🚩10 Red Flags for Declining Emotional Health in Kids

For all ages

Children and teens may not always be forthcoming or even be able to tell us how they're doing emotionally. Some reasons for this may be that they feel too shy to talk about their feelings, may worry about judgment, feel ashamed or embarrassed, do not know who they can talk to, do not want to burden parents or caregivers, and do not have insight or awareness about their thoughts and feelings. 

This is why it's important for parents/ caregivers, teachers, medical providers, and responsible adults to watch out for certain red flags 🚩in children's and teens' behaviors that may reflect that they are struggling emotionally. 

Here are 10 red flags to watch out for: 

1. Reduced interest or not wanting to do activities that they used to find enjoyable and would readily choose to participate in. 
2. Socially withdrawing and isolating themselves from friends and family. Some things to consider are if they stay in their room most of the time, don't talk or spend much time with family members or friends, and don't want to go out with family or friends.
3. Trouble sleeping. They might have difficulty falling asleep, staying asleep, waking up through the night, waking up early in the morning, or even sleeping more than what is appropriate for their age. 
4. Changes in appetite and eating behaviors. They might not feel hungry, skip meals, not eat enough during meal times, overeat at meal times, or engage in binge eating.
5. Problems at school. Things to look out for are if their grades are dropping, if they are struggling to pay attention or concentrate in class or to do their homework, and if they try to avoid doing their homework or procrastinate. 
6. Tummy (GI) problems. They might need to go to the toilet too often, have diarrhea or constipation, have stomach pain, or feel nauseous and vomit.
7. Irritability and anger outbursts. They may seem easily irritable and have anger outbursts for things that may not seem appropriate.
8. Avoidance behaviors. Avoidance is the first thing that our brain is programmed to do when we feel afraid of something. Based on what may be affecting them, they might procrastinate or avoid certain situations. For example, they may not want to go to school, to social events, to visit public places, to doctor's appointments, etc. They also may want to avoid talking about the thing that's bothering them.
9. Changes in mood and behavior. You may notice that they don't seem like themselves or that something feels off. You may also see that they are crying, worry a lot or appear anxious or nervous.
10. Thoughts of not wanting to be here anymore or thoughts of wanting to hurt themselves. They may experience passive suicidal ideation (wishing they weren't alive but have no desire to act on these thoughts) or active suicidal ideation (where they have thought about hurting themselves, intend to do so, and may even have a plan). Asking about suicidal thoughts does not instill suicidal thoughts in kids or give them ideas. Asking about suicidal thoughts will help us get the care they need if they endorse these.

"I notice some red flags! What now?" 

If you notice some of these red flags, it is advisable to visit a psychologist and seek professional help. An initial meeting with a psychologist will typically include a clinical evaluation to assess signs and symptoms and determine severity. They will then share a treatment plan to treat these mental health concerns. 

In the meantime, try to create a safe space for your child to talk about what's going on for them. It can be helpful to ask open-ended questions, actively listen, and validate what they are feeling in a non-judgemental manner. Try to avoid giving advice or even problem-solving. You can also spend 1:1 quality time with them to help them open up. When they're going through a difficult time, we want them to feel heard, accepted and cared for.

If your child or teen expresses thoughts of wanting to hurt themselves, you should take them to the nearest emergency room immediately. Here are some Crisis Resources that provide more information about what to do in a mental health emergency.