8 Signs It's Time For Your Child To See A Therapist

As World Mental Health Day rolls around, it's a reminder that we need to address the unspoken stigma of therapy for children. In a social climate like ours where incidences of bullying, self-harm and suicide are alarmingly high among the young, we really need to pay more attention to our kids and the fluctuating state of their mental and emotional health. 

It is no longer only the clinically depressed who need to “see someone”, and there is absolutely nothing wrong with you if you need some help coping with life at points. Yet if we want to be able to help our kids when they need it, we first need to know what tell-tale signs to watch out for.

Defiance

Getting in trouble at school or exhibiting disruptive behaviour at home, defiance can take many forms. Pushing boundaries, acting out, challenging authority, getting into fights with their siblings or friends—these could be interpreted as frustrated cries for attention. Instead of purely turning up the discipline, consider if there may be something else going on in your child’s life and if they could be better helped by talking. 

Ideally, our relationships with our children should be so close that we could get them to deeply share about what’s really motivating such negative behaviours, but in reality they may find it much easier to open up to an impartial person like a trained therapist.  

Changes in eating or sleeping habits

If you’ve noticed a drastic change in your child’s appetite or sleep patterns, this could signify an underlying issue that shouldn’t be ignored. Sleep disruption is a common sign of anxiety, worry or depression, as is sleeping too much. New eating habits or a pronounced loss of appetite can also signal depression, anxiety or a possible eating disorder.   

Even changes in hygiene can be a tell-tale sign of losing motivation for life. You might be able to help by implementing a daily schedule for meals and personal care, making sure they are eating well and maintaining personal hygiene by cleaning, washing and brushing regularly. If this doesn’t help though, there might be deeper issues that need addressing. 

Unusual sadness, worry or irritability

Crying or worrying excessively, especially without sufficient or reasonable cause, is quite a clear warning sign. It is of course perfectly natural that everyone feels sad and worried sometimes, so take the time to talk to your child and try to understand why they are feeling this way. It may help them just to be able to discuss their feelings with you and to receive your comfort, love, hugs and support.

Sudden clinginess or a marked decrease in confidence or self-esteem can also be clues, especially if it’s affecting the way they normally function. If your child seems unusually anxious or irritable for long periods of time, and lashes out or withdraws when you try to discuss how they are feeling, it would be a good idea to seek help. 

Social isolation and loss of interest 

Withdrawing from their favourite activities and suddenly losing interest in the people and things that they used to like are classic symptoms of depression. Dr Kate Eshleman, paediatric psychiatrist at Cleveland Clinic, says it is “especially important at this time to determine if the disinterest is related to mood versus fatigue from engaging in that favoured activity”, so don’t jump the gun if your child is just tired of playing hockey after two whole months of intensive training. 

Social isolation is more distinct though, and abruptly withdrawing from friendships or refusing to participate in group activities that they’d usually enjoy can be very telling of a poor emotional state. This should be investigated to rule out and deal with issues like bullying or violence.   

Mysterious physical pains

It is not uncommon for anxiety or depression to manifest in physical symptoms such as headaches or tummy aches, especially if they seem to recur in specific situations, E.g. having a tummy ache right on time just as they’re about to leave for school every morning. A daily tummy ache like that could reveal strong anxiety in your child about attending school. 

If you’ve already taken them to the doctor and there seems to be nothing physically wrong, you might wish to consider taking them to a counsellor next. It could greatly benefit them just to be able to talk to someone neutral about some of their hidden fears and insecurities. 

Self-harm

It would be pretty obvious that your child is unwell if you see methodical scars on their arm from cutting or slashing, but self-harm can also look like moderately self-destructive behaviour as innocent as pulling their own hair or picking at their own skin repeatedly. Other signs of extreme frustration or anxiety that warrant attention include digging their fingernails into their own skin, getting into fights when they’re likely to be hurt, hitting themselves or their own heads or punching walls, etc. 

If they’re older, more common overtly destructive behaviour can include having unsafe sex, indulging in excess intoxication or drug abuse. Self-harm is often a guise for difficult emotions like deep anger, grief, shame, guilt or self-loathing, which manifest as unhealthy coping mechanisms for dealing with such pain. 

Talking about death or suicide

Expressing hopelessness or explicitly talking about self-harm or suicide are major red flags. 

Instead of “I want to kill myself”, though, it might take the form of slightly more subtle expressions like “I wish I’m not here” or “nobody cares about me anyway”.

Repeated mentions of death and dying shouldn’t be ignored, but any talk about suicide or killing another person definitely requires immediate attention and most likely professional help. It is important to show your child that you care in such situations, and talking about it with them—or engaging a trained counsellor to do it—are both valid ways of expressing your love and concern.  

Your gut feeling

While some of the above signs may strongly signal a child’s need for immediate professional attention, and some are pretty mild indications of unhappiness that could just be fleeting or developmental, you—their parent—are in the best position to make that assessment. 

It doesn’t hurt to speak to the other adult figures in their life, of course, and to hear what their teachers may have observed at school, but trusting your instincts will generally serve you well. After all, you are their closest advocate and best defence against life and the rest of the world—you probably already know what’s best for your own child. Listen to your gut and you’ll rarely go wrong. 

Finally, don’t sit on it for too long… It can’t hurt to get them checked out even if you’re unsure but just feeling uneasy. Getting help can be as simple as initiating a discussion with your paediatrician or family doctor!