How to spot mental disorders in children

Stacy noticed that her three-year-old daughter was touching her age mates inappropriately.

“I saw her remove her pants, lift her dress and asked one of the boys to sleep on top. I was shocked, but I was calm and assured her safety. She told me that a neighbour was sexually abusing her.”

The case was reported and legal action taken, and although she was against therapy considering at her age she would forget, Stacy later changed her mind.

Another parent, David, a father of two, first sought pastoral intervention when his seven-year-old son became withdrawn following the death of their third born.

“My wife had a still birth. After the burial everything was okay, but I started noticing that my son, who was five, was withdrawn. He stopped eating well and later started recreating the burial ceremony,” recalls David, adding even prayers from a pastor did not help.

“We took him to a psychologist and found out that when we were mourning, we forgot about him. We forgot he was also prepared to welcome a baby brother so recreating the burial was his way of mourning.”  

Like adults, children have mental health issues including anger, mood swings, anxiety, panic attacks, bipolar disorder and fear of abandonment before they even celebrate their first birthday.

How does a parent or guardian diagnose these issues early?

Counselling psychologist Jacqueline Gathu explains that a child’s brain starts portraying mood swings between six and eight months, which is manifested in aggressive behaviour when one takes something from them, and this includes rolling on the floor.

Fear, anxiety and separation anxiety start at eight months, but Gathu advises that care be exercised considering “we do not diagnose children under five, but at that age they join play groups so you will get feedback from teachers.”  

Another indicator, she says, is delayed milestones like when a child is not able to speak or walk properly at certain ages. 

The worst mental health issue is depression, which is ranked among the five leading causes of suicide among teenagers, according to Unicef, which notes that one is seven adolescents between 10 and 19 years have a diagnosed mental disorder, globally. An estimated 45,000 adolescents die by suicide annually.

There are myriad causes of depression in children, including major life challenges like death and transformations like divorce for which children should also be involved, says Gathu, who warns against moving houses and changing schools without explanations. Sexual abuse also causes depression.

Parents fear having children with mental health issues. Depression might trigger stigma, and most parents find safety in silence.

“The more we avoid talking about anxiety, depression and mental ill-health in children the more we are worsening the situation,” offers Gathu, who has noticed that parents expect therapists to fix the problem before other people find out.

There are several things to expect at the therapist’s clinic as children.

For those aged between three and seven, their therapy room is more playful, with artwork crayons and colourful furniture for ‘play therapy’, explains Gathu, as “that’s how children express themselves and how they communicate to us about their world.” The play therapy has themes depending on the issues the child is battling and the play items are selected from the information the therapists gets from parents or guardians.

The first three sessions comprise “undirected play, where I let them choose items and the way they interact with them will give me an idea of their life,” says Gathu. “When a child touches a specific toy I know what we are dealing with.”

In case a child has been sexually abused, they mostly manipulate toys in a sexual manner. “The child will take a doll and lift the dress. In one case, I decided to knit a panty for a doll because most do not come with panties. The child lifted the dress and removed the panty and I knew something had been done to the child,” she explains. For children above seven, therapy involves parents or guardians, who are encouraged to speak out. many parents make the mistake of not informing the child they are going for therapy.

Once the concerns are expressed, the child is given a chance to respond after which the therapist takes over during the remaining five to 10 sessions. “They’ll be given feedback, and it’s not always rosy but it’s the journey of healing.”?

It is worrying that 75 per cent of children and young people with mental health disorders are not getting the help they need.

“It’s one thing to bring a child into the world, it’s another thing to raise it in the right environment. When we’ve got anything financially we think we’ve done it. No. A child needs a present parent, an intentional parent,” says Gathu, singling out respect and unconditional love as one of the best ways of dealing with children.

Gathu warns against conditional love, which includes treating them differently when they pass examinations to perceiving them as failures when they score Ds. Children, she notes, mistrust those who continuously criticise them. 

“Children are sponges,” says Gathu. “They absorb so much we are telling them. We need to be intentional in the way we parent them. We are looking for money and losing our children in the process.”