As mental health related challenges become increasingly prominent in teens and children, many are left searching for answers.

Simon Ovanessian, MD, director of psychiatry with the Hartford HealthCare Behavioral Health Network at St. Vincent’s Medical Center, says parents should always be aware of signs their child is experiencing pain, either physical or emotional. The trick is spotting, or hearing, the sign based on the child’s ability to communicate, he says.

“There are definitely signs of mental health struggles in children, but how they develop depends on the age and the communication skills of the child,” he says.

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Age by age

Dr. Ovanessian offers the following age-based guideline:

  • Birth to ages 6 or 7. “Children this young do not have the vocabulary or courage to tell people that they’re sad, can’t sleep or want to kill themselves,” he says. Instead, parents should be cued into their behavior, especially sudden changes. Are they more hyperactive or acting out more? Do they try to withdraw and isolate themselves?
  • Age 7 to early adolescence. Youth at this point are fixated on their personal appearance in the face of mounting peer pressure at school. Teachers and parents should note if a child suddenly doesn’t care how they look, takes extreme measures like getting multiple piercings, engages in harmful behaviors or becomes more promiscuous.
  • Age 12 to 18. This is when social media has a huge impact on what teens think, feel and act upon, Dr. Ovanessian says. “They see various ideas like suicide, and social media normalizes them,” he notes. This is also the age when people are more likely to turn to what he calls “methods of soothing” such as tobacco, drugs, alcohol and even self-mutilation.

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How to help

No matter the age, the most important thing an adult can do for a child in emotional distress is listen. Consider asking supportive questions like “Can you tell me what’s going on?” and “What are you thinking?” to gain insight.

“You might have to try a few times because it’s not something that’s easy to talk about,” Dr. Ovanessian says.

Teachers can pull an older child aside with a sincere offer to talk.

Professional support

News stories can prompt conversations with older children. If talk turns to self-mutilation, fire-setting or other drastic behavior, it’s a clear sign, Dr. Ovanessian says, to seek a professional evaluation. This can be either through a trip to the emergency department or an assessment by a school or private counselor.

“When a kid is talking about it, it’s time to get help,” he says.