Behavioral and mental health disorders in children

Equipping parents with resources and skills to keep their children healthy

Helping children deal with mental health and anxiety issues can be challenging for the entire family. ParentingNH reached out to two professionals to learn how to spot these challenges and best deal with them.

Our experts:

  • Kathy Nelson, Founder and President, World Academy, in Nashua;
  • Jeanna Still, LICSW, Director of Child and Adolescent Services at The Mental Health Center of Greater Manchester;

How common are mental health disorders in teens?

Still:   “The World  Health  Organization (WHO) cites 10-20% of teens will struggle with a mental health condition and The National Alliance on Mental Illness (NAMI) states 1 out of 5.”

What are some of the warning signs should I watch for that would indicate my child is dealing with mental health challenges?

Nelson: “Warning signs for mental health challenges in children and adolescents can manifest themselves in many different forms. It is important to understand the difference between the typical emotional swings of children and teens and the warning signs of mental challenges. The two key indicators are the length of which the change in behavior has been present and if the behavior is affecting the daily functioning of the child. Typically, any changes that last for more than two weeks are a red flag and need professional attention. Some of the changes in behavior to look for are mood swings, social withdrawal, loss of interest in favorite activities, intense feelings, weight loss, excessive worry, and sleep disturbances. In many cases, especially in children and teens, physical symptoms such as stomachaches, headaches and muscle tension can be also present. In addition, teachers can provide parents some important information about any changes in behavior at school. Any unexpected decline in school performance, persistent problematic and aggressive behavior, and refusal to attend or participate in school activities are some indicators that a child might be dealing with mental health challenges. It is important to reach out to a child’s pediatrician as soon as these warning signs are seen as early intervention is key when dealing effectively with mental illness.”

What’s the best way to talk to my teens about mental illness or issues they may be facing at school?

Still: “One of the best ways to talk to teens about mental illness is to listen to them if they are willing to talk to you. Validation is one of the best tools to use because it demonstrates listening without judgement. If a child tells their parent they are feeling depressed the parent might react unknowingly with an invalidating statement such as “How can you be depressed?  You have friends, play soccer and have your own room.  It could be a lot worse than this!” Although the facts could be correct, this type of statement will most likely lead to the teenager shutting down. A more helpful response to say is “I am sorry you are having such a rough time right now, what’s going on for you?” This is obviously simplified, yet validation is simple in that you are not necessarily agreeing with the teen’s statement and they feel understood without being judged. Unfortunately, many adolescents will not speak with parents about mental health challenges for a variety of reasons like not wanting to disappoint a parent, shame or family culture. Encouraging them to talk with other adults they feel comfortable with is a way to support them as well. Finally, if you do have a talker, then sharing education about the brain having diseases similar to how the body can have diseases is a normalizing way to decrease stigma. Hopefully this will be the encouragement needed to move forward with treatment. Your kids are always listening to you, even when you think they aren’t!”

Nelson: “Teens can be particularly more vulnerable to mental health challenges as they deal with many social pressures and physical changes. Therefore, mental health is always an important topic of conversation to have with your teen, even if there is no indication of a mental health issues. Like any potential life issue, educating teens about mental health in general and equipping them with the needed coping strategies can help prevent the development of or escalation of mental illness issues in the future. If parents have a trusting relationship with their child, expressing that there will be difficult and confusing situations that can arise throughout their growth years and that they can share anything with you confidently, without judgment (honestly), will keep the doors of communication open so you can be supportive early in the process.

“Talking to adolescents about mental illness or any other challenges they might be facing at school is an important conversation that needs to happen in a genuine and non-judgmental way. Validating their feelings and letting them know they are loved help teens feel supported and know they are not alone. Unfortunately, many times teens are misinformed about mental illness, so parents can help them get educated about this health issue and understand that anyone at any age can be affected with a mental illness and that as with any other medical condition there is a treatment and help available.”

What are the contributing factors to teen depression?

Still: “Some of the most common contributing factors that lead to teen depression are family history of depression, trauma history or recent incident, major life changes or stressors. Although feeling depressed from time to time is quite common for most teens (and adults), having depression affects less than 20% of adolescents. Speak with your primary care physician if you have concerns. As I mentioned earlier, this is a treatable condition with positive outcomes.”

Should I share my child’s mental health issues with the school?

Nelson: “Yes, with an administrator or person you can trust. Children and teens spend a significant amount of time in school. Sharing your child’s mental health challenges with your child’s teacher,  school counselor and/or a trusted administrator ensures that there can be a plan put in place to support your child’s needs. While always protecting your child’s confidentiality, schools can provide a great support system for students and their families facing mental health challenges, and the school staff can play a significant role in the treatment process. With parental permission, it’s common for mental health professionals to collaborate with schools to gain a better understanding of the challenges the child might face by looking at behavioral patterns, triggers, and social interactions. Schools have many resources available to support typical and atypical stages in the life of developing children and teens and those can make a great difference if embraced early in the process. The main goal is for parents and the school to work together in a constructive and positive manner for the overall well-being of the child.”

What are the consequences of not addressing adolescent mental health issues?

Still: “If adolescent mental health concerns are left untreated this can lead to substance misuse, lost or damaged relationships, physical illness and chronic mental health conditions as an adult. Drugs and alcohol can provide instant relief from the pain of anxiety, depression and trauma. Teens might be experimenting with cannabis, for example, and realize that they are much less anxious when they are high — which in turn can lead to using cannabis to self-medicate. When mental illness goes untreated a more frequent or habitual use pattern can develop. Anxiety can have a significant impact on a teen’s ability to socialize, attend school or even leave the house. This has obvious detrimental effects on forming relationships with friends and completing school requirements. Depression makes getting out of bed difficult and long-term effects of poor sleep, diet and exercise are linked with physical illness such as diabetes. There are many treatment options available to teens today; such as office or home- based services when appropriate, and a team approach that includes a psychiatrist to prescribe medication, clinician, and community support worker. I encourage caregivers to reach out with questions or concerns to me or other providers in the community.”


Categories: Behavior and Learning, Depression and Anxiety