Mental illness in children: Know the signs
Children can develop the same mental health conditions as adults, but their symptoms may be different. Know what to watch for and how you can help.
Mental illness in children can be hard for parents to identify. As a result, many children who could benefit from treatment don’t get the help they need. Understand how to recognize warning signs of mental illness in children and how you can help your child.
What is a mental illness?
Mental health is the overall wellness of how you think, regulate your feelings and behave. A mental illness, or mental health disorder, is defined as patterns or changes in thinking, feeling or behaving that cause distress or disrupt a person’s ability to function.
Mental health disorders in children are generally defined as delays or disruptions in developing age-appropriate thinking, behaviors, social skills or regulation of emotions. These problems are distressing to children and disrupt their ability to function well at home, in school or in other social situations.
Barriers to treating childhood mental health disorders
It can be difficult to understand mental health disorders in children because normal childhood development is a process that involves change. Additionally, the symptoms of a disorder may differ depending on a child’s age, and children may not be able to explain how they feel or why they are behaving a certain way.
Concerns about the stigma associated with mental illness, the use of medications, and the cost or logistical challenges of treatment might also prevent parents from seeking care for a child who has a suspected mental illness.
Common disorders among children
Mental health disorders in children — or developmental disorders that are addressed by mental health professionals — may include the following:
- Anxiety disorders. Anxiety disorders in children are persistent fears, worries or anxiety that disrupt their ability to participate in play, school or typical age-appropriate social situations. Diagnoses include social anxiety, generalized anxiety and obsessive-compulsive disorders.
- Attention-deficit/hyperactivity disorder (ADHD).Compared with most children of the same age, children with ADHD have difficulty with attention, impulsive behaviors, hyperactivity or some combination of these problems.
- Autism spectrum disorder (ASD).Autism spectrum disorder is a neurological condition that appears in early childhood — usually before age 3. Although the severity of ASD varies, a child with this disorder has difficulty communicating and interacting with others.
- Eating disorders. Eating disorders are defined as a preoccupation with an ideal body type, disordered thinking about weight and weight loss, and unsafe eating and dieting habits. Eating disorders — such as anorexia nervosa, bulimia nervosa and binge-eating disorder — can result in emotional and social dysfunction and life-threatening physical complications.
- Depression and other mood disorders. Depression is persistent feelings of sadness and loss of interest that disrupt a child’s ability to function in school and interact with others. Bipolar disorder results in extreme mood swings between depression and extreme emotional or behavioral highs that may be unguarded, risky or unsafe.
- Post-traumatic stress disorder (PTSD).PTSD is prolonged emotional distress, anxiety, distressing memories, nightmares and disruptive behaviors in response to violence, abuse, injury or other traumatic events.
- Schizophrenia is a disorder in perceptions and thoughts that cause a person to lose touch with reality (psychosis). Most often appearing in the late teens through the 20s, schizophrenia results in hallucinations, delusions, and disordered thinking and behaviors.
What are the warning signs of mental illness in children?
Warning signs that your child may have a mental health disorder include:
- Persistent sadness — two or more weeks
- Withdrawing from or avoiding social interactions
- Hurting oneself or talking about hurting oneself
- Talking about death or suicide
- Outbursts or extreme irritability
- Out-of-control behavior that can be harmful
- Drastic changes in mood, behavior or personality
- Changes in eating habits
- Loss of weight
- Difficulty sleeping
- Frequent headaches or stomachaches
- Difficulty concentrating
- Changes in academic performance
- Avoiding or missing school
What should I do if I suspect my child has a mental health condition?
If you’re concerned about your child’s mental health, consult your child’s doctor. Describe the behaviors that concern you. Talk to your child’s teacher, close friends, relatives or other caregivers to see if they’ve noticed changes in your child’s behavior. Share this information with your child’s doctor.
How do health care professionals diagnose mental illness in children?
Mental health conditions in children are diagnosed and treated based on signs and symptoms and how the condition affects a child’s daily life. To make a diagnosis, your child’s doctor might recommend that your child be evaluated by a specialist, such as a psychiatrist, psychologist, clinical social worker, psychiatric nurse or other mental health care professional. The evaluation might include:
- Complete medical exam
- Medical history
- History of physical or emotional trauma
- Family history of physical and mental health
- Review of symptoms and general concerns with parents
- Timeline of child’s developmental progress
- Academic history
- Interview with parents
- Conversations with and observations of the child
- Standardized assessments and questionnaires for child and parents
The Diagnostic and Statistical Manual of Mental Disorders (DSM), a guide published by the American Psychiatric Association, provides criteria for making a diagnosis based on the nature, duration and impact of signs and symptoms. Another commonly used diagnostic guideline is the International Classification of Diseases (ICD) from the World Health Organization.
Diagnosing mental illness in children can take time because young children may have trouble understanding or expressing their feelings, and normal development varies. The doctor may change or refine a diagnosis over time.
How is mental illness in children treated?
Common treatment options for children who have mental health conditions include:
- Psychotherapy, also known as talk therapy or behavior therapy, is a way to address mental health concerns by talking with a psychologist or other mental health professional. With young children, psychotherapy may include play time or games, as well as talk about what happens while playing. During psychotherapy, children and adolescents learn how to talk about thoughts and feelings, how to respond to them, and how to learn new behaviors and coping skills.
- Your child’s doctor or mental health professional may recommend a medication — such as a stimulant, antidepressant, anti-anxiety medication, antipsychotic or mood stabilizer — as part of the treatment plan. The doctor will explain risks, side effects and benefits of drug treatments.
How can I help my child cope with mental illness?
You will play an important role in supporting your child’s treatment plan. To care for yourself and your child:
- Learn about the illness.
- Consider family counseling that treats all members as partners in the treatment plan.
- Ask your child’s mental health professional for advice on how to respond to your child and handle difficult behavior.
- Enroll in parent training programs, particularly those designed for parents of children with a mental illness.
- Explore stress management techniques to help you respond calmly.
- Seek ways to relax and have fun with your child.
- Praise your child’s strengths and abilities.
- Work with your child’s school to secure necessary support.
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- Normal or not: When to get help. American Academy of Child and Adolescent Psychiatry. https://www.aacap.org/AACAP/Families_and_Youth/Facts_for_Families/FFF-Guide/Normality-022.aspx. Accessed Jan. 22, 2020.
- What are childhood mental disorders? Centers for Disease Control and Prevention. https://www.cdc.gov/childrensmentalhealth/basics.html. Accessed Jan. 28, 2020.
- Kliegman RM, et al. Psychosocial assessment and interviewing. In: Nelson Textbook of Pediatrics. 21st ed. Elsevier; 2020. https://www.clinicalkey.com. Accessed Jan. 27, 2020.
- Reardon T, et al. What do parents perceive are the barriers and facilitators to accessing psychological treatment for mental health problems in children and adolescents? A systematic review of qualitative and quantitative studies. European Child & Adolescent Psychiatry. 2017; doi:10.1007/s00787-016-0930-6.
- Anxiety and children. American Academy of Child & Adolescent Psychiatry. https://www.aacap.org/AACAP/Families_and_Youth/Facts_for_Families/FFF-Guide/The-Anxious-Child-047.aspx. Accessed Jan. 22, 2020.
- Attention-deficit hyperactivity disorder (ADHD). American Academy of Child & Adolescent Psychiatry. https://www.aacap.org/AACAP/Families_and_Youth/Facts_for_Families/FFF-Guide/Children-Who-Cant-Pay-Attention-Attention-Deficit-Hyperactivity-Disorder-006.aspx. Accessed Jan. 22, 2020.
- Autism spectrum disorders. American Academy of Child & Adolescent Psychiatry. https://www.aacap.org/AACAP/Families_and_Youth/Facts_for_Families/FFF-Guide/The-Child-With-Autism-011.aspx. Accessed Jan. 22, 2020.
- Depression in children and teens. American Academy of Child & Adolescent Psychiatry. https://www.aacap.org/AACAP/Families_and_Youth/Facts_for_Families/FFF-Guide/The-Depressed-Child-004.aspx. Accessed Jan. 22, 2020.
- Bipolar disorder in children and teens. American Academy of Child & Adolescent Psychiatry. https://www.aacap.org/AACAP/Families_and_Youth/Facts_for_Families/FFF-Guide/Bipolar-Disorder-In-Children-And-Teens-038.aspx. Accessed Jan. 22, 2020.
- Comprehensive psychiatric evaluation. American Academy of Child and Adolescent Psychiatry. https://www.aacap.org/AACAP/Families_and_Youth/Facts_for_Families/FFF-Guide/Comprehensive-Psychiatric-Evaluation-052.aspx. Accesssed Jan. 22, 2020.
- Psychotherapy for children and adolescents: Definition. American Academy of Child & Adolescent Psychiatry. https://www.aacap.org/AACAP/Families_and_Youth/Facts_for_Families/FFF-Guide/What-Is-Psychotherapy-For-Children-And-Adolescents-053.aspx. Accessed Jan. 22, 2020.
- Psychiatric medication for children and adolescents: Part I — How medications are used. American Academy of Child & Adolescent Psychiatry. https://www.aacap.org/AACAP/Families_and_Youth/Facts_for_Families/FFF-Guide/Psychiatric-Medication-For-Children-And-Adolescents-Part-I-How-Medications-Are-Used-021.aspx. Accessed Jan. 22, 2020.
- Learning to help your child and your family. National Alliance on Mental Illness. https://www.nami.org/find-support/family-members-and-caregivers/learning-to-help-your-child-and-your-family. Accessed Jan. 24, 2020.