Early Mental Health Evaluation: Diagnosing Childhood Mental Health Disorders

Early mental health evaluation in children can be challenging for many reasons—primarily because children may not be able to express themselves clearly. Their vocabulary is somewhat limited. Also, their feelings, emotions and understanding of themselves is evolving. Their cognitive and social skills are not fully developed. Because of these limitations, it is vital that parents and primary caregivers understand the symptoms associated with childhood mental health disorders… An early mental health evaluation by a specialist is critical to obtain the best possible short-term and long-term care. Below we discuss the most common mental health disorders diagnosed in children, along with the symptoms and behaviors associated with them.   

Anxiety Disorders 

Children, like adults have anxiety disorders. They can have obsessive-compulsive disorder, social phobias and general anxiety disorders. Anxiety is expected—and normal—at times. For instance, the first day of school or daycare. However, a professional evaluation should be conducted when anxiety in children is so persistent that it interferes with daily activities. There is no beginning age for anxiety in children, but infants/toddlers may experience separation anxiety as early as 18 months. Left untreated, anxiety in children can lead to anxiety as an adult, academic problems, low self-esteem and substance abuse. 

Some common symptoms of anxiety in children include: 

  • Restlessness
  • Tantrums
  • Crying
  • Refusal to go to school
  • Agitation
  • Poor focus
  • Headaches
  • Stomach aches 
  • Difficulty sleeping
  • Stress before school
  • Stress when dressing for school
  • Tantrums
  • Stress over homework
  • Difficulties during transitions (moving from one activity to another) 

Autism Spectrum Disorder (ASD)

ASD is a developmental disorder that appears in childhood—most often before three years old. It is estimated that one in 59 children in the U.S. has ASD. It consists of a wide range of behaviors and challenges with social skills, speech and nonverbal communication and repetitive behaviors. ASD symptoms can vary from mild to severe and may manifest themselves in many different ways. For example, children with ASD may: 

  • Not always respond to their name
  • Imitate or copy others
  • Not use eye contact for simple communication 
  • Not wave goodbye without being told or copying someone
  • Not smile at others without being smiled at
  • Not show interest in other children
  • Need to follow strict routines (leaving the house the same way; eating food in the same way)
  • Have intense fixations on things or activities (only plays with one type of toy or one part of a toy) 
  • Be stuck or fixated on objects (flicking a light switch)
  • Have unusual body movements like walking on their toes, hand-flapping or arm-stiffening 
  • Have sensory sensitivities such as getting irritated by sounds or only eating a certain type of food 

Attention-Deficit/Hyperactivity Disorder (ADHD)

Evaluating ADHD in children can be difficult as there is no set test. ADHD includes either inattention or hyperactive-impulsive behavior or both. Symptoms are noticeable beginning as early as three years old and may continue into adulthood. ADHD symptoms range from mild to severe. There are three subtypes of ADHD a child can be diagnosed with, depending on the number and type of symptoms they exhibit: primarily inattentive, primarily hyperactive, and combined. Children with ADHD may:

  • Have trouble controlling impulsive behaviors
  • Be overly active
  • Have problems paying attention

They may also exhibit the following symptoms or characteristics:

  • Daydream… a lot
  • Forget or lose things
  • Squirm or fidget
  • Talk too much
  • Make careless mistakes
  • Take unnecessary risks
  • Struggle with resisting temptation
  • Have trouble taking turns
  • Show difficulty getting along with others

Mood Disorders (Depression/Bipolar Disorder)

These are characterized by constant or persistent feelings of sadness (depression). Bipolar disorder involves extreme mood swings (manic highs and depressive lows), which are more drastic and intense than normal mood swings. Other mood disorders include:

  • Persistent depressive disorder (dysthymia): A low-grade irritable or depressed mode lasting at least a year
  • Disruptive mood dysregulation disorder:  Persistent irritability and an inability to control behavior
  • Premenstrual dysmorphic disorder: Includes feelings of depression, irritability, and tension before menstruation
  • Medically-induced mood disorder: Includes symptoms of depression following medical illnesses (i.e. cancer diagnosis) or injuries
  • Substance-induced mood disorder: Depression caused by substance abuse, use of medications or exposure to toxins

Children with mood disorders may exhibit a wide range of behaviors including, but not limited to: 

  • Feeling sad, irritable, depressed or angry, which is intense and lasts for long periods of time (or occurs frequently)
  • Less or lack of motivation
  • No pleasure in activities previously enjoyed
  • Fatigue or lowered energy levels
  • Change or difficulty in sleeping
  • Changes in eating habits, or fluctuations in weight gain or loss
  • Frequent headaches and/or stomach aches 
  • Lowered school performance 
  • Low self-esteem, including feelings of guilt or worthlessness
  • Sudden and/or recurrent temper outbreaks
  • Energy bursts with racing thoughts or fast speech 
  • High risk/rebellious behavior
  • Threats of running away from home or running away
  • Difficulty with social relationships (friends and peers)
  • Suicidal thoughts (which are serious and should be evaluated immediately)

Causes And Treatments

There are many factors that may contribute either individually or collectively to childhood mental health disorders. Biological factors, environmental factors (stress, abuse or traumatic events), psychological factors (how children perceive themselves) and brain injuries may all play some role. Drug use, illness or other injuries may also be contributing factors.  

Early evaluation of childhood mental health disorders is critical in order for children to receive a proper diagnosis and suitable treatment. Parents sometimes do not seek help or treatment because of feelings of embarrassment, shame, guilt and helplessness. However, help is available. Doctors can use psychotherapy and/or medication to help alleviate the symptoms associated with childhood mental health disorders. The first step is talking to a professional about what’s happening and then seeking a course of treatment.

How We Can Help You?

Best Day Psychiatry and Counseling is here to help you have a better day and find a better way. We treat a wide range of psychiatric conditions for both children and adults. Contact us today, we’re ready to help:

Fayetteville: (910) 323-1543  Fuquay-Varina: (919) 567-0684  Raleigh: (919) 670-3939  Greenville: (252) 375-3322