You and your pediatrician can foster good children’s mental health

Normalizing conversations around mental health and regularly checking in are key to ensuring kids have the emotional, social and mental support they need.

Norton Children’s Medical Group

If your child is experiencing a mental health crisis, call 911 or take them to the nearest emergency department.

Every child deserves to grow up happy and healthy, and to lead a successful life. Yet, 1 in 5 kids ages 3 to 17 in the U.S. could be diagnosed with a mental, emotional, behavioral or development disorder, according to the American Psychological Association. Many more are at risk of developing a disorder due to risk factors in their genetics or within their families, schools and communities.

That’s why it’s so important for adults to foster good children’s mental health. Here’s what you can do:

  • Maintain a strong relationship with your kids built on open communication.
  • Know your child’s patterns for what’s usual (and not usual) behavior.
  • Know the warning signs of stress.
  • Be your child’s partner in addressing mental health concerns.

“Locally, children and adolescents continue to show signs of depression exhibited through withdrawal from friends and family, tearfulness, and school and sleep difficulties,” said Felissa P. Goldstein, M.D., pediatric psychiatrist who works alongside pediatricians in Norton Children’s Medical Group offices. “Also concerning is the shortage of mental and behavioral health providers.”

Normalizing conversations around mental health and regularly checking in are key to ensuring kids have the emotional, social and mental support they need.

In a 2019 Centers for Disease Control and Prevention study, 37% of high school students said they had experienced such persistent feelings of sadness or hopelessness in the past year that they couldn’t participate in regular activities. About 1 in 6 students from the same study reported making a suicide plan in the past year. And this was before the pandemic, which has only inflated these numbers.

Anxiety and depression

Experiencing fears and worries, sadness and even hopelessness from time to time is a normal part of life — even for kids. However, persistent or extreme fear, anger or sadness could be due to anxiety or depression.

When a child does not outgrow typical fears or worries, or when they interfere with school, home life or play activities, the child may have anxiety that needs medical attention.

When a child feels helpless or hopeless in situations they are able to change or they are uninterested in things they used to enjoy, these could be signs of depression.

Anxiety signs to watch for

Very afraid when away from parents (separation anxiety)

Extreme fear about a specific thing or situation, such as dogs or going to the doctor (phobias)

Very afraid of school and other places with people (social anxiety)

Extreme worry about the future and bad things happening (general anxiety)

Repeated episodes of sudden, intense fear that come with symptoms such as heart pounding; or feeling shaky or sweaty (panic disorder)

Depression signs to watch for

  • Feeling sad, hopeless or irritable a lot of the time
  • Not wanting to do fun activities
  • Changes in eating (a lot more or less than usual)
  • Changes in sleep (a lot more or less than usual)
  • Tired and sluggish or tense and restless a lot of the time
  • Having a hard time paying attention
  • Feeling worthless, useless or guilty
  • Attempting self-harm and self-destructive behavior

“It’s never too early to get help for your child. Psychotherapy is beneficial even when children and adolescents are not acutely suffering. Early psychotherapy helps them develop and practice coping skills during a low stress time,” Dr. Goldstein said.

Extreme depression can lead a child to think about suicide. For youth ages 10 to 24, suicide is among the leading causes of death.

“When children and teens have suicidal thoughts and plans, urgent assessment may be necessary,” Dr. Goldstein said.

Never ignore a mention of or suspected signs of self-harm. Be sure you and your child know this hotline available 24/7 for anyone needing support for a suicidal, mental health or substance use crisis.


Attention-deficit/hyperactivity disorder (ADHD) is one of the most common neurodevelopmental disorders in kids. Kids with ADHD have trouble paying attention, listening, sitting still and waiting their turn — things all kids can have trouble with from time to time. For kids with ADHD, though, it’s almost all the time.

While it’s not a mental health disorder, ADHD can be misdiagnosed because symptoms can overlap with other conditions. It also frequently goes hand in hand with anxiety and depression in kids.

“If you suspect your child has ADHD, or if they have been diagnosed with it, pay close attention for signs of anxiety and depression so that they can be addressed,” Dr. Goldstein said. “Sometimes anxiety and ADHD can look very similar, so it’s important to reevaluate symptoms when treatments are not working.”

Too much stress

Signs of stress can be confused with a mental health condition, but they also can be an indicator that something serious is going on. If your child is experiencing some of these signs of stress, talk to your child’s pediatrician.

Physical signs of stress in kids

  • Headaches
  • Upset stomach
  • Chest pain or heart palpitations
  • Insomnia or nightmares
  • Bedwetting
  • Decreased appetite or binge eating
  • Pretending to be sick to avoid activities

Emotional signs of stress in kids

  • Anxiety and mood swings
  • Restlessness
  • Clinginess
  • New or recurring fears
  • Increased crying, anger, stubbornness or aggression
  • Decreased concentration or motivation
  • Regressing to comforting behaviors from early childhood
  • Loss of interest in formerly enjoyed activities

Where do we go from here?

“I can’t stress enough the importance of having positive, open communication with your child,” Dr. Goldstein said. “This is a critical way to both prevent a mental health issue and to recognize the signs of one.” If your child is showing any of the listed signs or a marked change in usual behaviors, it’s time to make an appointment with your pediatrician. Pediatricians are skilled in listening in a compassionate and nonjudgmental way. They are qualified to screen for mental health issues as well as determine whether a child is on track with behavioral development. Pediatricians also can treat mental health issues and refer families to a behavioral health specialist.