Is my child allergic to something?

Kirk Coverston, MD
In 2008-2009, an estimated 2 million U.S. children age 12 to 17 had major depression. Half of all mental health and substance abuse occurred prior to age 14, with a total cost of $247 billion reported in 2007.

In my practice, the statements I hear most frequently from parents are “my child seems angry and unhappy,” and/or “my child isn’t doing well in school.”

What does all this mean?

Mental health is multifaceted, and the causes may include the environment that we are exposed to, how we are nurtured and, ultimately, our gene pool. Children raised in horrific environments can be mentally healthy and those raised in the best of environments can have disabling mental health.

Many families have no experience with mental illness until it affects one of their children, or someone close to them. We may not see the warning signs. Sadly, many of the services are not offered until after a child is troubled and in distress. It is so important to have an integrated approach, including medical, mental, environmental and social aspects.

Mental health is part of a child’s overall health. Pediatricians become concerned when the parent sees a change in a child’s wellbeing, and will strive to determine if this a physical medical issue or a mental issue.

If you are worried about your child’s mental health, follow your instincts and ask questions!
As a parent, you are one of the first people to notice a difference in your child’s behavior. Don’t dismiss it. Write it down and tell your pediatrician.
1. Are there dramatic changes in emotions or behaviors or difficult behaviors that are starting to become persistent?
2. There may be many changes that happen at the same time. Changes in eating behaviors, such as anorexia, bulimia or binge eating, may accompany major depression, or concerns about substance abuse may accompany anxiety disorders.
3. Younger children may be unable to describe their feelings or thoughts. They may instead express physical symptoms which don’t have any physical basis like frequent headaches or stomachaches (psychosomatic complaints). Notice if you are more calls from your school nurse regarding your child’s symptoms.
4. Older children undergo major physical and chemical changes, along with social role changes, which can be difficult to navigate.

What are common mental health conditions in children and young adults?
1. Anxiety disorders (Post Traumatic Stress Disorder, panic disorders, obsessive compulsive disorders)
2. Mood disorders (depression and bipolar)
3. Substance abuse disorders
4. Eating disorders
5. ADHD – Attention Deficit Hyperactivity Disorder
6. Autism spectrum disorders
7. Psychotic Illnesses – generally seen in teen and early adult years.

What behaviors should I be worried about and tell my pediatrician about?
1. Mood changes
2. Feelings of sadness or withdrawal that last at least two weeks, or severe mood swings that cause problems in relationships at school or home
3. Intense feelings - overwhelming fear for no obvious reason that interferes with activities of daily living, hallucinations, paranoia or delusions
4. Behavior changes – fighting, expression of desire to hurt oneself or others, difficulty concentrating, unable to sit still, causing poor performance at school or home
5. Persistent or sudden drop in school performance
6. Appetite and sleep changes
7. Substance abuse - increased or persistent use of alcohol or drugs

What are the next steps?
Your pediatrician will do a comprehensive examination to rule out physical health conditions that may be causing the symptoms. These conditions can include endocrine disorders, recurrent head injuries, or other conditions.

If your pediatrician suspects a mental health issue, early intervention with treatment options will be discussed with you. You may be referred to a mental health specialist for additional help.

How can I best help my child during this time?
1. Seek help – be your child’s advocate
2. Nurture a strong family unit (however it is defined to you). Staying strong together makes the hills and valleys easier to go through
3. Encourage good communication amongst family members, school administrators, teachers, and school nurses.. They have eyes and ears to see and evaluate situations and behaviors that you are not there to assess. Having them on your team is crucial.
4. Know your child’s friends and how they behave.
5. Recognize the importance of healthy outlets such as sports, and encourage the involvement of your children’s friends with your own family.
6. A religious affiliation is very important to many people
7. Let your child know you love him or her, regardless and no matter what.

Early detection, intervention and treatment are crucial elements for your child’s long-term mental health. Together, your pediatrician, your child, and you can create a strong foundation for mental health for your child’s entire life.

(Kirk D. Coverston M.D. is a Board-certified pediatrician with his private practice at Visalia Medical Clinic. His practice covers all general pediatrics, from newborns to adolescence, with a special interest in behavioral pediatrics and ADHD.)