While stress, anxiety and depression are topics most people think of as adult issues, the truth is kids experience mental health problems too. Children deal with a lot, including pressure to perform well in school, navigate friendships, address bullying, grow their athletic skills and other talents and figure out how they want to present in the world.
Recognizing when your kids are feeling stressed, numb or sad can help you address problems before they lead to longer term, chronic behavioral health problems, such as anxiety and depression.
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 as you’d never ignore an infection, illness or injury, it’s important that you don’t ignore the common signs that your child 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 is getting the best of them.
5 Common Signs of Stress in Kids/Teens
Some behaviors 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. This makes it more important to be in tune with your kids’ mental health, offering healthier strategies instead. These include spending time with friends, participating in sports activities or hobbies and enjoying the outdoors.
5 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may seem a little “off,” such as trouble sleeping, more tantrums or outbursts, regressive behaviors, clinginess or withdrawn behaviors. 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, 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 any needed support.
#2 – Set limits to screen time.
Parents should always set limits to screen time for children, and that is particularly important when it comes to the competitive space of social media and news stories that can be overwhelming. Many have limitless access to information, but it is possible to overdo it.
Social media is a breeding ground for believing that the scripted and edited lifestyles presented on these channels are a true representation of daily life. This is false. Children need to understand that celebrities/influencers have struggles, classmates are not always having a good time, many people struggle with body image and a life of self-absorption is not the glamorous ideal it may appear to be.
What’s more, when it comes to the news, being informed is an important part of being a global citizen, but there has to be a limit to how much your children, and you, can take in at one time to protect your mental health. Watch the news or read stories about major issues, such as school shootings, with your children to be there should they have questions or you start to notice concerning behavior resulting from overindulging in the news.
#3 – Have open conversations with your child.
Children deal with a number of challenges as they navigate the childhood and teen years. While it may appear to be a life of leisure since they typically are not helping to pay bills, the levels of stress children endure can be overwhelming for them. This in mind, it is important to keep the lines of communication open with your child.
Additionally, when it comes to watching upsetting news about school safety, global warming, inequality, and more, it is important to talk with your children about what they have absorbed. Listen to their concerns and approach the conversation in a supportive, loving way. Let them know that is okay to feel overwhelmed, anxious or scared. It is also important to discuss where to find reliable information regarding recent events. And, of course, remind them it is okay to take a break and step away from these topics when needed.
#4 – Focus on who’s helping.
Sometimes in life, it can be easy to notice everything that is going wrong and none of what is going right, but even in the most challenging of circumstances, there are good people in the world doing good things. Help your child focus on gratitude for what is good in life and who is helping make life better for others. For example, your child’s friends may be going through homelessness or the breakup of their family, but you can be grateful for the opportunity to do even the smallest thing, such as packing an extra school lunch for a friend or inviting a friend out for a day at the park.
When it comes to bigger issues facing our country and our world, help your children focus on positive actions people are taking in response to various crises. Offer your children reassurance that the world is not a hopeless place. Point out those who are helping, such as relief organizations, charitable foundations, other countries and even local businesses and individuals. Consider brainstorming ways your family can help, so children understand that there is a lot of good in the world and things they, too, can do to make a difference.
#5 – Offer help and support.
Some kids can get the support they need from their parents to endure difficult, stressful times — while others may need professional support. Your pediatrician can offer advice or help connect you to a behavioral health professional.
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 your child to stay away from a doctor during a medical emergency — this is a decision best left to parents and guardians.
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
- CDC research found that mental health emergencies grew by 24% for children ages 5-11 years and 31% for children ages 12-17 years. ED visits for suspected suicide attempts rose by nearly 51% among girls ages 12-17 years in early 2021 compared to the same period in 2019.
Resources
- 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.
- Leeb, R T. (2020) Mental Health–Related Emergency Department Visits Among Children Aged 18 Years During the COVID-19 Pandemic — United States, January 1–October 17, 2020 | MMWR (cdc.gov)
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
National Suicide Prevention Lifeline
- 1-800-273-TALK (8255)
- Crisis Text Line : Text the word TALK to 741741
About Jessica Tomasula, PhD
Dr. Jessica Tomasula is a licensed pediatric psychologist 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.
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