Mental Health: Suffering in Silence

Melissa Kossler Dutton
Sasha Bowers with sons (from left) Kaiden, Arreion and Zay 'Vion

When a thunderstorm makes Arreion Bowers-Ulmer feel anxious, the 8-year-old knows he has several options to feel better. He can find his mom or dad and hug it out, use his earplugs or cuddle a teddy bear.

The third-grader learned these coping skills in therapy after he was diagnosed with ADHD, anxiety and oppositional defiant disorder. He's one of a growing number of children successfully learning to live with mental health challenges.

One out of seven U.S. children between the ages of 2 and 8 has a diagnosed mental, behavioral or developmental disorder, according to the Centers for Disease Control and Prevention. Twenty percent of 13- to 18-year-olds live with a mental health condition, according to the National Institute of Mental Health.

The rate of diagnosis for such illnesses has been increasing in recent years for a number of reasons, said Dr. Ujjwal Ramtekkar, a psychiatrist at Nationwide Children's Hospital. Increased awareness of mental health coupled with a better understanding of the illnesses—which also has reduced some of the stigma associated with a diagnosis—has caused more parents to seek treatment for their children, he said.

Mental health counselor JanineHalloran, offers online resources and products for parents, agrees. "It's more acceptable to be talking about it," she said. "It's always been around, but not labeled as clearly."

Anxiety disorders are the most common mental health concern in the United States, according to the National Alliance on Mental Illness. Approximately 8 percent of children and teenagers experience an anxiety disorder.Most people develop symptoms before age 21.

Risk Factors

Societal factors such as social media use, increased amounts of screen time and the 24/7 news cycle also are causing more children to experience mental health issues, Ramtekkar said. Social media platforms can lead to bullying and depression, he said, while too much time spent on digital devices can interrupt sleep or lead to anxiety, depression and mood disorders. Children who are overexposed to the news and stressful current events also may experience issues.

The opioid epidemic also has played a role in the problem, as children of addicted parents experience frightening and unacceptable living circumstances, saidJody Demo-Hodgins, director of the Children's Division of the National Alliance on Mental Illness Ohio. "Kids are experiencing trauma from living in unsatisfactory conditions—no food or shelter. They are not cared for in ways we should be caring for our kids," she said.

Warning Signs

All parents need to watch for signs that their children may be experiencing mental health difficulties, the experts said.Worrisome behaviors include changes in sleep or eating patterns. A child who seems overly anxious or worried about things in the news also is cause for concern.

When you see these behaviors, confront them, recommends Ramtekkar. "Talk to the child directly," he said. "Ask them candidly, 'Are you depressed? Are you sad?' Tell them: 'I have observed that you are not your usual self.'"

These types of conversations let children know "that somebody cares and that they do not have to suffer in silence," he said. It's also a good idea to raise these concerns with your child's doctor.

Parents or guardians who observe signs of suicide—talk of committing suicide, hopelessness, giving away possessions, obsessive talk about dying—should immediately call the emergency room and find a mental health provider, Ramtekkar said. "Always err on the side of caution."

Coping Skills

Many children who are diagnosed with a mental health condition can use medication and/or coping skills to manage it in their daily lives. The key is getting help from a professional counselor.

Some children may need counseling for a short time, while others may require medication and treatment for the rest of their lives,Demo-Hodgins said. People need to understand that these are health conditions and must be treated as such, she said.

When Arreion Bowers-Ulmer was in kindergarten, he was almost suspended because of his behavior. When his mother made school officials aware of his diagnoses and the recommendations of his counselor, they were able to implement supports to assist him. Now, Arreion is able to bring his teddy bear to school for comfort when he feels anxious or get up and move around when his ADHD prevents him from sitting still, said his mother, Sasha Bowers of Columbus.

The family also makes sure that his friends' parents and leaders of his after-school activities are aware of his diagnoses. Bowers counsels them to be patient with her son. "Some people think he can't do certain things. I don't want that to be what they see in him. These aren't reasons to limit him," she said. "I say, 'Let him try. It just may take him a couple of times.'"

Bowers, who has learned insights into children's behavior through NAMI Ohio, eagerly shares them with other parents. At a recent Cub Scouts meeting, she offered tips on helping children calm down for bedtime.

Barriers to Treatment

Many families may find it difficult to get mental health treatment because of a shortage of pediatric professionals. It's not uncommon for children to wait months or even years for qualified help, according to national studies.

There are only about 8,300 child and adolescent psychiatrists available to treat the nation's 15-million-plus children in need of services, according to the American Academy of Child & Adolescent Psychiatry.

When Karen Reed's daughter experienced a mental breakdown, she spent hours on the phone trying to find a psychiatrist to help her. There were no options near her home in Lawrence, Ohio. Ultimately, she had to drive her daughter nearly 150 miles for treatment. Thanks to regular therapy sessions, Lexie Reed, 16, is learning to manage her anxiety and autism.

Locally, Nationwide Children's is responding to the care crisis by opening a facility dedicated to treating and researching behavioral health issues impacting children and adolescents. When it opens in 2020, the Big Lots Behavioral Health Pavilion, believed to be the largest of its kind in the nation, will offer outpatient programs, a crisis clinic, general psychiatry, 48 inpatient beds, a 16-bed youth crisis stabilization unit, a 10-bed psychiatric crisis center and a family resource center.

In October, the hospital also launched the "On Our Sleeves" campaign designed to erase negative stereotypes associated with children's mental illnesses, provide resources for families and raise money for research into diagnoses and treatment. The goal of the campaign is to increase awareness about children's mental health issues and direct people to resources.

If you think your child is struggling with a mental health issue, these organizations can provide a starting point:

These are some warning signs that may indicate your child has a problem that requires specialized attention:

  1. Having more difficulty at school
  2. Hitting or bullying other children
  3. Attempting to injure him- or herself
  4. Avoiding friends and family
  5. Frequent mood swings
  6. Experiencing intense emotions, such as angry outbursts or extreme fear
  7. Lacking energy or motivation
  8. Difficulty concentrating
  9. Trouble sleeping, or having a lot of nightmares
  10. Numerous physical complaints
  11. Neglecting his or her appearance
  12. Obsession with weight, shape or appearance
  13. Eating significantly more or less than usual

Source: Psychology Today

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