We take our kids for regular physicals and make sure their vaccinations are up-to-date. How can we inoculate them against mental health problems, too?
Our children learn early to tell us when they have a tummy ache or come running to us with a scratched knee. But too often, they hold sad or negative feelings inside.
In Canada, 15 percent of children and youth have a mental illness, according to the Mood Disorders Society of Canada. In many cases, their mental health worsens into a serious condition in later childhood or early adulthood. How can parents make it as natural for children to talk about emotional pain as it is for physical pain?
Here are tips from the experts on how to promote positive mental health, help children feel comfortable about these topics and give kids the tools to express themselves.
Preschool (ages 3-5)
Advice from Carolee Cain, director of Healthy Child Development at the Child Development Institute in Toronto.
Preschool children may get angry or easily frustrated. Because they may not be able to express themselves with words, some preschoolers may hit or push. Others may suffer separation anxiety.
“Some children are unable to self-soothe. Some can go and sit quietly and others can’t,” says Carolee. “A child may be highly anxious and can’t take any comfort from an adult and can’t be soothed with a hug.” Anxiety or a major life event, such as moving, starting school or the arrival of a new sibling, may cause a child to lose a skill she’s mastered. She may start using baby talk or regress with potty training.
If You're Concerned…
Compare notes with other caregivers, says Carolee. “Talk about how to help the child and set up consistent routines for those who are struggling. They need predictability, a lot of support and a lot of patience.” If you are still concerned, talk with your family doctor or pediatrician.
Ways to Nurture Good Mental Health
- Provide a lot of physical connection and play.
- Go out and be with other parents and children.
Finding the Words
“At this age, talk a lot about feelings,” Carolee says. “If they hit another child, point out that the other child is crying. Ask ‘How do you think he is feeling? How can you make him feel better?’ It has to be real for them to understand, not abstract.” Look at photos and books with real pictures that identify emotions.
“Label their emotions. If they are excited because they have a new toy, say ‘You are happy.’ It is all in the context of play. That is how they understand issues of emotion and how they problem solve.”
School age (ages 6-10)
Advice from Dr. Shimi Kang, a psychiatrist in Vancouver and author of The Dolphin Way: A Parent’s Guide to Raising Healthy, Happy and Motivated Kids Without Turning Into a Tiger.
School age children are going through significant hormonal changes in preparation for puberty. This affects mood, energy levels, sleep patterns and brain function. “Kids at this age are also starting to distinguish themselves as their own person and will start asserting their opinions,” says Dr. Kang.
The most common mental health issues that can arise at this age include anxiety, depression and phobias. While irritability or changes in personality can be part of normal development, Dr. Kang says to note if changes are affecting functioning, such as school performance, relationships or sleep. Other warning signs include losing interest in favourite activities, a decrease in connection with family or a change in friendships. Children may also have physical complaints like headaches or stomach aches.
If You're Concerned…
Discuss concerns with your child’s teachers. Ask for help from a school counsellor or your family doctor. Dr. Kang recommends internet resources from the Canadian Mental Health Association or Kids Help Phone.
Ways to Nurture Good Mental Health
- “The centrepiece for health is sleep. Kids this age need 10 to 12 hours,” Dr. Kang says. “Forty percent of Canadian kids are sleep deprived because they are too busy. It is 100 percent affecting their health and mental health.”
- Dr. Kang also prescribes unstructured play and cultivating a sense of connection through family dinners or a game night.
Finding the Words
“Talk about how everyone has stress and part of life is learning how to manage it,” says Dr. Kang. “You can say, ‘Remember when I freaked out in traffic? That was me not coping well.’ The key is to learn from it and develop strategies to do better next time.”
Talk to kids about what works for you. “For example, ‘Listening to music helps me when I feel stress. What works for you?’ Elicit answers instead of giving answers. Guide them versus directing them.”
Early adolescence (ages 10–15)
Advice from Dr. Sandra Mendlowitz, a psychologist in the Department of Psychiatry at the Hospital for Sick Children in Toronto.
As children transition into adolescence, it’s a time of significant hormonal changes. Adolescents can be cranky, want to sleep a lot and their moods can change on a dime, says Dr. Mendlowitz.
Anxiety and depression are the most common mental health issues at this age. Dr. Mendlowitz says the hallmark of anxiety is avoidance. For example, you may think your child is trying to wriggle out of giving a school presentation, but he may legitimately be anxious about what might happen. A major sign of depression is withdrawal, including no desire to engage with family and friends or lack of motivation. Look for a significant shift in a child’s mood or behaviour.
If You're Concerned…
Check in with your child’s school or family doctor. Talk with your child to problem solve together. “If they don’t want to talk to you, get them to talk to another trusted adult,” Dr. Mendlowitz says. She also recommends printing information from a reputable website and leaving it on the kitchen counter, for example. “By just leaving it out there, you have basically said it’s OK to seek help if you have a problem. Giving permission is important.”
Ways to Nurture Good Mental Health
- Encourage your child to take risks. For example, if they are anxious about doing a presentation, discuss how you can help them by listening to them practise.
- Get kids involved in sports, exercise, family outings, volunteering and hanging out with friends.
Finding the Words
Kids can feel like they are being interrogated. Instead, make space for conversations, says Dr. Mendlowitz. “If you hear about something on the news or a TV show, ask your kids what they think about it and talk about how it makes you feel.” Don’t dismiss your child’s worries. Instead, ask why they are worried and work together to solve a problem. Listening is key, says Dr. Mendlowitz. “Parents don’t listen. They talk at a child and react.”
Late adolescence (age 16+)
Advice from Dr. Stan Kutcher, a professor of psychiatry at Dalhousie University in Halifax.
“Kids this age are dealing with negative emotions that are the result of the slings and arrows every teenager goes through – breakups, when people aren’t kind to you, you didn’t make the basketball team. The normal rites of passage,” says Dr. Kutcher.
Common mental health concerns for this age group are depression, anxiety, substance abuse and bipolar disorder. “Regular teen angst happens from an external event. This is usually normal. It is time to be concerned when symptoms persist for two to three weeks and are disrupting regular routines.” If a mental health disorder runs in your family, know the signs and symptoms.
If You're Concerned…
Dr. Kutcher says, “What is good for the bicep is good for the brain,” including exercise, eating well and getting enough rest. “Stress is not something to avoid or fear. Let your kids choose their university courses or go alone to that job interview,” he says. “If you protect your children from stress and normal negative emotions, it gets in the way of kids being able to adapt or cope with normal life stressors.”
Ways to Nurture Good Mental Health
- Have resources ready to discuss with your teen. Check out Dr. Kutcher’s online resources at teenmentalhealth.org. There’s advice for both parent and teen, including How Do I Parent My Teen? and How Do I Teen My Parent?
Finding the Words
“With younger kids you have more structured moments, like bedtime, when you can sit down and talk. With teens, you have to be ready when they are. Even if that is at 2 a.m., ”says Dr. Kutcher. He also suggests giving your teen reading material and then stepping back. “Be casual about it. Say ‘I enjoyed reading this.’ Not ‘Read this or else.’” Make your kids aware if a mental illness runs in the family, just as you would with diabetes or heart disease and talk about signs and symptoms. “Develop effective listening skills and help your teen figure out solutions to any challenges. If you can do that, you are more than halfway home as a parent of a teenager.”
Originally published in ParentsCanada magazine, February 2015.
