Of sadness, anxiety and other childhood monsters Of sadness, anxiety and other childhood monsters (February 11, 2004)

Book advises parents on what they should know and do about their kids' mental health

by The Health Library

Taking care of your children's health is usually straightforward, involving regular check-ups, vaccinations and dealing with the occasional virus.

But what do you do when your child's problem is sadness that won't go away or anxiety that disrupts sleep at night? Or when you wonder if your child is simply outgoing versus out of control and headed for criminal trouble?

Sometimes it's hard to know what's normal and what's not. But at a time when mental, emotional and behavioral problems are being diagnosed in children at ever-increasing rates and young people commit unthinkable crimes and take their own lives, it is imperative that parents pay attention to their children's minds as well as their bodies.

"Straight Talk About Your Child's Mental Health," a book by Harvard psychologist Dr. Stephen Faraone, addresses these issues. The book demystifies childhood mental health and gives parents tools to handle psychiatric illness with the same confidence they possess when dealing with a rash or the flu. The book helps parents understand how mental illness affects their child, find the right professional help and participate effectively in treatment decisions.

Faraone, an award-winning researcher and clinician who has worked with thousands of families, believes parents shouldn't blame themselves. He stresses that biology and genetics cause psychiatric difficulties more often than poor parenting.

He writes, "Research into the complex causes of childhood disorders shows why it doesn't make sense for parents to blame themselves. The good news is (that) parents can play an active role in easing the pain and distress their child is feeling. Parents aren't the problem, but together with doctors and school professionals, they can be part of the solution."

To help parents put their child's behavior in context and understand the thoughts and feelings behind it, Faraone provides a number of charts, checklists and questionnaires. Parents are asked to answer questions like: What specific problems are being observed and how severe are they? Where and when do difficulties take place, at home with Mom and Dad? At school? With the babysitter?

He identifies five main types of problems: disruptive behavior (disobedience, lying, stealing, etc.); moodiness (sadness, silliness, irritability, depression); fear (nervousness, shyness); learning disabilities; and abnormal development. After explaining these behaviors, Faraone describes possible diagnoses associated with each. Further, chapters on specific disorders include "treatment roadmaps" -- lists of possible interventions, including medication, psychological counseling and school-based services.

Readers not only learn how warning signs and symptoms add up to specific diagnoses, but also how some disorders can be confused with one another. Is it ADHD or anxiety, oppositional behavior or bipolar disorder? In his discussion of obsessive-compulsive behavior disorder (OCD), for example, Faraone explains that children initially try hard to hide their obsessions from their parents. But when the parent is spending an hour every night checking for monsters or locking and unlocking every window in the house, OCD might be the problem. He further explains that while OCD may develop into the uncontrollable physical or verbal tics of Tourette Syndrome, that situation is rare. The book states that Tourette affects only about 1 in 5,000 people and that most tics are transient, lasting up to one month on average.

The book helps parents feel more comfortable when seeking mental health care by giving a clear picture of what to expect during an office visit for mental health evaluation. Faraone also provides detailed information and explanations about the roles of various kinds of mental health experts, from psychiatrists to psychologists.

"Straight Talk About Your Child's Mental Health" is available for check-out at the Stanford Health Library. A number of other books on the same or related subjects can also be found there. They include: "The Hurried Child: Growing Up Too Fast, Too Soon," by David Elkind; "Growing Up Sad: Childhood Depression and its Treatment," by Leon Cytryn & Donald McKnew; "Adolescent Depression," by Francis Mondimore; "The ADHD Parenting Handbook," by Colleen Alexander-Roberts; and "Bipolar Disorder: a Guide to Helping Children and Adolescents," by Mitzi Waltz. Got a question for To Your Health? E-mail The Health Library at ndickenson@stanfordmed.org. The Health Library resources are not intended as a substitute for medical care. The main branch is located at 2-B Stanford Shopping Center. For more information, call 725-8400 or point your Internet browser to http://healthlibrary.stanford.edu. The Health Library is a community service of Stanford Hospital and Clinics.

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