Children can develop all of the same mental health conditions as adults, but sometimes express them differently.
By Sapna Bangar
Aniket is a 10-year-old boy who was brought to us with complaints of always being in trouble at school, distracting other children, back answering in class, being the class clown and ‘not studying’.
Smita is a five-year-old girl who plays by herself, is not interested in other children her age, plays with the same toys over and over again, likes to hear the same story, is not as ‘affectionate’ as her sister, hates being touched or cuddled even by parents.
The above are just some examples of presentations that we commonly see in a child mental health centre. Worldwide, 10-20 per cent of children and adolescents experience mental disorders. Half of all mental illnesses begin by the age of 14. If left untreated, these conditions severely influence children’s development, their educational attainments and their potential to live fulfilling and productive lives. So what are the challenges for seeking help early?
The onus of noticing that the child maybe suffering from any form of neuro-developmental or mental health issue falls on the caring adults in their lives, such as parents, grandparents and/or teachers. Hence, it is very important for them to be aware of symptoms and signs of issues which may be indicative of an underlying disorder. Another factor is being able to differentiate between normal growing pains and when the behaviour needs professional help especially as all children are different and many times especially in single child families, there is no benchmark to compare with.
COMMON DISORDERS IN CHILDHOOD
Children can develop all of the same mental health conditions as adults, but sometimes express them differently. For example, depressed children will often show more irritability than depressed adults, who more typically show sadness. Some of the common ones are:
Some worry is common among children as they are navigating and mastering stages of development. So separation anxiety and stranger anxiety are normal patterns of development and should be a cause of concern if the child is not showing those at the appropriate ages, but becomes a cause of concern if it is persistent and impacts on the day to day activities of the child.
The child is unable to talk in certain situations, such as in school where they are expected to speak in spite of being able to speak normally in other situations.
Attention-deficit/hyperactivity disorder (ADHD)
This condition typically includes symptoms in difficulty paying attention, being on the go all the time, climbing excessively, constantly having injuries due to falls, not being able to wait their turn and impulsive behaviour. Some children with ADHD have symptoms in all of these categories, while others might have symptoms in only one.
Autism spectrum disorder (ASD)
Autism spectrum disorder is a neuro-developmental disorder that appears in early childhood. It is characterised by not being able to form friendships, lack of social interactions and communication difficulties, lack of imitative or imaginative play and restricted interests. They also show repetitive motor movements such as flapping or twirling.
Children can become so preoccupied with food and weight that they focus on little else. They may also be excessively fussy eaters and prefer to have a restricted diet.
This can cause a child to feel persistent feelings of sadness or irritability accompanied by not wanting to go out, not sleeping or eating and talking about death or dying.
WARNING SIGNS IN CHILDREN
Look for feelings of sadness or withdrawal that last at least two weeks or severe mood swings that cause problems in relationships at home or school.
Be aware of feelings of overwhelming fear for no reason—sometimes with a racing heart or fast breathing—or worries or fears intense enough to interfere with daily activities.
These include drastic changes in behaviour or personality, as well as dangerous or out-of-control behaviour. Fighting frequently, causing harm to animals, breaking things and expressing a desire to badly hurt others are also warning signs.
Look for signs of trouble focusing or sitting still, both of which might lead to poor performance in school.
Unexplained weight loss
A sudden loss of appetite, frequent vomiting or use of laxatives might indicate an eating disorder.
Compared with adults, children with a mental health condition might develop headaches and stomach aches rather than sadness or anxiety.
Harm to self
Sometimes a mental health condition leads to self-injury, also called self-harm. This is the act of deliberately harming your own body, such as cutting or burning yourself in severe cases and head banging, bruising of knuckles due to hitting walls, holding their breath, etc.
WHAT CAN YOU DO?
Be supportive as your child needs your support more than ever. It is very common for parents to feel guilty, blame themselves, feel helpless and even angry when their child is diagnosed with a mental health condition.
Seek ways to relax and have fun with your child. Praise his or her strengths and abilities. Explore new stress management techniques, which might help you understand how to calmly respond to stressful situations.
Consider seeking family counseling or the help of support groups, too. It’s important for you and your loved ones to understand your child’s illness and his or her feelings, as well as what all of you can do to help your child. Also attending support group makes to realise that you are not alone and share your experiences with parents going through similar issues.
To help your child succeed in school, inform your child’s teachers and the school counsellor that your child has a mental health condition. If necessary, work with the school staff to develop an academic plan that meets your child’s needs.
It is never late but it is better early; be informed about early signs and symptoms of mental illness. Be aware of when and where to seek help. The earlier you seek help, the better is the outcome.
(The writer is a Specialist Child and Adolescent Psychiatrist and Head-Client Care (Psychiatrist), Mpower–The Centre, which runs a Youth Mental Health First Aid programme.)