As a parent of a child whose moods are strong and sometimes swift or unrelenting, you’re faced with a condition that doesn’t have a clear solution. And it is your responsibility to help your child manage these emotions—whether with lifestyle changes, therapy, or something more.
“Healthy habits are important for children’s well-being, and even for improving their mood,” says Rebecca Baum, M.D., chief of developmental behavioral pediatrics at Nationwide Children’s Hospital. “Good nutrition, exercise, and meaningful relationships are often components of a treatment plan for anxiety or depression.” And for good mental health, sleep is super important. “Many kids aren’t getting enough sleep,” Dr. Baum points out, “or their sleep is disturbed by electronics and lack of routine. So working on these lifestyle changes is key.”
If you haven’t already, these are some approaches you’ll want to try before turning to a pharmaceutical solution:
Look at your child’s diet.
Studies show that good nutrition can play an important role in alleviating mental health problems in children. One of the best ways to get started: Say goodbye to fast food. A study in the journal Public Health Nutrition found that people who pull into the drive-thru are 40% more likely to develop depression than those who don’t.
On the flip side: Study data from more than 45,000 participants published in Psychosomatic Medicine revealed that healthier eating significantly reduced symptoms of depression. While this research was done in adults, making sure your kid’s diet is filled with lots of fruits and vegetables might help him see a significant reduction in symptoms.
Get serious about sleep.
A good night’s sleep is one of the most important pieces of psychological health—especially for kids. Researchers at the University of Houston found that kids who skimp on sleep experience more negative emotions, less pleasure from positive activities, greater memory problems, and less impulse control—all of which play a part in their mental health.
While the amount of sleep is important, the quality of that sleep is, too. Make sure that your child’s bedroom is conducive to a restful sleep: it is quiet, dark, and cool. Also check in with them in the mornings to see if they feel rested or not.
READ MORE: How Sleep Affects Mental Health
Increase physical activity.
If your child would rather spend the afternoon on the couch or in his room, encourage him to move more—go on a walk, dance, or take calisthenics breaks. Research finds that exercise can prevent or delay the symptoms and the onset of many mental health disorders. One such study showed that physically active six- and eight-year-olds showed fewer symptoms of depression than they’d had two years earlier when they were less active.
Enlist professional help.
Meeting with a counselor—a psychiatrist, psychologist, or licensed clinical social worker—can be a super effective way for your kids to understand their problems, change their behavior, and make positive changes in their lives.
“Therapy can be extremely helpful for developing coping skills, reducing stress, and ultimately changing the way kids think about facing challenges,” says Dr. Baum. “Cognitive behavioral therapy (CBT) has been shown to be effective for treating anxiety and depression in children—it helps kids identify thought patterns that contribute to feeling down or scared and helps them try new behaviors that lead to different outcomes.” There are many different kinds of therapy, which are usually keyed to a child’s developmental stage and particular issues.
Younger children often do well with play therapy, while older kids may be more likely to respond to CBT, dialectical behavior therapy (DBT), or group therapy. Sometimes, the counselor will combine different types of therapy for the best outcome.
5 Steps to Take When Deciding Whether to Treat Your Child With Mental Health Medications
If you’ve tried the aforementioned strategies and your child is still struggling, it may be time to move on to the next phase of treatment: medication.
“Medication can be very helpful,” says Dr. Baum, “and we often consider it when symptoms are interfering with a child’s functioning. But because children’s brains are still developing, we don’t take prescribing these medications lightly.”
Thinking about medication for your child? Think carefully, says Dr. Baum. “Brain development continues into early adulthood, so it makes sense to be cautious about using medications in children. The available evidence suggests that these medications are safe for use in children and that they can potentially help kids who face significant problems with anxiety or depression.”
But before you make that decision, she says, know what to expect. Arm yourself with information—and ask all the questions you can. Here are five steps to take.
1. Start with your child’s pediatrician or family doctor.
Next to you, that’s the person who knows the most about your child’s health. Plus, the pediatrician is a professional who can spot behavioral health disorders. “Pediatricians are trained to treat the whole child, and they can screen for psychological problems,” says Mark Stein, Ph.D., a psychologist at Seattle Children’s Hospital and Genomind Scientific Advisory Board member. “Mental health problems don’t happen in isolation, and there are lots of physical issues, like sleep disorders and poor nutrition, that can contribute to behavioral issues.”
If your pediatrician or family doc discovers any complex mental health issues, they’ll know whether it’s time to call in a child psychiatrist or other mental health specialist. So first things first: Have a conversation with your child’s doctor, who will help you get started. “Pediatricians have connections with behavioral specialists and keep lists of referrals at their fingertips,” says Dr. Stein.
Therapy can be another tool that is integrated into your child’s mental health journey. For some issues, like attention deficit hyperactivity disorder (ADHD), schizophrenia, and bipolar disorder, medication may be the first line of treatment, with therapy as a very helpful addition.
For other conditions, though, like anxiety or depression, a combination of medication and therapy seems to be more effective. In milder cases, medication may not be needed.
2. Expect a thorough examination.
Before the doctor prescribes medication, your child will probably be given a complete examination, including a thorough medical history. Starting a psychiatric medication is a big step. “We don’t take it lightly,” says Dr. Baum.
For most medications prescribed by your child’s primary care doctor, additional tests won’t be necessary. Some medications, like those used for bipolar disorder, may have risks of side effects that might affect your child’s cholesterol or glucose levels, or even their kidneys. That makes it important to assess your child’s health and track their height and weight. For those medications, your doctor might recommend lab tests or heart tests. Medications like selective serotonin reuptake inhibitors (SSRIs), which are used to treat depression and anxiety in children, don’t usually require lab work.
The type of checkup your child gets will depend on the diagnosis and the prescription that’s being considered. Be sure to ask your doctor what type of evaluation is needed for your child, and about any tests they should get.
During this time, you may also want your doctor to perform genetic testing. Genomind’s pharmacogenetic (PGx) test identifies patient-specific genetic markers that can indicate which treatments have a lower risk for side effects or adverse events and may be more likely to be effective. It can also provide guidance for dosage based on an individual's metabolism. This information can help your clinician personalize your child's treatment based on their body and how it interacts with medication. This test was designed to reduce the often painful process of treatment by trial and error.
3. Ask questions.
Chances are, you’ll have dozens of them. It’s always important to have a discussion with the doctor about the potential benefits and risks of any medication you’re considering for your child. Go to your appointment prepared to ask away. Some of the things you may be wondering about include:
- What is the name of the medication? Is it ever called by different names?
- How will the medication help my child?
- How soon will it start to work?
- Is this medication addictive or can it be abused?
- How often will you check my child’s progress?
- What side effects should I look out for?
- How long will my child need to take this medication?
- How can I reach you if I have a question or if my child has a problem with the medication?
Still feeling uneasy? If the doctor dismisses your questions, or if you have any other reservations about treating your child with medication, remember that you can always seek a second opinion, which your insurance plan may cover.
4. Keep your child involved.
The more you can engage your child in the process and get them on board, the better things are likely to go. “I like to involve the child in the decision,” says Dr. Baum, “because, in large part, we need to rely on how he or she is feeling after taking the medication. Sometimes it’s good to make the decision in steps—I might say, ‘We can try counseling and if that doesn’t work, then maybe we’ll try medication.’”
And after beginning medication, doctors may use a questionnaire that your child completes to help them monitor the drug’s effectiveness.
5. Continue the positive lifestyle changes you’ve already made.
Don’t over-rely on the medication. Keep up with the good habits you’ve already formed—or try them out now. A healthy diet, plenty of sleep, and regular exercise are all still important.