It’s a difficult time to be a kid or teenager. According to a 2021 advisory from the surgeon general, about one-third of high school students report feeling persistent feelings of sadness or hopelessness – a rate that is 40% higher than it was in 2009. Unprecedented pressures and stressors have created a mental health crisis for our youth.
It's also a difficult time to be a parent. Parents are navigating this crisis amid misinformation and assumptions that are being shared about pediatric mental health. To battle these misconceptions, four of our pediatric behavioral health experts counter five common myths about kids and mental health. Their biggest takeaway is this: There is hope. Evidence-based treatments can help kids manage or even overcome mental illness and allow them to meet their true potential.
Myth 1: Kids are too young to experience depression, anxiety or other mental illnesses.
Not true. Half of all people who have mental health disorders will show initial signs before they’re 14 years old. Attention-deficit/hyperactivity disorder (ADHD) and anxiety disorders are frequently diagnosed in kids and teenagers. In addition, post-traumatic stress disorder, bipolar disorder, disruptive mood dysregulation disorder (DMDD) and major depression occur in kids as well, although not as frequently.
The pandemic – and all the uncertainty, stress and change came with it – have worsened pediatric mental health over the past couple years.
“Based on the research coming out after COVID-19, there has been an increase in mental health diagnoses such as anxiety and depression for both children and adults. This adjustment to life in this age of COVID is being studied intensely by mental health professionals,” says Zack Held, PhD, a pediatric psychologist with the division of pediatric psychology and neuropsychology at Atrium Health Levine Children’s.
Myth 2: Bad parenting is to blame for mental illness in children.
Not True. Mental illness has complex causes, both biological and environmental. Therapists and psychiatrists don’t blame parents for children’s mental health challenges – they partner with them for treatment. Parents can be the most powerful advocates for their children’s mental health. Parents know their child more than anyone, and they can be in the best position to identify changes and behaviors that signal their child may need help.
“I think a lot of parents are afraid they will be told they are bad parents and be blamed for the child’s problem. That is not how we approach these symptoms,” says Cheryl Dodds, MD, a child and adolescent psychiatrist and the medical director of Atrium Health Behavioral Health Davidson. “We just want to work with the child and family to get the best results possible for everyone.”
Parents can play active, crucial roles in their child’s treatment. For young children, parents may meet with the therapist at each appointment. For older kids and teenagers, providers may have periodic check-ins with the parent, but may not see them every time. Parents should ask questions of therapists and psychiatrists, as they would with any other health professional.
“There is no blame in the therapeutic relationship,” Held says.
MYTH 3: If my child seems happy around their friends, then they’re fine.
Not True. This can be tricky: A child seems isolated and depressed in many situations, but they seem positive and outgoing with friends. This is more common than you may think, and it can mask mental illness.
“Often, teens will experience what is called mood reactivity, which is a time period when one’s mood can brighten in response to a positive experience, such as spending time with friends or participating in a fun event,” says Tyler Cecil, DO, the associate program director of Atrium Health Wake Forest Baptist Department of Psychiatry and Behavioral Health. “Mood reactivity is often associated with a sub-type of depression called atypical depression, which is further characterized by increased sleep, as well as increased appetite and/or weight gain.”
It's important for parents to know symptoms of childhood mental illness. Some kids will show internalizing behaviors, such as withdrawal, isolation, sleep complaints and depression. Other kids present with externalizing behaviors, such as acting out, defiance and aggression. Symptoms also include abdominal pain, headache and fatigue. If your child’s symptoms disrupt their life or suddenly affect their grades, it’s time to seek professional help – even if they seem fine in certain situations.
Myth 4: Kids are too young to benefit from therapy or medications.
Not true. Providers can adapt therapy for kids and teenagers based on their age. For toddlers and young children, therapists might teach kids mindfulness through play, such as blowing bubbles or using their “Spiderman Sense” to notice everything they hear, smell, feel and taste. Teenagers might use therapy to talk through their feelings and challenge irrational thoughts. If medications are needed, they’ll be given under the careful supervision of a doctor.
“Oftentimes, therapy is a first-line treatment, and medications may be added for moderate-to-severe cases or when therapy alone hasn’t been effective,” Dr. Cecil says. “If a parent or guardian has concerns that their child may be struggling, I highly encourage them to seek professional help to further discuss when to start therapy and/or medication.”
MYTH 5: If my child is diagnosed as depressed or anxious, they'll be labelled "mentally ill" for life.
Not true. In fact, the goal of a therapist is to allow the child to reach their full potential and to no longer require therapy or medication.
“It takes strength to talk about anxiety and depression, and strength will get them through. About 90% of kids who have anxiety or depression see successful results with therapy and medication, if needed,” says Rachel Wiese, MD, a pediatrician and the medical director at Atrium Health Levine Children’s Charlotte Pediatrics Matthews.
Finding a Way Forward
Even with so much to navigate during this mental health crisis for youth – different conditions, multiple treatment options – medical providers help parents and children through each step. The most important step is seeking help when challenges arise.
“I see a lot of parents who regret delaying seeking treatment for their child, once they see how well their child responds to treatment and how much happier and successful they are,” Dr. Dodds says. “If you have concerns, it is better to see a provider and be told there is not a problem than to risk delaying needed treatment. Early intervention is key.”
Learn more about Atrium Health Behavioral Health Services for children, teenagers and adults.
For immediate assistance, please call Atrium Health’s 24/7 Behavioral Health Help Line at 704-444-2400 or 800-418-2065.
