Millions of American Children Face Mental Health Challenges. There’s a Good Chance it’s Your Kid, Too.
A friend recently told me how impressed she was that I would talk openly about my daughter’s regular therapist visits for anxiety. She said it was refreshing to hear it spoken about in matter-of-fact, non-judgmental terms.
I think that if people can talk openly about their kid’s broken ankle or heart condition, they should also talk about anxiety and depression. These are all health issues that are beyond a kid’s control.
Metro Health – University of Michigan Health pediatrician Dr. Kseniya Bezpalko is also encouraged by the shift over the last decade to reduce the stigma of mental health issues and identify them sooner—before they spiral out of control.
It could be that people are starting to see mental health on the same level as physical health.
Or it could be that there’s been a steep rise in diagnosed anxiety and depression in kids, so people are forced to talk about it.
“It could be the rise of school shootings and more frequent drills and lockdowns,” explains Dr. Bezpalki. “There’s also social media influence and the increasing pressure to succeed.”
According to the CDC, millions of children, ages 3-17, live with mental health issues such as depression, anxiety and ADHD. It’s up to us parents, health care professionals, teachers, school administrators to get children the help they need.
The 6 Types of Anxiety in Children
Two of my kids live with anxiety. And the second kid was a lot harder for me to notice and get help for because his symptoms were drastically different from his sister’s. I had one image of anxiety in my head, and he was not displaying it.
Dr. Bezpalko says there are six key types of anxiety in children:
- Social anxiety: In the most common anxiety disorder in adolescence, a child will experience distress in social situations so will avoid them. The child may be afraid of drawing attention and may avoid asking questions in class or even talking on the phone.
- Separation anxiety: A normal part of development in preschoolers becomes a problem if it persists beyond this stage.
- Specific phobia: A fear of an object or situation that is out of proportion to the actual danger presented. Examples include needles, heights and spiders.
- Generalized anxiety: This manifests as excessive worry about daily events and tasks such as school, work, sports, friends and the future for a period of six months or more. Children may not start or complete their tasks/projects due to fear of failure.
- Obsessive compulsive disorder: Intrusive thoughts or images (obsessions) and/or repetitive behaviors (compulsions) to relieve anxiety can interfere with tasks of daily living. Examples include extreme fear of illness (obsession) and repetitive washing of hands (compulsion) to avoid getting sick.
- Panic disorder: Characterized by sudden attacks of fear, panic attacks may occur without a known reason, but more frequently, they are triggered by fear-producing events or thoughts.
Symptoms of an Anxious Child
So how do you even know if your child is struggling? Oftentimes anxiety comes out as negative behavior and it’s hard to know if the kid is just being naughty (and has control over his actions) or if there’s something darker at work.
Thankfully, doctors are getting better at identifying anxiety and depression in kids, says Dr. Bezpalko.
One of my children was acting out so strongly in preschool that the teacher thought he had oppositional defiant disorder. I brought this up with our pediatrician and he looked at me and said, “no, this sounds more like anxiety.”
Dr. Bezpalko is right – docs are gaining more and more understanding of mental health issues in kids. I took that kid to a mental health professional and it looks like he has anxiety. (We are still in the diagnosing stages.) Now that we are narrowing in on the root of the problem, we can start to address it.
Here’s what anxiety can look like in kids:
- Frequent physical complaints such as headache, abdominal pain, muscle aches
- Significant changes in behavior such as irritability, aggression, or tantrums
- Poor sleep
- Difficulty in concentrating
- Avoiding school
- Avoiding social situations
- With panic disorder, the child may experience chest pain, shortness of breath, racing heart, nausea, shaking, numbness and tingling, sweating, dizziness/lightheadedness, and fear of dying
How to Support a Child With Anxiety
Teach Your Community how to Support Your Child
“If your child exhibits symptoms of anxiety or is diagnosed with an anxiety disorder, don’t tell them to push through it or get over it,“ recommends Dr. Bezpalko. “Acknowledge and validate their feelings and encourage them to talk about their feelings.”
I think the first thing you can do for your anxious child is to educate friends and family members on how to support your kid. You can do everything right at home, but if grandma gets stern and tells your kid to get over it, and starts punishing the anxious behavior, your kid is going to crash and burn.
Find a Professional Psychologist/Therapist/Psychiatrist for your Child
Once everyone is on the same page (as much as possible – not everyone will understand the situation), it’s time for professional help.
Cognitive behavioral therapy (CBT) is often the first line treatment for anxiety disorders in children. It involves teaching a child to recognize his or her fears with skills to manage the anxiety.
This is where we are at with my daughter. We talk a LOT about why she’s feeling a certain way, if these are big fears or little fears, and what she can do about it. Her psychologist walks her through all sorts of coping mechanisms, and probably will for – well, forever.
If your child sees a professional for anxiety, chances are a couple of sessions won’t cure them. They could be in therapy for a lifetime. But it will give your child a lifetime of support and better mental health. #worthit.
You can also encourage healthy habits such as sleep hygiene, a nutritious diet, regular exercise, consistent routines and social support. These all contribute to a healthy mental well-being (for everyone!).
Sometimes, CBT is not enough, and medication may be needed. This doesn’t mean you failed as a parent or the therapist isn’t doing their job properly. It just means that your kid needs this extra help.
What Does Depression Look like in Kids?
I grew up around a lot of people suffering from depression. But it was back in the 80’s, people weren’t talking about it and really, people didn’t even understand it. Looking back, even though I was just a kid, I really wish I had an understanding of depression. I may have treated some classmates with more compassion, and maybe even advocated for my sister to get the help she needed.
Depression in children presents a little differently than anxiety. It’s kind of… heavier.
A child with depression can experience sad moods, irritability, change in appetite, change in sleep habits, sudden loss of interest in doing things they once enjoyed, loss of energy, trouble focusing in school, low self-esteem, aches and pains, and thoughts of harming themselves.
“Even if you’re not sure your child has depression, I strongly suggest you talk to your child’s physician,” Dr. Bezpalko emphasizes.
“Management of depression is based on severity, but typically, treatment consists of therapy or a combination of therapy and medication. The first-line medication is often a selective serotonin reuptake inhibitor (SSRI).
Children suffering depression do not know how to advocate for themselves so it’s extremely critical that a trusted adult seeks help for them.
How You Can Support a Child Suffering Depression
Don’t wait for your kid to come to you. People suffering depression often feel like a burden on their family, and that talking about these dark things will just bring everyone down. They believe that you won’t want to be around them anymore if you know they’re experiencing dark thoughts and emotions.
But that’s simply not true, is it? If you love someone, you love them. And you want to be with them, whether it’s a happy day or a sad day.
If you suspect your child is struggling with depression:
- Ask about his or her feelings
- Encourage and model a healthy lifestyle: eat well, stay active, surround him or her with supportive people
- Point out strengths and praise positive behavior
- Limit screen time, especially social media
- Lock away ALL medications
- Acknowledge that they will still have bad days/weeks, but that you’re still going to support them.
Seek Help at the First Signs Your Kid has of Anxiety or Depression
“The earlier a mental health condition is addressed, the better the outcome for the child,” Dr. Bezpalko says. “We know that unaddressed mental problems can lead to worsening mental health, substance abuse, poor school performance and difficulties with relationships.
“Anxiety and depression are real, and acknowledgment is the first step in helping your child.”
I’ve seen this first hand in friends and family. It’s horrible.
I’ve started talking to friends and family about my 6 year old’s anxiety symptoms. I want to get him tested so that we can know what we are dealing with ASAP.
A few of them have questioned this early involvement, wondering if some of his behavior is just because he’s a little kid. But I see more happening under the surface. If he does “grow out of it,” great, but if he truly has anxiety, I’m giving him the gift of professional help as soon as possible.
Dr. Bezpalko also stresses that it’s important to take care of yourself so you can take care of your child. Prioritize your own health and well-being and consider reaching out to your own health care provider for help.
I talk to my child’s therapist about my child and sometimes my own life and it’s super helpful.
“It’s important for parents to understand that sometimes anxiety and depression cannot be prevented and to recognize that their child’s diagnosis does not mean they are failing as a parent,” Dr. Bezpalko points out.
“In fact, it means by getting help, they are being the best parent they can be.”