By David Joel Miller.
Age impacts mental health.
A reader asked “You keep mentioning children in your posts, how are their problems like or different from adult mental illness?
There are some differences between the issues children have and adults, but my experiences tell me that there are a lot of similarities.
We used to have a separate section for “Disorders usually first diagnosed in Infancy, Childhood, and Adolescence, in the DSM-4. In the DSM-5 those disorders get moved around. One problem with the old approach was that many clinicians missed the “Usually” part. We tended to think of these problems as something children get and adult problems as something only adults got.
That just is not so.
Some of these early onset problems get missed or continue to plague people throughout their lives. Stress-related issues are a good example of this. Reactive Attachment Disorder may be easy to see in a small child but the after effects can result in a bunch of problems that in adults we usually call by other names.
Just like the child develops, the mental health problems of that child may develop and change with time.
Also, it is very possible for children to develop problems that we used to think were only the providence of adults. Remember that “Happy childhood” myth. There must have been a few people with happy childhoods but there were a lot of people who did not get their ration of that one.
So children can and do suffer from depression, anxiety, stress, trauma and a host of other adult looking problems.
We currently believe, I think for good reason, that the earlier in life we recognize some of these problems and treat them the better the chance that the person will not grow up to have a severe emotional disorder. That treatment, by the way, need not be medication or prolonged therapy.
Lots of other things can help these children. Anger Management and Parenting classes for unprepared parents also help. So do supportive environments like quality preschool or even grandparents or other supportive adults.
A disclaimer here – my perspective on working with children may be a bit different from other clinicians. My work with children has been largely in crisis settings, these kids were brought in because they said they were suicidal or they were way out of control. The other groups of children I worked with were substance abusing or those brought in for an assessment because someone believed this child has a serious emotional problem or a serious mental illness.
My experiences were with a group of children that may be the more seriously affected by society’s problems. As a result, some childhood problems were probably not represented and others were way over-represented.
The problems that bring children to the attention of professionals change as they get older. The 3-year-old who is not talking is a way different problem than a 17-year-old girl who has been abusing drugs and is now suicidal because she found out she is pregnant by her 24-year-old boyfriend.
Both may have been the victims of abuse or neglect, so these very different “symptoms” may stem from the same or similar roots.
As a child gets older the way we should be assessing and the way we treat this “child’s” issues should get more and more like the way we treat adults. Mental health has had problems here for years as I see it. Some clinicians continue to treat adult clients as if they were mentally retarded or little kids.
One day you are 17 and you get the “now little girl” treatment and the next day you are 18 and you get the “grow up” lecture.
One other thing to consider when talking about the difference between adults and youth mental health issues is how to tell the difference between normal adolescent issues and those problems that could be the beginnings of a serious mental health issue. Just being a teen is, in and of itself, not a diagnosis.
Recently I attended a training to get certified as a Youth Mental Health First Aid trainer. I can’t begin to cover all that info here. If the issue of how to recognize mental health problems in young people interests you, you might want to check out that training.
The question about how the treatment approaches may differ between a young person with a disorder and a person who has accumulated more years, presumably an adult, that topic needs a whole other post.
Till next time, David Miller, LMFT, LPCC
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- Extra practical therapy book is coming (counselorssoapbox.com)
- What if your Therapist loses their cool? (counselorssoapbox.com)
- Mental Health Monsters – Depression and Anxiety (counselorssoapbox.com)
- Mental Health Disorders Growing Faster Among Kids Than Adults (nlm.nih.gov)