Only in the past two decades has depression in children been taken very seriously. The child may pretend to be sick, refuse to go to school, cling to a parent, or worry that the parent may die. Older children may pout and be moody, get into trouble at school, be negative, grouchy, and feel like no one understands them or likes them.

Most behaviors vary from one childhood stage to another and it can be difficult to tell whether a child is just going through a temporary stage or is suffering from depression. At times, the parent(s) might become concerned about how the child’s behavior has changed, or a teacher may mention that the child doesn’t seem to be himself. If this is the case, a visit to the child’s pediatrician may rule out physical symptoms and therefore the pediatrician may suggest that the child be evaluated by a psychiatrist or licensed social worker who specializes in the treatment of children. For every parent, gaining a understanding of mental illness and how the brain develops, helps young children and their parent(s) manage difficulties early in life may prevent the development of disorders. Once mental illness develops, it becomes a regular part of your child’s behavior and more difficult to treat. Although we know how to treat many disorders, many children with mental illnesses are not getting proper treatment.

Research has shown that half of all cases of mental illness begin by age 14. Scientists are learning that changes in the body leading to mental illness may start much earlier, before any symptoms appear. Disorders affecting children may include anxiety disorders, attention deficit hyperactivity disorder (ADHD) bipolar disorders, eating disorders, autism spectrum disorders, and schizophrenia.

As a parent or caregiver concerned about your child’s mental health, here are some helpful suggestions:

¯ Talk to your child’s doctor or health care provider.

¯ Ask questions and learn everything you can about the behavior or symptoms that worry you.

¯ If your child is in school ask the teacher if your child has been showing changes in behavior and share this with your child’s doctor or health care provider. Keep in mind that every child is different.

¯ Ask if your child needs further evaluation by a specialist with experience in child behavioral problems. Specialists may include psychiatrists, psychologists, social workers, psychiatric nurses, and behavioral therapists. Educators may also help evaluate your child.

¯ If you take your child to a specialist, ask, if they have have experience treating the problems you see in your child? Don’t be afraid to interview more than one specialist to find the right fit.

Not every problem is serious. Many everyday stresses can cause changes in your child’s behavior. For example, the birth of a sibling may cause a child to temporarily act much younger than he or she is. It is important to be able to tell the difference between typical behavior changes and those associated with more serious problems.

Pay special attention to behavior changes:

¯ Problems across a variety of settings, such as at school, at home, or with peers

Changes in appetite or sleep

¯ Social withdrawal, or fearful behavior toward things your child normally is not afraid of

¯ Returning to behaviors more common in younger children, such as bed-wetting, for a long time

¯ Signs of being upset, such as sadness or tearfulness

¯ Signs of self-destructive behavior, such as head-banging, or a tendency to get hurt often

¯ Repeated thoughts of death

Just like adults, children with mental illness are diagnosed after a doctor or mental health specialist carefully observes signs and symptoms. Some primary care physicians can diagnose your child themselves, but many will send you to a specialist who can diagnose and treat children.

Very young children often cannot express their thoughts and feelings, so making a diagnosis can be challenging. The signs of a mental illness in a young child may be quite different from those in an older child or adult.

Each child has individual needs, and will require close monitoring. Psychosocial therapies can be very effective alone and in combination with medications. Psychosocial therapies are also called “talk therapies” or “behavioral therapy,” and they help people with mental illness change behavior. Therapies that teach parents and children coping strategies can also be effective. Some children benefit from a combination of different psychosocial approaches. An example is behavioral parent management training in combination with CBT for the child. In other cases, a combination of medication and psychosocial therapies may be most effective. Psychosocial therapies often take time, effort, and patience. As with other serious illnesses, taking care of a child with mental illness is hard on the parents, family, and other caregivers. Stress on the caregiver can make it hard to cope with your child’s symptom, and support groups can play an important role in parent(s) ability to manage and care for themselves as well as their child.

Sylvia A. Emerling is a LMSW School Based Social Worker, Family Service of the Chautauqua Region Inc.

As parents and caregivers, remember that children are constantly changing and growing. Diagnosis and treatment need to be viewed with these changes in mind. While some problems are short-lived and don’t need treatment, others are ongoing and may be very serious. In either case, more information will help you understand treatment choices and manage the disorder or problem.

For more information, please contact Family Services of the Chautauqua Region Inc. at 488-1971 or by E-mail at familyservice@fscr.mygbiz.com.