What to Look For and When to Act | NAMI

While each mental health condition is unique, they all impact emotions, thoughts and behavior. Here are some things to consider in deciding to intervene.

Disruptions In Daily Interactions And Relationships

Everyone experiences a “bad day” from time to time, but when your child seems to be having difficulty with routine daily tasks, it’s important to take notice. This can look like difficulty participating in regular social activities (with family, friends, adults), academics or play/activities.

It can also look like a personality change. For example, if your child is typically socially interactive, but begins to withdraw and has no interest in others, this could be an indicator of an underlying mental health issue. If you notice these type changes lasting more than just a few weeks, it may be time to seek professional help.

Excessive Anxiety

Anxiety is a typical reaction to situations that we perceive as potentially dangerous or where performance has a possible negative effect (like failing a test or losing a game). But when the amount of anxiety or stress is out of proportion to the reality of the risk, you should pay attention to these reactions. It’s time to consider intervening if your child:

  • Worries about almost everything to the point of withdrawal or has difficulty functioning
  • Is fearful of certain places (such as school) or going to new places
  • Experiences sudden bursts of intense fear, impending doom or physical symptoms, such as rapid heart rate, hyperventilation, dizziness or nausea
  • Believes they must repeat certain thoughts (obsessions) or behaviors (compulsions) to prevent something bad from happening


We can all feel “down” at some point, especially when setbacks happen. But if your child has ongoing difficulties with any of the following symptoms, it is time to act:

  • Disturbances in mood (usually irritability in children, compared to deep sadness in adults)
  • Impaired sleep (typically too much sleep, but some may have trouble falling or staying asleep)
  • Decreased energy
  • Decreased self-esteem
  • Difficulty concentrating
  • Change in appetite (typically excessive appetite or, more rarely, reduced appetite)
  • Seems agitated or conversely, “slowed down”
  • Expresses thoughts of hurting themselves, especially thoughts of suicide

Substance Use

Be on the lookout for changes in behavior that may be due to using substances, including alcohol, marijuana products, psychedelic drugs, prescription medications and others. Substance use may also extend to misuse of over-the-counter drugs or medications prescribed to other people (typically friends or family).

If your child is using substances, you may observe a decline in school or sports performance, decreased engagement with family or friends, sleep problems and sluggish or agitated behavior. Treatment for substance use can be very helpful.

Changes In School Performance

Some children have challenges with standard academic work. However, if your child typically performs well and begins having difficulties, there may be an underlying mental health condition to blame. If academic challenges persist, it may be helpful to get consult with a clinician.

Acute Or Prolonged Stress

A child witnessing violence or experiencing abuse/neglect at home will most likely experience acute or prolonged stress. Post-traumatic stress disorder (PTSD) can be the result of these trauma experiences and may include symptoms like:

  • Disturbances in memory issues, such as flashbacks
  • Recurrent thoughts of the trauma
  • Emotional numbing, such as avoiding social and emotional contact with others
  • The emergence of a hyper-state of arousal, like they might panic at any time

It is important for anyone experiencing trauma to be able to process, or work through, those experiences. Meeting with a professional can be helpful.

Difficulties Adjusting

Just like the rest of us, children react to challenging situations. Those reactions can include increased anxiety, depression or a mixture of emotional reactions. Common situations that contribute to adjustment difficulties include grief and loss (such as death of a loved one), changes in a parent’s employment, military deployment of a parent, domestic violence, bullying or harassment. If your child seems to be struggling after experiencing a certain event or situation, it can be helpful to talk with a professional about what you are observing.

What To Do

It can be extremely difficult when your child experiences mental health symptoms, but there is hope. Below are some actions you can take to help your child.

Have Frequent Conversations About Mental Health

Even if your child isn’t experiencing any difficulties, it’s always helpful to engage in frequent emotional “check ins” starting early in life. If your child sees this as a routine part of family life, they will likely feel more comfortable coming to you when they experience challenges. Additionally, if you notice something seems off with your child and ask them about it, they may be more receptive to sharing with you.

Listen And Validate Their Experiences

While you may not understand what is upsetting your child, creating a safe space (a place where your child can share openly without fear of retaliation) at home can suggest that you are eager to hear about their life in a supportive, non-judgmental way. This paves the way for your child to see you as an ally, not as a judge.

Get Feedback From Others

While your observations and perceptions may be accurate, consider talking with siblings, other family members, teachers, coaches, clergy — or anyone in your community who knows your child — to see if they have noticed changes in behavior. Hearing others’ perspectives may help to determine how severe the problem is and to decide what the next steps should be.

Get A Professional Opinion

If you are concerned, there is no harm in talking to your pediatrician or other health care professional about whether they think your child could benefit from seeing a mental health professional. They can also be helpful in providing resources or referrals in your community.


  • NAMI Basics
    NAMI Basics is a six-session education program for parents, caregivers and other family who provide care for youth who are experiencing mental health symptoms.

NAMI HelpLine is available M-F, 10 a.m. – 10 p.m. ET. Call 800-950-6264,
text “helpline” to 62640, or chat online. In a crisis, call or text 988 (24/7).