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Why it matters and what you can do to help
Depression and anxiety are often thought of as adult problems. However, a new study shows that nearly 7.7 million children and teens in the U.S. – about one in seven – have a treatable mental health disorder, such as depression, anxiety, and/or attention-deficit/hyperactivity disorder (ADHD).[1] Sadly, half of these kids are not receiving treatments for their problems.[1] “Untreated mental health disorders can have a debilitating impact on children’s healthful growth and throughout their transition to adulthood,” says lead author Dr. Daniel Whitney, Ph.D.[2]
The incidence of children’s mental health issues has soared in recent years.[3] Perhaps most alarming is the increase in self-injury, which often occurs in conjunction with depression and anxiety.[4],[5] The incidence of self-injury among 10- to 14-year-old girls, for example, has nearly tripled since 2009.[6]
Good mental health in childhood is imperative, as it enables children to cope with life’s challenges and grow into well-rounded, healthy adults.
Good mental health in childhood is imperative, as it enables children to cope with life’s challenges and grow into well-rounded, healthy adults. Let’s look at some ways society and individuals can reduce the risk of mental health problems in children.
Risk factors for childhood mental health problems
Mental health problems in children often begin as a direct response to their environment and experiences.[7] Circumstances that increase the risk for mental health disorders include:
- Having a long-term physical illness
- Having a parent who has had mental health problems, problems with alcohol/drugs, or who has been in trouble with the law
- Experiencing the death of someone close to them
- Having parents who separate or divorce
- Having been severely bullied or physically/sexually abused
- Living in poverty or being homeless
- Experiencing discrimination, perhaps because of their race, sexuality, or religion
- Acting as a caregiver for a relative or taking on adult responsibilities
These are major, highly uncontrollable events (particularly for the child that is subject to them), but everyday lifestyle factors also can tip the balance between mental resilience and mental health problems. For example:
Poor diet
Scientists have found evidence of a link between unhealthy dietary patterns and poorer mental health in children and adolescents.[8] A recent global nutrition report found that one-third of children do not eat fruit or vegetables daily. This important food group provides crucial vitamins, minerals, fiber, and phytonutrients to support brain health.
Even more worryingly, the report found that four in ten children drink at least one sugar-sweetened soft drink every day. Frequent sweetened beverage consumption has been shown to affect brain development, learning, and mood regulation in children.[8],[9] Children with ADHD, for example, were found to consume more high sugar and high fat foods, and less vegetable, fruit, and protein-rich foods than their non-ADHD counterparts.[10] Soft drink consumption is linked not only to behavior problems in children,[11] but also to poor sleep,[12] depression,[13] and obesity.[14],[15]
Social media/internet use
There’s no doubt that there has been a huge rise in internet use among children and young adults. According to a recent analysis, even 5- to 8-year-olds spend almost three hours per day either using smartphones, tablets or other devices, or watching TV.[16] Among 14- to 17-year-olds, high users of screens were more than twice as likely to have been diagnosed with depression or anxiety as low users.[17] The evidence also suggests that vulnerable adolescents who spend more time on online social networking have an increased risk of self-harm and suicidal ideation.[18] In fact, the increase in screen time since 2010 may well account for the increases in depression and suicide among adolescents in that period.[19]
What keeps children and young people mentally well?
When we consider our children’s health we automatically think of a nutritious diet and plenty of physical exercise, preferably outdoors.[20] Other protective factors include:
- Being part of a family that gets along well most of the time
- Going to a school that looks after the well being of all its pupils
- Taking part in activities for young people
- Feeling loved, trusted, understood, valued, and safe
- Being interested in life and having opportunities to enjoy themselves
- Being able to learn and having opportunities to succeed
- Accepting who they are and recognizing what they are good at
- Having a sense of belonging in their family, school, and community
So what practical steps can adults take to help children develop resilient minds? Here are six areas that can be addressed:
- Focus on a healthy diet
The Dietary Guidelines for Americans recommend reducing added sugar consumption to less than 10% of calories per day and, specifically, choosing beverages with no added sugars.[21] You may not have total control over what your child eats, but introducing a daily fruit/veggie smoothie for breakfast or after school can help ensure that essential nutrients are consumed. Including supergreens powders in the smoothie can help boost the nutrient content.
- Boost nutrition with supplements
Adequate intakes of micronutrients are essential for supporting the growth and development of children, as well as maintaining overall health across the lifespan. Nearly one third of the U.S. population over the age of nine is at risk of deficiency in at least one vitamin, or has anemia.[22] A comprehensive multivitamin and mineral supplement designed for children can address many if not all of their basic nutrient requirements.[22] Additional vitamin D supplementation may be particularly helpful for children with low sun exposure and/or allergies.
Brain development and mood are strongly influenced by the gut microbiota. A diet rich in fiber from vegetables helps support the right balance of gut bacteria, which can also be boosted with fermented foods like yogurt or kefir, prebiotic foods such as bananas and apples, and a daily good quality probiotic supplement.
- Set limits on screen time
Less screen time, and more physical activity and sleep, are all associated with improved cognition and learning.[23] Experts suggest putting off buying smartphones for kids until they are emotionally ready and, when they get one, making sure their use stays under two hours a day (at which point, research suggests, the risks of mental health issues start to increase).[5] The World Health Organization further advises that children under age five should not have more than one hour of screen time per day, and that infants (under one year of age) should get none at all.[24]
- Encourage children to take up a team sport or group hobby
Encouraging social inclusion with a group of like-minded children or teenagers can promote strong friendships, which are essential for a healthy mind. It doesn’t matter what the focus of the activities are, e.g. learning a musical instrument, craft or sport, but the act of doing something fun helps stimulate a child’s mind, and has the added benefit of reducing screen time.
- Suggest keeping a positive diary
Keeping a diary or journal helps children (and adults) create order when their world feels like it’s in chaos. There’s always something good that happens in the day, even if it’s small, like someone laughing at your bad joke! Encourage children and teenagers to keep note of their happy times, accomplishments, feelings, and things they are grateful for. A diary can be helpful as a reminder of the good things in their lives and how amazing life can be!
- Help them do something they love
It’s easy for children and teenagers to focus on things they don’t like about themselves, but, encouraging them to do something they love can leave them feeling proud of what they’ve achieved. For example, if they like cooking, then encourage them to enjoy the process of making the food and be proud of the finished product. Enjoy the meal as a family or group for even more socializing.
Summary
Trends in children’s mental health are raising alarm bells around the globe. However, it’s also clear that there are many things we can do to encourage and support the young people in our lives. Along with the suggestions in this post, extensive resources can be found at these links:
National Alliance on Mental Illness
U.S. Department of Health and Human Services: Mental Health in Adolescents
Centers for Disease Control and Prevention: Children’s Mental Health
Click here to see References[1] Whitney DG, Peterson MD. US national and state-level prevalence of mental health disorders and disparities of mental health care use in children. JAMA Pediatr. 2019;173(4):389-91.
[2] Motafavi B. University of Michigan Health blog. Half of U.S. Children with Mental Health Disorders Are Not Treated [Internet]. Ann Arbor (MI): Regents of the University of Michigan; 2019 [cited 2019 May 24]. Available from: https://labblog.uofmhealth.org/rounds/half-of-us-children-mental-health-disorders-are-not-treated
[3] Twenge JM. Psychology Today. 5 Reasons Why Self-Harm and Depression Have Tripled in Girls [Internet]. New York (NY): Sussex Publishers, LLC; 2017 [cited 2019 May 24]. Available from: https://www.psychologytoday.com/us/blog/our-changing-culture/201711/5-reasons-why-self-harm-and-depression-have-tripled-in-girls
[4] Mental Health America. Self-Injury and Youth [Internet]. Alexandria (VA): Mental Health America, Inc.; 2019 [cited 2019 May 24]. Available from: https://www.mentalhealthamerica.net/conditions/self-injury-and-youth
[5] Monto MA, et al. Nonsuicidal self-injury among a representative sample of US adolescents, 2015. Am J Public Health. 2018 Aug;108(8):1042-8.
[6] Mercado MC, et al. Trends in emergency department visits for nonfatal self-inflicted injuries among youth aged 10 to 24 years in the United States, 2001-2015. JAMA. 2017 Nov 21;318(19):1931-3.
[7] Interagency Working Group on Youth Programs (IWGYP). Youth Mental Health: Risk & Protective Factors. Bethesda (MD): US Department of Health and Human Services; 2019 [cited 2019 May 24]. Available from: https://youth.gov/youth-topics/youth-mental-health/risk-and-protective-factors-youth
[8] O’Neil A, et al. Relationship between diet and mental health in children and adolescents: a systematic review. Am J Public Health. 2014 Oct;104(10):e31-42.
[9] Molteni R, et al. A high-fat, refined sugar diet reduces hippocampal brain-derived neurotrophic factor, neuronal plasticity, and learning. Neuroscience. 2002;112(4):803-14.
[10] Wang LJ, et al. Dietary profiles, nutritional biochemistry status, and attention-deficit/hyperactivity disorder: path analysis for a case-control study. J Clin Med. 2019 May 18;8(5):709.
[11] Suglia SF, et al. Soft drink consumption is associated with behavior problems in 5-year-olds. J Pediatr. 2013;163(5):1323-8.
[12] Franckle RL, et al. Insufficient sleep among elementary and middle school students is linked with elevated soda consumption and other unhealthy dietary behaviors. Prev Med. 2015 May;74:36-41.
[13] Pabayo R, et al. Sweetened beverage consumption is a risk factor for depressive symptoms among adolescents living in Boston, Massachusetts, USA. Public Health Nutr. 2016 Dec;19(17):3062-9.
[14] Hu FB. Resolved: there is sufficient scientific evidence that decreasing sugar-sweetened beverage consumption will reduce the prevalence of obesity and obesity-related diseases. Obes Rev. 2013 Aug;14(8):606-19.
[15] Fidler Mis N, et al. Sugar in infants, children and adolescents: a position paper of the European Society for Paediatric Gastroenterology, Hepatology and Nutrition Committee on Nutrition. J Pediatr Gastroenterol Nutr. 2017 Dec;65(6):681-96.
[16] American Heart Association. Limit screen time among kids, experts caution [Internet]. Dallas (TX): American Heart Association, Inc.; 2018 [cited 2019 May 24]. Available from: https://www.heart.org/en/news/2018/08/06/limit-screen-time-among-kids-experts-caution
[17] Twenge JM, Campbell WK. Associations between screen time and lower psychological well-being among children and adolescents: evidence from a population-based study. Prev Med Rep. 2018 Oct 18;12:271-83.
[18] Memon AM, et al. The role of online social networking on deliberate self-harm and suicidality in adolescents: a systematized review of literature. Indian J Psychiatry. 2018 Oct-Dec;60(4):384-92.
[19] Twenge JM, et al. Increases in depressive symptoms, suicide-related outcomes, and suicide rates among US adolescents after 2010 and links to increased new media screen time. Clinical Psychological Science. 2018 Jan;6(1):3-17.
[20] Gunnell KE, et al. Examining the bidirectional relationship between physical activity, screen time, and symptoms of anxiety and depression over time during adolescence. Prev Med. 2016 Jul;88:147-52.
[21] Rosinger A, et al. Sugar-sweetened beverage consumption among U.S. youth, 2011-2014. NCHS Data Brief. 2017 Jan;(271):1-8.
[22] Bird JK, et al. Risk of deficiency in multiple concurrent micronutrients in children and adults in the United States. Nutrients. 2017 Jun 24;9(7):655.
[23] Walsh JJ, et al. Associations between 24 hour movement behaviours and global cognition in US children: a cross-sectional observational study. Lancet Child Adolesc Health. 2018 Nov;2(11):783-91.
[24] World Health Organization. Guidelines on physical activity, sedentary behaviour and sleep for children under 5 years of age [Internet]. Geneva (Switzerland): World Health Organization; 2019 [cited 2019 May 24]. Available from http://www.who.int/iris/handle/10665/311664
The information provided is for educational purposes only. Consult your physician or healthcare provider if you have specific questions before instituting any changes in your daily lifestyle including changes in diet, exercise, and supplement use.
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