with others, is difficult to get along with
- In relationships with others, the child is highly critical or overly attached
- Seems afraid and anxious around other people
- Misreads or cannot read other people
Lack of Self-Care – A child with mental illness may:
- Not take care of his or her appearance, lack cleanliness
- Eating problems – either overeats or doesn’t eat enough
- Pays little or no attention to physical health
- Doesn’t do homework, yard work, chores around the home as required
- Doesn’t care about or pay attention to personal things
Functioning Problems – Besides difficulties thinking, socializing, and lack of self-care, a child with mental problems may:
- Become easily irritated or angry over expectations or minor everyday stresses
- Quits projects or tasks quickly, often without even giving it much chance
- Unable to concentrate or work through projects or tasks effectively
- Unable to get along with others in most situations – at home, at school, in others’ homes or locations outside the home
Problems in the Home – This is where it is either easiest to detect problems or more difficult because it’s hard to notice changes from day to day. Be concerned if your child displays more than one of the following on a regular basis:
- Gets into fights or deliberately instigates fights or arguments with other family members, particularly siblings
- Finds it difficult to keep up with assigned chores or duties around the home
- Pays no attention to the needs of others, preoccupied with self
- Feels overwhelmed by responsibilities or place in the family structure
While the presence of any of these signs occurs in children and adults at one time or another, they don’t necessarily indicate mental illness. It’s the aggregation and consistency of the signs that should be cause for concern. In addition, signs of bipolar disorder, schizophrenia, depression and anxiety may overlap. In other words, they are not unique to each mental illness. Only a professional can diagnose mental illness.
What to Do If You Suspect Mental Illness
First, don’t panic. Even if you have noticed several signs on a recurring basis, you are not the mental health professional. Don’t jump to conclusions. But do take your child to your general practitioner or pediatrician for a consultation. Indicate your concerns to the doctor privately, out of earshot of your child.
The physician will examine your child to rule out any physical cause or illness that may account for the symptoms. If necessary, he or she will be able to refer you to the appropriate care professionals, including psychiatrists or psychologists, school healthcare staff, and other doctors or professionals. According to the Agency for Healthcare Research and Quality (AHRQ), a growing number of children and adults with mental illness are being diagnosed and treated by primary physicians. In addition, advances in telepsychiatry and new medications offer promising hope for such patients.
WebMD, quoting statistics from the U.S. Surgeon General, states that childhood mental illness occurs in about 20 percent of U.S. children in any given year. Nearly 5 million children in America have some type of mental illness (one that severely impairs daily living). Furthermore, experts estimate that 5 percent of all teenagers suffer from depression. Unfortunately, only about 20 percent of them will receive treatment. With treatment, more than 90 percent of those suffering from depression can be helped. Treatment for depression includes antidepressant medications and psychotherapy. Two types of psychotherapy are particularly effective: cognitive-behavioral therapy (CBT) and interpersonal therapy (IPT). More than 80 percent of people with depression improve when they receive appropriate treatment with a combination of psychotherapy and medication.
It is important to note that left untreated, an episode of depression in childhood may lead to another episode of depression within the next five years. Childhood depression may predict a more severe depressive illness in adulthood. Episodes of depression in children and adolescents are associated with an increased risk for suicidal behaviors.
Diagnostic evaluation for childhood mental illness may consist of psychological testing, lab tests, and consultation with other specialists. A comprehensive treatment plan (for depression, for example), may include psychotherapy, psychiatric medication (if necessary), and ongoing evaluation and monitoring. Group and family therapy are also used in treatment childhood mental illness. Creative therapies are especially useful in treating young children who may have trouble communicating their thoughts and feelings. Creative therapies include art therapy and/or play therapy.
Research Now Focusing on Mental Illness in Children
While most of the research on mental illness has centered on adults, now it is being focused on children. Researchers are looking at childhood development in terms of what is normal and abnormal behavior. They are trying to understand how factors affecting development may impact the child’s mental health. The goal, overall, is to attempt to predict and potentially prevent developmental problems that could lead to mental illness. Identification of risk factors is a key part of this research. Health community professionals are also calling for more research into medications that are used to treat children with mental illness.
How Parents Can Support a Child with Mental Illness
Children with mental illness can present a challenge to parents and family members, as well as educators, classmates and friends. Parents can help by giving the child guidance and understanding. Before a mental illness has been diagnosed and a treatment plan proposed, frustration, anger, guilt and shame may have built up in the child and the family. Special help may be required to help the family and the child deal with these feelings. Through therapy, the family and the child will be able to develop new skills, techniques, attitudes and ways of dealing with issues and relating to each other.
In addition, parenting skills training may be beneficial to help parents be more supportive of their child with mental illness. This includes learning stress-management techniques to help the parents deal with their own frustrations so that they’re able to respond to their child’s behavior in a calm manner. Training encourages parents to praise their child’s strengths and abilities, share relaxing and pleasant activities with their child, to point out what their child does well, and to arrange family situations to be more positive.
Where to Get Help
Dealing with the situation of a child with mental illness can take its toll on all family members. It can be difficult and frustrating, and parents and caregivers may not know where to turn for help. Here are some sources where you may be able to find assistance.
- Mental health specialists – including psychiatrists, psychologists, social workers or mental health counselors
- Community mental health centers
- Private clinics and facilities
- Health maintenance organizations
- Hospital psychiatry departments and outpatient clinics
- Mental health programs at universities or medical schools
- State hospital outpatient clinics
- Peer support groups
- Clergy, family services, or social agencies
- Employee assistance programs
- Local medical and/or psychiatric societies
You can also find help by looking in the phone book under “mental health,” “health,” “hotlines,” “physicians,” or “social services” to obtain phone numbers and addresses. An emergency room physician can also provide temporary help and may be able to tell you how and where to obtain further assistance.
Resources
For more information about bipolar disorder, mental illness, finding a mental health practitioner and other helpful information, see the following:
- The Balanced Mind Foundation – The mission of the Balanced Mind Foundation is to “guide families raising children with mood disorders to the answers, support and stability they seek.” Website includes learning materials, support groups, blogs, chat, educational resources, family response team, where to find a professional, and more.
- National Alliance on Mental Illness (NAMI) – information on child and adolescent bipolar disorder, symptoms, treatments, side effects, prognosis and more. Also includes links to general information about medications, including specific medications, and psychosocial interventions.
- Substance Abuse and Mental Health Services Administration (SAMHSA), Center for Mental Health Services (CMHS) Mental Health Services Locator – website provides comprehensive information about mental health services and resources.
- National Institute of Mental Health (NIMH) – Treatment of children with mental illness, answers to frequently-asked questions about the treatment of mental disorders in children.
- Mental Health America (MHA) – helping to support your child’s mental health. Website includes tips to support mental health of children, help finding treatment, support groups, medication information, help paying for medications, help finding a local Mental Health America affiliate, and other mental health-related community services. Includes a toll-free crisis line 1-800-273-TALK.
- Childhood Mental Disorders and Illnesses – Article published on the website of the MHMR Services for the Concho Valley (Texas).