The emotional well-being of children and adolescents is just as important as their physical health. Good mental health allows children and adolescents to develop resilience to cope with whatever life presents to them and to grow into well-rounded, healthy adults.
Many of the things that adults can do to take better care of their mental health and wellbeing are also relevant to children and young people.
Specifically, things that can help keep children and adolescents stay mentally well include:
Other factors that positively affect their mental health include:
All families go through times when they have to deal with a lot of stress and worry. During times like these, parents and their children or teenagers may need extra help and support from family members, friends and others.
Can children and adolescents experience mental health issues?
Mental illness affects the mood, thinking and behavior of children and adolescents, as well as adults.
These conditions may present as symptoms or behaviors related to a range of issues faced by young people in this age group; including:
Many young people who visit clinics in Qatar, complain about irritability, nervousness, foul mood and hostility towards their siblings.
Apparently, some of them drink more than two cans of energy drinks per day because they go for workouts and the high level of caffeine has been identified as the contributing factor
(Source: Qatar Tribune, 13/3/2016)
How do I know if a child or adolescent is experiencing mental health issues?
It can be difficult to determine what is a symptom of a mental health condition and what is just a normal part of growing up.
For example, typical teenagers face many challenges around their identity and independence and have competing demands and stressors. It is not uncommon for them to have mood swings and anger outbursts, misinterpret social cues and emotions, test limits, act on impulse and engage in risky behavior. Similarly, children have all sorts of strong feelings and emotions about what is happening in their lives and behaviors to express these feelings. It is also natural for everyone to feel fearful or worried from time to time.
"…During exams, you can see stress and anxiety with everyone,
but it's usually temporary…"
However, children and adolescents experiencing symptoms of mental health issues or changes in behavior for a prolonged period may undergo a lot of distress and it can seriously affect the quality of their lives now and into their adult life.
It is important to note that the presentation of symptoms of mental health conditions can be different in children (age 0-12) and adolescents (13-18). For example, young children may present as irritable whereas older children may appear sad and withdrawn.
Some common early 'warning' signs that a child or adolescent is struggling with their mental health may include:
"…There's stuff that accumulate during childhood,
like the way of raising a child that might reflect on their personality…."
How children and adolescents experience Mental Health Conditions?
Depression
Unfortunately, children and adolescents are not immune from depression and it can affect them at any age and in many different ways.
"11% of adolescents have a depressive disorder by age 18"
Source: NCS-A
Depression is characterized by sadness, loss of interest or pleasure, low self-worth, disturbed sleep or appetite, tiredness and poor concentration.
Click here to learn more about the Signs and Symptoms of Depression common across all age groups
Usually, depression in children and adolescents presents in their behavior. Some common signs and symptoms include:
Depression can happen suddenly as a result of some difficult life experiences, or can emerge more slowly, with no clear reason for it.
Before puberty, boys and girls are equally likely to develop depression. By age 15, however, girls are twice as likely to have had a major depressive episode.
They are more likely to experience depression if they are under a lot of stress and have no one to share their worries with.
Depression occurring during teenage years may come at a time of great personal change, when boys and girls are forming an identity apart from their parents, dealing with gender issues and emerging sexuality, and making independent decisions for the first time in their lives. Depression in adolescence frequently co-occurs with other disorders such as anxiety, eating disorders, or substance misuse. It can also lead to increased risk for self-harm and suicide (Getting Help).
Anxiety
Children and Adolescents can experience anxiety, characterized by constant worries and fears, feelings of nervousness or tension, recurring intrusive thoughts or concerns, restlessness or irritability as well as physical symptoms such as sweating, trembling, dizziness or rapid heartbeat.
Click here to learn more about the Signs and Types of Anxiety Disorders common across all age groups.
Anxiety disorders such as obsessive compulsive disorder (OCD), post-traumatic stress disorder (PTSD), social phobia and generalized anxiety disorder can be a persistent problem which interferes with their daily activities.
Some common physical and emotional symptoms of anxiety in children may include feeling fearful or panicky, feeling breathless, sweaty, or complaining of 'butterflies' or pains in the chest or stomach or feeling tense, fidgety or using the toilet often. Young children cannot tell that they are anxious. They become irritable, tearful and clingy, have difficulty sleeping, and can wake in the night or have bad dreams. Anxiety can even cause a child to develop a headache, a stomach-ache or to feel sick. These symptoms may come and go.
Adolescents who have excessive anxiety regularly experience a range of physical symptoms as well. They may sweat, tremble, startle easily or complain about muscle tension and cramps, stomach or headaches, pain in the limbs, fatigue or discomfort associated with pubertal changes.
Anxiety during adolescence typically centers on changes in the way the adolescent's body looks and feels, social acceptance and conflicts about independence. In a social setting, anxious teenagers may appear dependent, withdrawn or uneasy. They may be preoccupied with worries about losing control and may avoid their usual activities or refuse to engage in new experiences. In an attempt to diminish or deny their fears and worries, they may also engage in risky behaviors.
A lot can be done to help prevent children and adolescents being anxious. It is important for anyone concerned about a child or young person to show them that you care and want to understand the reason they are experiencing worries. Most importantly, if you have concerns, seek professional advice as soon as possible.
Attention-deficit/hyperactivity disorder (ADHD)
Attention Deficit Hyperactivity Disorder (ADHD) is one of the most common mental health conditions affecting children and is more common among boys than girls. It is often first identified in school aged children due to disruption in the classroom and challenges with their academic performance. ADHD can also affect adults but usually starts in childhood. Many adults who are diagnosed with the condition at a young age continue to experience symptoms, although it may improve with age.
ADHD is a condition with behavioral symptoms in three categories: difficulty paying attention, hyperactivity and impulsive behavior. Some children with ADHD have symptoms in all of these categories, while others may have symptoms in only one. Symptoms can also include being distractible, slow task performance and day-dreaming. ADHD can impact the school performance significantly as well as friendships and family relationships. It can be difficult to determine if it is ADHD or a behavioral issue, which is why seeking diagnosis from a trained health professional is important. Children with ADHD have difficulty focusing attention on a single task, excessive talking, often moving frequently from one uncompleted activity to another.
Autism Spectrum Disorder (ASD) and Autism are both general terms for a group of complex brain development disorders that affect a person's ability to communicate, interact with others and make sense of the world around them. Autism is a lifelong developmental disorder that appears in early childhood. For a diagnosis of autism, individuals with ASD must show symptoms from early childhood, even if those symptoms are not recognized until later. Though symptoms and severity vary, ASD always affects a child's ability to communicate and interact with others. The main areas of difficulties are:
A diagnosis is the formal identification of autism following assessment, usually by a professional team including a pediatrician or a child psychiatrist. Having a diagnosis is helpful for two reasons:
Eating Disorders
Some children and adolescents can become so preoccupied with food and weight that they focus on little else. Eating disorders involve a preoccupation or obsession with eating, exercise and body weight/shape. Distorted thoughts and emotions about body image and self-worth can lead to changes in eating and exercise behaviors. Eating disorders are serious.
Symptoms and warning signs of eating problems in children and adolescents may include:
Anorexia nervosa and bulimia nervosa are the two main types of eating disorders. A teenager with anorexia nervosa may present as a perfectionist and a high achiever in school, but at the same time they may have very low self-esteem. A young person with anorexia experiences a sense of control only when they says "no" to the normal food demands of their body and in a relentless pursuit to be thin, they starve themselves.
Teenage girls and young women are more likely than teenage boys and young men to have anorexia or bulimia. Males can have eating disorders too and it may present itself mostly through compulsive exercise patterns.
The symptoms of bulimia are usually different from those of anorexia nervosa. The patient binges on huge quantities of high-calorie food and/or purges their body by self-induced vomiting and often by using laxatives. These binges may alternate with severe diets, resulting in dramatic weight fluctuations. Teenagers may try to hide the signs of vomiting by running water while spending long periods of time in the bathroom. The purging of bulimia presents a serious threat to the person's physical health, including dehydration, hormonal imbalance and damage to vital organs.
Binge eating can also occur on its own without the purging of bulimia and can lead to eventual purging. Children with binge eating disorder also require treatment from a mental health professional.
Symptoms of Psychosis
Psychosis is when a person perceives or interprets events differently from people around them. Symptoms of psychosis can first appear in adolescence and may include experiencing hallucinations, delusions or disorganized thinking, which can affect their thoughts and behavior. A young person may exhibit or mention symptoms such as:
Click here to learn more about the signs of Psychosis and related illnesses, such as Bipolar Disorder, which are common across all age groups.
Tic Disorder
A tic is a problem in which a part of the body moves repeatedly and uncontrollably.
In some cases, children will have both body and vocal tics (i.e. throat clearing). They may also have problems with attention and learning disabilities.
Children affected may act impulsively, and/or develop obsessions and compulsions.
Some tics disappear by early adulthood, and some continue.
Enuresis and Encopresis
Attachment Disorders
Attachment disorders are problems in emotional attachments to others starting in childhood as the result of severe problems or difficulties in a child's early relationships. Research suggests that inadequate care-giving could be the possible cause.
Learning (Intellectual) Disabilities
For most people, a learning disability first appears from birth or during the early development period of life. (Other Mental Health Conditions). Learning or intellectual disability are general terms that refers to individuals who find it harder to learn, understand and communicate. Children with learning disabilities exhibit a wide range of symptoms including problems with reading, mathematics, comprehension, writing, spoken language, or reasoning abilities. The primary characteristic of a learning disability is a significant difference between a child's achievement in some areas and his or her overall intelligence. Hyperactivity, inattention and perceptual coordination may also be associated with learning disabilities but are not learning disabilities themselves.
Click here to learn more about the signs of learning disabilities common across all age groups.
Other issues impacting Child and Adolescent Mental Health
Internet and Social Media Use
Online activity offers children and young people the opportunity for global communication and learning and provides social interaction with peers, especially with similar interests. However, the internet and social media can be a real risk and danger for an unsupervised child, including through "cyber bullying" and vulnerability to predatory adults. Some of the risks or problems include:
It can be tempting for adolescents to share their thoughts and feelings about personal challenges on social media, but this is not always the most helpful way of dealing with problems.
Therefore, it is important for parents to realize that a high level of guidance and supervision is optimal of a child or young person's online experience and frequency of use. Spending time with a child initially exploring an online service and periodically participating with a child in the online experience gives parents an opportunity to monitor and supervise the activity.
Parents need to seek professional help if children's excessive use or habits are out of control and they find it hard to stop. This could be an addictive behaviour (Addiction) if interferes with children's life, and potentially has an adverse effect on their relationships and schooling.
Self-Injury or Self-Harm
Self-injury or self-harming behaviors are seen differently by groups and cultures within society and the causes and severity of self-injury can vary. There are different forms of self-harm including cutting or scratching, marking, picking, and pulling skin and hair, burning/abrasions, biting, head banging, bruising, hitting or excessive body piercing and tattooing.
Adolescents who have difficulty talking about their feelings may show their emotional tension, physical discomfort, pain and low self-esteem with self-injurious behaviors. Some adolescents may self-mutilate to take risks, rebel, reject their parents' values, state their individuality or merely be accepted. Others however, may injure themselves out of desperation or anger to seek attention, to express their hopelessness or because they have suicidal thoughts. These behaviors may be a sign that a child or adolescent has a mental health condition. Parents are encouraged to talk with their children about respecting and valuing their bodies and to seek advice from a trained health professional to identify and treat the underlying causes of the self-harm.
What to do if you have concerns about mental, behavioral or emotional symptoms in a child or adolescent
Effective treatments and support are available in Qatar for all ages, including children and adolescents. If symptoms of mental health conditions or other issues are of concern, are causing difficulties and impacting significantly on daily life, it is important to seek advice from the specialist Child and Adolescent Mental Health Services (CAMHS).
Just like adults, children and adolescents with mental illness are diagnosed after a mental health specialist carefully observes signs and symptoms and collects information to rule out physical or other possible causes.
Once a diagnosis is made, the specialist will recommend a specific treatment based on their history, level of development, ability to cooperate with treatment, and what interventions are most likely to help with the presenting concerns.
There are various treatment choices, which often include psychotherapy or medication. Each child has individual needs, and each child needs to be monitored closely, especially while taking medications. Psychotherapy is often used in combination with other treatments (medication, behavior management, or work with the school). Psychotherapy can help children and adolescents with emotional support, resolve conflicts with people and understand feelings and problems.
Parents are encouraged to talk to their child's health care provider and ask questions and learn everything they can about the symptoms that worry them and treatment options. If the child is in school, it may be helpful to ask the teacher if they are showing worrisome changes in behavior and share this with the health professional. For further information on helping a child or young person you are concerned about see (Family and Friends).
…it doesn’t happen in a sudden, it has symptoms from an early age and parents can pay attention to that…
