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.