A guide to caring about children’s mental health

Being able to distinguish between "normal developmental characteristics" and "abnormal signals", giving priority to the pediatric and psychological departments of public institutions for dual evaluation when encountering uncertain problems, and maintaining equal communication habits on a daily basis are enough to cover 90% of risks.

Don't tell me, I encounter more than a dozen parents in my clinic every week who regard normal behavior as a problem. A mother who just picked up a 7-year-old boy last week said when she came in that she suspected the child had ADHD. He couldn't sit still in class and kept talking. He stayed at home doing homework until 11 o'clock. He couldn't even sit still in interest classes. Do he need to take medicine? As a result, after asking, I found out that the child had just entered the first grade and the elders had never asked him to sit quietly in kindergarten. At home, he usually moved as he pleased while watching TV and eating. Speaking of this, we have to mention different views in the academic world: Developmental psychology schools generally believe that the active attention span of 6-8-year-old children is originally "age × 2-3 minutes", and 7-year-old children can only concentrate for 11-14 minutes. Requiring them to sit motionless for 40 minutes in class is inherently anti-developmental. It is also recommended to give children half a year to adapt to school and slowly adjust the rhythm. ； However, most consultants from the behaviorist school will recommend using training methods such as token systems to help children adapt to school rules faster. ； If attention deficit hyperactivity disorder (ADHD) is really diagnosed, the psychiatrist may also recommend drug intervention based on the severity. There is no absolute right or wrong among the three options, only the appropriate scenarios will be considered.

But on the other hand, there are also many parents who regard real abnormal signals as "children having a tantrum." Last year, a 10-year-old girl was brought here by her mother. She said that in the past three months she had been complaining of headaches and nausea and did not want to go to school. She went to a general hospital for a checkup and found no organic problems. Her mother thought that the child was lazy and did not want to do her homework. Later, when I talked to my child alone, I found out that she had been bullied by her classmates for half a semester. I dare not say that she is now in a moderate state of depression and needs medication and psychological intervention. In fact, the signs that you need to be vigilant about are not as complicated as those listed online. The core is to look at two dimensions: First, the duration. It is normal to occasionally lose your temper and not want to go to school. If you are depressed, irritable, hiding in your room and not interacting with others for more than 2 weeks in a row, you need to be careful. ； The second is whether the social function has been damaged. Your grades were average and suddenly dropped to the bottom. You used to love playing with friends and now you don’t even want to leave the house. You even engage in self-injurious behaviors such as biting yourself and hitting walls. Don’t hesitate to seek evaluation from a professional agency immediately. Data in the "2023 China Youth Mental Health White Paper" show that the prevalence of mental disorders among children and adolescents under the age of 14 in my country is about 17.5%. If early identification and early intervention are made, the prognosis is much better than if it is dealt with in adulthood.

Oh, by the way, there is another very controversial question. Many parents asked me: Can I scold and hit my children? Is it necessary to fully implement happiness education? In fact, there is no standard answer. Current clinical tracking data shows that long-term physical violence and verbal humiliation will indeed increase the risk of anxiety and depression in children by more than three times, and may even affect the development of the prefrontal lobe of the brain, resulting in poorer emotional control. ； But a completely borderless "coddling happy education" is not advisable. I once met an 8-year-old child who never had a harsh word at home. He jumped off the building after being criticized by the teacher at school. Fortunately, his life was not in danger, but it was also obvious that he had no ability to resist frustration. The more recommended state is "gentle and bounded": catch it emotionally and stand firm in terms of rules. For example, if a child drops a toy and cries, you can hug him and say "I know you are angry now", but you must also clearly tell him "It is wrong to drop a toy, you have to pick it up yourself." There is no need to go to extremes.

Let me tell you a little trick that I have summarized from five years of doing child psychological intervention. It is more useful than all the test scales on the Internet: take 10 minutes every day to "talk nonsense" with the child. Don't ask "what did you learn today" or "how many points did you get on the test?", just follow his topic. If he says Ultraman, just listen to him talk about Ultraman's skills. If he says he got into trouble with a classmate today, just complain along the way, "How could he be like this?" Don't make excuses or make demands the first time. For such a simple thing, many parents who had been at odds with their children before told me after trying it for half a month that their children had so many thoughts that they had never mentioned before. The psychology of children is actually like a young sapling that has just sprouted. It is normal for it to grow a little crooked occasionally. There is no need to go to great lengths to prune and straighten the branches. Water more water, get more sunshine, and give it a hand when the wind is strong. Most of them can grow well. In many cases, it is not that children are too fragile, but that we are too anxious to use adult standards to demand them.