Mental disorders of childhood
Disruptions in family life and schooling from the COVID-19 epidemic have increased the risk of the mental disorders that typically occur in childhood.1 2 They include:
- Anxiety disorders. Anxiety disorders, including obsessive-compulsive disorders, cause persistent fears, worries or anxiety that disrupt a child’s ability to participate in play, school, or typical age-appropriate social situations. Examples of different types of anxiety disorders include
- Being very afraid when away from parents (separation anxiety)
- Having extreme fear about a specific thing or situation, such as dogs, insects, or going to the doctor (phobias)
- Being very afraid of school and other places where there are people (social anxiety)
- Being very worried about the future and about bad things happening (general anxiety)
- Having repeated episodes of sudden, unexpected, intense fear that come with symptoms like heart pounding, having trouble breathing, or feeling dizzy, shaky, or sweaty (panic disorder)
- Attention-deficit/hyperactivity disorder. Children with ADHD have difficulty with attention, impulsive behaviors, hyperactivity, or some combination of these problems. (See Timely Topic on ADHD)
- Oppositional Defiant Disorder. When children act out persistently so that it causes serious problems at home, in school, or with peers, they may be diagnosed with Oppositional Defiant Disorder (ODD). ODD usually starts before eight years of age, but no later than by about 12 years of age. Children with ODD are more likely to act oppositional or defiant around people they know well, such as family members, a regular care provider, or a teacher. Children with ODD show these behaviors more often than other children their age.
Examples of ODD behaviors include:
- Often being angry or losing one's temper.
- Often arguing with adults or refusing to comply with adults' rules or requests.
- Often resentful or spiteful
- Deliberately annoying others or becoming annoyed with others
- Often blaming other people for one’s own mistakes or misbehavior
Conduct Disorder (CD). Conduct Disorder is diagnosed when children show an ongoing pattern of aggression toward others, and serious violations of rules and social norms at home, in school, and with peers. These rule violations may involve breaking the law and result in arrest. Children with CD are more likely to get injured and may have difficulties getting along with peers.
Examples of CD behaviors include:
- Breaking serious rules, such as running away, staying out at night when told not to, or skipping school
- Being aggressive in a way that causes harm, such as bullying, fighting, or being cruel to animals
- Lying, stealing, or damaging other people’s property on purpose
- Obsessive-Compulsive Disorder. Children may have an obsessive-compulsive disorder (OCD) when unwanted thoughts and the behaviors they feel they must do because of the thoughts happen frequently, take up a lot of time (more than an hour a day), interfere with their activities, or make them very upset. The thoughts are called obsessions. The behaviors are called compulsions.
Having OCD means having obsessions, compulsions, or both.
Examples of obsessive or compulsive behaviors include:
- Having unwanted thoughts, impulses, or images that occur over and over and which cause anxiety or distress.
- Having to think about or say something over and over (for example, counting or repeating words over and over silently or out loud)
- Having to do something over and over (for example, handwashing, placing things in a specific order, or checking the same things over and over, like whether a door is locked)
- Having to do something over and over according to certain rules that must be followed exactly in order to make an obsession go away.
Children do these behaviors because they have the feeling that the behaviors will prevent bad things from happening or will make them feel better. However, the behavior is not typically connected to the actual danger of something bad happening, or the behavior is extreme, such as washing hands multiple times per hour.
A common myth is that OCD means being really neat and orderly. Sometimes, OCD behaviors may involve cleaning, but many times someone with OCD is too focused on one thing that must be done over and over rather than on being organized. Obsessions and compulsions can also change over time.
Autism spectrum disorder (ASD). Autism spectrum disorder is a serious neurological condition that is usually manifest 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 disorder — can result in emotional and social dysfunction and life-threatening physical complications.
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.
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.
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.
Of these disorders, ADHD, anxiety problems, behavior problems, and depression are the most common.
Some children are more likely to develop anxiety or depression when they experience trauma or stress, when they are maltreated, when they are bullied or rejected by other children, or when their own parents have anxiety or depression.
In addition to avoiding childhood traumas, here are some healthy behaviors that may help prevent mental disorders:
- Having a healthy eating plan centered on fruits, vegetables, whole grains, legumes (for example, beans, peas, and lentils), lean protein sources, and nuts and seeds
- Participating in physical activity for at least 60 minutes each day
- Getting the recommended amount of sleep each night based on age
- Practicing mindfulness or relaxation techniques
The first step to treatment is to talk with a healthcare provider, such as your child's primary care provider, or a mental health specialist, about getting an evaluation.
The main treatments for mental disorders are psychotherapy–– talk or behavior therapy with a mental health professional and a variety of medications––such as a stimulant, antidepressant, anti-anxiety medication, antipsychotic or mood stabilizers. It is important to seek expert treatment for childhood mental problems. They are most treatable if addressed early.
This report presents opinions and ideas and is intended to provide helpful general information. Catalyst for Children is not engaged in rendering advice or services to the individual reader. The ideas, procedures, and suggestions that are presented are not in any way a substitute for the advice and care of the reader's own physician or other medical professional based on the reader’s own individual conditions, symptoms, or concerns. If the reader needs personal medical, health, dietary, exercise, or other assistance or advice, the reader should consult a physician and/or other qualified health professionals. Catalyst for Children specifically disclaims all responsibility for any injury, damage, or loss that the reader may incur as a direct or indirect consequence of following any directions or suggestions given in this report or participating in any programs described in this report.
2 Children’s mental health disorders. CDC. https://www.cdc.gov/childrensmentalhealth/symptoms.html