You know your child better than anyone. You’ve seen their ups and downs, their energy shifts, their meltdowns, their quiet moments. And sometimes, it’s hard to know: Is this just a phase? Or is something more serious going on?
Children and teens go through many changes as they grow. But when certain behaviors last more than a couple of weeks, it may be a sign of a mental health condition.
You’re not alone in asking questions. And you don’t have to wait for a crisis to get help. We spoke with Alyssa Bowman, LMFT, a mental health counselor with Banner Health, to learn the early signs of a few mental health conditions in children and when (and where!) to seek help.
Why mental health matters at every age
We often think of mental health as something that affects adults. But it’s just as important for kids. Globally, one in seven 10 to 19-year-olds experiences a mental health disorder.
Children and teens are growing, changing and trying to understand the world around them and themselves. They’re also dealing with pressure from school, social media, friendship and sometimes even family struggles. These pressures can be a lot for a developing brain to handle.
Mood changes, occasional irritability or periods of low energy are normal, but the key is paying attention to:
- How intense the mood or behavior changes are
- How long they last (two weeks or more)
- How much do they affect their daily life, school or relationships
If your child’s mood swings, behaviors or emotions affect their ability to function, learn or enjoy life, it’s time to take notice.
Understanding specific conditions in children and teens
Mental health conditions affect children differently from adults. “Some symptoms may overlap, but others are unique to children based on their age, development and personality,” Bowman said.
Here’s how to recognize the signs of five common mental health conditions in children and teens.
Depression
While adults may discuss sadness openly, children often express it through their actions.
“Children often express depression through irritability, crying, isolation, low energy and changes in sleep or hygiene,” Bowman said. “They may also act out or withdraw from activities they once enjoyed.”
Watch for these signs:
- Irritability or mood swings
- Regular crying or sadness lasting more than two weeks
- Avoiding friends, family or social activities
- Low energy or fatigue
- Sleeping too much or too little
- Saying they feel worthless, guilty or hopeless
- Drop in grades or motivation to do schoolwork
- Changes in eating habits
- Skipping showers or caring less about hygiene
- Self-harm or talk of suicide
Pay attention to how your child plays. Bowman notes that “kids tend to play out their emotions. You may see sadness, fear or even anger come through in their stories or games.”
Anxiety
Anxiety in children and teens can look like nervousness, but may also show up as anger, perfectionism or physical complaints. Kids may not say “I feel anxious,” but they’ll show it in other ways.
Signs of anxiety in kids may include:
- Constant worrying or fear, even about small things
- Trouble sleeping or staying asleep
- Complaints of stomachaches, headaches or racing heart
- Avoiding school, social events or new situations
- Irritability or anger outbursts
- Difficulty concentrating
- Needing a lot of reassurance
- Perfectionism or fear of failure
“Anxiety often hides behind behaviors that seem like defiance, anger, sadness or disinterest,” Bowman said. “But underneath, your child may just be overwhelmed and unsure how to cope.”
ADHD (attention deficit/hyperactivity disorder)
ADHD is often misunderstood. Many people think it just means a child can’t focus. But there’s more to it than that.
“A myth of ADHD is that people with it can’t focus, but ADHD often looks like hyperfocus,” Bowman said. “Kids may focus deeply on a topic or task that’s interesting to them but not the one they’re supposed to be working on.”
Signs of ADHD in children and teens can include:
- Trouble paying attention or finishing tasks
- Acting impulsively or interrupting others
- Struggling to follow multi-step instructions
- Constant fidgeting or movement
- Sensitivity to noise or busy environments
- Losing things often
- Difficulty making or keeping friends
- Emotional outbursts or frustration
Symptoms can appear differently in each child. “I often see more boys with hyperactivity and disruptive behavior,” Bowman said. “Girls may show more trouble with focus, maintaining conversations or feeling ‘behind’ in school.”
Mood disorders (including bipolar disorder)
If your child is a teenager, you know that they can be emotional from time to time. But when moods swing from very high to very low and those shifts last longer than a few hours or days, it could be something more serious.
“Mood swings usually pass quickly and don’t include manic behavior,” Bowman said. “Mood disorders, like bipolar disorder, involve longer and more intense mood changes, including manic episodes with high energy and impulsivity followed by deep depressive episodes.”
Signs of a possible mood disorder include:
- Intense mood swings that last for days or weeks
- Manic behavior (very talkative, little sleep, racing thoughts)
- Risk-taking or impulsive actions
- Periods of sadness, hopelessness or low motivation
- Difficulty functioning at school or home
- Trouble with friendships and family relationships
- Sleeping much more or much less than usual
Eating disorders
Changing eating habits can be a normal part of growing up. But when a child becomes overly focused on food, weight or body image (or begins restricting food), it may be a sign of an eating disorder. Eating disorders can be very serious and affect children of any size, shape or gender.
You might notice:
- Skipping or hiding meals
- Obsessing about weight or body shape
- Sudden weight loss or gain
- Refusing to eat with others
- Going to the bathroom right after meals
- Exercising excessively
- Feeling cold all the time
- Mood swings or withdrawal
When to seek help
It’s always okay to ask for help, even if you’re not sure something is wrong.
“If behavior changes suddenly or lasts more than two weeks, that’s when I recommend reaching out to a therapist, counselor or provider,” Bowman said. “Also, if your child has experienced trauma, is being bullied or talks about wanting to die, don’t wait to get help.”
She added, “I always tell parents to trust their heart. If something doesn’t feel right, it’s okay to ask questions or bring in a professional to help.”
Get started by talking with your child
Bringing up mental health can feel awkward, especially if your child doesn’t like to talk about their feelings. Start by making space for them to open up. Find a calm time, maybe on a walk or drive, and ask gentle, open-ended questions.
Bowman suggests mirroring the symptoms you see.
“I’ve noticed you’ve been crying a lot lately. What’s going on in your world?”
“You used to love soccer, but you haven’t gone to practice in weeks. How are you feeling about it?”
“You’ve been spending a lot more time alone. Is something bothering you?”
This kind of approach helps your child feel seen without feeling judged. And it shows you’re paying attention in a caring way.
Learn more about how to start a conversation with your child or teen, by reading How to Talk to My Child About Mental Health.
Ask for additional support
- Call your child’s primary care provider: They can help you decide if your child needs to be seen or referred to a specialist.
- Check your insurance provider for coverage: This can help you find in-network therapists or counselors in your area.
- Know who to call in a crisis: If your child is suicidal, homicidal or at immediate risk, call 911, text or call 988 (Suicide & Crisis Lifeline) or go to the nearest emergency room.
Bottom line: What your child needs most is you
Your child may not always have the words to say that they’re struggling, but your attention, concern and willingness to show up for them mean everything.
You don’t need to have all the answers. Just being there, asking questions and showing them they matter, can be a lifeline.
Need support for your child’s mental health?
Watching your child struggle with mental health is hard. You may feel unsure, scared or even blame yourself. Banner Health has a team of compassionate providers ready to help. Learn more about our behavioral health services or talk with your child’s health care provider to find resources near you.
