Mental Health Guide – Anxiety & Depression in Children

Many children experience anxieties and worries, and may feel sad and hopeless from time to time. Strong fears can occur at different points during development. For example, toddlers often become highly distressed about being away from their parents, even when they are safe and cared for. While anxieties and worries are natural in children, persistent or excessive fear and sadness could be signs of anxiety or depression. Since these symptoms are often linked to thoughts and feelings, they are classified as internalizing disorders.

Signs and Symptoms

Anxiety

When children do not outgrow common childhood fears, or when their worries interfere with school, home, or play, they may have an anxiety disorder. Anxiety is not a single condition but encompasses several different disorders:

• Separation Anxiety Disorder: Intense fear when away from parents, often accompanied by fear of being separated.
• Phobia: Extreme fear of specific objects or situations, such as animals, insects, or doctors.
• Social Anxiety Disorder: Fear of social situations, such as school or group activities.
• Generalized Anxiety Disorder: Persistent and excessive worry about various aspects of life, not tied to one situation.
• Panic Disorder: Recurring episodes of intense fear with physical symptoms like rapid heartbeat, shortness of breath, dizziness, trembling, or sweating.

Children with anxiety may also exhibit irritability or anger. Additional symptoms may include difficulty sleeping, fatigue, headaches, or stomachaches. Since many anxious children keep their worries to themselves, symptoms can sometimes be overlooked.

Depression

Sadness or hopelessness is a normal part of life for children. However, if a child feels consistently sad or loses interest in activities they once enjoyed, they may be experiencing depression. Depression in children can manifest in various ways:

• Frequent feelings of unhappiness, despair, or irritability.
• Loss of interest in enjoyable activities.
• Changes in eating habits—eating significantly more or less than usual.
• Changes in sleep patterns—sleeping much more or less than normal.
• Fluctuations in energy levels—being sluggish or overly restless.
• Difficulty concentrating.
• Feelings of worthlessness or guilt.
• Self-injury or self-destructive behaviors.

In severe cases, depression may lead children to think about or plan suicide. Suicide is the second leading cause of death for children aged 10-14. Some children may not openly discuss their feelings, and instead, they may act out or appear unmotivated, leading others to label them as troublemakers or lazy. Depression may also cause children to become irritable or aggressive. Anxiety and depression often co-exist in children, adolescents, and adults.

Managing Symptoms: Staying Healthy

Good physical and mental health is essential for all children, especially those with anxiety or depression. Along with appropriate treatment, healthy lifestyle practices can help manage symptoms:

• Healthy Diet: Focus on fruits, vegetables, whole grains, legumes, lean proteins, and nuts.
• Physical Activity: Aim for at least 60 minutes of daily exercise.
• Adequate Sleep: Ensure children get the recommended amount of sleep for their age.
• Mindfulness Techniques: Practice relaxation methods such as deep breathing or meditation.

Treatment for Anxiety and Depression

The first step in treatment is consulting a healthcare provider, such as a pediatrician or mental health specialist, for an evaluation.

• Screening Guidelines: The U.S. Preventive Services Task Force recommends anxiety screenings for children ages 8-18 and depression screenings for adolescents ages 12-18.
• Comprehensive Evaluation: Some symptoms may stem from other issues, like trauma, making an accurate diagnosis critical.

A tailored treatment plan may include:

• Behavior Therapy: Involves therapy for the child, family, or both, often including school support. For younger children, parental involvement is key.
• Cognitive Behavioral Therapy (CBT): Helps older children shift from negative to positive thought patterns, leading to healthier behaviors.
• Exposure Therapy: Gradually introduces children to their fears in a safe environment, helping them realize that feared outcomes are unlikely.

Treatments may also involve promoting healthy routines, proper nutrition, physical activity, and social support to reduce stress.

Finding Professional Help

Pediatricians and other healthcare professionals can assist families in determining when specialized care is necessary. Referrals for mental health providers can be obtained through:

• Schools
• Primary Care Providers
• Health Insurance Networks

Additionally, trusted friends or family members with local experience can be valuable resources.

If insurance coverage is an issue, families can explore:

• Medicaid
• Children’s Health Insurance Program (CHIP)
• Marketplace Plans via HealthCare.gov
• Low-Cost Care at community health centers

Mental Health Specialists and Resources

To find a suitable healthcare provider, use these tools:

• Psychologist Locator (American Psychological Association)
• Child and Adolescent Psychiatrist Finder (AACAP)
• Cognitive Behavioral Therapist Finder (ABCT)

By recognizing the signs early and seeking appropriate care, parents can play a pivotal role in their child’s mental health journey.