By Kathy Hubbard
“My daughter has been very depressed for the last several months,” a woman wrote on the Ask the Expert page of the Association for Children’s Mental Health (ACMH) website. “She was very withdrawn and rarely wanted to come out of her room. At one time we were even fearful we would have to hospitalize her because she was threatening to hurt herself.
“All of the sudden this week she seems to be feeling much better. She is more social and interactive and is spending more time with the family. I know I should be happy and I am but something doesn’t feel right and I feel like I am just waiting for the next shoe to drop…she seems just a little ‘too happy.’”
This brings up the question, when is a child just going through a phase, and when is she exhibiting signs of mental illness? The Mayo Clinic says that it can be difficult to distinguish the signs of a problem from normal childhood behavior.
“You might reason that every child displays some of these signs at some point. And children often lack the vocabulary or developmental ability to explain their concerns.” Mayo says.
They also point out that the concerns about the stigma associated with mental illness; the possible need for expensive medications, and the cost or logistical challenges of treatment enter into the reluctance to suspect mental illness and to seek care.
“Children can develop all of the same mental health conditions as adults, but sometimes express them differently,” they say. “For example, depressed children will often show more irritability than depressed adults, who more typically show sadness.”
In a recent interview, Dr. Joe Wassif, a licensed psychologist at Bonner General Health, said that parents should try to understand the intent of children’s actions.
“Ask, what are they trying to tell me? Don’t just focus on their behavior,” Wassif said. “Don’t look at needing counseling or mental health services as there being something wrong with your child, but as a way for them to learn about themselves and gain tools to live a better life.”
According to the Mayo Clinic the most common mental health conditions are: anxiety disorders (obsessive-compulsive disorder, post-traumatic stress disorder), attention-deficit/hyperactivity disorder, autism spectrum disorder, eating disorders, mood disorders (depression and bipolar disorder) and schizophrenia.
Forty-three warning indicators are detailed on ACMH’s website, but because of space restraints, I’ll depend again on the Mayo Clinic. They say to look for mood changes that cause problems in relationships at home or school. Be aware of feelings of overwhelming fear for no reason.
Look for any behavior changes, particularly if it involves dangerous or out-of-control behavior such as fighting or expressing a desire to hurt others. Look for trouble focusing or sitting still, both of which might lead to poor performance in school.
Watch for unexplained weight loss. “A sudden loss of appetite, frequent vomiting or use of laxatives might indicate an eating disorder,” Mayo says. Listen if your child repeatedly complains of headaches and stomachaches.
Watch for symptoms of self-injury, also called self-harm. “This is an act of deliberately harming your own body, such as cutting or burning yourself,” Mayo explains. And, of course look for the indicators that your child may be abusing drugs and/or alcohol, or toying with the idea of suicide.
The expert advice for the mother of the little girl at the beginning of this article was, “When in doubt it’s always good to trust your instincts.” ACMH’s expert suggested that the mother speak to the girl and ask if she knows why she feels better. And, they suggested taking her to a professional therapist.
If you suspect your child’s behavior isn’t just a phase, make an appointment with your pediatrician. He or she can look for other possible causes for your child’s behavior, such as a history of medical conditions or trauma.
And listen to Mayo Clinic’s advice: “Don’t avoid getting help for your child out of shame or fear. With appropriate support, you can find out whether your child has a mental health condition and explore treatment options to help him or her thrive.”
Kathy Hubbard is a member of Bonner General Health Foundation Advisory Council. She can be reached at firstname.lastname@example.org.