In a 2021 study conducted by JAMA Pediatrics, the number of children and adolescents globally experiencing depression and anxiety symptoms nearly doubled during the first year of the COVID-19 pandemic. Before the pandemic, these statistics were 11.6% for anxiety and 12.9% for depression. In 2021, the percentage rose to 20.4% in anxiety and 25.2% in depression among children and adolescents worldwide.[1]
With May being Mental Health Awareness Month, now is a great time to address this increase in mental health disorders in children and adolescents. Learning about mental health, knowing what symptoms to look for, and having the right tools are vital to helping your child’s mental — and overall — well-being.
The National Alliance on Mental Illness (NAMI) defines mental illness as “a condition that affects a person’s thinking, feeling, behavior, or mood.”[2] One in six children and adolescents in the United States is diagnosed with a mental health disorder every year.[3] The most common diagnoses for youth are anxiety disorders and behavior disorders, according to the Journal of the American Academy of Child & Adolescent Psychiatry.[4]
Feeling anxious about a test or a class presentation is normal, but it’s when this anxiety is constant and creates disruptions in everyday life that it could be a disorder.[5] The “I’m So Stressed Out!” fact sheet by NIMH is a great resource to help adolescents know the difference between stress and anxiety and what they can do to get help. Children ages 8-12 can learn about stress and anxiety in NIMH's free “Stand Up to Stress!” coloring and activity book.
The second most common mental health disorder in children is behavior disorders, which MentalHealth.gov defines as “a pattern of disruptive behaviors in children that last for at least 6 months and cause problems in school, at home, and in social situations.”[6] The most common behavioral disorders are attention deficit hyperactivity disorder (ADHD), oppositional defiant disorder, and conduct disorder.
It’s important to understand that mental health disorders can present differently in children depending on their age and temperament. “When it comes to mental health, every child has a different personality and experience of what life is like for them,” says Carolyn Guidry, M.A., NCC.
For some children and adolescents with anxiety disorders, their behavior may include changes or problems with concentration, sleeping, energy, and eating. Irritability, frustration, constant worrying, intrusive thoughts, stomach aches, and crying can also be symptoms.[7]
Symptoms of behavior disorders can include inattention, hyperactivity, impulsivity, and defiant behavior. These behaviors become disruptive when the child or adolescent has trouble concentrating, completing tasks, sitting still, and having self-control.[8]
While it may be easier for some children and adolescents to share their feelings with you, others may not be as comfortable. “Many people internalize fears and keep anxious thoughts to themselves,” Caroline Murphy, LPC-MHSP, says. “You may notice the behavior changes instead and need to facilitate conversations to understand their behaviors.”
If you notice that these changes in your child’s behavior persist for more than a few weeks, schedule an appointment with a psychiatrist or a pediatrician specializing in mental health care for an evaluation. They can assess your child’s behavior, make a diagnosis, and offer treatment options, such as counseling, cognitive behavioral therapy, and medicine.
Guidry explains that the treatment plan depends on the diagnosis and age of the child. “After a parent goes with their child to a psychiatrist or a primary care doctor for an initial assessment, they might be referred to counseling or therapy to try that first. Oftentimes with younger children, before you try medicine, trying counseling or therapy might help.”
Set up a parent-teacher conference to discuss options for assisting your child if they are struggling in school. “The school can provide more information about relevant resources and accommodations, but most schools offer support meetings and can help determine the appropriateness of an Individualized Education Plan (IEP) or other accommodations, testing, etc.,” Murphy says. “Accommodations may range from increased time on tests, breaks, etc., to more intensive services.”
If you and your child’s teacher decide that an IEP is the best route to take in your child’s mental health journey, the next step is for an IEP team to write an evaluation report. The team can consist of teachers, guidance counselors, principals, and psychologists who assess your child’s needs. Their evaluation report and recommendations for accommodations and services are then discussed with you. Next, the information from the report is used to write the IEP, which includes a detailed outline of the services the school will offer to your child.[9]
As the parent, you are allowed to contribute to the development of the IEP and review it before it goes into effect. After the IEP goes into effect, it will be reviewed every year and updated based on your child’s needs.[10] To learn more about IEPs, refer to the Center for Parent Information and Resources and Nemours Children’s Health.
When you were a kid and teenager, what were some of your favorite ways to unwind when you got home after a long day at school? Maybe it was reading a book, playing outside, taking your dog for a walk, talking on the phone with your best friend, or a combination of all the above!
Encourage your kids to do the same by trying different ways to release their energy or soothe their anxiety. Murphy recommends implementing a balance of stimulating (i.e., running, jumping, listening to fast music) and calming (i.e., reading, coloring, listening to soothing music) activities and allowing your child to decide which type they need.
“Letting kids be the leaders in their play and exploring their bodies’ responses to their environment (helping them notice that loud music seems overwhelming, but quiet play with art makes them feel relaxed) is how kids learn to internalize coping skills,” Murphy says.
Establishing routines is another way you can create a healthy environment at home. “Depending on the child, routines can help certain children to maintain a sense of calm or ease their anxiety,” suggests Guidry.
For younger children, these routines can be eating a snack as soon as they get home from school, playing outside for 30 minutes, reading a story before bedtime, and going to bed at the same time every night. With older children and adolescents, you can establish a routine of doing homework first for an hour, followed by doing something they enjoy.
Mental health is as important as physical health, and just like maintaining your physical health through exercise and eating well, taking care of your mental well-being should be a part of a healthy lifestyle for both you and your child. You can do this together through simple, everyday activities like learning breathing techniques, getting fresh air and sunshine, doing hobbies you both enjoy, writing in gratitude journals, learning yoga, and practicing meditation.
Sometimes, though, these tools aren’t enough, and more help is needed. Many resources are available to assist your child on their wellness journey if that's the case. Seek professional help, ask questions, and find healing!
________________[1] Racine, Nicole, PhD, RPsych, McArthur, Brae Anne PhD, RPsych, Cooke, Jessica E., MSc1,2; et al. “Global Prevalence of Depressive and Anxiety Symptoms in Children and Adolescents During COVID-19.” JAMA Pediatrics, 19 May 2021, doi:10.1001/jamapediatrics.2021.2482. Accessed 17 May 2022.[2] “Mental Health Conditions,” National Alliance on Mental Illness (NAMI), https://www.nami.org/About-Mental-Illness/Mental-Health-Conditions. Accessed 17 May 2022.[3] Whitney, Daniel G., PhD, Peterson, Mark D., PhD. “US National and State-Level Prevalence of Mental Health Disorders and Disparities of Mental Health Care Use in Children.” JAMA Pediatrics, 11 Feb. 2019, doi:10.1001/jamapediatrics.2018.5399. Accessed 17 May 2022.[4] Merikangas, Kathleen Rise, PhD, He, Jian-ping, M.Sc., Burstein, Marcy, PhD, et al. “Lifetime Prevalence of Mental Disorders in U.S. Adolescents: Results from the National Comorbidity Survey Replication–Adolescent Supplement (NCS-A).” Journal of the American Academy of Child & Adolescent Psychiatry, Volume 49, Issue 10, 2 Aug. 2010, doi:10.1016/j.jaac.2010.05.017. Accessed 17 May 2022.[5] “Anxiety Disorders.” National Institute of Mental Health (NIMH), https://www.nimh.nih.gov/health/topics/anxiety-disorders. Accessed 24 May 2022.[6] “Behavioral Disorders in Children.” MentalHealth.Gov, U.S. Department of Health & Human Services, 11 March 2022. https://www.mentalhealth.gov/what-to-look-for/behavioral-disorders. Accessed 24 May 2022.[7] “Child and Adolescent Mental Health.” National Institute of Mental Health (NIMH), May 2019. https://www.nimh.nih.gov/health/topics/child-and-adolescent-mental-health. Accessed 24 May 2022.[8] “Attention-Deficit/Hyperactivity Disorder in Children and Teens: What You Need to Know.” National Institute of Mental Health (NIMH). https://www.nimh.nih.gov/health/publications/attention-deficit-hyperactivity-disorder-in-children-and-teens-what-you-need-to-know. Accessed 24 May 2022.[9] “Individualized Education Programs (IEPs).” Nemours Children’s Health, March 2022. https://kidshealth.org/en/parents/iep.html. Accessed 24 May 2022.[10] “Individualized Education Programs (IEPs).” Nemours Children’s Health, March 2022. https://kidshealth.org/en/parents/iep.html. Accessed 24 May 2022.