INFANCY THROUGH MIDDLE CHILDHOOD (BIRTH TO 12 YEARS)

Mental health disorders can begin in very early childhood – even infancy. Most young children haven’t learned how to talk about their thoughts and feelings, but we can observe their behaviors.

This is critical because even serious mental illnesses like bipolar disorder, OCD, and depression can be present in very young children causing them to struggle or fail in school and have poor lifelong outcomes if they are not diagnosed and treated.

SIGNS / SYMPTOMS IN INFANCY AND TODDLERHOOD

  • Extreme separation anxiety
  • Complete lack of separation distress
  • Prolonged crying – other than colic
  • Difficulty self-soothing
  • Constant thumb sucking
  • Oversensitivity to sound, smell, touch, or taste
  • Breath-holding
  • Head-banging
  • Prolonged poor or irregular sleep or eating
  • Lack of weight gain/failure to thrive
  • Failure to meet developmental milestones as expected
  • Inability to potty train

DIFFICULT TEMPERAMENT

“Temperament Is Your Baby’s Behavioural Style Which Determines How He/She Reacts To Situations And Expresses And Regulates Emotions. Characteristics Of Temperament Include Activity Level, Distractibility, Adaptability, Sensitivity And Quality Of Mood.”
From About Kids Health

Having a difficult temperament predisposes children and adults to mental health challenges such as anxiety and depression, beginning as young as preschool age. Temperament characteristics are relatively stable over a lifetime, however, they can be influenced by the environment such that characteristics will become more or less pronounced. A “difficult” temperament is defined by the following characteristics. No one characteristic alone is a sign of a difficult temperament, just as no one sign means a child will develop a mental health disorder.

SIGNS OF DIFFICULT TEMPERAMENT

  • Frequent negative mood
  • Withdrawing from new situations/experiences
  • Slow to adapt
  • High intensity of reactions
  • Low rhythmicity of physical states, which should cycle reasonably easily between deep sleep; light sleep; drowsiness; quiet and alert; active and alert; and crying.

Signs that indicate a mental health emergency are in red.

These signs mean that an individual is at high risk of harming him/herself or others.
They should be considered especially serious if they are new, worsening, or related to a painful event, loss, or change.

SIGNS / SYMPTOMS IN EARLY AND MIDDLE CHILDHOOD AGES 3-12

 (THIS IS NOT A COMPREHENSIVE LIST – SEE ALSO SIGNS ACROSS THE LIFESPAN)

As hard as it is to believe, 50% of first episodes of mental health disorders occur before the age of 14. Further, research during the pandemic showed that 8 out of 100 9 to 10-year-olds have experienced suicidality (ideas, plans, and attempts some of which may be fatal.) Further research will be needed to determine if this trend continues. Finally, suicide is now the second leading cause of death among children 10-14 years old. For all these reasons, we must be on the mental health front line for children. Watch for:

  • Frequent temper tantrums
  • Frequent nightmares
  • Not wanting to go to bed most nights
  • Having toileting accidents in the night
  • Being unusually clingy with a parent or other adult
  • Not wanting to separate from parent/caregiver
  • Thumb sucking beyond toddlerhood
  • Chewing, sucking on clothes
  • Stuttering
  • Ceasing to talk
  • Talking extremely rapidly
  • Throwing up before or at school
  • Stomach aches, headaches, other physical complaints with no underlying medical issue
  • Saying “I don’t feel well” – he/she may mean they are not feeling well emotionally
  • Inability to make friends
  • Difficulty learning
  • Staring off into space instead of being engaged
  • Inability to keep up with grade-level work
  • Getting into trouble at school
  • Defying rules
  • Frequently disrupting class
  • Disobeying parents, teachers, coaches, camp leaders, or other authorities
  • Running away from authorities
  • Stealing from other children
  • Lying repeatedly
  • Telling elaborate and untrue stories while insisting they are real
  • Exhibiting no empathy
  • Rudeness
  • Picking verbal fights
  • Demanding attention through negative behavior
  • Excessive silliness
  • Repeatedly acting out a scary event during playtime
  • Hurting other children – biting, pinching, hitting, pushing, etc.
  • Harming, torturing, killing insects/animals
  • Not recognizing or disregarding dangerous situations or behaviors
  • Excessive swearing
  • Skipping classes
  • Obsession with video gaming
  • Bullying
  • Inability to control impulsive, angry, violent, self-harming behavior – sometimes, even despite wanting to do so
  • Being bullied
  • Persistent school avoidance
  • Social withdrawal – staying in bedroom, not engaging with family or friends
  • Confused thinking
  • Drop in school performance
  • Running away from home
  • Saying “I want to hurt (you, him/herself, someone else, a pet).”
  • Seeing, hearing, believing things that aren’t real
  • Violently attacking someone
  • Saying “I don’t have any friends” repeatedly
  • Saying “I don’t fit in” repeatedly
  • Saying “Nobody likes me” repeatedly
  • Expressing a wish to die
  • Describing a method to hurt him/herself or dying – “I want to jump out the window, jump in front of a train, run into the street,” etc.

BELIEVE THE CHILDREN

Very young children can suffer from a diagnosalbe serious mental illness when they are very young.  For example, pediatric bipolar disorder can be diagnosed as young as 3 years old. So, it’s incredibly important to pay attention to signs that may mean a child is suffering.

When I was a third-grade Girl Scout leader, one of the girls came to me after a meeting and told me she wanted to die. She told me she had a plan. She’d sit on the steps leading out of the school and be trampled to death by the students as they left. Because of my experience with mental health disorders, I understood I needed to believe this child was in pain and needed help. I told her I heard how sad she was and that I would help her talk to her parents. After we did so, her parents took action.

IF YOU OR SOMEONE YOU KNOW FEEL(S) SUICIDAL, go to the emergency room, call a mental health professional who can talk to you NOW, or call the police and say you have a mental health crisis, not a criminal situation!

In the US, call the National Suicide Prevention Lifeline: 1-800-273-TALK (8255)

FIND INTERNATIONAL HOTLINES

Text HOME to The Crisis Textline at 741741. They are available 24/7 in the U.S., Canada, United Kingdom, and Ireland.

See Also: HELPING SOMEONE WHO IS SUICIDAL