Young children should not be worried about war and violence
around the world, but they are.
Posted on October 04, 2017, 16:02 GMT
For this post, BuzzFeed Health spoke with Yamalis
Diaz, PhD, clinical assistant professor of child and
adolescent psychiatry at the NYU Child Study Center, and
Leffler, PhD, assistant professor of psychology at the
Mayo Clinic College of Medicine and director of Mayo Clinic’s
Child and Adolescent Integrated Mood Program.
1. Kids go through ups and downs just
like adults, but when those downs start causing problems in
everyday life, it’s probably time to talk to a professional,
Trouble paying attention, being disorganized, worrying,
trouble sleeping. Whether you’re a kid or an adult, everyone
experiences these from time to time. But in mental illness,
these symptoms are often more severe. In fact, when trying to
figure out if you should go see a professional, think about
whether these symptoms in your child are happening 1) more
frequently than the average person of that age, 2) more
severely than the average person of that age, and 3) if all
of this is making it hard for your child to function in every
day life. If all three add up, then it could be time to talk
to someone who can help.
2. Kids as young as 2 can start showing
signs of an anxiety or a behavior disorder.
The signs may vary, but there are children who exhibit
extreme tantrums or aggression, are completely avoidant of
social situations, or show anxiousness over things that most
other kids their age wouldn’t be concerned about. We’ve
literally seen 7-year-old kids worrying obsessively about the
war in Afghanistan and the violence in Charleston, South
And when it comes to developmental delays, like those related
to autism, they can show up even earlier, in a baby as young
as 6 months old.
3. Because it’s hard to know right away
which particular disorder a kid has, we first narrow it down
seeing which of two major buckets their symptoms fit
We usually ask this question: Is it an internalizing disorder
or externalizing disorder? Internalizing disorders are those
only the person experiencing them can feel, like bipolar
disorder, depression, anxiety, and adjustment issues.
Externalizing disorders are those like ADHD, oppositional
defiant disorder, and conduct disorder, the symptoms of which
are usually seen by people in that person’s life.
Since there are so many mental illnesses — and variations of
them — fitting the symptoms into one of these two categories
gives us a general direction to go in. From there, we’ll be
able to develop an evidence-based treatment plan.
4. We wish there was a
one-size-fits-all way to go about treating kids, but there’s
So many parents come to us wanting concrete answers about
what they and their kids are dealing with and how to tackle
very specific issues, such as tantrums, but unfortunately
it’s more complicated than that.
Some kids might need a certain kind of therapy — outpatient
or inpatient therapy; family therapy, involving not only the
parents and their child, but siblings, too; or cognitive
behavioral therapy — while others might need medications plus
therapy. Other kids, such as those with eating or mood
disorders, might need a specialized program where only the
child and their parents participate. No two patients will
have the same exact treatment, and that’s because every
treatment plan is meant to teach your child the skills they
need to develop into fully functioning adults.
5. If you think your child is showing
signs of mental illness, talk to the other adults in your
We’ll usually make a diagnosis based on the entire history of
your child from birth, including their family, school, and
social histories. So if you think your child is showing
signs, talk to other parents to get an idea of how your kid
might compare, developmentally; talk to their
teachers/counselors, who spend lots of time with them every
day; and talk to their primary care provider, who knows their
medical history (and can refer you to a mental health
professional). Taken together, these are all clues that will
help you figure out what your kid is going through and how to
6. The more parents and guardians can
support their kids at home, the better.
Ideally, everyone in the child’s life — from siblings to
teachers to babysitters and coaches — should be on board with
helping the child with a mental illness thrive, but
parents/guardians are their greatest partners in overcoming
the difficulties of living with a mental illness.
7. And btw, if that sounds
overwhelming, it’s our job to help parents learn how to do
Kids do not exist in isolation, so we work with their
parents/guardians, too. That usually means figuring out the
best ways for them to be partners in their child’s care. As
much as we provide treatment for kids, we provide resources
and support for parents, too.
8. If we could recommend two skills for
kids to learn ASAP, they’d be communication and problem
If you set the foundation for communication early on —
modeling deep listening and trying to understand where your
kids are coming from — the door will be open for them to
speak comfortably with you when it really matters, regardless
of the topic or who starts the conversation. That’s why it’s
so important to listen to them, rather than talk at them.
Likewise, a lot of parents assume it’s their job to find
solutions to all of their kid’s problems, but, in our
opinion, that’s not actually the best setup. At some point in
their teen years, they’ll need to start learning to solve
problems on their own. For parents, that means asking kids to
come up with solutions to their challenges and obstacles
(within reason!), and then having them try things out on
their own. Sometimes it might work and sometimes it might
fail, but that’s OK: The goal is to teach them resilience,
9. The other thing we need to ask
parents to do: Be pretty involved in their therapy
That means asking questions about literally everything, from
what skills your child should be learning to the skills you
should be working on with them at home. You want to have an
idea of what the outlook is, and if, after some time, you
don’t see much improvement, then have a conversation with the
therapist — you might realize, or they might even tell you,
that it’s time to see a specialist or get a second opinion.
10. We don’t usually expect kids
(especially younger ones) to be pros at articulating their
inner emotional landscape.
Developmentally, young children aren’t ~there~ yet, where
they’re able to grasp and discuss abstract concepts. They
also have limited insight and awareness of who they are and
what’s going on. So if they’re always worried, for example,
and you asked them to think about their negative thoughts and
to talk to those thoughts, they probably wouldn’t be able to
put it into words.
11. But that’s OK, because we are pretty
good at getting it all out anyway.
There isn’t really a single specific way we’d tackle this
since it depends on the child’s age and treatment, but to
build rapport and open them up, we might try playing games
with them or drawing. These are, themselves, therapies, but
they also work to put the children more at ease — the child
might feel more comfortable talking about their feelings
while playing these games — and that can help them engage in
the therapeutic process. Similarly, these techniques may
expose certain behaviors (if the child gets frustrated, for
example) and that can prompt a conversation, too.
12. There’s always the chance that a
kid’s diagnosis might change.
Treating mental illnesses often means treating the symptoms
of the disorder as they appear, so that they’re less of an
impediment on the child’s life right now. But things change —
kids mature, their brains develop, and they’re exposed to
more and more things in the world. All these things can
affect the symptoms they have, how they’re able to talk about
their symptoms, and, ultimately, their diagnosis. It’s also
worth mentioning that not all mental illnesses develop at the
same speed — some may be more of a slow burn, with symptoms
popping up over a few months or years, whereas the full scope
of other illnesses can show up much faster.
When this happens, it’s not necessarily the fault of whoever
made the original diagnosis — they were working with the
symptoms that were present at the time… Unfortunately, this
is one of the harder things we have to deal with since it can
be so frustrating for parents.
13. We all go through similar training
at first, but eventually each of us will choose a path to
Describe our schooling in one word? LENGTHY. It can take
about six to seven years of training to be a clinical
psychologist, and that might include clinical internships or
postdoctoral fellowships. All this extensive training
basically sets us up with the skills to provide therapy,
psychological testing, and research. We all come out of that
training knowing these things, but because there are so many
mental illnesses out there, we usually find something to
specialize in, whether that’s mood disorders and severe
pathologies or ADHD and behavior problems.
14. No, we won’t prescribe
One of the biggest misconceptions about mental health
professionals in general is that right away we’re going to
prescribe medication for whatever the illness is. Sometimes
this keeps people from going to see a professional, and other
times this is the first thing people ask about. Well, it
turns out that psychologists cannot prescribe meds in the
first place (we’re not MDs!), and even if we could, they
wouldn’t be our first treatment option.
Why? Because we know that there are all sorts of therapies
that might work without having to resort to meds.
15. Consistency is huge when it comes to
treatment being as effective as possible.
When it comes to getting the most out of outpatient therapy,
it’s crucial that kids’ visits are consistent — you can’t
just come by whenever there’s a problem, especially if your
child’s issues are particularly serious.
Oftentimes, the only thing a child needs to stay on track
will be consistent therapy sessions. Without them, there’s
potential for conflicts to arise between family members or
for the child to have a full-on mental health crisis, where
the only way to stabilize them is in the ER or an inpatient
hospital. And we definitely don’t want that to happen.
16. Insurance coverage for mental health
services is actually one of the biggest obstacles to
Sure, this is a problem for anyone looking for mental health
treatment, but that doesn’t mean it isn’t important. Mental
health care is covered at a lower rate than other medical
illnesses — that ices out families who can’t afford to pay
copays or see a really good mental health professional.
Sometimes insurance companies will even put a cap on the
number of sessions a family is allowed to have.
Unfortunately, with so many challenges to getting care,
therapy ends up being a last resort for many families.
17. It’s true: Teens can get moody,
irritable, and argumentative. But when these behaviors become
extreme or disruptive, it might be a sign of a bigger
All kids go through puberty, so there’s bound to be changes
in their behavior, whether that’s teen angst, fighting for
independence, etc. Of course, it’s hard to tell what’s
“typical” teen behavior and what’s next level, but go with
your gut and also be aware of common warning
signs. And don’t forget you can always try having a
conversation with them or looking into therapy options.
18. Lots of teens use social media as an
emotional outlet, which we wish parents were way more aware
It’s really common in today’s world for teenagers to use
social media and the internet as an outlet for their
emotional issues — whether that’s just talking about being
sad or even talking about suicide — probably because it’s
easier to say things more freely online than it is in person.
But parents won’t catch these things if they’re not
monitoring their child’s social media. Instead, it’ll
probably be one of the kid’s friends who reports the issue
back to the parent, or to a teacher or counselor.
Every family’s values are different when it comes to privacy,
so parents need to figure out what feels right for them in
terms of staying on top of what their kids are posting
online. Tracking how they expressing themselves online can
help you keep tabs on their wellbeing and, if something they
say sounds an alarm, you’ll be able to check in with them.
19. The reports are in: Therapy
From research, we know that there are A LOT of treatments
that are effective. Of course, there are a bunch of factors
that influence this, including the kind of therapy being
used, the skill set of the therapist, the diagnosis of the
child, and their consistency in going to therapy. But the
bottom line is there’s a very high likelihood that the child
and their family will benefit and see improvements if they go
20. There are definitely times when the
job can be especially tough on our hearts.
We are humans with our own emotions, too. So it can be tough
seeing kids and their families dealing with so much hardship.
For us, the hardest things are seeing patients admitted to
inpatient facilities for their mental illnesses or dealing
with a mental illness on top of another serious medical
illness, like cancer. It’s hard to see patients dealing with
a lengthy hospital stay, unknown trajectory, or painful
procedure, because it almost makes sense as to why they’re
having behavior problems, or are anxious or depressed.
21. But at the end of the day, it’s all
about helping this generation of kids feel better than the
Regardless of our own feelings, it’s our job to help our
patients understand and process their emotions, and let go of
unhealthy patterns. We do this because we truly care about
helping families and their kids function better — and by
extension, future generations who will learn these skills. If
we do that, then we can work to erase mental health stigma
and start appreciating people with mental illness for who
they are, instead of focusing on their illness or symptoms.