Mental Illness in Children: Signs, Diagnosis, and Treatment

Children are not immune to mental health problems. In fact, they are one of the most vulnerable populations, with one in six American children aged two to eight years (17.4%) diagnosed with mental, behavioral, or developmental disorders [*]. Despite this, mental illness in children often goes unnoticed or not taken seriously, and children still do not receive the help they need. Untreated mental health problems can cause issues in children’s lives at home, school, and in the community.

This emphasizes the role of parents, caregivers, and family members in protecting the well-being of children. Here, we will discuss mental illness in children, including its signs, diagnosis, and treatment, so you can seek help for your child if needed.

Mental Illness in Children

Recognizing mental illnesses in children can be challenging for parents, caregivers, and sometimes even healthcare providers. Unlike adults, children are still undergoing developmental changes physically, emotionally, and mentally. They are also learning how to adapt to their environment and relate to others.

Aside from this, every child matures at their own pace. What is considered “normal” in children falls within a wide spectrum of abilities and behaviors. Therefore, diagnosing any mental illness or disorder must take into account not just a child’s symptoms and age but also how well they function in different aspects of life, including at home, school, with peers, and in the community.

Common Mental Illnesses in Children

Various mental illnesses and disorders can affect children. These include the following:

• Anxiety disorders
• Autism spectrum disorder (ASD)
• Attention-deficit/hyperactivity disorder (ADHD)
• Post-traumatic stress disorder (PTSD)
• Schizophrenia
• Eating disorders
• Learning and communication disorders
• Affective (mood) disorders

Some of these mental illnesses, such as mood, eating, and anxiety disorders, can occur in both children and adults. Some begin in childhood only, while others progress into adulthood. It is common for a child to have more than one disorder.

Factors Contributing to Mental Illness in Children

There are many factors contributing to mental illness in children, including the following:

Biological factors

Biological factors are anything physical that can negatively affect a child’s mental health. These factors include:

• Genetics
• Brain defects of injuries
• Prenatal influences
• Infections
• Exposure to substance abuse
• Exposure to toxins

Environmental factors

Environmental factors influence a child’s immediate surroundings. The environmental factors that may contribute to mental illnesses in kids are:

• Pollution
• School conditions
• Weather
• Housing
• Lack of stimulation
• Lack of green outdoor spaces

Social factors

Social factors are the conditions in which children live, including the forces and systems that shape the conditions of daily life [*]. The most common social factors that influence mental illness in children are the following [*]:

• Food security
• Childhood adversity
• Education
• Social support
• Parental income and employment
• Harmful relationships
• Abuse
• Socioeconomic status

Psychological factors

Psychological factors are elements that contribute to the development of personality, behavior, and well-being. Such factors that can affect a child’s susceptibility to mental illness include the following:

• Emotional attachments
• Beliefs (worldview)
• Motivations
• Attitudes
• Responses to life stressors

Signs of Mental Illness in Children

It is important to be observant of the signs of mental illness in children. Here are a few things you can look out for if you think your child is developing a mental illness or disorder.

Behavioral changes

There may be changes in your child’s behavior, such as:

• Difficulty coping with daily activities and problems
• Chronic nightmares or night terrors
• Persistent disobedient or aggressive behavior
• Spending a significant amount of time alone
• Change in eating and/or sleeping habits
• Hyperactivity

Emotional changes

• Frequent angry outbursts
• Excessive anxiety or worrying
• Negative moods that last a long time
• Intense fear of gaining weight

Physical changes

There are also some physical manifestations of mental illnesses.

• Frequent complaints of physical ailments
• Rapid weight gain or weight loss

Academic and social changes

You may also notice some changes in your child’s social and academic life if they have developed a mental illness.

• Changes in school performance (i.e., poor grades despite good efforts)
• Loss of interest in friends
• Loss of interest in activities previously enjoyed
• Abusing substances (e.g., alcohol and/or drugs)

Psychological changes

Your child may also experience changes at the psychological level, such as:

• Hallucinations (hearing or seeing things that are not there)

Diagnosing Mental Illness in Children

Mental illnesses in children are diagnosed and treated based on how their symptoms affect daily life. To make a diagnosis, your child’s pediatrician may suggest that your child see a mental health specialist. This could be a psychologist, psychiatrist, or clinical social worker.

Mental health specialists may require any of the following:

• Complete medical exam
• Medical history
• Family history of mental and physical health
• History of emotional or physical trauma
• Developmental and maturity timeline
• School history
• Talking with you as a parent or caregiver
• Talking with your child
• Observing your child’s behavior
• Mental health tests and questionnaires for both child and parents

Mental health professionals may use the Diagnostic and Statistical Manual of Mental Disorders (DSM). This guide helps them diagnose any mental illnesses should your child exhibit the symptoms.

Remember that diagnosing your child can take time. Young children may have difficulty knowing or saying how they feel, and their developmental timeline may vary from that of other children. Even if your child is diagnosed, a mental health professional may still adjust the diagnosis over time.

How is Mental Illness in Children Treated?

Fortunately, there are varieties of treatments available for helping children manage mental illnesses. Here are some of the treatment methods that are most recommended.

Psychotherapy

Psychotherapy is a form of talk therapy that involves a child working with a trained therapist to figure out ways to solve problems and cope with mental health symptoms. While self-care is important for mental health, the presence of symptoms that are severe enough may require the help of a professional.

Two major approaches are used to treat childhood mental illness: interpersonal psychotherapy and cognitive behavioral therapy. Cognitive behavioral therapy (CBT) helps children identify and decrease any irrational thoughts and behaviors that reinforce unhelpful behaviors. Interpersonal therapy (IPT) allows children to learn more effective skills to cope with relationships, thereby reducing the symptoms of mood disorders like anxiety and depression.

Some practitioners may also opt for creative therapies like art or play therapy. These are especially helpful when working with young children who struggle to communicate their thoughts and feelings.

Medication

Different types of medication are prescribed for different mental illnesses. For anxiety and depression, a child would typically be prescribed selective serotonin reuptake inhibitors or SSRIs. These medications affect the serotonin levels in the brain. Many doctors choose SSRIs for their high effectiveness and general safety.

There are also medications for attention-deficit/hyperactivity disorder (ADHD), including stimulants and non-stimulants. These work by improving the balance of neurochemicals in the brain thought to contribute to ADHD symptoms.

If a child has bipolar disorder, medications are used to relieve existing symptoms of mania or depression and prevent these symptoms from returning. Some medications are effective in treating manic and mixed symptoms and are approved for use in children 10 years of age and older.

How to Help Your Child Cope with Mental Illness

Your child will rely on you as a parent or caregiver in developing mental health coping skills and navigating their mental illness. Here are some ways you can help them:

• Observe behavior changes. While it is quite normal for children to go through many changes in behavior as they develop and mature, it helps to watch out for signs that something is out of the ordinary for your child. Check for changes like withdrawing from friends, family, or routine. Reach out to your child and let them know you are there to support them.
• Communicate honestly and openly. It is essential that your child knows they can approach you with any issue and that they will be met with understanding and support. Let them know that you are there to listen without judgment. This will increase the likelihood that they will come to you with any problems they may struggle with.
• Model healthy coping skills. Children often model their parents’ or caregivers’ behaviors, including coping skills. One of the best ways you can teach your children how to deal with their emotions in a healthy way is by modeling healthy coping skills. Whether using a stress ball, going for a walk, or making art, learning these skills is important for kids to manage their mental illnesses.
• Establish boundaries and routines at home. Routines can help ease your child’s stress or anxiety by making daily schedules more predictable. These can also include fun activities, such as weekly movie nights. Clear boundaries are also necessary so that children know what is expected of them. For example, knowing how social media affects mental health can help you set healthy expectations for time allowed on gadgets like smartphones and tablets.
• Provide positive feedback and encouragement. Children love receiving positive feedback, whether verbal praise, extra time to play, or tangible rewards like food or toys. Knowing that they have done something well can increase feelings of confidence and pride, which will stay with them long-term. Positive reinforcement will also encourage children to repeat the desired behavior.
• Provide education on good mental health. Educating your child about good mental health can lead to better self-care and increased engagement in positive coping skills and healthy habits. Emphasizing that mental health is just as important as physical health can also help kids understand the importance of making their mental health a priority.
• Get professional help if needed. Recognizing when your child needs help is a vital skill for parents and caregivers. Don’t be afraid to ask for help when it is needed. It will benefit you and your child in the long run.

The Bottom Line

Accepting that your child may have a mental illness, as well as managing it, can be difficult. Learning how to help a child with mental health issues will present many challenges. Fortunately, there are also many ways to treat mental illnesses in children by way of therapy, medications, and, of course, family support. Mental health professionals may give you tools such as depression worksheets and coping strategies to make things easier at home. By showing up for your child in the ways we have detailed above, it becomes possible for them to manage and recover from their mental illnesses.

References:

1. Centers for Disease Control and Prevention. Data and Statistics on Children’s Mental Health. 8 March 2023.
2. World Health Organization. Social determinants of health.
3. Kirkbride J, Anglin D, Colman I et al. The social determinants of mental health and disorder: evidence, prevention and recommendations. 12 January 2024.