When to be concerned about your child's mental health

When I do intakes with parents to get more information about how their child is doing, I ask "Are there any signs of depression or anxiety that you're concerned about?" Often parents say "what would that look like in a child?" The answer is that they have the same symptoms as adults, but they may show up differently. Look for:

• changes in eating patterns 
  • loss of appetite
  • increase in appetite
  • eating fewer healthy foods
  • unable to try new foods
  • the operative word here is "changes". Look for any differences in their usual food patterns. If you've had a kid who's always been a picky eater and is still a picky eater, that is not indicative of a change. 
• changes in sleeping patterns
  
  • increased need for sleep
  • decreased need for sleep
  • increased nightmares or night waking
  • difficulty falling asleep
  • increased fear or anxiety around sleep
• irritability
  • just like with adults, irritability can be a sign of depression or anxiety in kids. 
  • Look for patterns over time. One day of irritability is not a pattern, it is a difficult day. Are you consistently seeing irritability or negativity, even in the face of something fun? 
• aggression
  • just like with eating and sleeping patterns, focus on if this is a change. 
  • also consider if your child may be feeling more aggressive, even if not acting on those feelings. Examples would be increased threats of aggression to others, increased verbalization of aggression
• difficulty focusing
  • this is difficult to assess when there are a lot of variables that change (for example, has your child started virtual learning, or more rigorous academics, or now has a teacher with a new teaching style? 
  • ask others (teachers, grandparents) if they've noticed any changes in focus
  • consider if your child can still focus on things they enjoy? 
• loss of pleasure in activities they formerly enjoyed
  • again, we want to assess for patterns over time, not an isolated event
  • if swinging on the swings in the yard was their favorite activity and now doesn't seem enjoyable, that might be relevant. 
  • if they don't enjoy the swings because now they're really into beyblades and they're enjoying that instead, that is likely not indicative of a concern. 
• increased headaches or stomach aches not related to a physical or medical concern
  • the child may not associate the physical complaint with the anxiety or depression
  • do these complaints persist when the child is doing an activity they enjoy? Or do they only occur when it is time for homework to start? 
• suicidal ideation
  • if your child says that they want to hurt themselves or others, take their statement seriously. 
  • you can call the national suicide prevention hotline at 800-273-8255
• below is an infographic to help you remember these signs.