Flags for mental health: How to spot signs of a struggling child

Early childhood (ages 3-6 years)

During early childhood, children exhibiting stress, confusion, or anger could be early indicators of mood disorders such as anxiety or depression, ADHD, or neurodivergence. 

"Symptoms often start in early childhood, although some disorders may develop during the teenage years," Daigle said, adding that serious changes in children's behavior can cause distress and problems getting through the day.

Changes might include frequent or intense temper tantrums, fear or worry, being in constant motion, struggling to sit quietly, repeating certain actions out of fear that not doing so will cause a bad outcome (for instance, checking that a door is locked many times), or experiencing frequent physical pain or discomfort with no reasonable cause.

It is also important to note that what are considered warning signs will likely vary from culture to culture or even region to region. For instance, in some communities, crying loudly and often may be more acceptable; in others, it could be considered alarming, and thus indicate greater cause for concern about a child.

"Many children occasionally experience fears and worries or display disruptive behaviors,"  Daigle said. "Early self-regulation—how we process thoughts into feelings and actions—helps us understand how children are developing."

Middle childhood (ages 7-11 years)

During middle childhood, many of the same concerns from early childhood still apply, but with added considerations for the more complicated psychosocial developments among this age group. For instance, many gender-nonconforming children are around age 7 when they start to recognize that their gender identity is different than what they were assigned at birth. These children may experience anxiety at the realization that they are different from their peers.

Among all children, the onset of early puberty can also exacerbate or introduce issues rooted in depression, confusion, or the capacity to regulate intense emotions. "Youth with poor mental health may struggle with school and grades, decision making, and their health," Daigle said. "Look for signs of disruption and changes in sleep, activity, friendships, and behavior."

Additional signs could include discussing suicide or death, losing interest in socializing with friends, an inability to concentrate, feeling irritable, overly anxious, or excessively angry, and frequent nightmares.

Adolescence (ages 12-18 years)

It is no secret that adolescence is an emotionally and socially turbulent time. Many of the warning signs exhibited by a teenager struggling with their mental health can be less obvious and easier to conflate with the challenges that emerge during this time of transition and change.

According to Daigle, the same indicators from middle childhood also apply to adolescents, who may start exhibiting more behaviors that indicate that they are struggling.

"Mental health problems in youth often go hand-in-hand with other health and behavioral risks like increased risk of drug use, experiencing violence, and higher risk of sexual behaviors that can lead to HIV, STDs, and unintended pregnancy," Daigle said. "Fortunately, the same prevention strategies that promote mental health—like helping students feel connected to school [or] family—help prevent a range of negative experiences, like drug use and violence."

Daigle emphasized the importance of fostering relationships for adolescents, whether with family, friends, or members of the larger community. These bonds are critical in establishing a sense of connectedness, which can act as a crucial deterrent for negative mental health outcomes. "Youth need to know someone cares about them," Daigle said.

These indicators are universally applicable; every child, family, community, and culture is different. Additionally, these flags should not be taken as direct medical advice but rather help caretakers and parents identify whether they should seek professional assessment.

"Just like with physical illness, treating mental health problems early may help to prevent a more serious illness from developing in the future," Daigle said. "Talk to your child's health care professional if you have concerns about the way your child behaves at home, in school, or with friends. Continue to have open and honest discussions with your child, offering encouragement and support."

Story editing by Alizah Salario. Additional editing by Kelly Glass. Copy editing by Sofía Jarrín. Photo selection by Lacy Kerrick.