Mental disorders in children are a growing concern in South Africa, with the stresses of modern daily life, the demands to excel in school and at sport, divorce and exposure to violence taking their toll on the country’s young people. It is estimated that about 20% of children and adolescents have a mental health disorder and approximately half of all mental illness and substance-related problems start at the age of 14 years.
According to Lwanele Khasu, Clinical Psychologist at Ubuntu Family Health Centre, signs of depression, anxiety and stress are also seen in much younger children.“We live in a highly demanding, highly pressured society. Children are under immense pressure to succeed at school and on the sports field. But they are also exposed to high levels of violence, either directly or indirectly. They hear their parents talking about robberies in their neighbourhoods, they hear of people they know who have been hi-jacked, and they listen to news about murders and political issues. They absorb this information and it can begin to weigh them down.
“Many children experience fighting between parents, while others are acutely aware of financial stress in the home. The result is that many of South Africa’s children, much like many South African adults, are living with post traumatic stress. We see it in children as young as two. Some mental disorders, such as Bipolar, Attention Deficit Disorder and Obsessive Compulsive Disorder can be evident from earlier than that, sometimes even within the first year.”
There are a number of mental health disorders that can affect children. Some may affect their developmental milestones, intellectual ability, motor skills, and psychological maturity. Khasu says it is important to be aware of signs and symptoms from a child’s early years so that interventions can be taken early on, when they are most effective.
“Children and adults can develop the same mental health conditions but they are often expressed differently in children. For example, depressed children will often show more irritability and aggression than depressed adults, who typically show sadness. Parents and caregivers need to be observant of their children’s behaviour, especially if there are any noticeable changes such as mood swings, irritability or withdrawal.”
Other signs that parents should look out for include
• Restless and an inability to sit still to complete tasks
• Forgetfulness and losing items at school like a jersey or books
• Sudden demotivation with school work or lack of interest to play with friends, even though they liked it before
• Unusual changes in behaviour or personality, such as fighting, bullying other kids or expressing a thoughts of hurting others
• Disobedience in the home or at school
• Sudden fears, frights, or anxiety. This can also include in an inability to sleep or eruption of nightmares
• Difficulty concentrating which might lead to poor performance in school.
• A sudden loss of appetite. Frequent vomiting or use of laxatives could also indicate an eating disorder.
• Physical symptoms such as headaches. These might be evident rather than shows of sadness or anxiety.
• Self-injury and mutilation such as cutting or burning themselves.
• Using drugs or alcohol to try to cope with their feelings.
“If parents or caregivers notice any signs and symptoms in children that continue for longer than two weeks, they should seek help. It is almost certainly not just a passing phase,” stresses Khasu.
She concludes with this advice to parents: “Take the time to sit and talk with your child. Ask them if anything has happened to them that might be causing them to behave uncharacteristically. Remember though that children often find it difficult to open up to their parents so it is important to be patient and supportive. Create opportunities to relax and have fun with your child, praise their strengths and abilities. You might find they are more willing to talk because they are more at ease in these contexts.
“You should also consider talking to your child’s teacher and even their close friends to see if they have noticed any changes. If through these interactions you find that there is cause for concern, don’t delay contacting your doctor or a psychologist. You will need to help your child to make sense of why they need to go for therapy or take medicine. Mental illness often carries a stigma so you have to help your child understand that there is no harm in seeking help. In fact, it will benefit them now and in the long term if they have support and have appropriate coping strategies.
“Some people can go most of their lives without being treated and they can manage with the pressures of their lives, but others are not so fortunate.”