While mental health has become more understood and less stigmatized within recent years, we still have a lot of work to do when it comes to children and their mental health. The pandemic, and the accompanying isolation, shed much needed light on children and their struggle with mental health. One recent survey indicated that at least one in six children have a mental health disorder of some sort. Sadly, less than half of these participants who reported mental health symptoms consistent with a diagnosis received any type of treatment from a mental health professional. While there is plenty of research to indicate that children are indeed susceptible to mental health disorders, it seems that we still don’t take it as seriously as we should be.
Children and adolescents who express concern about their mental health are often dismissed. Before I became a licensed psychotherapist, I was a research coordinator for a pediatric psychiatrist. The study I worked on focused on the potential relationship between intestinal permeability and depression in children. The electronic medical records system we had access to flagged any child who had been seen recently at that hospital who had endorsed depressive symptoms so that we could reach out to them about participating in the study. I will never forget speaking with a parent about the study only to have them respond that their child was just acting up for the attention. They explained that they weren’t going to cater to these theatrics by having their child participate in the study, that it would just be feeding more attention to their child’s drama. I have never forgotten that conversation and I frequently think about that child I have never even met, and hope they are okay.
Unfortunately, this scenario is not rare. Children who suffer from depression or other mental health issues are often dismissed as being “dramatic” or “attention seeking.” One potential issue that younger people face is the fact that they are at an age where they are figuring out their emotions and how to regulate them. Add hormones to this and you have a young human who may be acting like a total train wreck and at that age range, this behavior isn’t unusual. However, this behavior can mask a more serious underlying issue when a potential mental health disorder is written off as hormones, an inability to regulate emotions, and a lack of distress tolerance. It is not uncommon to see a child’s anxiety or depression relabeled as “moody teenager” or “oversensitive.” Younger people can also be perceived as “attention-seeking” when attempting suicide or engaging in self-harm. This needs to be acknowledged as an actual cry for help and not dismissed as overdramatic behavior and a desire to be the center of attention. Younger people may not have the ability adults do to communicate their needs and identify what they are feeling. Sometimes this “attention seeking behavior” is the only way they know how to say they are in pain and need help. Many adults don’t even have the ability to communicate these needs and identify their emotions; it is unrealistic to expect children to do this when some adults aren’t capable of it.
Furthermore, mental health in children often looks different than what we would expect since we often judge it against how we see mental health issues manifest in adults. Children struggling with mental health issues may be moody, irritable, and may lean towards self-isolation. Children suffering from depression may be cranky and act out. They may also withdraw socially. They may report ailments and symptoms like stomachaches or headaches that can't be explained by other medical conditions. Alcohol and drug use can be a problem as well, considering the fact that they may be trying to self-medicate pain they can’t name or describe. Poor grades may also indicate that your child is struggling. Behavioral issues in general can be a cry for help.
If you are a parent, teacher, or concerned family member and you know a young person you are worried about, you may be asking yourself what you can do to help. The most important thing you can do is listen and take their feelings seriously. Just because they have less life experience than an adult doesn’t mean they can’t feel adult emotions nor does it mean they can’t experience real pain. Let them talk about how they are feeling and ask them questions. If you have concerns about suicide don’t be afraid to ask them to tell you how they feel about this or if they are wanting to hurt themselves. It is a common myth that talking about suicide will encourage a person to think more about it or inspire them to actually act on it. This isn’t true. In fact, many people tend to feel better when they are allowed the space to talk about these feelings without censure. If a young person confides in you that they are self-harming, such as cutting, don’t freak out. This isn’t the same as suicidal ideation. By not freaking out you are letting them know that you are a safe adult they can talk to who will listen instead of shaming them. And most importantly, if they need professional help, help them access these services. If a child tells you they are feeling suicidal or feeling like harming themselves, take this seriously and get them help.
Written by Elizabeth Seabolt-Esparza, LPC