How to talk to your child about mental health

While it’s normal for teens and kids to experience difficult feelings and emotions, how can you tell if what your child is experiencing is something more serious? And how do you talk with your child about their mental health?

Mental health issues in children have been on the rise for some time. In the 10 years leading up to the pandemic, feelings of persistent sadness and hopelessness—as well as suicidal thoughts and behaviors—increased by about 40% among young people, according to the Centers for Disease Control and Prevention.

Two Eugene doctors—Dr. Pallav Pareek, a child and adolescent psychiatrist with PeaceHealth, and Dr. Pilar Bradshaw of Eugene Pediatric Associates—agree the pandemic has only exacerbated the increasing number of children experiencing anxiety and depression.

“I would say the pandemic was just icing on the proverbial cake,” Dr. Pareek says. “The rates of anxiety as well as depression are going higher with every given day and we just need to be more mindful that this is becoming a pandemic in itself.”

It’s very common for all children of all ages to demonstrate different moods. “But if your child is starting to consistently have a very anxious mood or a very depressed mood, that’s one clear sign for parents to get in to their doctor or get in to a psychiatrist for children and start talking about it,” Dr. Bradshaw says.

Online factors

What accounts for the rise of adolescent anxiety and depression? For one thing, students who experience bullying may find it is no longer limited to only school hours. Online bullying can happen any time of day.

“Online bullying is a big, big thing that’s bothering our children,” Dr. Pareek says. “That doesn’t shut down until you shut down that phone.”

Complicating matters, children struggle to stay off their devices. “They just can’t leave that phone because they don’t know how many people are going to connect at that time,” Dr. Pareek says. “So, teens especially are experiencing that fear of missing out and constantly checking their phones until they can’t check it anymore, which is sometimes around 2 or 3 a.m.”

What to watch for

Dr. Pareek says common signs of mental health distress in kids can include:

• Significant and prolonged changes in mood
• Changes in eating habits
• Struggling with schoolwork and grades
• Withdrawing from friends and family

A major mood change is a key indicator, Dr. Pareek says. “That’s the No. 1 marker if your child is usually a happy-go-lucky child and suddenly they appear very low or sad or depressed.”

Similarly, another sign could be a change in appetite – if your child was eating well, but now is eating much more or much less or even not at all. Other changes in behavior such as spending more time in isolation or sudden mood swings could also be indicators.

“If your child has suddenly become more aggressive or is having more tantrums, or there’s a significant change from whatever was their baseline, the change in behavior could be a good marker,” Dr. Pareek says.

Dr. Bradshaw says children who are anxious or depressed may also experience physical symptoms. “Crippling headaches, crippling stomachaches, sudden complaints of physical unwellness causing them to be unable to go to school,” she says. “Those are things that should really sendoff red flags.”

How to start the conversation

It can be difficult as a parent to know how to initiate a conversation with a child if we’re worried about their mental health, Dr. Bradshaw says. “One of the things I recommend is to just sit with your child in a quiet space, just the two of you, and say something simple and open like, ‘Gosh, I’ve noticed that you seem different these days. How are you feeling?”

Asking open-ended questions is a good way to get your child talking, Dr. Pareek says. Then pay attention to what they’re saying and guard against distractions. “Active listening is when you are immersed in whatever the child is saying, not worried about the deadline or the laundry that needs to be folded, just being in that moment. Be patient for the teenager or the child to answer.”

Bonding strategies

Dr. Pareek encourages parents to be empathetic and share your own experiences with your child. “Showing how you deal with things lets them know it’s a normal thing,” he says. “‘I also feel stressed at work. I also felt left out during this meeting. I had this conflict with another person.’ I think it’s a great starting point.”

If they’re not ready to start a conversation, be understanding. “Sometimes just planting that seed is a good idea, just asking that question even if they didn’t answer, just leave it at that. Don’t prod too much because if they’re not ready, they’re not ready, and someday they might be.”

Make a goal to eat one meal together a day to promote discussions with the family, Dr. Pareek says. Cooking with children can be a great way to get them more involved in mealtime. Outdoor activities or just spending contemplative time together can also help.

“Being outside, being close to nature, looking at those leaves, that is a healing experience in general for everyone including us as parents,” he says. “Another thing we can do with our children is mindfulness activities like yoga, meditation, or going to a place where you’re just sitting quietly—something like that can foster a lot of connection and healing.”

Talk to your pediatrician

If you have concerns about your child’s mental health, start by talking with your pediatrician. Your doctor can help screen your child and can provide a referral to a mental health specialist if needed.

“It’s really nice to know that your pediatrician, the person that you’ve known since the day your baby was born, can be an important partner in your mental health care journey, as well as your physical health care journey,” Dr. Bradshaw says. “I always tell people, your mind and your body are like one. So go to your pediatrician who you’ve trusted for many years and have that conversation. Say ‘I’m kind of worried about my kid’s mental health.’ That’s all you have to say, and then we’ll take it from there.”