Do Young People & Children Suffer from Mental Health Issues? Why

Yes, they do. It may sound unbelievable , but it is the truth!

The above statement by itself has within it the potential to set our minds ticking by the sheer intrigue and exasperating cluelessness it conveys. Young People and Children facing Mental Health Issues in present times can be a very concerning fact as the youth has always been appropriately associated with new beginnings and fulfilling promises of satisfying futures not only for themselves but also for multiple communities at large.

Having said that, the silver lining  is the growing awareness regarding Mental Health Problems by the Youth with respect to its various dimensions like:

1. Onset and Presenting Symptoms

2. Possible Underlying Causes and Subsequent Development

3. Ways and Means to Deal with the presenting problem  itself as well as the individual  concerned.

So, let’s begin with understanding Mental Health Problems faced by  the Youth and Children by deconstructing this unknown yet prominently noticeable iceberg.

What is the essential difference between Mental Wellness and Mental Illness?

While Mental Health refers to a person’s state of mental, emotional well-being, Mental Illnesses are diagnosed conditions that affect thoughts and behaviors. Though anyone can have moments of poor mental health, not everyone has a mental illness.

Mentally Wellness implies that the brain (physiological cognitive domain) and mind (affective domain) are functioning in harmony and order and in the best interest of the self and the ecosystem. The individual is able to think, feel and act in ways that create a positive impact on one’s physical and social well-being.

Mental Illness  refers collectively to all diagnosable mental disorders — health conditions involving significant changes in thinking, emotion and/or behavior. distress and/or problems functioning in social, work or family activities.

What the Statistics say? Mental Health Problems are observable in a 1:6 ratio among children and young adults, meaning out of every six children out there, there is one child who is a prevailing case of a mental health concern. source : https://www.mentalhealth.org.uk/

And how do we conclude this? We arrive at this on the basis of observable behavior that presents itself in the affected individual in an array of symptoms like anxiety, depression or any kind of conduct disorder. These symptoms have been studied and understood to be like a reaction to the environmental condition(s) which may be serving as a stimulus towards such a response. On the flip side, this also suggests that there are also those who do not exhibit explicit observable behavior (but maybe experiencing them within themselves) and often go unnoticed.

Estimations suggest:

• An alarming 75% of children and young people who experience a mental health problem aren’t getting the help they need, which is a serious cause for worry
• approximately 20% of adolescents may experience a mental health problem in any given year out of which 50% of mental health problems are established by age 14 and 75% by age 24

10% of children and young people (aged 5-16 years) have a clinically diagnosable mental problem, yet 70% of children and adolescents who experience mental health problems have not had appropriate interventions at a sufficiently early age.

source: https://www.mentalhealth.org.uk/                                         

What are the parameters of Individual Holistic/ Wholesome Wellness:

 At the most basic level, Physical Quotient (P.Q) is a function of the individual’s physical wellbeing and the awareness and state of his or her body mass, daily activities and diet. For children and young adults, it is usually the primary caretaker who would be aware of these parameters. Next comes the Mental Quotient or Intelligence Quotient (I.Q) as is popularly known. It is a measure of a person’s ability to think logically, reason critically and solve complex problems. An overview of this is familiar to the individual himself/herself and also to the immediate family and interacting academic authorities. Coming to the most important parameter that features high on Mental Health Checklist is the Emotional Quotient (E.Q) which is a measure of a person’s ability to manage emotions, not only of self but also of others.  A sound E.Q enables overcoming emotional challenges, avoiding/resolving conflicts, relieving stresses, effectively communicating (both verbally and non-verbally), empathizing rather than ridiculing, feeling motivated, leading and inspiring.

What is the importance of Emotional Quotient/ Intelligence in Mental Health Concerns

It reflects  the individual’s  ability to:

• be able to accept criticism and responsibility.
• be able to move on after making a mistake
• be able to say no when you need to
• be able to share feelings with others

The foundation of strong Mental Health are the four major domains of Emotional Quotient/ Intelligence which are

• self-awareness
•  self-management
• social awareness
• relationship management

Emotional wellbeing of individuals, be it children or young adults, is just as important as physical health. Good mental health helps them develop the flexibility and resilience to cope and manage effectively with real life situations and grow into well-rounded, healthy adults.

Causes of Mental Health Problems among Children & Young Adults 

There are many factors responsible for harmfully impacting one’s mental health and status, that can be broadly classified as below.

Hereditary / Genetic Reasons: Certain factors that may have been present in the family lineage could be in a dominant/ recessive state in the individual which may surface when a testing time (for the particular individual) comes up. These could be seen in people with a family history of psychotic disorders such as schizophrenia and may have a slightly increased chance of developing psychosis. There is no single gene that causes psychosis, but a number of different genes may increase the likelihood of developing it. Research shows that parents and siblings of someone with ADHD are more likely to have ADHD themselves. New research suggests the seeds of psychological problems are planted well before birth, environmental factors can also boost risk – sometimes considerably.

Physiological Factors like hitting puberty can create self-identity problems and difficulties in accepting oneself creating an inner complexity and lack of self-esteem within, which may lead one towards possible experimentation with activities like substance abuse, etc. Adolescence is a time when young people are struggling to fit in, socially and emotionally. They are especially vulnerable to bullying, social ostracization, family dysfunction, problems in school, and trauma, any of which may trigger a mental health issue.

Medical Factors like long term physical illnesses and their treatments like cancer, chemotherapies, etc.  can also be a determining factor in undermining one’s zest and capabilities. Viral Infections during pregnancy or early childhood can also change the way the brain develops causing symptoms of mental illnesses like Autism. For example, connection between obsessive compulsive disorder and Strep Infection has been reported.

Cognitive Factors: Faring low in academic and intellect-based performances can bring down faith in ones’ capabilities and hamper personal growth leading to an inferiority complex.  Cognitive impairments may include problems with attention, memory recall, planning, organizing, reasoning and problem solving lowering the individual’s self-esteem and paving the way for poor mental health conditions.

Environmental Factors like birth of a sibling, change of school/college/ work place, moving homes, consumption of alcohol and other detrimental products for social acceptance could be major factors contributing towards debilated mental health. Being on the wrong side of law can heavily impact an individual’s self-worth and can be challenging to regain one’s reputation in the face of social adversities. Socio- cultural- economic factors like poverty, caste-race-creed-sex discriminations, etc. are very common reasons that pull down an individual’s ability to realize his/her full potential.

Link Between Social Media Use and Increase in Adolescent Mental Health Issues is a very important and crucial relationship that needs to be taken into consideration. While teens are habituated to using social media to stay connected with their social communities in a positive way, extensive use of social media also carries its risks and negative consequences. Experts say risks increase when adolescents obsess about gaining ‘likes’ on their posts and make comparisons between their own physical appearance or life circumstances and that of others. This can lead to anxiety, depression, and even thoughts of suicide. Unfortunately, the anonymity of social media has made it easier for people to engage in cruel, hate-filled cyberbullying. Studies have found adolescents who experience cyberbullying are about twice as likely to engage in self-harm, including attempted suicide, as those who do not experience such bullying. Interestingly, bullies themselves are about 20 percent more likely to exhibit suicidal behaviors than non-bullies. About 63 percent of teens are using social media more than they did before the pandemic, according to surveyed parents and hence the increase in Mental Illnesses.

Emotional Factors like those stemming from ‘Personal Life Events’ like traumatic incidents in one’s past or present life span which could be responsible for creating voids, vulnerabilities and susceptibilities e.g. death of a close one, parents who may be divorced or those who may be having constant dis agreements at home, having faced sexual abuse, bullying, discrimination at the hands of others at school, college, work place or even at home – all could be  major reasons for mental illnesses cropping up within. Experiencing trying times financially or being disowned by family members for whatever reason, being a constant caregiver at home can have a draining impact on the care giver and make one feel used and not important enough.

Pandemic Present: The Journal Pediatrics found significantly higher increases of adolescent suicide in the months “when COVID-related stressors and community responses were heightened, indicating that youth experienced elevated distress during these periods.” The authors based their findings on the comparison of positive suicide risk screens for January-July 2020 as compared to January-July 2019. The National Suicide Prevention Lifeline also reported a four percent increase in call volume between December 2019 and December 2020. COVID-19 has given rise to what we now call the ‘New Normal.’ Unprecedented school closures, loss of face-to-face support systems, enforced isolation, disrupted routines, family problems and more have created an environment of stress, anxiety, and fear that has triggered or worsened adolescent mental health issues. Many studies have linked isolation and loneliness to an increased risk for depression, anxiety, substance use and eating disorders, and other mental health problems. Isolation from their peers is especially difficult for adolescents and may increase suicide ideation in that population.

How do Mental Health Problems manifest in Children and Young Adults ?

Mental illnesses in children can be hard for parents/ caretakers to identify. As a result, many children who could benefit from treatment don’t get the help they need. Hence it is very important to understand how to recognize warning signs of mental illness in children to help them.

Mental health disorders in children usually surface as delays or disruptions in acquiring developmental milestones such as age-appropriate thinking, behaviors, social skills or regulation of emotions. These problems are distressing to children and disrupt their ability to function well at home, in school or in other social situations.

What could be the possible barriers to treating childhood mental health disorders?

It can be difficult to understand mental health disorders in children because

• normal childhood development by itself is a process that involves constant and rapid changes
• the symptoms of a disorder may differ depending on a child’s age
• children may not be able to explain how they feel or why they are behaving a certain way.
• Families could be concerned about the stigma associated with mental illness, the use of medications and the cost/ logistical challenges of treatment.

What are the Mental Health Disorders/ Developmental Disorders in children that are addressed by mental health professionals?

Anxiety disorders. Anxiety disorders in children are characterized by persistent fears or worries that disrupt their ability to participate in play, school or typical age-appropriate social situations. Diagnoses include social anxiety, generalized anxiety and obsessive-compulsive disorders. Social Anxiety: This is a chronic mental condition in which every day social interactions cause irrational anxiety, fear, self-consciousness and embarrassment. Symptoms may include excessive fear of situations in which one may be judged, worry about embarrassment or humiliation or concern about offending someone. Generalised anxiety disorder (G.A.D): can cause young people to become extremely worried. Very young children or children starting or moving school may have separation anxiety. Obsessive Compulsive Disorder (O.C.D): characterized by unreasonable thoughts and fears (obsessions) that lead to compulsive behaviors. OCD often centers on themes such as a fear of germs or the need to arrange objects in a specific manner. Symptoms usually begin gradually and vary throughout life. 

Attention-deficit/hyperactivity disorder (ADHD). Compared with most children of the same age, children with ADHD have difficulty with attention, impulsive behaviors, hyperactivity or some combination of these problems. Such children are consistently overactive, impulsive and have difficulty paying attention. Autism spectrum disorder (ASD). Autism spectrum disorder is a neurological condition that appears in early childhood — usually before age 3. Although the severity of ASD varies, a child with this disorder has difficulty communicating and interacting with others.

Eating disorders. Eating disorders are defined as a preoccupation with an ideal body type, disordered thinking about weight and weight loss, and unsafe eating and dieting habits. Eating disorders — such as Anorexia Nervosa, Bulimia Nervosa and Binge- Eating  can result in emotional and social dysfunction and life-threatening physical complications. They usually start in the teenage years and are more common in girls than boys. The number of young people who develop an eating disorder is small, but eating disorders such as anorexia nervosa and bulimia nervosa can have serious consequences for their physical health and development.

Depression and other Mood Disorders. Depression is persistent feelings of sadness and loss of interest that disrupt a child’s ability to function in school and interact with others. Bipolar disorder results in extreme mood swings between depression and extreme emotional or behavioral highs that may be unguarded, risky or unsafe. Affects more children and young people today than in the last few decades. Teenagers are more likely to experience depression than young children. 

Self-harm:  is a very common problem among young people. Some people who experience intense emotional pain may try to deal with it by hurting themselves e.g., attempting physical harm using sharp objects Post-traumatic stress disorder (PTSD). PTSD is prolonged emotional distress, anxiety, distressing memories, nightmares and disruptive behaviors in response to violence, abuse, injury or other traumatic events. It can follow physical or sexual abuse, witnessing something extremely frightening or traumatizing, being the victim of violence or severe bullying or surviving a disaster. Schizophrenia. Schizophrenia is a disorder in perceptions and thoughts that cause a person to lose touch with reality (psychosis). Most often appearing in the late teens through the 20s, schizophrenia results in hallucinations, delusions, and disordered thinking and behaviors.

What are the warning signs of in children/young adults before these Mental Illnesses actually start manifesting completely?

• Persistent sadness that lasts two weeks or more
• Withdrawing from or avoiding social interactions
• Hurting oneself or talking about hurting oneself
• Talking about death or suicide
• Outbursts or extreme irritability
• Out-of-control behavior that can be harmful
• Drastic changes in mood, behavior or personality
• Changes in eating habits
• Loss of weight
• Difficulty sleeping
• Frequent headaches or stomachaches
• Difficulty concentrating
• Changes in academic performance
• Avoiding or missing school
• Expressing hopelessness about the future

IMPORTANT NOTE: If you or a loved one are considering suicide, please contact the National Suicide Prevention Lifeline

What can a parent/ care giver do in case of suspicion of a Mental Health condition?

• Consult a health care provider and describe the behaviors that are concerning.
• Talk to the concerned teacher, close friends, relatives or other caregivers to see if they’ve also noticed any changes in behavior.
• Share this information with the concerned health care provider.

How do health care professionals diagnose mental illness in children?

Mental health conditions are diagnosed and treated based on signs and symptoms and how the condition affects the individual’s daily life. To make a diagnosis, the health care provider might recommend proper evaluation by a specialist, such as a psychiatrist, psychologist, clinical social worker, psychiatric nurse or other mental health care professional. The evaluation might include:

• Complete medical exam
• Medical history
• History of physical or emotional trauma
• Family history of physical and mental health
• Review of symptoms and general concerns with parents
• Timeline of child’s developmental progress
• Academic history
• Interview with parents
• Conversations with and observations of the child
• Standardized assessments and questionnaires for child and parents

Diagnosing mental illness in children/young adults can take time because young children may have trouble understanding or expressing their feelings and development varies. The health care provider may change or refine a diagnosis over time. 

How is Mental illness in children treated? 

Psychotherapy: Also known as Talk Therapy /Behavior therapy, is a way to address mental health concerns by talking with a psychologist or other mental health professional. With young children, psychotherapy may include play time or games, as well as talk about what happens while playing. During psychotherapy, children and adolescents learn how to talk about thoughts and feelings, how to respond to them, and how to learn new behaviors and coping skills. Medication:  Such as stimulant, antidepressant, anti-anxiety medication, antipsychotic or mood stabilizer explaining all the risks & benefits. 

Hence, the gist of the problem is to come forward in creating  positive transformations, because …

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