Spotting Trouble and Fixing it
Parents are the watchdogs of their kids’ mental health. Here’s what to look for – article from TimeHealth, November 2010
Depression
Age of Onset- May strike at age 9 or younger, though during adolescence is more common
When it’s nothing – Sometimes moody kids are just moody and sensitive ones are just sensitive. Sadness triggered by a particular situation is also unlikely to be depression, provided the child adjusts and moves on.
When it’s something – Symptoms in kids are the same as in adults: loss of appetite and energy, irritability, difficulty sleeping, feelings of worthlessness, inability to feel enjoyment. Thoughts of suicide are also a sign.
Treatment – Cognitive therapy can help kids reframe feelings and change perspectives. Drugs may be used as an adjunct to treatment, though they have been associated with suicidal thoughts. Depression itself, however, carries its own suicide risks, so the medication decision must be made carefully.
General Anxiety Disorder
Age of onset- Strikes at all ages but most commonly from childhood to middle age.
When it’s nothing – Kids have three early phases of high anxiety – at 8 months, 2 years and 5 years. All are part of the process of learning to get by in a very big and very scary world, and all should pass.
When it’s something- Beyond age 5, kids who can’t let go of Mom or Dad may be experiencing symptoms of true anxiety. Kids who never run of what-if questions (“What if there’s a fire?”) may also be sending a signal. One key test: Does your child eventually function in social settings or withdraw completely.
Treatment- Cognitive therapy can help, as can acceptance and commitment therapy, which teaches kids to tolerate discomfort.
Obsessive Compulsive Disorder
Age of onset- The median is 19, but many kids show symptoms much earlier
When it’s nothing- OCD-type behaviors before age 8 are often no cause for concern, since rituals are a normal part of growing up. Even when kids are older, don’t confuse tidiness with obsessiveness or common hand-washing with compulsiveness.
When to seek help- The key is when rituals and anxieties start to interfere with a child’s happiness or ability to engage in activities.
Treatment- Exposure and response prevention help kids tolerate uncertainty. Drugs are an option but should not be a first resort.
Bipolar Disorder
Age of onset- Usually starts in the late teens or early adulthood but may hit young kids too. One study found that the share of children with bipolar is the same as the share of adults: about 1%
When it’s nothing – Mood swings and extreme silliness or sadness are common among all kids. Even what seems to be a true manic state may be attention- deficit hyperactivity disorder (ADHD), not bipolar.
When it’s something – Short temper, hyperkinetic speech, inability to focus and giddiness that doesn’t quit may be signs of the manic phase of bipolar. Loss of appetite, energy and interest in things and too little or too much sleep may signal the depressive phase. Look for cycling between the two.
Treatment – Talk therapy helps kids regulate moods, especially when the family participates in the sessions. Drugs – mostly mood stabilizers, anticonvulsants and antipsychotics – are a part of treatment but can lead to side effects including weight gain and motor control disorders. Children and adults with bipolar can often come off drugs for a time but typically must resume when symptoms do.
Attention-Deficit/Hyperactivity Disorder
Age of onset – attention –deficit/hyperactivity disorder is just what it sounds like and usually hits somewhere from ages 3 to 6, though it can strike later.
When it’s nothing – one of the things that makes ADHD difficult to diagnose is that it’s hard to find a kid who’s not hyperactive or short on attention some of the time. Don’t assume every wild mood is ADHD. And since the disorder is more common in boys than in girls, it’s easy to mistake gender typical rambunctiousness for a problem. Undetected hearing or vision problems or common learning disorders may also masquerade as ADHD.
When to seek help- Kids who talk nonstop, have difficulty following directions, become bored very easily, can’t complete tasks or can’t sit still even during a meal may be showing signs of ADHD. Impulsivity is also an important sign – though it’s a tricky one because most kids lack good impulse control. The key is severity: children who always have trouble waiting their turn or seem incapable of letting an adult finish speaking without interrupting are likelier to have ADHD than kids who sometimes behave that way.
Treatment– Behavioral therapy to teach children to organize their thoughts, control impulses and reward themselves for achieving goals can help. Stimulant medications, which paradoxically improve focus, are a common part of therapy.