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By Madeline Vann, MPH Just like adults, many kids — infants and toddlers included — are plagued with mental health problems. In fact, nearly one in five children has a mental illness, and for some of these youths, the disease interferes significantly with their daily lives.

But according to recent research from the American Psychological Association, young children are less likely to get mental health treatment than their grownup counterparts. Why? Too often, kids are expected to “grow out” of their emotional problems.

That means it’s up to the parents not to ignore any instinctive sense that their child’s emotional health is at risk. If you suspect any signs of mental illness such as ADHD or depression in children, it’s important to seek help from an expert in kids’ psychology.

What to Do When Something’s ‘Off’

“Most parents want to believe that their kids are doing okay,” says psychiatrist William M. Klykylo, MD, professor and director of the division of child and adolescent psychiatry at the Wright State University School of Medicine in Dayton, Ohio. “But if you feel that something is going on or if someone you trust — a teacher or counselor, a minister or other clergy person, or a coach — says ‘I’ve got a feeling about your child,’ pay attention.”

The signs of mental illness in children vary by age and type of illness, with some psychiatric disorders appearing even in preschool years. However, two warning signs tend to cross over into all categories and signal that you should consult with an emotional health professional experienced in kids’ psychology:
Extremes or peculiarity of behavior for the age and gender of the child, such as being significantly more hyper, aggressive, or withdrawn
Sudden, hard-to-explain negative changes in behavior, such as a steep drop in grades
But many children have more than one mental illness — which makes getting a diagnosis even more challenging.
Know These Signs of Kids’ Mental Illness

Here are some of the signs of mental illness during different age ranges.

Preschool/early elementary school years:
Behavior problems in preschool or daycare
Hyperactivity way beyond what the other kids are doing
Trouble sleeping
Persistent nightmares
Excessive fear, worrying, or crying
Extreme disobedience or aggression. Because it’s often within a child’s nature to disobey or intrude on a playmate’s space, an excessive degree of this behavior is what should concern you, says Dr. Klykylo, such as deliberate destructiveness or hurting peers or animals.
Lots of temper tantrums all the time
Persistent difficulty separating from a parent. Klykylo acknowledges that many children experience separation anxiety at first; there could be a problem if this goes on for months.

Klykylo adds that what you might think are signs of mental illness may in fact be symptoms of another condition entirely, such as a sleep disorder, but that you should still seek medical help.

Grade school years:

At this stage, Klykylo suggests looking at your child’s relationships as a good external barometer of well-being. A child might only have one or two friends, but it’s not the number of friends that you want to watch — it’s the type of friends and how well your child maintains those friendships. If one drops off, that’s an issue, says Klykylo.

Other possible signs of mental illness include:
Excessive fears and worries
Extreme hyperactivity
Sudden decrease in school performance
Loss of interest in friends or favorite activities
Loss of appetite
Sudden changes in weight
Excessive worry about weight gain
Sudden changes in sleep habits
Visible prolonged sadness
Substance use or abuse
Seeing or hearing things that are not there

Klykylo notes that from a parent’s perspective, it can be hard to figure out what type of mental illness could be threatening your child. For example, he says, “Depression in children does exist, but it is often accompanied by hyperactivity.” While depression can cause a loss of appetite, if your child is refusing to eat or only eats very limited selections, you might also be seeing the early signs of an eating disorder.

Tween and teen years:

The preceding signs of mental illness are still a concern, but the behaviors may be more pronounced as children get older. Look for:
Destructive behavior, such as damaging property or setting fires
Constantly threatening to run away or running away, which can be a precursor to self- harm, says Klykylo
Withdrawal from family and friends
Comments or writings that suggest a desire to harm himself or others

Once you seek help, your child will be evaluated. The Child Behavior Checklist, which contains more than 100 questions related to child behavior, may be used — or the kids’ psychology expert you choose may refer to the DSM-IV with strict medical guidelines for diagnosing mental illnesses.

Your participation in both the evaluation and the treatment of your child could be essential, says Klykylo. Younger children are often treated with the involvement of their caregivers and family, he says. Medication, therapy, behavior change, modifications in the school setting, and other tools may be needed to help you and your child, depending on the diagnosis.

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