Mental Disorders in Children

Overview How to help a child who has a mental disorder. • What is a mental disorder? • Signs of a problem • Common mental disorders in children • What causes mental disorders? • How to find help • Types of treatment • Resources

Over the past few decades, psychiatrists have learned that mental disorders are nearly as common in children as in adults. Experts now estimate that as many as one in 10 children may suffer from a serious behavioral or emotional problem. Unfortunately, even though effective treatments are widely available, about two-thirds of children aren’t getting the help they need. It is normal for children and teenagers to go through periods when they feel sad, anxious, or angry. For example, the death of a beloved pet or a switch to a new school is likely to be upsetting to any child. However, when your child’s distress lasts for a long time and begins to interfere with his ability to cope with everyday situations, you may need to seek the help of a mental health professional. A thorough assessment will identify the problem so that your child can overcome his particular difficulties -whatever they may be. What is a mental disorder?
Mental disorders are brain diseases that affect mood, thinking, behavior, and/or memory. Since mental disorders involve changes in brain chemistry, they rarely go away on their own. In fact, if left untreated, a mental disorder is likely to get progressively worse. That’s why it is important to seek help as soon as you notice a problem.

Signs of a problem
If you think that your child might have a mental disorder, you might first try to engage her in a frank discussion. Try to remain calm and avoid saying anything critical or disapproving. You might begin by mentioning your concern about a specific issue, for example, poor grades. Then, ask your child if anything is bothering her. You might say, “I’ve noticed you’ve been feeling a little anxious today. Is anything bothering you?” Some children will open up, but others may deny that anything is wrong. Here are some of the warning signs that indicate the need to get professional help: • poor grades despite hard work • social isolation or difficulty making friends • persistent worry or anxiety

In severe cases. If your child has separation anxiety. If your child has a common mental disorder. and many children who receive treatment make a complete recovery. he may have a temper tantrum whenever he has to be apart from you.2 l Mental Disorders in Children • fidgeting or restlessness • chronic sadness or irritability • severe temper tantrums • frequent nightmares • refusal to engage in normal activities (such as going to school) • harming other children or pets • use of alcohol or illegal drugs • sudden weight loss or weight gain • anger toward authority figures and/or law-breaking activity • lack of interest in activities that used to provide pleasure • reluctance to spend time with friends or family • frequent complaints about bodily aches and pains • difficulty falling asleep or waking up • worry about harming self or others • feelings of worthlessness or extreme guilt • sadness or crying a lot in response to minor frustrations Common mental disorders in children Like adults. . . In panic disorder.Phobias. a child experiences intense fear accompanied by uncomfortable physical sensations such as a pounding heart and nausea. Anxiety disorders are the most widespread. There are several different types: .Panic disorders. When a child has a phobia. she has persistent fears about specific objects or things (such as snakes or heights).Separation anxiety. children can suffer from a wide range of mental disorders. there are numerous methods of treatment available. and these disorders can vary greatly in severity and duration. The common disorders in children are: • Anxiety. children may refuse to attend school. . affecting up to one in 10 children. Separation anxiety can also cause a child to have constant worries about his own safety.

For example. a particularly distressing event. tend to experience depression differently than adults do. She may have frequent conflicts with peers. • Depression. If your child engages in repetitive behaviors that appear senseless. but this is not always the case. In some children. such as counting or rinsing his hands. They may frequently blurt out answers and are likely to be impulsive. stealing cars. Even though a traumatic event may have happened long ago. Sometimes. serves as a trigger. . toxins such as lead. Some mental disorders such as ADHD. .Posttraumatic stress disorder. A child may routinely start fights or harm animals. They are easily distractible and often can’t follow directions. particularly young children. A depressed child often has difficulty in relationships. have witnessed or been the victim of violence. sluggish. Outbursts of anger or chronic irritability are common. for example.Obsessive-compulsive disorder. but is not hyperactive. he may be suffering from obsessive-compulsive disorder. Children with ADHD often have problems in school because they have great difficulty sitting still and concentrating. a child will hardly ever acknowledge the disorder on her own. both sets of symptoms can appear intermittently. she is likely to engage in behavior that causes problems at home or in school. Children. Instead. ADD is similar but without the hyperactivity. Mental disorders can also be caused by a chemical imbalance in the brain. For example. • Conduct disorder. A severely depressed child may also express thoughts of killing herself or others. or have experienced a natural disaster may develop posttraumatic stress disorder. or setting fires. have been in an accident. They also have trouble staying focused on any particular task. such as divorce in the family. ADHD affects nearly 10 times as many boys as girls. • Attention-deficit hyperactivity disorder (ADHD) and attention deficit disorder (ADD). or may withdraw from others altogether. or distracted. Children who have endured sexual or physical abuse. In addition. Children with conduct disorder often suffer from another disorder as well. Your child may seem dreamy. about 30 percent have ADHD and about 20 percent are clinically depressed. as are feelings of sadness and hopelessness. Here are the major causes for mental disorders: • Biological. What causes mental disorders? Children and teenagers develop mental disorders for a variety of reasons. Aggressive or destructive behavior is the hallmark of conduct disorder. preferring to move from one activity to the next. appear to be transmitted genetically. Experts point to a series of factors that often work in combination with one another. it can resurface in the form of intrusive flashbacks or nightmares.3 l Mental Disorders in Children . and accidents like a head injury that can damage the central nervous system. he may commit crimes such as breaking into homes.

Many urban areas are fortunate to have hospitals and/or medical centers that specialize in the treatment of children and can serve as excellent resources for assessment and/or ongoing care. Unfortunately. witnessing violence can often be traumatic. . Every state has several associations of mental health professionals that can give you the names of specific clinicians in your city. stress might take the form of too many activities (such as a demanding part-time job in addition to a full course load). Although this therapist may not be able to see your child for more than a few sessions. In addition. • Psychological. Psychotherapy often helps by teaching children new strategies for managing stressful situations. So. The pediatrician or primary care physician will be able make a referral to an individual mental health professional or a children’s hospital or center to conduct an assessment. they may not be able to adjust easily. so it may take longer to schedule an appointment with a psychiatrist than with a social worker. sexual abuse. Many university hospitals run specialized clinics that provide a wide variety of mental health services to children. can parental conflict. or professional counselor. Another social factor that can lead to problems -. The loss of an important person. How to find help If you suspect that your child has a mental health disorder. such as bullying at school. When faced with a big change. there is a shortage of child psychiatrists throughout the nation. in psychology or social work. For a teenager. including assessments.a therapist who typically has a master’s degree or Ph. psychologist.D. nurse peer pressure. such as a parent or grandparent. Some children have trouble learning effective coping skills. • Call professional associations in your state.particularly for adolescents -. You might try one of the following options: • Contact your employee assistance program (EAP) or employee resource program. too. you first need to make an appointment with a pediatrician or primary care physician who has experience working with children to rule out any medical issue. at the present time. he or she can usually help you find another therapist if more extensive treatment is needed. • Call local children’s hospitals or medical centers. Examples of traumatic events include a serious medical illness. can be very upsetting to a child. or a mugging.4 l Mental Disorders in Children • Environmental. such as a move to a new neighborhood. Your EAP can usually schedule a prompt appointment with an employee assistance professional -. • Social. • Call your local medical school. Stress and trauma can have a major impact on your child’s mood and behavior.

Sometimes medication may be prescribed. Sometimes it is also useful for one or both parents to attend a few therapy sessions. especially the treatment of young children. they are usually most effective when combined with psychotherapy. Since parents are the primary caretakers of their children. Most hospital stays last only a few days or weeks.a mental health professional who typically has a background in psychiatry. a trusted friend. your child will need to begin receiving psychotherapy on a weekly or biweekly basis. respectively. you may need to send her to a partial hospitalization program where she can receive extensive mental health services during the day. most children improve significantly within a few months. antidepressants. There are three main classes of psychiatric drugs: stimulants. Although many parents initially worry about the length and cost of treatment. Older adolescents may need more time alone in treatment. you may need to consider hospitalization. In addition. In case of a crisis (if your child is suicidal. • Medication. but they are not usually recommended for very young children. and anxiety. Usually. a child might be asked to express himself by drawing pictures or by telling stories with dolls.” By talking about his thoughts and feelings in a safe setting. but most psychologists and social workers work closely with a doctor who can monitor your child’s medication. For example. such as a family doctor. for example).might encourage an anxious child to identify his biggest fears in order to help him develop new ways of coping with them. You might also want to get the opinion of other people. In play therapy. the round-the-clock care provided by a hospital can help stabilize your child in a matter of days. which are used to treat ADHD. however.5 l Mental Disorders in Children Types of treatment The mental health professional who conducts the initial evaluation will usually discuss various treatment options with you. • Hospitalization. If your child still needs intensive treatment. a therapist -. For most common mental disorders. Although drugs can provide relief for some mental disorders by fixing faulty brain chemistry. parents still need to be involved in the overall treatment plan in order to help support the goals of the treatment. • Psychotherapy. most health plans cover mental health services. In family therapy. but can return . depression. • Family therapy. These drugs are generally safe. only psychiatrists can prescribe drugs. Among mental health professionals. Therapists tend to use play therapy for younger children because they are less able to put their feelings into words. There are two basic forms of therapy for children: “talk therapy” and “play therapy. and antianxiety agents. a child can often make needed changes in behavior. a therapist might help family members improve communication and resolve conflicts. they need to be actively involved in any treatment. psychology. or a family member. or social work -.

In order for you to take care of your child. Q. She is a past board member of the Philadelphia chapter of the National Association for the Prevention of Child Abuse. be sure to take care of yourself by asking for the help you may need to handle any of the emotions that you are feeling about your child’s diagnosis. © 2001.S. M. and sometimes brings up issues of guilt and feelings of failure as a parent. Although accepting that a child has a mental disorder is difficult for parents. Resources The following organizations can give you useful background information on mental disorders in children: • National Mental Health Association. Aboutourkids. All rights reserved. 2004 Ceridian Corporation. • American Academy of Child and Adolescent Psychiatry. parents can take comfort from knowing that the earlier mental disorders are addressed.nmha.. L. • New York University Child Study Center. Seeking help is what being a good enough parent is about..W. Dion is regional director of Behavioral Health Residential Services at Northwestern Human Services and is a member of the National Association of Social Workers. In addition.P.C. The level of care is determined by the mental health professionals. the better the outcome. www. there are many organizations that deal specifically with helping parents dealing with children with mental disorders. 212-263-6622.W. .E. www. C.6 l Mental Disorders in Children home in the evening. • National Alliance for the Mentally Ill. 800-950-6264. 703-684-7722.nami.S. Written with the help of Rebecca Dion..aacap.