October is Mental Health Awareness Month, with the intention of raising awareness around mental health in general. When we consider the statistics of mental health in South Africa, and the world, it becomes very apparent that mental health requires far more focus and understanding. We need to educate ourselves and those around us to dispel myths and assumptions about mental health-related issues so that we can better treat them, and support those suffering.
Focusing on adult mental health is one thing; however, childhood mental health requires significant attention. Children with untreated or unsupported mental health concerns often become adults with untreated concerns, which can be even more difficult to support. Addressing mental health with children not only helps us support concerns when they arise, but we can also help influence generations to be more caring, understanding and supportive of mental health.
Prevalence rates of childhood anxiety and depression have seen a steady increase over the past several years. Unfortunately, it often seems that because this relates to children, it has received less attention. Often, we hear comments related to children being too young to be considered as having a mental health illness and that children these days are too spoilt, entitled, etc.
The reality is that our children are dealing with far more than we would have even considered when we were children. We live in a world that is expecting so much from children and they are just not ready for it all, and we see the impact of this as they grow older.
Childhood anxiety and depression conditions are rising particularly quickly, and so we need to better understand them and what we can do to help address them. First and foremost, we need to understand where they come from, or how they can develop.
“For many parents, it is very difficult to try to relate to their child when they experience such difficult times, and what we need to remind ourselves is that the world is a very different place for children than it was when we were children.”
Three main factors that can contribute to a child (or an adult) developing anxiety or depression:
Family plays a critical role for two reasons:
- Genetics – If there is a family history of mental illness, a child may be predisposed to that illness too. This does not mean that a child will present with the same condition as their parent, but it does mean that given certain factors, they are more likely to present similarly to their parents.
- Home Environment – The home environment in which a child lives is a fundamental contributor to who, or how that child will be. The types of relationships that exist in the home, the coping mechanisms and the role modelling that takes place, for example, will guide the child towards the person they will become as an adult.
The home environment in combination with any genetic predispositions are factors that need to be reflected on regularly in order to better understand the more subtle and less considered factors.
2. Brain chemistry
Our genes help determine how our neurotransmitters work (how the chemicals in our brains are used). If there is an oversupply or undersupply of these specific brain chemicals, an individual may experience symptoms that could require intervention. This can include symptoms of depression, anxiety, poor concentration, etc., all dependant on the specific chemicals.
Irrespective of whether a child is predisposed towards anxiety or depression, certain significant events that they experience could act as a trigger for anxiety or depression. The type of event which could trigger a child can differ for each individual. Just because children experienced the same event, it does not mean that they will all internalise it in the same way. Trigger events are often once-off events such as a car accident, death of a loved one, experiencing crime, or other traumatic events.
In some cases, a trigger event can be events that take place over a period of time (sometimes many years). These situations expose a child to a prolonged negative experience or trauma which can be very difficult for them to make sense of emotionally which can then manifest in the form of depression, anxiety, or other conditions.
Each individual is unique, both in who they are as a person as well as their environments and their experiences of the world. As such, each child will experience and handle situations differently. A contributor to how a child will handle difficulties that they experience is the protective factors which the individual has. Protective factors are conditions or personal attributes such as support structures, resources, internal strengths and coping skills to name a few. These protective factors can help a child process experiences in a productive manner so that there is little to no residual impact that could lead them to develop more significant and more pronounced symptoms that need to be treated.
“Childhood anxiety and depression conditions are rising particularly quickly, and so we need to better understand them and what we can do to help address them.”
No person experiences the world exactly like another. There may be many similarities and common understanding, but the reality is that each of us experiences the world from our very own unique perspective. As such, there is no one-size-fits-all approach to identifying and treating children that we may be concerned about. Each case needs to be handled uniquely in order to understand the individual involved so that the best interventions can be implemented.
Having said that, there are a number of symptoms that could indicate that a child may be experiencing a difficult time coping. However, just because a child may experience one or many of the symptoms, it may not mean that they are in fact depressed or anxious.
Similarly, we should not simply overlook these common symptoms as they may be considered “normal” emotional and psychological changes that occur during a child’s development. If in doubt, enquire and research to better understand if it is development-related, and if you are still unsure, always seek a professional opinion.
Often an underlying depression or anxiety can manifest in many different forms which can make it difficult to pinpoint immediately, such as:
- Irritability or anger
- Continuous sadness
- A feeling of hopelessness
- Increased sensitivity to relationship dynamics
- Increased sensitivity to failure or criticism
- Appetite changes
- Changes in sleep patterns
- Emotional outbursts
- Withdrawal from family, friends, activities, etc.
- Difficulty focusing on tasks or activities
- Complaints of regular headaches and/or stomach aches
- Low energy levels
- Lack of motivation
- Suicidal ideation
Not all children will display all of these symptoms. In fact, there is generally a combination of symptoms that may also present differently in different contexts. As such, it can be difficult to identify a child struggling if they always appear to be coping. If concerns are raised, consider all contexts that surround your child to better understand how they’re coping.
Since we’re dealing with children who do progress through numerous developmental changes in a relatively short period of time, we need to be cautious that we do not assume the worst when they may, in fact, be transitioning into a new developmental phase.
What to do
If the concerning behaviour or symptoms have been continuous for more than two weeks and there does not appear to be an obvious or normal reason for this behaviour, it is a good idea to consult with a medical practitioner to rule out any physical reasons first. Following this, a consultation with a mental health practitioner who works specifically with children is recommended.
How to support
There are a number of options to support your child should they be experiencing difficulty. Much of the treatment for children can be very similar to the treatment of adults, including psychotherapy, or play therapy for younger children, as well as the possible use of medication.
From a parental perspective, it is so important to offer your child as much compassion and understanding as possible. For many parents, it is very difficult to try to relate to their child when they experience such difficult times, and we need to remind ourselves that the world is a very different place for children today than it was when we were children. As such, we cannot compare, or use our own childhood as a benchmark to gauge or judge the severity of our children’s challenges.
Children need to feel understood (or at least the effort is there). So often parents engage with their children using words, logic and reasoning and the space for connection, support and understanding disappear. Try to demonstrate your love and care by using as little “intellectualising” as possible. Just be there for them, and with them. Model unconditional positive regard for them, and create an environment of support where they can learn and experience further protective factors to assist them in overcoming future challenges.
Our children are doing the best they know how, with what has been given to them (genetically and role modelling) as well as with what they have learned along the journey of their life thus far. If they are struggling at any point, it is our responsibility to guide and support them, and help them get back on track as they strive towards achieving their dreams.