Many of us have been there—sitting in a waiting room filled with kids and their parents. It's overwhelming: the bright lights, the papers stacked up on the desk, moaning in pain from a kid who just fell off his bike. But for some families, it isn't just about a broken arm or an infected wound. They're here because their child has been diagnosed with ADHD or depression, anxiety disorder or bipolar disorder. And as parents we are often left feeling clueless and alone questioning our own parenting style and child mental health.
There are no easy solutions to the problem. Mental health disorders are difficult to diagnose, difficult to treat and have a high burden of recurrence. Unfortunately, many psychotherapies don't work for children, who have a severe shortage of specialized pediatric psychiatric training and an over-reliance on drugs in non-specialized settings. And there is something else too: For some children, getting a diagnosis of mental illness can have devastating effects on their families.
So what's the solution to kids' mental health declining? The simple answer: education. It is time to break the silence and challenge stigma related to mental health among children. That is why we have written this article in order to provide a comprehensive overview of pediatric mental health disorders.
This article is more than just an academic overview; it is a call to action for parents who wish to increase their knowledge about psychiatric disorders and for professionals who want to learn about this growing population of children. Parents will be able to better understand their children and how to improve child mental health, while professionals will be empowered with information that they can use in practice.
How Do You Know For Sure Your Kids’ Mental Health Is Declining?
While some of us may think about the causes of child mental health problems, we are suddenly too self-confident to worry about our children's mental health, it is best to be prepared. We can tell when a child's symptoms are increasing through many signs and symptoms, such as:
1. A dramatic change in confidence or self-confidence. For example, a child who used to repel going outside and would want to stay inside all the time suddenly changes his/her behavior entirely. At this stage it is important that you educate yourself and take action before you allow this sudden change in behavior to escalate. It is normal for children to have little challenges in their development and sometimes "test" the limits of their parents' patience.
2. Changes in eating patterns, energy levels or sleeping patterns. Children diagnosed with mental health disorders often experience numerous physical symptoms that can be difficult to detect, such as:
Changes in eating and sleeping habits—Children with anxiety disorders tend to eat less food than others their age due to a fear of vomiting. They may also wake up during the night or beg for food or water when they are not hungry.
Changes in energy levels—Children might complain about having no energy and feeling tired all the time, even though they don't do much activity; others may feel wide awake yet spend their day sitting on their parent's lap rather than playing or interacting with friends or siblings.
Changes in activity level—Children with anxiety disorders or ADHD might have a decreased interest in engaging in activities with other children, like going to school, socializing at the playground or playing soccer with friends.
Changes in body image—Children might complain of headaches, stomach aches and difficulty breathing, which could signal symptoms of depression.
3. You may also start to notice changes in their behavior. Some mental health disorders are more obvious than others; for example, a child who is suffering from depression may exhibit changes in emotion and may almost always appear sad. Children who suffer from anxiety disorders can also have trouble controlling their emotions and may be irritable and angry all the time. Whereas, other mental health disorders like ADHD are usually characterized by problems with attention, concentration and impulsivity.
4. Thoughts about harmful behaviors, such as harming their parents or themselves. Children with depressive disorders often feel guilty over perceived failures at work or school and may also feel guilty about their illness itself. Negative thinking can lead a child to feel like he/she has disappointed his/her family members and friends.
5. Self-isolation from the family or peers consistently, spending most of his or her time alone. Children with ADHD are often highly creative and usually have a lot of energy, but due to their inability to concentrate may not be able to complete any tasks for extended periods of time. However, children with anxiety disorders can also isolate themselves from others. Children with anxiety disorders tend to have social phobia and avoid playdates or gatherings with friends.
6. More physical complaints than others his/her age. The term "school refusal" refers to children who refuse to go to school despite having no obvious health problems; this is considered a hallmark sign of depression that warrants intervention.
A New Way Of Understanding Mental Health Disorders in Children
Children diagnosed with mental health disorders often suffer from several symptoms at once. Rather than focusing on one problem, it is more helpful to think about their symptoms as part of a family of problems that can be grouped together in a DSM diagnosis. This allows us to see the child's problems in the context of his or her entire mental health system, rather than as isolated issues.
We can apply this same logic to adult patients too. For example, an adult may be diagnosed with both ADHD and generalized anxiety disorder, which can help us understand how the two conditions are interrelated. Growing scientific evidence of November 2020, reveals that ADHD is related to a deficient capacity to inhibit or control brain networks related to attention and executive function, while anxiety disorders are related to overactive brain networks related to fear, vigilance and threat appraisal. What this means is that a child with ADHD may also have anxiety, which can potentially be treated with drugs that dampen down the overactivity of the brain network (an antidepressant).
Instead of talking about mental health problems as distinct categories—physical health problems, learning disabilities, behavior problems and so on—we should start thinking about the person's entire picture at once.
The Common Players: Depression And Anxiety Disorders
The most common mental disorders in children are depression and anxiety. According to the National Comorbidity Survey Replication May 2019, which surveyed 9,282 American kids aged 8 to 18 years old, depression affects between 5 and 10% of boys and girls at some point during their teenage years. When we start to add up the lifetime prevalence of depression in adulthood (a whopping 17%), it becomes increasingly important for us to understand how best to treat it. Moreover, in an UNICEF survey across 21 countries, only 41 per cent of young people in India said that it is good to seek support for mental health problems, compared to an average of 83 per cent for 21 countries.
Anxiety disorders are also widespread among children and teenagers. The National Comorbidity Survey conducted in 2013, found that between 3 and 5% of young American people experience an anxiety disorder during their lives. Like depression, anxiety disorders are also more common in children than in adults, with a lifetime prevalence rate of around 26%.
Since depression and anxiety disorders are so widespread among kids and adolescents, they deserve serious attention. Our society has been told that the prescription medications we have at our disposal can help with these conditions. But the untold story is that psychiatric drugs are often inappropriate for children with such disorders. Most antidepressants aren't even approved by the FDA to treat pediatric depression and anxiety; instead, these prescriptions tend to be written for off-label use. This means that many children who could be helped by counseling, for example, are instead placed on mind-altering drugs.
What's The Solution To This Dilemma?
New research is turning the mental health field on its head, with exciting new strategies for helping kids who are suffering from depression and anxiety. These methods are not limited to drugs and can be used by all types of therapists, including counselors and teachers.
For example, mindfulness-based stress reduction has been shown to be successful in reducing symptoms of depression among adults, but it wasn't clear if the same approach was helpful for children. Researchers in England conducted a study in 2012 examining whether mindfulness training could help reduce depressive symptoms in kids aged 7 to 12 years old who had been diagnosed with depression. After eight weeks of daily practice, the children showed significant improvement on a number of outcome measures, compared to children who only received usual care.
5 Ways Parents Or Guardians Can Work Against Their Child's Declining Mental Health
While the research has only just begun, there is growing evidence as of 2015 that mindfulness and other strategies can be used to help children who are suffering from depression. But we need to go further. We also need to understand how to help caregivers cope with the stress of caring for a child plagued with mental health disorders.
Because helping kids who are struggling with anxiety and depression requires a mix of skills, it also requires an approach that takes into account the entire family system as well as the individual child. This means that all family members, including parents and caregivers, must be involved in the treatment plan so they can support one another during difficult times. Here are five ways in which parents or guardians can work towards their child's declining mental health. Here are 5 ways you can work against your child's mental issues:
1. Embrace the Help Available
Close relationships with schools, nurses, counselors and teachers are helpful for kids who are dealing with mental health issues. Having an opportunity to talk about their issues can be hugely beneficial to children struggling with depression or anxiety. Parents should take the initiative and build relationships with these professionals so that their child receives the support he or she needs. Try contacting your child's school or pediatrician to request a referral for counseling services if these haven't yet been offered.
2. Explore Treatment Options Together
A mental health issue can be a family affair, so it's important that parents work closely together to make sure they are on the same page when it comes to their child's treatment plan. This means sharing research about various treatment methods, exploring options and making sure you're both on board with the plan. If you have a partner, discuss which tactics might work best for your family and then brainstorm ways of making these changes.
3. Get Everyone as Involved as Possible
If your child is anxious or depressed, getting involved in self-care activities that reduce stress can be a great way to help kids cope with their situation. This includes everything from exercise (both physical and mental), hobbies, doing things you enjoy together as a family and more. Even just having someone spend time with your child by playing games or just hanging out can make a big difference.
4. Be a Positive Role Model
Make sure you're surrounding yourself with positive people in your daily life to help your child feel supported and loved. This is especially important if your child feels like he or she doesn't have anyone to turn to for comfort. Having someone to talk with and bounce ideas off of can be beneficial in so many ways, whether it's talking about kids who are going through similar situations or simply just having someone listen while they vent: everyone needs someone they can bounce their ideas off of sometimes.
5. Be Aware of the Consequences
When your child is feeling overwhelmed, it can be easy to try and make things better by giving in to requests for food, activities or other indulgences. Although it's important to take care of yourself and take time out for yourself, it's also vital to remember that certain indulgences might not be helpful for your child's mental health.
If you're not careful, you might find yourself enabling unhealthy behaviors that work against the treatment plan you have in place. This can become a vicious cycle where your child feels dependent on these indulgences and you don't feel good about withholding them.
These five tips are just a starting point for parents or guardians who are looking for ways to help their child cope with anxiety or depression. While it's important to focus on what can be done to help these children, it's also vital to remember that you're trying to get your child back on track.
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Because this requires strength and perseverance, it's important that you don't lose yourself along the way. The last thing your child needs is one more person in his or her life who’s feeling helpless themself. But if you build up your own mental health and adhere to the treatment plan, you'll be ready for anything the world throws at you.