The treatment section for bipolar disorder has been extensively revised with separate treatment sections for mania and for depression. In addition, information has been added throughout to address how COVID-19 impacts mental health.
Several important mental health disorders, such as depression, anxiety disorders, and eating disorders, often start during childhood and adolescence. Schizophrenia and related mental health disorders (sometimes referred to as psychotic disorders) are much less common. When they do occur, they typically start anytime during the middle of adolescence through young adulthood (into a person's mid-30s). Some disorders, such as autism, start only during childhood.
As many as 20% of children and adolescents may have a diagnosable mental health disorder that causes some sort of impairment. The risk of being diagnosed with a mental health disorder increases with age. By some estimates, about 30% of adolescents between the ages of 13 and 17 meet the criteria for two or more mental health disorders. Environmental stressors (eg, the COVID-19 pandemic) may disrupt critical routines and relationships enough to make even otherwise resilient children and adolescents more vulnerable to mental health disorders.
With a few exceptions, symptoms of mental health disorders tend to be similar to feelings that every child experiences, such as sadness, anger, suspicion, excitement, withdrawal, and loneliness. The difference between a disorder and a normal feeling is the extent to which the feeling becomes so powerful as to overwhelm and interfere with the activities of normal life or cause the child to suffer. Thus, doctors must use a significant degree of judgment to determine when particular thoughts and emotions stop being a normal component of childhood experience and represent a disorder.
Disruptive behavioral disorders affect mainly behavior. The behavior is not intentionally disruptive but may disturb others, including teachers, peers, and family members. These disorders include
Neurodevelopmental disorders affect both mental health and overall development in children. These disorders include
Autism spectrum disorders may involve some combination of impaired social relationships, a restricted range of interests, abnormal language development and use, and, in some cases, intellectual impairment. Rett syndrome, a genetic disorder, causes some similar symptoms, including difficulties with social skills and communication.
No test can confirm the diagnosis of a mental health disorder. Doctors rely on an interview with the child or adolescent and observations of parents and teachers and on those made during the office visit to help determine whether a mental health disorder is present. Sometimes doctors refer the child or adolescent to a mental health care practitioner who is trained to diagnose and treat mental health disorders in children and adolescents. These practitioners may use specially designed interview and assessment tools to evaluate the child.