As with adults, mental illnesses in children are diagnosed based on signs and symptoms that suggest a particular disorder. However, this process can be especially challenging with children. Many behaviors that are seen as symptoms of mental disorders, such as shyness, anxiety (nervousness), strange eating habits and outbursts of temper, can occur as a normal part of a child's development. Behaviors become symptoms when they occur very often, last a long time, occur at an unusual age or cause significant disruption to the child's and/or family's ability to function.
If symptoms are present, the doctor will begin an evaluation by performing a complete medical history and physical examination. Although there are no laboratory tests to specifically diagnose mental disorders, the doctor may use various tests, such as X-rays and blood tests, to rule out physical illness or medication side effects as the cause of the symptoms.
If no physical illness is found, the child may be referred to a child and adolescent psychiatrist or psychologist, mental health professionals who are specially trained to diagnose and treat mental illness in children and teens. Psychiatrists and psychologists use specially designed interview and assessment tools to evaluate a child for a mental disorder. The doctor bases his or her diagnosis on reports of the child's symptoms and his or her observation of the child's attitude and behavior. The doctor often must rely on reports from the child's parents, teachers and other adults because children often have trouble explaining their problems or understanding their symptoms.
How Is Mental Illness in Children Treated?
Mental disorders are like many medical illnesses that require ongoing treatment. Although much progress has been made in the treatment of adults with mental disorders, the treatment of children is not as well understood. Experts are still exploring which treatments work best for which conditions in children. For now, many of the treatment options used for children, including many medications, are the same as what is used to treat adults. The most common treatment options used include:
Medication: Many mental illnesses can be effectively treated with medications. The medications often used to treat mental disorders in children include antipsychotics, antidepressants and antianxiety drugs, stimulants and mood stabilizing drugs.
Psychotherapy: Psychotherapy (a type of counseling) addresses the emotional response to mental illness. It is a process in which trained mental health professionals help people deal with their illness, often by talking through strategies for understanding and dealing with their symptoms, thoughts and behaviors. Types of psychotherapy often used with children are supportive, cognitive-behavioral, interpersonal, group and family therapy.
Creative therapies: Certain therapies, such as art therapy or play therapy, may be helpful, especially with young children who may have trouble communicating their thoughts and feelings.
Depression is an illness that involves the body, mood, and thoughts and affects the way a person eats and sleeps, the way one feels about oneself, and the way one thinks about things. The principal types of depression are major depression, dysthymia, and bipolar disease (also called manic-depressive disease).
Schizophrenia is a disabling brain disorder that may cause hallucinations and delusions and affect a person's ability to communicate and pay attention. Symptoms of psychosis appear in men in their late teens and early 20s and in women in their mid-20s to early 30s. With treatment involving the use of antipsychotic medications and psychosocial treatment, schizophrenia patients can lead rewarding and meaningful lives.
Borderline personality disorder is a serious mental illness characterized by pervasive instability in moods, interpersonal relationships, self-image, and behavior. This instability often disrupts family and work life, long-term planning, and the individual's sense of self-identity. Originally thought to be at the "borderline" of psychosis, people with borderline personality disorder (BPD) suffer from a disorder of emotion regulation.
Down syndrome is a chromosomal disorder that results in the presence of an additional third chromosome 21, also referred to as trisomy 21. Most individuals with Down syndrome have widely recognizable physical characteristics. The severity of Down syndrome ranges from mild to severe. Diagnostic testing for Down syndrome include amniocentesis, chorionic villus sampling, and percutaneous umbilical cord sampling. The most common risk factor for Down syndrome is a woman's age.
Attention deficit hyperactivity disorder (ADHD) is a behavioral disorder characterized by the symptoms hyperactivity, impulsivity, and inattention. Treatment for ADHD may involve behavioral therapy and psychostimulant or antidepressant medication.
Fragile X syndrome is the most common inherited form of mental retardation. It's caused by a mutation on the X chromosome. People with Fragile X syndrome suffer from physical, social, emotional, speech, language, sensory, intelligence, and learning impairments. There is no definitive treatment for Fragile X, though there are ways to minimize the symptoms.
Childhood depression can interfere with social activities, interests, schoolwork and family life. Symptoms and signs include anger, social withdrawal, vocal outbursts, fatigue, physical complaints, and thoughts of suicide. Treatment may involve psychotherapy and medication.
Dysthymia is a less severe form of chronic depression. Symptoms and signs include insomnia, suicidal thoughts, guilt, empty feeling, loss of energy, helplessness, sluggishness, and persistent aches and pains. Treatment may involve psychotherapy, electroconvulsive therapy, and antidepressants.
Good parenting helps foster empathy, honesty, self-reliance, self-control, kindness, cooperation, and cheerfulness, says Steinberg, a distinguished professor of psychology at Temple University in Philadelphia. It also promotes intellectual curiosity, motivation, and desire to achieve. It helps protect children from developing anxiety, depression, eating disorders, antisocial behavior, and alcohol and drug abuse.
Bipolar disorder, or manic-depressive illness, is a disorder that causes unusual and extreme mood changes. Symptoms of bipolar disorder in children and teens include having trouble concentrating, behaving in risky ways and losing interest in activities they once enjoyed. Treatment for bipolar disorder in children and teenagers incorporates psychotherapy and medications.
Munchausen syndrome is a factitious disorder and attention-seeking syndrome in which an individual pretends to have physical or psychological symptoms in order to gain attention. Symptoms and signs vary from heart symptoms, chest pain, and fainting to ear problems and hallucinations. Sufferers tend to seek help from multiple care providers, seem overly pleased at being subjected to tests and procedures, and have vague symptoms that are inconsistent with test results. There is no particular treatment approach that is consistently effective in treating Munchausen syndrome.
Factitious disorders are conditions in which people pretend to have physical or mental illnesses when they aren't sick. These people may lie about or fake symptoms to obtain the sympathy and attention given to people who are genuinely ill. Symptoms of factitious disorders include dramatic, inconsistent medical history, the presence of many surgical scars, and a history of seeking treatment at many different hospitals.
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