Mental illness in children: Know the signs

By Mayo Clinic staff

Mental illness in children can be hard for parents to identify. As a result, many children who could benefit from treatment don't get the help they need. Understand the warning signs of mental illness in children and how you can help your child cope.

Why is it hard for parents to identify mental illness in children?

It's typically up to the adults in a child's life to identify whether the child has a mental health concern. Unfortunately, many parents don't know the signs and symptoms of mental illness in children. Even if you know the red flags, it can be difficult to distinguish signs of a problem from normal childhood behavior. You might reason that every child displays some of these signs at some point. Concerns about the stigma associated with mental illness, the use of certain medications and the cost of treatment might also prevent parents from seeking care for a child who has a suspected mental illness.

What mental health conditions affect children?

Children can experience a range of mental health conditions, including:

• Anxiety disorders. Children who have anxiety disorders — such as obsessive compulsive disorder, post-traumatic stress disorder, social phobia and generalized anxiety disorder — experience anxiety as a persistent problem that interferes with their daily activities.
• Attention-deficit/hyperactivity disorder (ADHD). This condition typically includes a combination of issues, such as difficulty sustaining attention, hyperactivity and impulsive behavior.
• Autism. Autism is one of a group of serious developmental problems called autism spectrum disorders that appear in early childhood — usually before age 3. Though symptoms and severity vary, all autism disorders affect a child's ability to communicate and interact with others.
• Eating disorders. Eating disorders — such as anorexia nervosa, bulimia nervosa and binge-eating disorder — are serious conditions. Children can become so preoccupied with food and weight that they focus on little else.
• Mood disorders. Mood disorders — such as depression and bipolar disorder — can cause a child to feel persistent feelings of sadness or extreme mood swings.
• Schizophrenia. This chronic mental illness causes a child to lose touch with reality (psychosis).

What are the warning signs of mental illness in children?

Warning signs that your child might have a mental health condition include:

• Mood changes. Look for feelings of sadness or withdrawal that last at least two weeks or severe mood swings that cause problems in relationships at home or school.
• Intense feelings. Be aware of feelings of overwhelming fear for no reason — sometimes with a racing heart or fast breathing — or worries or fears intense enough to interfere with daily activities.
• Behavior changes. This includes drastic changes in behavior or personality, as well as dangerous or out-of-control behavior. Fighting frequently, using weapons or expressing a desire to badly hurt others also are warning signs.
• Difficulty concentrating. Look for signs of trouble focusing or sitting still, both of which might lead to poor performance in school.
• Unexplained weight loss. A sudden loss of appetite, frequent vomiting or use of laxatives might indicate an eating disorder.
• Physical harm. Sometimes a mental health condition leads to suicidal thoughts or actual attempts at self-harm or suicide.
• Substance abuse. Some kids use drugs or alcohol to try to cope with their feelings.

Teen Depression

Teen depression is a serious medical problem that causes a persistent feeling of sadness and loss of interest in activities. It affects how your teen thinks, feels and behaves, and it can cause emotional, functional and physical problems. Although mood disorders, such as depression, can occur at any time in life, symptoms may be different between teens and adults.

Issues such as peer pressure, academic expectations and changing bodies can bring a lot of ups and downs for teens. But for some teens, the lows are more than just temporary feelings — they're a symptom of depression.

Teen depression isn't a weakness or something that can be overcome with willpower — it can have serious consequences and requires long-term treatment. For most teens, depression symptoms ease with treatment such as medication and psychological counseling.

Teen depression signs and symptoms include changes in your teen's emotions and behavior, such as the examples below.

Emotional changesBe alert for emotional changes, such as:

• Feelings of sadness, which can include crying spells for no apparent reason
• Irritability, frustration or feelings of anger, even over small matters
• Loss of interest or pleasure in normal activities
• Loss of interest in, or conflict with, family and friends
• Feelings of worthlessness, guilt, fixation on past failures or exaggerated self-blame or self-criticism
• Extreme sensitivity to rejection or failure, and the need for excessive reassurance
• Trouble thinking, concentrating, making decisions and remembering things
• Ongoing sense that life and the future are grim and bleak
• Frequent thoughts of death, dying or suicide

Behavioral changesWatch for changes in behavior, such as:

• Tiredness and loss of energy
• Insomnia or sleeping too much
• Changes in appetite, such as decreased appetite and weight loss, or increased cravings for food and weight gain
• Use of alcohol or drugs
• Agitation or restlessness — for example, pacing, hand-wringing or an inability to sit still
• Slowed thinking, speaking or body movements
• Frequent complaints of unexplained body aches and headaches, which may include frequent visits to the school nurse
• Poor school performance or frequent absences from school
• Neglected appearance — such as mismatched clothes and unkempt hair
• Disruptive or risky behavior
• Self-harm, such as cutting, burning, or excessive piercing or tattooing

What's normal and what's notIt can be difficult to tell the difference between ups and downs that are just part of being a teenager and teen depression. Talk with your teen. Try to determine whether he or she seems capable of managing challenging feelings, or if life seems overwhelming.

If depression symptoms continue or begin to interfere in your teen's life, talk to a doctor or a mental health professional trained to work with adolescents. Your teen's family doctor or pediatrician is a good place to start. Or your teen's school may recommend someone.

When to see a doctorIf you suspect your teenager is depressed, make a doctor's appointment as soon as you can. Depression symptoms likely won't get better on their own — and they may get worse or lead to other problems if untreated. Depressed teenagers may be at risk of suicide, even if signs and symptoms don't appear to be severe.

If you're a teen and you think you may be depressed — or you have a friend who may be depressed — don't wait to get help. Talk to a health care professional such as your doctor or school nurse. Share your concerns with a parent, a close friend, a spiritual leader, a teacher or someone else you trust.

Suicidal thoughtsIf your teen is having suicidal thoughts, get help right away. Take all talk of suicide seriously. Here are some steps you can take:

• Call a suicide hotline number — in the United States, call the National Suicide Prevention Lifeline at 800-273-TALK (800-273-8255) to reach a trained counselor or encourage your teen to do so.
• Seek help from your doctor, a mental health provider or other health care professional.
• Reach out to family members, friends or spiritual leaders for support as you seek treatment for your teen.

When to get emergency helpIf you think your teen is in immediate danger of self-harm or attempting suicide, make sure someone stays with him or her. Call 911 or your local emergency number immediately. Or if you think you can do so safely, take your teen to the nearest hospital emergency department.

What's the connection between diabetes and depression? How can I cope if I have both?

Diabetes and depression: Coping with the two conditions

What's the connection between diabetes and depression? How can I cope if I have both?

Answer

If you have diabetes, you have an increased risk of developing depression. And if you have depression, you have a greater chance of developing type 2 diabetes. The good news is that diabetes and depression can be treated together. And effectively managing one can have a positive outcome on the other.

How they're related
Though the relationship between diabetes and depression isn't fully understood:

• The rigors of managing diabetes can be stressful and lead to symptoms of depression.
• Diabetes can cause complications and health problems that may worsen symptoms of depression.
• Depression can lead to poor lifestyle decisions, such as unhealthy eating, less exercise, smoking and weight gain — all of which are risk factors for diabetes.
• Depression affects your ability to perform tasks, communicate and think clearly. This can interfere with your ability to successfully manage diabetes.

Managing the two conditions together

• Diabetes self-management programs. Diabetes programs that focus on behavior have been successful in helping people improve their metabolic control, increase fitness levels, and manage weight loss and other cardiovascular disease risk factors. They can also help improve your sense of well-being and quality of life.
• Psychotherapy. Similarly, participants in psychotherapy, particularly cognitive behavioral therapy, have reported improvements in depression, which has resulted in better diabetes management.
• Medications and lifestyle changes. Medications — for both diabetes and depression — and lifestyle changes, including different types of therapy coupled with regular exercise, can improve both conditions.

If you have diabetes, watch for signs and symptoms of depression, such as loss of interest in normal activities, feelings of sadness or hopelessness, and unexplained physical problems like back pain or headaches.

If you think you might be depressed, seek help right away. Your doctor or diabetes educator can refer you to a mental health professional.