Dealing with mental illness in children

Children with ADHD normally have difficulty paying attention, they tend to be hyperactive and prone to impulsive behaviour. PHOTO| FILE| NATION MEDIA GROUP

What you need to know:

Where to seek help

  • Ideally, you should start with your paediatrician. He/she will refer you to a child development centre where they will assess your child to see whether your child is going through normal childhood ups and downs or if there may be a problem brewing. In some cases, the paediatrician may refer you straight to a psychiatrist.
  • If your child is diagnosed with a mental condition, the following may be considered:

    Psychotherapy (talk therapy or behaviour therapy): Psychotherapy allows for your child to learn about their moods, feelings, thoughts and behaviour. It also teaches them how to handle stressful conditions.

    Medication: In some cases, medication to reduce anxiety, such as anti-depressants and mood stabilisers may be needed to help manage your child’s condition.

    Family therapy: Family and couple therapy may be needed to allow for the family to cope with the child’s condition.

    School team: In order to manage the child’s health, it is usually in their best interest to let the teachers at school know what is going on and how to best handle your child when they are unwell. In addition, it also helps if the teacher assists your child deal with external stressors such as bullying and learning difficulties.

These days, there are a lot of stories making headlines in our local newspapers about heinous crimes being committed by people who are later diagnosed to have mental illness. Most of these crimes are directed towards people close to them such as family members and work colleagues.

There is also a rise in the number of teenagers committing suicide after the release of national examination results. The question that most people ask themselves is, ‘where has all this mental illness come from?’

Mental illness is currently the most stigmatised medical condition worldwide (rivalled only by HIV/Aids). Most people even avoid marrying a person who has a distant relative with mental illness. For this reason, most people keep the condition hidden from the rest of the world and often do not seek treatment.

In most cases, mental illness symptoms begin in childhood but most parents do not recognise the symptoms or if they notice an odd behaviour, they put it down to a passing phase. However, it has been found that the earlier you recognise and begin to treat mental illness, the better the outcome.

What are the different types of mental illnesses that affect children? Mental illness is a very broad term which covers a large number of medical conditions. These include:

Autism spectrum disorder (ASD): Autism is the most common mental/developmental disorder that appears in early childhood. Usually, most children will have shown symptoms by the age of 3 years. The main challenge faced by these children is the inability to communicate and interact with other people.

Mood disorders: These include conditions such as depression and bipolar disorder. Often these children have extreme mood swings and may sometimes go through phases of extreme sadness/unhappiness.

Anxiety disorders: During the different transition periods of a child’s life, a little anxiety is expected such as when the child is left for the first time under the care of a nanny, the first day of school etc. However, children with anxiety disorder tend to experience such severe anxiety and distress (almost on a daily basis) that it begins to interfere with their ability to interact with other people and learn new things about their environment.

Attention-deficit/hyperactivity disorder (ADHD): Children with ADHD normally have difficulty paying attention, they tend to be hyperactive and prone to impulsive behaviour. This is the child who is often described in Kiswahili as ‘hana masikio’ as he/she tends not to be able to follow simple instructions, rules and regulations.

Eating disorders: Problems such as starving oneself (anorexia nervosa), purging/forcing oneself to vomit after meals (bulimia nervosa) and binge-eating were usually more common among teenagers and young adults. These days, however, it is not unusual to find girls in Kenya (especially in Nairobi) as young as six and seven years who have eating disorders.

Interestingly, some parents actually play a role in this as they repeatedly jokingly put down their children for their various body shapes. This is a dangerous as these children can become so preoccupied with food and weight that they focus on little else.

Schizophrenia: This is a condition in which the child tends to lose touch with reality (psychosis). They may begin to hear or see people who aren’t there. They may also become paranoid and think that someone is out to hurt them. They may go as far as walking around picking fights or having animated conversations with the people they are hallucinating with.

Most young children have imaginary friends and this is a normal part of growing up and does not constitute mental illness. If this behaviour continues into late childhood and teenage years, then you need to have your child assessed.

How to recognise mental illness in your child?

There are tell-tale signs that could show that your child may need further review by a mental health specialist. These include:

Lagging behind in development milestones: Most children develop physical, social and mental abilities at a certain pace. For example, most begin walking at around 12-18 months, they can engage in conversation with adults by 2-3 years and can read simple words by age 5. Children with mental illness may experience delays in the various developmental milestones and this can act as a red flag to an underlying problem.

Extreme feelings and mood changes: The child may become very sad or withdrawn with little explanation. In some cases, the child is relatively happy between these episodes of low mood. In other cases, the child may show extreme fear or irrational anger towards a particular situation.

Poor school performance: Difficulties concentrating and poor memory in a child usually indicates an underlying mental or emotional problem but it can also be a sign of a learning disability.

Unusual violence: Violence and repeated cruelty towards animals is always a red flag when it comes to symptoms of mental illness in a child. They also often have a desire to hurt other people. In most cases, the violence is directed towards younger siblings (these children may do things like push siblings down flights of stairs and other extreme forms of violence). Teens may begin to carry weapons.

Self-harm: These children may try and harm themselves by cutting or burning themselves. Older children may attempt suicide.

Out of control behaviour: This child may be very difficult to control, hyperactive and have problems obeying rules. Older children may engage in drugs/alcohol to cope with their feelings.

Physical symptoms: Children with a mental health condition may develop unexplained headaches and tummy aches when they are dealing with extreme anxiety or sadness. Massive weight gain or loss may indicate an eating disorder.

Night terrors and hallucinations: Persistent nightmares and night terrors may be indicative of a mental disorder. In some cases, the child may actually hear or see imaginary people talking to them even when they are awake.