How do I know if my child has a mental health problem?

It’s easy to think of mental illness as only affecting adults, but children are vulnerable to it as well. At its most basic, mental illness is simply a medical condition that causes ways of thinking or feeling that result in distress or impede functioning. And while mental health issues in children and youth are common, parents may not be aware of the early signs, or what to do about them. Here’s what you should know about mental health in children.

Signs of mental health problems in children

Childhood is marked by constant change. That can make it difficult to distinguish between markers of mental health issues and normal pediatric behaviours and stages. Teenagers, for example, tend to be sleepier in the daytime and need more hours of sleep than pre-teens. While this may signal depressive symptoms, it’s often normal for many teens. In adults, however, this behaviour is more likely to be a sign of depression.

When it comes to younger children, they might not have the vocabulary or emotional maturity to be able to express what they’re feeling. They’re much more likely to exhibit distress through changes in behaviour.

Regardless of your child’s life stage, however, there are certain markers that you can look out for. The following signs and symptoms may indicate a mental health issue in a child:

Avoiding school, family, or friends
Difficulty making friends
A decline in academic performance or low grades
Acting out, getting into trouble
Significant changes in mood or behaviour
Frequent mood swings
Complaining of frequent headaches or stomach aches without an underlying medical issue
Persistent sadness lasting two weeks or more
Not caring about their appearance (in older children)
Putting an extreme focus on their weight
Significant changes to eating, sleeping patterns, or both
Drinking, taking drugs, or both
Excessive worrying

What can affect a child’s mental health?

Both nature and nurture affect a child’s mental health. Genes can predispose certain children towards certain conditions, and some are especially heritable. If you have a parent with ADHD, for example, you’re more likely to have it too. And, no matter which one they have, if you have a parent who has a mental illness, you’re much more likely to suffer from depression as an adult.

Luckily, genetics aren’t absolute. While your mother or father may pass down a gene that predisposes you towards depression, for example, if environmental factors don’t “turn on” that gene, you may never develop that condition. This is why environment is such a critical part of a child’s development.

Children who experience extreme deprivation, parental substance abuse, homelessness, or domestic abuse are all particularly vulnerable to mental health issues. Trauma, such as sexual or physical abuse, neglect, or witnessing the death of a loved one also makes a young person more vulnerable to mental health issues.

For a child’s mental health, however, nothing is more important than stability and a strong bond with a loving and responsible parental figure. If that bond is disrupted or dysfunctional, it can have major repercussions. Children as young as one-and-a-half have been found to suffer from mental health issues due to disruptions in the normal parent-child relationship.

How the COVID-19 pandemic has affected mental health in children

The COVID-19 pandemic has been awful for everyone, but some of the hardest hit have been children. Children are resilient, however, their youth and immaturity also make them vulnerable, and the uncertainty, instability, and reduction in social connections of the past two years had a huge effect.

Pre-pandemic, about 1.2 million Canadian children and youth had some form of mental illness. Research shows, however, that closing schools and increasing the amount of time spent learning online caused rates of anxiety and depression to spike among children. This was especially true for those whose parents lost their jobs, or whose families became food insecure during the pandemic.

What are some examples of mental illness in children?

While mental illness is often thought of as something that only adults deal with, half of all mental health challenges begin by age 14. Some of the most common examples of mental illness in children include:

Post-traumatic stress disorder (PTSD) — characterized by consistent fears and hypervigilance, PTSD develops after a traumatic event such as a car accident or experiencing sexual abuse. Children may have flashbacks, nightmares, and experience intrusive thoughts.
Attention-deficit / hyperactivity disorder (ADHD) — while technically categorized as a psychiatric disorder, ADHD is much more commonly referred to as a neurological one. Classic symptoms include hyperactivity, inattention, and impulsivity. Diagnosis is more common in boys than girls, likely because symptoms in girls present differently.
Anxiety disorder – anxiety disorders can manifest in children in a few different ways. They may experience generalized anxiety disorder (GAD), characterized by persistent worrying about different issues that don’t merit that amount of distress. Alternatively, their anxiety might be more specific, focusing on social settings, or surrounding separation from a parent.
Autism spectrum disorder (ASD) — ASD is a developmental disorder and doesn’t fall under the umbrella of mental health. Despite this, it may be diagnosed by a psychiatrist or pediatrician. Individuals with ASD are also more likely to be diagnosed with other mental health conditions such as anxiety, or obsessive-compulsive disorder (OCD).
Depression — researchers estimate that about 2% of children and between 4 and 8% of youth deal with depression, also known as major depressive disorder. This may manifest as persistent feelings of sadness. It may also show up, however, as recurring stomach or headaches, or as fatigue and low energy.
Eating disorders — eating disorders tend to begin between the ages of 10 to 20, although children as young as five have been diagnosed as well. Disordered eating may involve restrictive eating, overeating, or binging and purging.
Psychosis — although it’s a symptom of mental illness and not one itself, first-episode psychosis often develops in the late teens or early twenties. During an episode of psychosis, a child or youth may experience hallucinations and delusions. While psychosis may be the result of a chronic mental illness like schizophrenia, it can also be stress or drug-induced. Many people experience only a single episode of psychosis in their lives and never go on to have another episode.

How are mental disorders diagnosed in young children?

If you think something’s going on with your child, you should begin by making an appointment with their healthcare provider. Children are complicated, and not all of their behaviours are straightforward. Certain symptoms like persistent tummy aches may seem like they’re an indication of constipation, for example, while they might actually be a sign of depression or anxiety instead.

Your child’s healthcare provider can help to figure out what’s actually going on. In order to diagnose a mental illness, they’ll take a patient and family history. This usually involves going over a timeline of behavioural and academic changes with primary caregivers.

Finally, they’ll likely administer specific standardized assessments and questionnaires to the child and interview and observe them. If necessary, they can refer them to a therapist or a psychiatrist, or help you to access other resources in your community.

What does good mental health in children look like?

Experiencing good mental health isn’t the same as being happy all the time. It’ll look different for each child and each family. That being said, there are some general signs that can give you insight into your child’s state of mind.

Children — even teenagers — are naturally curious. If your child is asking questions, engaging and exploring different topics, this is a good sign. This applies to their social life as well.

Introverted children might not be as social, but even they want to be around others occasionally. Whether they have one or many close friends, if your child is socializing and interacting with others it’s likely a positive. Feeling connected is a key component of maintaining good mental health.

Another great indicator of how things are going with your child is how they’re functioning in their day-to-day life. Do they wake up and get to school on time, groom and dress themselves, and complete their schoolwork? Younger children will need help with many of these things, but if they’re happily sticking to the routine it’s also a positive.

Even the happiest child has bad moods sometimes, but if your child’s moods seem mostly stable, they’re maintaining their routine, and being social, it’s a good sign.

How to support a child with mental health issues

The mental health of a child is directly tied to their relationship with their caregiver, and to their caregiver’s stability. A strong relationship with a caring and supportive caregiver can diminish any harmful effects a child experiences.

Foster an open and caring relationship with your child. Knowing they can trust and confide in someone is crucial for stemming feelings of isolation that mental health issues can bring on.

If you feel comfortable, it may also be helpful to speak to your child’s teacher. Filling them in on the situation gives them the opportunity to provide additional support at school. Your child’s teacher may be able to help foster feelings of belonging in their school community. They can also offer extra support with academics if needed.

How can parents help their children’s mental health?

Maintaining an open and caring relationship with your child is crucial, but there’s more to it than that. Help your child to develop a positive sense of self by encouraging them to have healthy relationships with others. You should also help them to set attainable goals, making sure to celebrate their accomplishments and achievements.

Model healthy behaviours and attachment. You can do this by normalizing things like having dinner together as a family and resolving conflicts respectfully. While boundaries are important to impose and stick to, avoid criticizing or shaming your child for things. It’s okay to label your child’s behaviour as bad or unacceptable, but not them.

Ask questions about your child’s life. Depending on their age, this may be difficult, but try to engage your child in conversation. Actively listen to your child in a supportive and non-judgmental way. This lets them know that they’re important to you and that what they do and say has meaning.

Finally, try to put yourself in your child’s place. It might not seem like a big deal if one of your eight-year-old’s friends doesn’t invite them somewhere, but try to remember how important social acceptance was for you in third grade.

How a mental health physician can help

While focusing on your child’s physical health might seem like the number one priority as they grow up, their mental health is just as important. And the only constant with children is change, which can make it hard to pinpoint certain behaviours as concerning. But you know your child best, and if you feel that something’s wrong, you’re probably right. Seeing a mental health professional may be an important first step in figuring out what’s going on with your child psychologically and socially.

With Maple, you can book an appointment to see a mental health physician whenever and wherever it’s most convenient for you. Taking into account your child’s individual needs, they may be able to recommend a treatment plan including medication, counselling, or both. And, if you live in Quebec, a mental health physician can also diagnose and treat ADHD.

If you’re concerned that your child is wrestling with a mental health issue, reach out today and take the first step towards helping them get professional support and peace of mind.