A Guide to Children’s Mental Health

Understanding childhood mental illness is important for supporting children and helping to treat the conditions that affect them. This resource is intended to help parents, educators, and other adults better understand childhood mental illness, and to provide them with resources to help a child in need seek a diagnosis and treatment for their condition.

This piece will cover everything from childhood mental health statistics to the most common mental health disorders and their potential causes, as well as the appropriate treatment strategies for each condition.

Note: This resource is not a substitute for the advice or diagnosis of a condition by a licensed doctor or psychologist, and is only intended for informational purposes. If you are concerned that a child is struggling with a mental health condition, contact a licensed health professional to discuss concerns and potential treatments.

Early intervention for children with mental health conditions can help them develop healthy coping mechanisms. However, identifying conditions can be difficult, and puberty, along with the fluctuations of hormones it can bring on, can disguise or confuse a mental illness diagnosis.

Parents or relatives should be familiar with their children’s routines and moods, and sudden changes should warrant further investigation. Puberty can cause some changes in mood and behavior, but significant changes to sleep, eating habits, or school performance are potential warning signs.

In turn, teachers and educators should be cognizant of any sudden changes in a student’s performance or any signs of potential self-harm or the desire to hurt others. Educators with a background in psychology may be able to help students and parents access the necessary resources they need to find treatment.

Guidance counselors are also trained to talk with children about any issues affecting their life, and use key identifiers such as body language, eye contact, or voice tone as a measure of a potentially troubling situation.

For the purposes of mental health diagnosis, children are classified as individuals between ages 3 and 18. The term “youth” or phrase “young person” is often reserved for those between ages 13 and 24. Additionally, the World Health Organization (WHO) and Britannica define adolescents as anyone between ages 10 and 19.

Regardless of the age of the child, mental health conditions are not temporary diagnoses for most people. Even if a child is going through puberty or another stressful life event, waiting to see if the child will “grow out of it” can be more harmful to the child’s overall development. Early intervention and treatment for mental health conditions is key. While there are many resources available to help college students and young adults with mental health conditions, children and adolescents might struggle to get the help they need without assistance from a family member, teacher, or friend.

Treatment options for children and adolescents experiencing mental illness show some encouraging numbers. According to the CDC:

However, these numbers could be even higher, especially when considering those from marginalized communities or backgrounds that may not have access to resources that can help provide relief.

There’s also the matter of breaking through the stigma of mental illness that still pervades throughout society. But through continued outreach and education, the percentage of those receiving treatment for mental illness should continue to rise in the foreseeable future.

Recognizing mental health conditions can be difficult, but according to the National Alliance on Mental Illness (NAMI), there are some tell-tale warning signs adults can look for, including:

However, it is also important to understand the unique differences between childhood, adolescent, and adult mental illness. According to the Lindner Center of Hope, there are some key differences between adult and adolescent mental health:

Below are various statistics on the frequency and prevalence of mental illness in children, adolescents, and youths.

Just as with mental illness in adults, the causes of mental illness in children are often complex, multifaceted, or unknown. There is no known single cause of mental illness, but many factors may cause a child to develop these conditions.

Additionally, research is still being conducted to better understand the causes, early signs, and treatments that can help these conditions.

Children may develop a mental condition either due to a single cause or a combination of different factors. Below are some of the most commonly cited causes of most mental illnesses.

Children whose parents are struggling with a mental illness may be more likely to develop an illness themselves, due to genetic factors.

Additionally, as noted by the National Institute of Health (NIH), some research has suggested certain mental illnesses may be caused by gene markers, including a gene that helps regulate calcium flow into neurons in the brain. Furthermore, chromosomes 3 and 10 may have an illness-linked variation.

The findings of this research suggested that five conditions — autism, ADHD, bipolar disorder, major depression, and schizophrenia — may be related to genetic factors, although further research still needs to be conducted to determine the best course of action for identifying these genetic links and diagnosing these conditions.

Biology and brain chemical imbalances are common causes for mental illness, but these conditions are typically triggered by other causes such as stress, disease, or trauma.

The production of serotonin, dopamine, and norepinephrine are the three brain chemicals responsible for mood regulation that are affected due to depression or similar mental illnesses. Certain medications can help the brain rebalance the production of these chemicals through stimulating neurotransmitters.

Trauma can be a significant catalyst for the development of mental health disorders or illnesses, but identifying trauma can be difficult.

Trauma can be verbal (including bullying, teasing, and verbal abuse), emotional (including psychological manipulation and invalidating emotions), or physical.

Additionally, children may still experience trauma by witnessing violence without being the physical victim of the violent act.

As noted by Harvard Health, stress can be a major factor that influences the chemical production of the brain as well as the symptoms of mental illness, especially depression.

Stress for children can come in many forms, including stress at school, due to bullying, in the family, or due to social, economic, or physical instability. Although children may not be able to identify or understand stress, adults and healthcare professionals may be able to identify the source(s) on their behalf.

The government’s youth program website, Youth.gov, lists the following as common risk factors for mental illness in children:

Bullying, either in person or online (cyberbullying), is a common risk factor for developing mental illness.

Youth.gov notes that young women as well as transgender boys and girls are more likely to experience bullying and harassment throughout their childhood based on their gender identity, both from peers and adults.

One study found that social media use was tied to an increased risk of depression in teenage girls specifically. Additionally, rigid beauty standards can often place unrealistic expectations on girls, which they then internalize, lowering their self-esteem, and can cause them to develop mental health or eating disorders.

Young boys can also experience bullying and harassment based on negative or toxic perceptions of what a “man” should be, both physically and emotionally, which can also lead to mental health concerns, as noted by NAMI on the importance of self-esteem.

Children experiencing puberty may be more likely to develop a mental health condition if they are not properly supported through this period of their life, according to Youth.gov.

Additionally, experiencing early puberty can have a negative effect on self-worth and image. Positive support during this time of physical development can help children adjust, and helping children understand emotional self-regulation can also create a positive impression.

Children who are unable to effectively communicate their needs, or are not being supported when they do, can experience stress or develop negative experiences related to emotions, which can then cause a loop of self-deprecation and self-denial.

Family instability or conflict can cause serious environmental stress for children at any age.

The stress that individuals (both adults and children) may feel due to lack of financial security can be a significant indicator of future mental health concerns.

Communities of color and black Americans often experience higher amounts of depression, stress, and other mental health issues due to over-policing and high incarceration rates, which USA Today highlighted, noting that police brutality should be treated as a public health issue.

Both aspects of economic instability and racial tension between police and the people within these communities can cause serious stress and trauma for children.

Youth.gov notes that in both communities and schools, if children are regularly exposed to violence or trauma, they may be more likely to develop serious mental health conditions.

This can include experiencing a school shooting, police shooting, or other forms of violence due to community upheaval. A study in Cape Town, South Africa, released in 2017, noted the correlation between exposure to violence and the increase in symptoms of depression, anxiety, and PTSD for young adolescents.

Some of the most common mental health conditions among children and adolescents are depression, anxiety, behavioral problems, and ADHD. However, children can experience all the same mental health disorders and illnesses that adults do, though their risk of experiencing any of those conditions may differ based on their surroundings, upbringing, resources, and genetics.

Below are some of the various mental health conditions that children and adolescents may develop.

Attention-deficit/hyperactivity disorder (ADHD), and the related condition of Attention-deficit disorder (ADD), are both common chronic neurodevelopmental disorders among children and adolescents.

As explained by the CDC, these disorders are characterized by:

It’s important to note that ADHD and ADD often present differently in girls compared to boys. Young boys are more commonly diagnosed with ADHD/ADD, while girls are just as likely to struggle with the condition but may be less likely to receive a diagnosis until they’re much older.

As illustrated by Rae Jacobsen, writing for the Child Mind Institute, ADHD/ADD in young girls often presents in much subtler ways compared to boys. Unlike the external energy that boys may present due to hyperactivity, girls are more likely to vividly daydream and less likely to appear “hyperactive” on the outside.

Furthermore, both boys and girls with ADHD/ADD struggle with paying attention to tasks, but whereas boys may be more aggressive due to frustration, a girls’ frustrations are much more likely to be internalized and turned against themselves.

As a result, girls with undiagnosed and untreated ADHD/ADD are more likely to struggle with self-esteem and other mental health conditions, including anxiety, depression, and eating disorders. Many adolescents may not receive a proper diagnosis for their conditions until they’re well into their adult years.

ADHD and ADD are both treatable and manageable conditions, either with the help of behavioral therapy, medications, or both.

Early intervention and treatment can help set children with ADHD/ADD up for success. Additionally, many public K-12 schools offer accommodations for children with ADHD/ADD to help them succeed in their classes.

According to the Anxiety and Depression Association of America (ADAA), childhood anxiety can manifest in many different ways.

Anxiety is typically characterized by the body triggering the “fight, flight, or freeze” response due to a perceived or real threat. However, the triggers for anxiety in children can be different depending on the type of anxiety disorder they are experiencing.

As the ADAA explains, the following are some of the most common forms of anxiety disorder present in children and adolescents:

As noted by Harvard Health, occasional anxiety is healthy and normal, as it is the human body’s response to a threat. However, serious anxiety and any of the above disorders can cause significant trauma to a child and may also hinder their development.

Treatments for anxiety typically vary, depending on the severity and type of condition the child experiences, but cognitive behavioral therapy (CBT) is often the most effective form of treatment for children. Additionally, medications and mindfulness techniques may also help, as well as a combination of all three options.

According to the CDC, conduct disorder (CD) is a type of disruptive behavior disorder, and is often diagnosed in children when there is:

Children with CD are more likely to face legal issues, get injured, or have a more difficult time getting along with peers and family members. They may also act out by bullying others, being cruel to animals, damaging property, or getting in fights at school.

As noted by the American Academy of Child & Adolescent Psychiatry (AACAP), treatment for CD can help kids develop healthy coping mechanisms and benefit their overall development. Children who do not receive treatment are more likely to have continued issues into adulthood and may have trouble finding stable employment or relationships.

Treatment for CD may include medication, but AACAP notes behavioral therapy and psychotherapy are usually the most necessary forms of treatment.

The ADAA notes that childhood depression has been on the rise for the past several years. Depression in children often manifests differently than adults, typically as:

For both children and adults, depression can also appear as withdrawal and lack of enjoyment in normally engaging activities.

The cause of depression in children is not entirely known, but is typically believed to be due to biological, psychological, and social underpinnings, according to the ADAA. Additionally, children with parents who experience depression may have a genetic predisposition to the same condition.

Treatment typically consists of a mixture of CBT and medication (typically in the form of selective serotonin reuptake inhibitors or SSRIs), or more specialized forms of psychotherapy if the child is under age 10.

The CDC notes that children experiencing depression-like symptoms may also be experiencing other issues such as anxiety, ADHD, or PTSD related to trauma.

For parents who are concerned about their child’s mental health, a healthcare provider should be contacted so the child can receive an evaluation to determine diagnosis and treatment.

The CDC notes that OCD in children occurs when a child has frequent unwanted thoughts accompanied by odd or irrational behaviors to negate those thoughts.

OCD becomes apparent when these thoughts (obsessions) and actions (compulsions) take up a significant portion of time, such as an hour or more a day, or interfere with other daily activities in the child’s life.

The ADAA also notes the following symptoms as potential signs that a child is struggling with OCD:

The ADAA states that nearly 1 million children in the U.S. struggle with OCD, and it is a treatable and manageable condition. The condition is considered neurobiological, meaning the cause depends on the environment and biology of the child, and traumatic events — such as the sudden death of a loved one — can often trigger OCD to develop.

Treatment is often a mix of psychotherapy and exposure and response prevention (ERP) therapy. Antidepressant (SSRI) medications may also be prescribed.

Like Conduct Disorder, Oppositional Defiant Disorder (ODD) is a form of disruptive behavior disorder, as classified by the CDC. According to the Mayo Clinic, ODD presents itself in children and adolescents as a frequent and persistent pattern of anger, irritability, arguing, defiance, and or vindictiveness toward parents or authority figures.

Although parents should expect the occasional argument with their teenager, consistent lashing out is not normal behavior.

Other symptoms to look out for include:

The cause of ODD is not known, but behavioral psychologists believe it could be a mix of genetics and environmental factors such as harsh discipline, abuse, or neglect.

The Mayo Clinic recommends seeing a child psychologist or psychiatrist to diagnose disruptive behavior problems. Additionally, these specialists may be able to identify other, co-occurring mental health disorders such as depression, anxiety, ADHD, or other behavioral issues.

Treatment typically consists of regular behavioral therapy for ODD, as well as any underlying mental health conditions.

Although many children may experience stress over their lifetimes, the CDC explains, post-traumatic stress disorder (PTSD) is typically caused by severe stress due to traumatic experiences.

This can include injury, the death or threatened death of a loved one, and experiencing violence or witnessing violence against another person. PTSD is often related to anxiety, and may have similar symptoms as GAD or panic disorder when the child is reminded of the traumatic event.

Symptoms can vary depending on the experience that the child has been traumatized by, but some common symptoms include:

Treatment for PTSD most often consists of regular visits with a psychotherapist to help the child process the trauma they’ve experienced.

CBT is very effective as a form of treatment. Additionally, the child may also develop other mental health conditions, such as depression or anxiety, and a psychologist may be able to help prescribe SSRI medications to help these underlying conditions.

The CDC defines Tourette syndrome (TS) as a condition affecting the nervous system that causes people to have uncontrollable “tics.” These tics can be either motor or vocal, meaning sudden twitches, movements, or sounds that people with TS will make repeatedly.

The Mayo Clinic provides some examples of common tics:

For children or adolescents with TS, symptoms are similar to those of adults and may start appearing at age 5 or 10. A common progression of symptoms may follow the following chronology:

Diagnosing TS can be difficult, as it cannot be seen in a blood test. Health professionals will simply have to observe the tics in action to determine the severity of the condition. Typically, TS diagnosis requires a person to experience the tics for at least a year.

There is no cure for TS, as noted by the CDC, but treatment via behavioral therapy and medication can help alleviate symptoms. For some people, the condition may disappear entirely, or it may be subtle enough that it doesn’t get in the way of their daily life or cause undue stress.

Mental health conditions can have different effects on children throughout their lifetimes. Depending on the condition and when treatment is first sought out, children either can adapt to the condition and learn to live with it or will struggle to understand why they are mentally unwell and may be unable to lead a healthy and happy life.

However, outside of the potential quality of life improvement that treatment may provide, there are also other long- and short-term effects of mental illness that children and parents should be aware of.

As the CDC notes, undiagnosed or untreated conditions can cause children to have issues at home, in school, and in forming and maintaining healthy relationships throughout their lives. Additionally, overall development of the child — emotional, physical, and mental wellbeing — may be halted or underdeveloped if a condition is left untreated.

Furthermore, untreated conditions such as PTSD, depression, anxiety, ODD, CD, and more can lead children to develop risky and destructive behavior, including self-harm and potentially suicidal ideation. This is why treatment and early intervention are so important in helping children and adolescents develop healthy coping mechanisms to manage their condition.

Parents should seek help for their children as soon as they suspect a potential mental health condition is developing.

Doctors, nurses, or mental health specialists can help parents determine what the condition is (or if there is a condition at all) and how best to treat and manage it. If the nurse or doctor is unable to properly diagnose the condition, they may recommend a specialist who may be more knowledgeable on these conditions. A nurse practitioner who specializes in psychiatry or mental health may be able to help parents come to a diagnosis or get the child the help they need.

Determining if a child is struggling with a mental health condition, an illness, or a new stage of childhood development can be difficult, which is why it is so important to seek the help of a professional. If a parent is unsure of their child’s condition, a general rule to follow is to seek help if the behavior or moods begin to interfere with other daily tasks, such as school, friendships, hobbies, sports, or family.

Additionally, as advised by the National Institute of Mental Health (NIMH), parents should seek help immediately if their child begins to talk about wanting to hurt themselves or others.

It’s important to understand that most mental illnesses are not curable conditions and there is no sure-fire way to prevent them. Most of these conditions are chronic (lasting longer than three months), and children may have to manage them for their entire life. However, that doesn’t mean they can’t be managed or treated with the help of medical supervision. These children can still go on to lead happy and productive lives.

Treatment options differ depending on the individual seeking treatment, the condition, and the local resources available to families seeking treatment. Typically for many mental illnesses, a combination of treatments may be recommended, such as medication and cognitive behavioral therapy (CBT).

All treatments should be prescribed and monitored by a licensed child psychologist or doctor to determine the best course of action and monitor the progress of the condition. Not every form of treatment will work or be available for everyone, but below are some of the most common options to explore.

Various medications can help manage the symptoms of mental health conditions and help rebalance the brain’s internal chemistry.

Medications such as SSRIs or Tricyclics antidepressants are commonly prescribed for a variety of mental health conditions related to depression or anxiety. However, there are also mood stabilizers, relaxants, stimulants, and other variations of prescription medications that may be able to help a child, depending on their condition and the advice of their doctor.

If medications are prescribed by a doctor or certified nurse practitioner, be sure to follow the prescription recommendations and closely monitor your child for any potential negative side effects or concerns. Additionally, although medication may be suggested, it often works best when this treatment is used in conjunction with other forms of treatment, such as therapy or counseling.

Also called “talk therapy” or simply “therapy,” psychotherapy involves having a child visit with a professional psychologist, therapist, or other mental health professional who has studied psychology. Additionally, certain conditions can impact the way children speak or communicate; someone trained to work with people who have speech/communication problems can also be helpful when used in conjunction with therapy.

In these environments, children are invited to discuss anything from their life, or anything related to their feelings, moods, behaviors, or thoughts. Psychologists will also give the child different tools (such as calming exercises or thought experiments) or teach them important coping mechanisms and skills that can help them manage their condition between sessions.

Another option available to children and their families is family counseling. Similar to psychotherapy, this form of counseling can include parent(s), siblings, and the child as the therapist talks them through certain aspects of their life, as well as any emotions, thoughts, moods, or behaviors that each individual may be struggling with.

Including family members in the treatment process can help give children and adolescents the support and help they need to work out any differences they may be having with a parent or sibling.

Additionally, the therapy can greatly benefit the other members of the family, as the therapist may help point out problematic language or stigma to provide a more supportive environment for the child who is struggling.

For more information on childhood mental illness, treatment, causes, signs, or concerns, consider the following resources:

Sources

American Academy of Child & Adolescent Psychiatry, “Conduct Disorder”

Anxiety and Depression Association of America, “Childhood Anxiety Disorders”

Anxiety and Depression Association of America, “Childhood Depression”

Anxiety and Depression Association of America, “How to Help Your Child”

Anxiety and Depression Association of America, “PTSD Symptoms in Children Age Six and Younger”

Anxiety and Depression Association of America, “Symptoms”

CDC, “Data and Statistics on Children’s Mental Health”

CDC, “Anxiety and Depression in Children”

CDC, “Attention-Deficit / Hyperactivity Disorder (ADHD)”

CDC, “Behavior or Conduct Problems in Children”

CDC, “Obsessive-Compulsive Disorder in Children”

CDC, “Post-traumatic Stress Disorder in Children”

CDC, “Tourette Syndrome”

CDC, “What Are Childhood Mental Disorders?”

Child Mind Institute, “How Girls With ADHD Are Different”

Child Mind Institute, “2017 Children’s Mental Health Report”

Harvard Health, “Anxiety in children”

Harvard Health, “What causes depression?”

Healthline, “Chemical Imbalance in the Brain: What You Should Know”

The Independent, “Teenage girls twice as likely to be depressed due to social media than boys, study suggests”

Lindner Center of Hope, “Adolescent Depression Different from Depression in Adults”

Mayo Clinic, “Oppositional defiant disorder”

Mayo Clinic, “Tourette syndrome”

Mayo Clinic, “Tricyclic antidepressants and tetracyclic antidepressants”

National Alliance on Mental Illness, “Warning Signs and Symptoms”

National Alliance on Mental Illness, “Why Self-Esteem Is Important for Mental Health”

National Institutes of Health, “Common Genetic Factors Found in 5 Mental Disorders”

National Institute of Mental Health, “Children and Mental Health”

National Institute of Mental Health, “Coping with Traumatic Events”

Stephen A. Stansfeld, corresponding author Catherine Rothon, Jayati Das-Munshi, Cathy Mathews, Arlene Adams, Charlotte Clark, and Crick Lund, “Exposure to violence and mental health of adolescents: South African Health and Well-being Study”

U.S. Department of Health and Human Services, “Adolescent Health”

USA Today, “Police killings, brutality damaging mental health of black community”

WebMD, “How Different Antidepressants Work”

World Health Organization, “Child and adolescent mental health”

Youth.gov, “Risk & Protective Factors