Children and Mental Illness – Misbehavior or Misdiagnoses?

I wonder about the diagnosis of children as it relates to mental unwellness. Does the word unwellness signify illness … or is it something else? Often I think there is a rush to judgment on the part of parents. Could it be that the unruly child kicking and screaming in the main isle of the grocery store is merely having a temper tantrum? I remember listening to family stories,” there he was screaming and kicking, face down in the woman’s department, I was so embarrassed I could have just died!”

Perhaps there is too urgent a willingness to put a label on children because their behavior is something that seems incomprehensible. In the past 15 years it has become acceptable to label our children with the term mental disorder. Some of the acronym’s for illnesses are ADD (Attention Deficit Disorder), ODD (Oppositional Defiant Disorder), and now BPD (Bipolar Disorder). The remedy for these illnesses? Medicate the little buggers and wipe away our fears. But in the face of poor behavior in children, I have seen worse in their parents.

About 20% of American children suffer from a diagnosable mental illness during a given year, according to the U.S. Surgeon General. Further, nearly 5 million American children and adolescents suffer from a serious mental illness (one that significantly interferes with their day-to-day life).

Which Mental Illnesses Are Most Common in Children?

Children can suffer from the following mental illnesses:

  • Anxiety disorders: Children with anxiety disorders respond to certain things or situations with fear and dread, as well as with physical signs of anxiety (nervousness),
    such as a rapid heartbeat and sweating.
  • Disruptive behavior disorders: Children with these disorders tend to defy rules and often are disruptive in structured environments, such as school.
  • Pervasive development disorders: Children with these disorders are confused in their thinking and generally have problems understanding the world around them.
  • Eating disorders: Eating disorders involve intense emotions and attitudes, as well as unusual behaviors, associated with weight and/or food.
  • Elimination disorders: These disorders affect behavior related to the elimination of body wastes (feces and urine).
  • Learning and communication disorders: Children with these disorders have problems storing and processing information, as well as relating their thoughts and ideas.
  • Affective (mood) disorders: These disorders involve persistent feelings of sadness and/or rapidly changing moods.
  • Schizophrenia: This is a serious disorder that involves distorted perceptions and thoughts.
  • Tic disorders: These disorders cause a person to perform repeated, sudden, involuntary and often meaningless movements and sounds, called tics.

Some of these illnesses, such as anxiety disorders, eating disorders, mood disorders, and schizophrenia, can occur in adults as well as children. Others, such as behavior and development disorders, elimination disorders, and learning and communication disorders, begin in childhood only, although they can continue into adulthood. In rare cases, tic disorders can develop in adults. It is not unusual for a child to have more than one disorder.

What Are the Symptoms of Mental Illness in Children?

Children’s symptoms vary depending on the type of mental illness, but some of the general symptoms include:

  • Abuse of drugs and/or alcohol.
  • Inability to cope with daily problems and activities.
  • Changes in sleeping and/or eating habits.
  • Excessive complaints of physical ailments.
  • Defying authority, skipping school, stealing, or damaging property.
  • Intense fear of gaining weight.
  • Long-lasting negative moods, often accompanied by poor appetite and thoughts of death.
  • Frequent outbursts of anger.
  • Changes in school performance, such as poor grades despite good efforts.
  • Loss of interest in friends and activities they usually enjoy.
  • Significant increase in time spent alone.
  • Excessive worrying or anxiety.
  • Hyperactivity.
  • Hearing voices or seeing things that are not there (hallucinations).
  • Persistent nightmares or night terrors.
  • Persistent disobedience or aggressive behavior.
  • Frequent temper tantrums.

What Causes Mental Disorders in Children?

The exact cause of most mental disorders is not known, but research suggests that a combination of factors, including heredity, biology, psychological trauma and environmental stress, might be involved. 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 life.

So how does a parent know … illness or bad behavior? This can be tricky. Children experience many physical, mental and emotional changes as they progress through their natural growth and development. They also are in the process of learning how to cope with, adapt and relate to others and the world around them. In addition, each child matures at his or her own pace, and what is considered “normal” in children falls within a wide range of behavior and abilities. For these reasons, any diagnosis of a mental disorder must consider how well a child functions at home, within the family, at school and with peers, as well as the child’s age and symptoms.

Children and Mental Illness – Misbehavior or Misdiagnoses?

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 might use various diagnostic 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, health care 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. The doctor then determines if the child’s symptoms point to a specific mental disorder.

Mental disorders are like many medical disorders, such as diabetes or heart disease, 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 those used in adults but with different dosing. The most common treatment options used include: Medication, Psychotherapy, and often Play Therapy.

What Is the Outlook for Children With Mental Disorders?

Without treatment, many mental disorders can continue into adulthood and lead to problems in all areas of the person’s adult life. People with untreated mental disorders are at high risk for many problems, including alcohol or drug abuse, and violent or self-destructive behavior, even suicide.

When treated appropriately and early, many children can fully recover from their mental disorder or successfully control their symptoms. Although some children become disabled adults because of a chronic or severe disorder, many people who experience a mental illness are able to live full and productive lives.