Your daughter cried before school three mornings this week. Your son, who used to talk your ear off at dinner, has been giving one-word answers since Halloween. Is that something? Or is it nothing?
Ask a child psychologist and you’ll get a slightly annoying answer: it depends on how long it’s been going on. Annoying, but useful. A bad week and a bad season can look identical from the kitchen table, and they mean very different things. Time won’t tell you everything on its own. Put it next to how much the change is messing with school, sleep and friends, though, and it tells you a lot.
Two things decide it: how long the change has lasted, and how much of your kid’s normal life it’s getting in the way of.
Is It Just A Bad Week?
Kids have big feelings and almost no practice handling them. A meltdown after a birthday party. A clingy first week back at school. A stomachache the night before the spelling bee. If it’s gone by Thursday, there’s probably nothing to chase.
Fears, worries and acting out now and then are a normal part of being a kid, and on their own they don’t point to a disorder. Doctors only start thinking about a diagnosis when symptoms are severe and persistent and get in the way of school, home or play.
It helps to know a little about what’s going on inside your child before you try to talk it through. Read up on how emotions work in the body and the brain. Little kids feel the rush in their chest long before they have a word for it, and naming it for them (“you look really frustrated right now”) is half the battle.
Start Counting At Two Weeks
Two weeks is the first line on the calendar that pediatricians pay attention to. Depression can be present when a low or irritable mood shows up nearly every day for more than two weeks, especially when a child also loses interest in things they used to love.
That word “irritable” matters. Sad little kids don’t always look sad. They look grouchy. A 7-year-old who snaps at everyone, every day, for weeks may be hurting more than he’s angry. Here’s what it can look like at home:
- He used to beg to go to soccer. Now his cleats haven’t left the closet in a month.
- She’s sleeping till noon on Saturdays, or she’s wide awake at 1 a.m.
- Homework turns into a fight every night, and the grades are sliding.
- He’s barely touching dinner, or raiding the pantry at 10 p.m.
- She says stuff like “I’m stupid” or “nobody likes me” and seems to mean it.
Roughly 2% to 3% of kids between 3 and 11 have depression, and about 1 in 5 teens will go through it at some point. It isn’t some rare thing that happens to other families.
Sad or cranky most days for two weeks, plus no interest in their favorite things? Call the pediatrician this week. Don’t wait for it to pass.
“We Just Moved. Is This Normal?”
Big changes take longer to settle. A child can struggle hard after a move or a divorce and still be on track. Doctors call a stronger-than-expected reaction to a life change an adjustment disorder, and its symptoms start within three months of the stressful event and ease by around six. In kids, it often looks like separation anxiety: crying at drop-off, following you room to room, refusing sleepovers.
The direction matters more than any one bad week. Slowly getting better month by month is a good sign. Flat or getting worse after six months is your cue to call.
A New House Or A New School
The first month is rough for almost every kid. Old friends, old room, old routine, all gone at once. By the end of the first semester most kids have found someone to sit with at lunch. If yours still hasn’t by spring, or still fights going to school every morning, get some help.
Divorce
This takes longer, and it comes in waves, worst around handoff days. Judge it by the season, not the week.
Losing Someone
Kids grieve in bursts. Playing happily one hour, sobbing the next. That’s normal, and it softens with time. Grief that keeps a child from functioning month after month needs a professional. For more on getting someone through a loss, see these ways of helping people cope with grief in healthy ways.
A Scary Accident
Nightmares, jumpiness and refusing to get back in the car are common for a few weeks after a crash or a frightening event. The first month is the window to watch, and there’s a good breakdown of which stress reactions after an accident are normal and which aren’t.
His Teacher Has Mentioned It Twice Now
Worry and attention problems creep up slowly. You might not see them until you look back over a whole school year, or until the second parent-teacher conference where you hear the same comment.
A good rule from the National Institute of Mental Health is to consider getting help when behaviors or emotions last for weeks or longer. In younger kids that might be constant tantrums or a fearful, worried streak that never seems to switch off. Older kids may drop the hobbies they loved. Sleep changes show up at every age.
Teachers catch attention problems first a lot of the time, because school asks a kid to sit and focus for six hours. If the doctor brings up therapy, go in knowing what therapy for ADHD can and can’t do.
Whatever’s going on, keep a scrappy log on your phone for a couple of weeks. Date, what happened, how long it lasted, where it happened, what seemed to set it off. Doctors love this stuff. “She’s been off lately” is hard to work with. “Five meltdowns in nine days, all after school” isn’t.
Length Isn’t Everything
A kid who’s been shy for years but has two good friends and does fine in class is in a very different spot from a kid who got shy a month ago and now won’t leave the house. How much of their life the change is eating up counts just as much as how long it’s lasted.
Run through your child’s week in your head. Is she sleeping? Eating? Getting to school without a fight? Seeing at least one friend? Still enjoying something, anything? And how’s the rest of the house holding up, or is everyone walking on eggshells? If several of those answers have changed for a few weeks running, you don’t need to wait six months to ask for help.
Don’t Wait If Your Child Talks About Hurting Themselves
Forget the calendar here. If your child talks about hurting themselves or someone else, or does something unsafe, get help right away. Call or text 988, the Suicide & Crisis Lifeline, any time of day or night. If someone’s in immediate danger, call 911.
Any talk of self-harm means you call for help today.
Call The Pediatrician First
You don’t have to go hunting for a child psychologist on your own. Your pediatrician already knows your kid, can check for physical causes like a thyroid problem, bad sleep or a hearing issue, and can refer you to a therapist if that’s the next step. It’s also smart to ask your child’s teacher and coach what they’ve noticed. They see a side of your kid you don’t.
Bring your log, and jot down roughly when things started to change. “Around Halloween” is fine.
