According to the Centre for Disease Control and Prevention, 10% of children between the age of 3 and 17 years are diagnosed with anxiety, depression, or both. And this rate has been rising every year.

Ayushi Ramaiya sits with child psychologist Letisia Murungyi in Kampala to discuss how parents can identify the signs of anxiety and depression in kids and take a step forward without feeling ashamed or fearful about the future of their children.

Reflecting on our attitude

Murungyi works with schools and one of her major roles is to be a liaison between teachers, parents, and children. She expresses her concern. When I notice certain atypical behaviors in children such as being tearful all the time, isolating themselves or being rebellious in the school setting, it is easier to assume the child is being bad mannered, lacks good discipline or is overly pampered. Sometimes, it is easier to hope that “the child will just get over it”.Parents also find themselves perplexed and may not quickly realise or acknowledge that the symptoms they are seeing are indicative of an underlying mental health concern.

Signs of anxiety and depression start developing from 3 years and may become more frequently evident in the 9 to 12 year age range. This is the age when children spend the most time at their school and a sensitive period, in which the problem is either acknowledged or ignored. There is definitely a need for more consistent open communication between parents and teachers as well as teachers and students outside academic related conversations and more so between parents at home and with their children too.

Anxiety and Depression develop from the most unexpected places

According to Murungyi, the change of environment that a child was not adequately given time to process and prepare for can affect a child triggering mental health challenges in some. Other reasons include

• Traumatic experiences such as seeing a parent fade away
• Separation of parents where often, children think they may be part of the a cause of it
• Phobias, which are often towards things and situations that are considered normal for others like certain animals, experiences, objects
• Physical or emotional abuse by parents, children, or anyone in their environment
• The stress of coping up at school, home, or with siblings
• Feeling neglected or rejected
• Family history
• Imbalance in hormones and neurotransmitters

How can you help at this stage as parents?

Murungyi prompts that in addition to reaching out for help from psychologists, psychiatrists, counselors, friends, or anyone else, keep talking to your children. Acknowledge their feelings and empathize with them. She says, “Think of the moment when you went through one of these problems and how helpless you must have felt.” Also, reassure your kids that they should not take the blame for anything going wrong in the family. See them as human beings and acknowledge to them that problems are a part of our lives – basically, normalize facing challenges with the hope to cope and overcome them.

Signs of Depression and Anxiety in Children

As adults, it’s important to remember, we can not raise our children the way our parents raised us because our parents raised us for a world that no longer exists. Murungyi says, “The pressure and challenges keep changing. Today the world is more competitive, day to day stressors and expectations are higher and there are more evident family challenges such as divorce and separation.

Depression and anxiety have a combination of signs and symptoms in children. Murungyi emphasizes that these are not meant to diagnose a child and a parent should use these symptoms to consult a specialist only if you see a combination of these signs consistently developing over time

Depression

• Change in sleep pattern – insomnia or hypersomnia
• Change in appetite and weight
• Feeling low in energy and unwilling to participate in typically enjoyed activities
• Loss of interest
• Lack of concentration
• Prolonged sadness
• Irritable mood
• Saying sentences like “I wish I wasn’t alive or I want to hurt myself.
• Drop-in school performance

Anxiety

• Avoiding school for a prolonged period
• Separation
• Fearing to socializing or being in the crowd
• Fearing parents separation or divorce
• Selective mutism- remaining completely silent when expected to speak like at school
• Panicking, fidgeting, or sweating
• Poor concentration or ADHD
• Avoiding eye contact
• Being aggressive

Coming to terms with mental health problems do exist in children.

Despite seeing the symptoms, not all parents can accept that a child can go through something severe as anxiety or depression. Murungyi makes us aware that by denying this fact, the disorder will simply not disappear. Children who are left unsupported, pick unhealthy coping mechanisms because it is the easiest way to run away from the problem. Denying the existence of a mental health challenge needing support in children unfortunately restricts them from reaching their full potential as they continue to grow into adults.

Where should you start to help as parents?

• Listen to your child and do your best not to be judgemental about the situation. Start Prioritise building a relationship with your child to the point that they are comfortable talking to you about their problems.
• Be compassionate. Ask them how happy are you on a scale of one or 10? If they say 2 don’t question how can that be as you have given you everything.
• Don’t say things like you will get over it. Validate their feelings and let them know you are there to help.

Seeking professional support

It is important for both parents to agree on how you desire to raise your children so you can agree on the SHARED consistent roles you will play in discipline, enforcing rules, emotional support, family time, values.

In Uganda, there is not enough mental health awareness or a concrete support system however, the brighter side, Murungyi shares is that there are hospitals and organisations that have affiliations with psychologists and psychiatrists. Consult your pediatricians for referrals where possible. Schools should also prioritise building affiliations with child mental health specialists and professionals. Below are some places affiliated with child mental health professionals to start from:

• Industrial Medical Services – Kiira Road (Murungyi consults here)
• The Surgery hospital (Naguru) will recommend you to the right professionals for the treatments.
• Safe Haven Child and Family Counselling (Ntinda)
• Family Health Information and Education Services (Nakulabye)

Depending on the level of anxiety, psychologists or psychiatrists will suggest therapy and medication. CBT therapy, Interpersonal Therapy and Play Therapy are some of the most common approaches specialists may use to help reshape distorted thoughts of the children and how they perceive themselves.

Here are some supportive ways Murungyi suggests parents can adopt to elevate children suffering from mental health

• Plan game nights
• Use positive affirmations
• Have meals together
• Take them for outdoor experiences
• Have a ‘You Time-Walk’ or drive to run errands and talk
• Look out for good behavior and appreciate them

Murungyi’s final word of advice is “Be patient, consistent and intentional with the time and relationships you have with your children. Schedule time if you must. Children are like plants, and you have to nurture them with all the love, care and support to see them flourish.”