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How to talk to children about anxiety and mental health: An age-by-age guide

Talking to your kids about their mental health can feel really challenging but parents should check in.
/ Source: TODAY

Understanding if your child has symptoms and is facing a mental health condition like anxiety feels tough. Is that sulking simply part of childhood? When your daughter rejects her favorite video game is that a sign she's losing interest in things she once enjoyed?

Knowing whether behaviors are part of childhood development or signs of a mental health concern can be a challenge. But there’s good news: Asking children about their mental health won’t cause a problem.

“Don’t ignore it. You may not be right. It is better to err on expressing your concerns to a kid who isn’t having concerns,” parenting expert Dr. Deborah Gilboa told TODAY Parents. “Asking people about suicide does not cause them to contemplate suicide. Asking kids about anxiety wouldn’t make them anxious.”

Experts say parents should talk to their children about their mental health from a young age to help them accurately identify feelings and develop coping mechanisms. Getty Images

Gilboa wants parents to start talking to their children at a young age.

"The first part of resilience in mental health is being able to talk about it," she said.

She notes that dramatic shifts in behavior could indicate a problem. Changes to look out for include:

  • Loss of interest in things they once enjoyed
  • Changes in eating or sleeping habits
  • Avoidance of friends
  • New behaviors
  • Isolation

If parents notice troubling signs, they don’t have to solve them alone.

“You don’t have to have the answers. Your job is to advocate for your children, to reach out to resources,” Gilboa said. “You are a ‘your child’ expert, not a mental health expert.”

Gilboa shares how parents can talk to their children about their mental health, age by age.

Preschool to Kindergarten: 4 to 6

Parents of young children should help them identify feelings. Gilboa says researchers know that children learn emotions like they learn colors or shapes. If parents teach them the words for 30 different feelings, they learn nuances.

“The best thing we can do for them as preschoolers is give them names,” she said. “When we teach kids to name embarrassed versus ashamed versus anxious versus sad … they get better and better at speaking their truth and naming it.”

While it might be tempting for parents to tell their children how to feel — or not feel — we shouldn't, Gilboa said.

“You’re saying their feelings don’t matter,” she explained. “Telling a kid that an emotional reaction is wrong can make them try to fake it. But that’s not a healthy coping strategy.”

Parents can also help their preschool and kindergarten children with coping mechanisms for handling tough feelings. Does crying help? What about hugging mom or dad? Will drawing help?

When kids use these skills, parents should praise them.

“Catching them doing good is really useful,” she said.

Grade School: 7 to 10

Parents still should ask about feelings and forget about labels to conditions, such as depression or anxiety.

“We can’t diagnose them. They can’t diagnose themselves. We shouldn't ask any kid this age to try,” Gilboa said. “Ask in terms of emotions.”

If children struggle to explain how they are feeling, parents can ask their children to tell them a story. That way they feel it's safe to open up.

“Kids this age understand that there are some feelings that are frustrating and disappointing to adults,” she said.

She also suggests that parents play a game with their children every night. Each family member lists their high and low of their day.

“A high gets you a whole story and a low gets a whole other story,” Gilboa said. This shows children that: “I am the person you bring the hard stuff to and I am the person you bring the good stuff to.”

Middle School: 11 to 14

By now children have heard of mental health conditions, such as depression, bipolar disorder or schizophrenia. Give them a pre-test and ask about them what the know.

Parents can say ‘Have you ever heard the term depression? In what context and what do you understand it to mean?’” Gilboa said. “You can say, ‘Do you ever experience that yourself?’”

Middle school students might push back and think their parents are being lame. That’s OK. It’s better to persist and be wrong.

Try saying: “I am asking you this because I see you; I love you; you’re very important to me.”

Middle school students often lack self-confidence and need such reassurances.

High School: 14 to 18

By high school, teens are trying to figure out how they can talk to their parents about mental health.

“Don’t wonder if you should talk to a high schooler, you definitely should,” Gilboa said. “Every teenager needs to be having a conversation with a trusted adult.”

Parents can ask if their teens are worried about someone else or themselves. But adults should be specific about what they will do if someone is at risk.

“You should be really clear with your teen that if someone’s life is in danger, you will step in,” Gilboa said.

If your teens dismiss your effort to talk about their mental health, ask them for input.

“Give them some autonomy of when and where and how you can approach it to make it more successful,” Gilboa said.

While some teens will talk to their parents, other might feel comfortable talking to another adult. Parents shouldn't take it personally. Say something like, “Who are the adults in your world you can trust if you feel you can’t come to me? I won’t be angry. I might be hurt.” But parents should make sure they know who those resources are.

This article was originally published in September 2019.