Signs Of Mental Illness In Children, Types, And Causes

Mental illness in children may obstruct their development and growth. According to the Centres for Disease Control and Prevention (CDC), one in five children is diagnosed with mental health conditions every year (1). Unfortunately, most of these children are not supported or treated.

It may be difficult to recognize mental disorders in children since the symptoms are often difficult to differentiate from normal developmental changes. Therefore, being aware of different mental illnesses is critical for parents.

Read on to know the most common mental health disorders that affect children, the symptoms, causes, and treatment choices for these disorders, and some preventative advice regarding mental health disorders in children.

Symptoms Of Mental Illness In Children

Certain behavioral patterns in children may indicate a psychiatric problem. Here are a few indicators of mental illness in children (2) (3).

In young children

• Feeling of desolation for two or more weeks
• Avoiding interactions with other children
• Poor academic performance
• Extreme and irrational fear or worries that impact everyday activities
• Frequent or increased frequency of physical complaints such as stomach aches or headaches for no known medical cause
• Restlessness and trouble sitting in one place except while looking at a TV, mobile, or computer screen
• Frequent fights, getting into trouble, and inclination to harm others
• Mood swings and tantrums
• Repeating certain actions or checking certain things to relieve fear and worry
• Feeling of impending doom

In older children and adolescents

• Self-harming or suicidal thoughts
• Out of control, dangerous, and destructive behavior
• Low energy for no apparent reason
• Noticeable loss of interest in things they usually enjoy
• Withdrawal from friends and family
• Insomnia, oversleeping, lethargy during the day, nightmares
• Excessive efforts to lose weight — skipping meals, throwing up food, and extreme dieting
• Smoking, drinking, or drug abuse
• Bouts of over excitement
• Hearing sounds or voices no one else hears
• Severe mood swings

Types Of Mental Illnesses In Children

The following are a few mental disorders or illnesses that commonly affect children.

• Anxiety disorders: Anxiety disorder is an umbrella term for several illnesses. The most common ones include separation anxiety (fear of being away from parents), social anxiety (fear of interacting with people), phobias (irrational fear of certain things or situations), generalized anxiety disorder (extreme anxiety about normal life events and future), and panic disorder (frequent panic attacks characterized by increased palpitations, trouble breathing, dizziness) (4).

Children suffering from anxiety disorder have many irrational fears and worries that affect their daily activities such as studies, participation in school, playtime, extracurricular interests, and social interactions. They might also find it challenging to make friends, feel extremely afraid of certain things, and become distressed, angry, or irritable.

• Depression: Depression in children is associated with persistent feelings of sadness and hopelessness. They may become uninterested in doing things they enjoyed, feel tired, or attempt to harm themselves (4).

• Attention-deficit hyperactivity disorder (ADHD): Children with ADHD find it difficult to focus on things or sit still in one place. They may become excessively active, restless, and impulsive. This behavior can cause them to struggle socially and in school (5).

• Posttraumatic stress disorder (PTSD): PTSD is generally associated with a traumatic or stressful event in the past. Children suffering from PTSD might get fearful of this event and keep recollecting and re-experiencing it. They might suffer from loss of sleep and nightmares (6).

• Oppositional defiant disorder: Children suffering from this behavioral disorder often act hostile and defiant, particularly towards authority figures in their lives, such as parents, other family members, caregivers, and teachers. They may refuse to follow the rules and often argue and misbehave with adults (7).

• Obsessive-compulsive disorder: Obsessive-compulsive disorder causes the child to obsess and worry over certain thoughts. To ease these stressful thoughts, the child may resort to compulsive actions, such as repeatedly washing hands, cleaning, arranging objects in a particular order, or counting (8).

• Tourette syndrome: Children with Tourette syndrome make repeated involuntary sounds or movements called tics. Blinking or squinting of the eyes, jerking of the arm, and shrugging shoulders are some symptoms of physical tics. Vocal tics include whistling, repetition of certain sounds and words, grunting, and humming (9).

• Conduct disorder: Children with conduct disorder may exhibit aggressive behavior, break the rules, disregard social norms, and disrespect others. They might also resort to stealing, destroying of property, physical fights, and bullying (10).

• Eating disorders: Children with eating disorders may have anorexia nervosa (obsession about weight and food coupled with warped body image), bulimia nervosa (overeating and purging to avoid weight gain), binge eating disorder (uncontrolled overeating), and avoidant restrictive food intake disorder (eating only selected food items) (11) (12).

• Autism spectrum disorder: This disorder is characterized by problems in communication, social interactions, and behavior. It is called a spectrum disorder because of the considerable degree of difference in symptoms between individuals (13).

Causes Of Mental Illness In Children

Several studies indicate that mental illnesses may be caused by a combination of several factors. Here are a few factors that can increase the risk of mental illnesses in children.

• Heredity: Certain mental disorders may run in families, so a child born into a family where other family members have a mental illness is at a higher risk. However, while genetics may have a crucial role, environmental factors also play a part. A mental disorder is caused by a combined impact of multiple genetic and environmental factors. It is rare for a single genetic factor to cause a mental illness (14) (15).

• Biology: Neurotransmitters are chemical messengers that drive the communication between the brain neurons. Any change or imbalance in the neurotransmitters can disrupt the communication between neurons, leading to a mental disorder (16). Other biological factors that increase the risk of mental illnesses include

• • Hormonal changes or certain infections (17). Activation of specific immune cells due to an infection or an ongoing immune response can trigger a mental disorder (18).
  • Traumatic brain injuries (19).

• Psychological trauma: Some traumatic events may increase a child’s susceptibility to mental disorders. The following are a few key causative events (14) (17).

• • Physical, emotional, or sexual abuse during childhood
  • Natural disasters
  • Living in war zones
  • Loss of a loved one
  • Social isolation or neglect

• Environmental factors: Certain harmful environmental triggers can cause mental illnesses in children. They include  (14)

• • Violence, bullying, or other problematic situations in school
  • Exposure to drugs, alcohol, or tobacco in the womb or in childhood
  • Toxic and stressful home environment

When To See A Doctor?

Seek the help of a medical professional in the following scenarios (2).

• The child exhibits any of the symptoms given in this post.
• The symptoms continue for a few weeks or more.
• There is a drastic change in the child’s personality.
• The child’s behavior negatively impacts their daily life and those of people around them.

If the child discusses harming themselves or shows self-harming behavior, it is crucial to immediately reach out to a medical professional.

Diagnosis Of Mental Illness In Children

Diagnosis of mental illness in children is generally made by trained medical professionals such as psychiatrists, psychologists, clinical social workers, psychiatric nurses, and other mental health care professionals.

Multiple steps are involved in the diagnosis of a mental illness (20).

• The symptoms and behavior patterns are discussed with the child and the parents.
• Assessment tools, such as questionnaires and interviews, are used for the evaluation of the child.
• Parental assessment may also be done to get a clear understanding of the child’s condition.
• To eliminate the possibility of a physical illness, medical tests may be conducted.
• Besides the child and the parents, the medical professional may also take feedback from the teachers, caregivers, and other adults in the child’s life.

Based on these detailed assessments and reports, the doctor diagnoses the mental condition and gives a treatment plan.

Treatment Of Mental Illness In Children

Once the root cause of the mental disorder is ascertained, the treatment plan can be finalized under the guidance of the psychiatrist and therapist. The following are some treatments that may be considered.

• Psychotherapy: Psychotherapy is a treatment method that involves conversations between a trained mental health care professional and the family or the child. The therapist helps the child understand and process their mental condition. They may suggest techniques for managing and modifying problematic thoughts, feelings, and behavior (21). A combination of different psychotherapies can be used, such as (22)

• • Acceptance and commitment therapy (ACT)
  • Interpersonal therapy (IPT)
  • Cognitive behavioral therapy (CBT)
  • Play therapy
  • Group therapy
  • Family therapy
  • Supportive therapy
  • Parent-child interaction therapy (PCIT)
  • Psychodynamic psychotherapy
  • Mentalization-based therapy (MBT)

• Medication: Medications are often prescribed in combination with psychotherapy to treat mental disorders in children (2). A detailed psychiatric assessment is done, and the class of medicine and its dosage is finalized based on the results. Details such as the benefits of the medication, side effects, risks, warnings, type of prescription (on-label or off-label) are discussed with the parents before going ahead with the medication plan. The following classes of medications are generally used (23).

• • Anti-anxiety
  • Antidepressants
  • Antipsychotics
  • Mood stabilizers
  • Stimulants

How To Explain Mental Illness To A Child?

Mental illnesses are often misconstrued and misunderstood. Due to the stigma surrounding mental illness, usually, only a small percentage of mental health patients receive the help they need. Hence, it is essential to educate children about mental disorders and debunk any associated misconceptions.

While it can be challenging to explain complex subjects, such as mental illness, to a child, here are a few ways to go about it (24).

• Read up on the topic and ensure you have a fair amount of knowledge to answer the child’s questions. Inform them about the meaning of mental illness and the causes, diagnosis, and treatment options. The child should know that mental illness can be treated.
• Use age-appropriate language.
• Explain by comparing mental illnesses to physical illnesses they know to get the point across.
• Be honest and straightforward while speaking on the subject.
• Make sure the child feels safe and comfortable during the conversation.
• Keep an eye on the child’s expressions and responses. If they seem confused, go slow and gently clear their doubts. In case they look worried or upset, comfort them.

Preventive Tips For Mental Illness In Children

While not all mental disorders can be entirely prevented, you could take a few steps to protect your child’s mental health and reduce the risks.

Here are a few steps you can take to prevent mental illness in children (25) (26)

1. Encourage healthy relationships: Give your child an opportunity to connect with other members of your family, your friends, and neighbors. Encourage them to play with other children and make friends.

2. Keep the line of communications open: Be straightforward and honest in your communication with your children. Speak to them about their day, school, and friends.

3. Get involved in their life: Speak to their teachers and friends. Learn about your child’s progress from their teachers and caregivers and discuss with them the kind of support your child needs. Talk to your child about their feelings, and show them you care about their physical and mental well-being.

4. Fulfill their physical and emotional needs: Take care of their basic needs, such as food, clothing, shelter, hygiene, and medical care. Tell them you love and value them unconditionally and provide support when they are worried, scared, or distressed.

5. Teach them how to cope with stress: Figure out the things that help relieve your child’s anxiety and encourage them to do these activities when they feel anxious or overwhelmed. The stress-relieving activities may vary for every child, such as talking to parents or their friends, drawing, writing, or playing.

6. Help them develop their self-esteem: Encourage independence by allowing them to do some things on their own. Let them do small tasks around the house, such as setting the table, washing vegetables, and folding clothes. Offer them genuine praise for good behavior or for doing something constructive, and teach them to be optimistic.

7. Encourage them to play: Encourage them to join sports events in school. Schedule a playtime for them, and take the time out to play with them.

8. Inculcate good values: Educate children about appropriate behavior, and discourage any kind of bad behavior. Teach them discipline, good values, and thoughtfulness. You could also encourage them to volunteer and help others in need.

9. Develop their problem-solving skills: Inspire them to undertake new challenges and provide your full support in any of their new endeavors. Encourage them to solve their problems independently but provide guidance and help wherever necessary.

10. Teach healthy habits: Encourage your children to eat healthy, exercise, and sleep on time. You could also inculcate a love of reading in them, teach them about practicing gratitude, and include meditation in their daily schedule.

11. Provide structure and stability: Create a safe home environment. Avoid yelling or fighting, and don’t shame your children if they do something wrong. Be consistent in your behavior. In case of a significant change, such as when you move to another city, change schools, move into a new house, or get a divorce, speak honestly with your child. Provide emotional support, and help them deal with the situation by setting up a routine and indulging in fun activities.

12. Take care of your health: If you notice any changes in yourself, such as loss of sleep, oversleeping, sadness, anger, anxiety, or fatigue, consult a medical professional. If you have an untreated mental condition, it may impact your children.

13. Pay attention to your child: Pay attention to your child’s behavior. If there is a drastic change in their behavior, and they seem over-anxious or unusually quiet and withdrawn, it may be a cause for concern.

14. Get professional help if necessary: Never hesitate to seek professional help if you feel your child is suffering from a mental disorder. Give them all the help and support they need.

References

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Reviewer

Shreshtha DharM.A, M.Phil

   

Shreshtha Dhar is a licensed Clinical Psychologist with a professional experience of around seven years. Presently, she operates her private practice, Thought Craft, based out of Kolkata. She has special interest in the emotional and behavioral issues of both children and adults.

Read full bio of Shreshtha Dhar