How Do I Know If My Child Needs Help?

All children have mood fluctuations. They get sad, or angry, or anxious. They procrastinate and become forgetful. This is all perfectly normal. It’s part of growing up. However, when unhealthy behavior or an unhealthy emotional state persists and begins to negatively impact your child’s ability to function in one or more settings (self, family, school, or community) you should consider seeking professional help.

Remember, it is extremely common for children to need help with their mental health and it’s nothing to be embarrassed about. In fact, one in every five children in the U.S. has a diagnosable mental health condition that requires treatment.

Seek professional help if an unhealthy behavior or an unhealthy emotional state persists and begins to negatively impact your child’s daily functioning.

How do I know if my child’s emotional or behavioral challenges are just a stage they will outgrow?

Know the warning signs. Long-lasting and severe mood swings, excessive fears and worries, extreme behavioral changes, disturbing physical changes, self-harm, or an inability to concentrate are common signs of an emotional disorder. You may be concerned about your child’s development, emotional well-being, what they are thinking and saying, or how they are acting. You may have experienced their behavior very differently in different environments. If your worries are persistent, first talk with your child’s teacher or an adult in a leadership role to best understand if the behaviors you are noticing are being observed by others.

When observing your child’s behaviors, ask yourself the following questions:

  • How is my child functioning at home, at school, or with friends? Is my child’s behavior impairing his or her ability to function in any one of the major areas of life? Is my child functioning in a way that is typical for a child his or her age?
  • How frequent are the behaviors I am concerned about? Do they happen daily, weekly, or
    on a regular basis? If you are not sure, consider keeping a log to track how often they occur.
  • How long does the behavior last? What is the duration of a particularly concerning “episode?” For instance, does an angry outburst last much longer than seems reasonable under the circumstances that triggered it?
  • How intense is my child’s behavior? Is my child reacting in a way that is out of proportion
    in intensity to the situation that triggered the reaction?

Most importantly, trust your own instincts because no one knows your child better than you do. If you are concerned and believe that your child is exhibiting trouble with functioning, do not hesitate to get recommendations from your child’s school, from friends, or from your child’s pediatrician for a mental health professional that can help.

My toddler/young child is exhibiting concerning behavior, what should I do?

It’s never too early to start wondering about your child’s mental health. The early childhood years lay the foundation for a lifetime of sound mental health, development (cognitive, communication, and emotional), and physical health.

“Infant – early childhood mental health is the developing capacity of the child from birth to three to: experience, regulate, and express emotions; for close and secure interpersonal relationships; and explore the environment and learn – all in the context of family, community, and cultural expectations for young children. Infant – early childhood mental health is synonymous with healthy social and emotional development.”-  Zero to Three, 2001

If your toddler/young child is demonstrating big behaviors (significant aggression, inability to self-soothe) or emotions, is having difficulty separating from you or another primary caregiver, or has been involved or witnessed a traumatic event, you may want to seek advice from a mental health professional.

Note: A traumatic event can include a severe fall, a broken bone, or something as simple as a scary movie. The important note about trauma is that individuals experience trauma differently.

I think my child needs a comprehensive mental health evaluation. What can I expect?

Always seek professional help if you believe that behaviors are beginning to negatively impact your child’s level of functioning.

At some point during the therapeutic process, an assessment or evaluation by a mental health professional might be necessary. Comprehensive mental health evaluations usually require several hours over one or more office visits with the child/adolescent and parent(s). With parent’s permission, other significant natural supports (e.g., family physician, school personnel, and/or other relatives) may be contacted for additional information.

A comprehensive evaluation may include the following:

  • Description of presenting problems and symptoms;
  • Information about the child’s health history, e.g., past/current illnesses (physical and psychiatric), as well as current medication(s);
  • Family health and psychiatric histories;
  • Information about the child’s development;
  • Information about the child’s social interactions, e.g., school, friends, family;
  • Interview of the child/adolescent and parent(s);
  • Information related to the child’s education and learning;
  • If needed, laboratory studies, e.g., blood tests, x-rays, or special assessments (speech and language evaluation).

How long will my child need to be in therapy?

Therapy can last from just a few weeks to months or even years. It all depends on the therapeutic goals you and the therapist establish, the unique needs of your child, and the progress being made.

There is no simple answer to this very common question. The length of time therapy takes depends on the complexity of the diagnosis, the treatment used, the goals you, your child, and the therapist have set, the severity of the symptoms your child is experiencing, and the pace of improvement. It is important to periodically ask your therapist how he or she feel things are going and what progress is being made.

Remember, progress does not usually move in a straight line. Your child might show quick improvement and then plateau for a while, or you may not see any improvement for a while and then observe a sudden leap forward. Try to be patient and remember that treatment can work to improve your child’s mental health and well-being.

Will my child need medication?

Most children who receive mental health services do not require medication, but for some, medication can be an important part of a comprehensive treatment plan.

If you or your child’s clinician believe that your child could benefit from a medication evaluation, you will be referred to one of our board-certified Child and Adolescent Psychiatrists or Advanced Practice Registered Nurses (APRNs).

If medication is recommended, the psychiatrist or APRN will explain the rationale and the risks, benefits, and side effects of initiating medication for your child. Ongoing evaluation and monitoring by the prescribing psychiatrist or APRN is essential. Remember, medication is part of a comprehensive treatment plan that usually includes individual or group therapy.

Treatment decisions are yours to make, in collaboration with your child’s psychiatrist or APRN. However, it is important to never make changes to or discontinue your child’s medication without first discussing with the prescribing psychiatrist or APRN. Abrupt discontinuation of medication may be dangerous and may cause serious side-effects and/or rebound symptoms.

About Anxiety & Depression

Anxiety

When a child does not outgrow the fears and worries that are typical in young children, or when there are so many fears and worries that they interfere with school, home, or play activities, the child may be diagnosed with an anxiety disorder. Examples of different types of anxiety disorders include

  • Being very afraid when away from parents (separation anxiety)
  • Having extreme fear about a specific thing or situation, such as dogs, insects, or going to the doctor (phobias)
  • Being very afraid of school and other places where there are people (social anxiety)
  • Being very worried about the future and about bad things happening (general anxiety)
  • Having repeated episodes of sudden, unexpected, intense fear that come with symptoms like heart pounding, having trouble breathing, or feeling dizzy, shaky, or sweaty (panic disorder)

Anxiety may present as fear or worry, but can also make children irritable and angry. Anxiety symptoms can also include trouble sleeping, as well as physical symptoms like fatigue, headaches, or stomachaches. Some anxious children keep their worries to themselves and, thus, the symptoms can be missed.

Depression

Occasionally being sad or feeling hopeless is a part of every child’s life. However, some children feel sad or uninterested in things that they used to enjoy, or feel helpless or hopeless in situations they are able to change. When children feel persistent sadness and hopelessness, they may be diagnosed with depression.

Examples of behaviors often seen in children with depression include

  • Feeling sad, hopeless, or irritable a lot of the time
  • Not wanting to do or enjoy doing fun things
  • Showing changes in eating patterns – eating a lot more or a lot less than usual
  • Showing changes in sleep patterns – sleeping a lot more or a lot less than normal
  • Showing changes in energy – being tired and sluggish or tense and restless a lot of the time
  • Having a hard time paying attention
  • Feeling worthless, useless, or guilty
  • Showing self-injury and self-destructive behavior

Extreme depression can lead a child to think about suicide or plan for suicide. For youth ages 10-24 years, suicide is among the leading causes of death.

Some children may not talk about their helpless and hopeless thoughts, and may not appear sad. Depression might also cause a child to make trouble or act unmotivated, causing others not to notice that the child is depressed or to incorrectly label the child as a trouble-maker or lazy.