While stress, anxiety and depression are topics most people think of as adult issues, the truth is that kids experience mental health problems, too. Recognizing when your kids are feeling stressed, numb or sad can help parents address problems before they lead to longer-term, chronic behavioral health problems like anxiety and depression.
Particularly this summer, with COVID-19 and the isolation, fear, anxiety and disruption it’s bringing to families’ lives, healthcare professionals are definitely seeing an increase in the prevalence of behavioral health problems in both children and adults.
One of our goals as behavioral health professionals is to remind parents that mental health is just as important as physical health, and there’s a great deal of data to support that claim.
That’s why when you notice behavioral changes, it’s critical to address them. Just like you’d never ignore an infection, illness or injury, it’s important not to ignore the common signs that your children may be struggling emotionally.
How Stress Manifests in Children
Because kids often don’t know how to communicate what they’re feeling or advocate for themselves, you’ll have to keep an eye on their behavior to recognize when stress or anxiety are getting the best of them.
5 Common Signs of Stress in Kids/Teens
Some things to look out for are many of the same coping strategies adults use. Here are a few of the most common signs of stress in kids and teens:
- Eating too much or too little.
- Sleeping too much or too little.
- Overusing social media/screen time.
- Avoiding people/interaction altogether.
- Mood changes such as being overly irritable or not being able to get along with others.
We call these “maladaptive” coping mechanisms because they aren’t healthy. Sadly, due to COVID-19, many of the healthier strategies such as spending time with friends, sports activities or hobbies have all been halted. This makes it more important to be in tune with your kids’ mental health and to offer healthier strategies instead.
4 Strategies to Help Kids Manage Their Mental Health
If you’re worried that your child is struggling emotionally, the good news is there are things you can do before the problems escalate. Here is the advice I routinely give to parents who are concerned about their kids’ mental health.
#1 – Make sure the adults are on the same page.
Oftentimes, one parent will be the first to notice something may seem a little “off.” I always recommend first that this parent have a discussion with any other adult caregivers – whether it’s an in-house spouse, a co-parent in another home, or even a grandparent or other caregiver. Even if they’re not noticing the same signs, make sure they’re on board with addressing the potential issues that have been identified. Working together as adults, make a plan for how to handle next steps so you’re a unified front all focused on getting your child the support they need.
#2 – Have an open conversation with your child.
In the most non-confrontational way possible, have an open discussion with your child about the behaviors you’ve been noticing. Be sure they understand you’re not criticizing or suggesting something is wrong with them, but instead come at it from a supportive, loving perspective. Try to talk about emotions and feelings in a neutral way and encourage them to open up to you. This isn’t easy for every parent or child – some are better at talking about feelings than others, so engaging advice or professional help from a pediatrician or trained behavioral health expert can help.
#3 – Maintain structure and boundaries.
All kids need and thrive on structure – some more than others. Parents can help by strengthening or reinstating boundaries that have possibly been relaxed when it comes to sleep, meals and screen time. Implementing this structure can support the shift back to where things need to be to get kids healthier emotionally. While this can be challenging during COVID-19 when many parents have allowed a bit more flexibility for everyone’s sanity – structure remains more important than ever right now.
Set digital bedtimes (screens off 1-2 hours before bedtime is ideal), maintain regular mealtimes and most importantly, model healthy lifestyle behaviors. Kids pay more attention to what you do than what you say, so leading by example is essential when trying to manage behavior change.
Encourage healthier behaviors like exercise and outdoor time, crafts or other hobbies, journaling, socially-distanced visits with friends and family, etc.
#4 – Offer help and support.
Some kids can get the support they need from their parents to get through difficult, stressful times – while others may need some professional support. Your pediatrician can offer advice or can help connect you to a behavioral health professional as needed.
If you are truly concerned for your child’s emotional well-being, getting professional help should NOT be left for the child to decide. You can expect to get some push-back, but just as you wouldn’t allow them to stay away from a doctor during a medical emergency – this is a decision best left up to the parents.
Staggering Stats on Mental Health in Kids
- As many as 1 in 5 children in the US suffers from a diagnosable mental health disorder, with 50% of all lifetime cases of mental illness beginning by age 14 and 75% by age 24. 1, 2
- According to the 2016 National Survey of Children’s Health, 49% of children under age 18 with a mental health disorder did not receive needed treatment or counseling from a mental health professional. 3
- From 2011 to 2015, there was a 28% growth in emergency department visits for psychiatric purposes among individuals ages 6 to 24, and only 16% of these patients were seen by a mental health professional during their emergency visit. 4
- Any Mental Illness (AMI) Among Adults. (n.d.). Retrieved April 4, 2019, at https://www.nimh.nih.gov/health/statistics/mental-illness.shtmll
- Kessler RC, Chiu WT, Demler O, Walters EE. Prevalence, severity, and comorbidity of 12-month DSM-IV disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry. 2005;62(6):617-27.
- Whitney DG, Peterson MD. US national and state-level prevalence of mental health disorders and disparities of mental health care use in children. JAMA Pediatrics. 2019. Advance online publication.
- Kalb LG, Stapp EK, Ballard ED, Holingue C, Keefer A, Riley A. Trends in psychiatric emergency department visits among youth and young adults in the US. Pediatrics. 2019. Advance online publication.
WakeMed Pediatric Behavioral Health Services
WakeMed offers a wide range of pediatric behavioral health services. For more information, please contact your child’s pediatrician to discuss your concerns and get connected to an expert. If you need immediate assistance for your child, here are some local crisis resources.
Wake County Crisis and Assessment Services
107 Sunnybrook Road, Raleigh, NC 27610 | 919-250-1260
Wake Behavioral Health Urgent Care
319 Chapanoke Road, Ste. 120, Raleigh, NC 27603 | 919-703-2845
About Jessica Tomasula, PhD
Dr. Jessica Tomasula is a licensed pediatric psychologist and manager of behavioral health services at WakeMed Children’s. She provides clinical care to patients and families in WakeMed Children’s Pediatric Weight Management & Adolescent Bariatric Surgery programs.
Dr. Tomasula’s professional interests include family-based behavioral interventions for health and wellness, parent training, sleep hygiene, adolescent suicide prevention, and pediatric integrated care.
Learn more about Dr. Tomasula and request an appointment here.