22 December, 2011
An interview with Dr. Elina Durchman, Psychiatrist at Ryther.
How can parents tell when their child needs professional help?
There is no easy answer for that, but anytime a parent is concerned about their child, they should seek professional advice. When there is a behavior or mood change, parents should seek professional help. The most common symptoms are acting out in a school setting or daycare. Very young children who don’t know how to verbalize their feelings can be aggressive at daycare or preschool. This can be a warning sign that something is going on. Parents should check with their child’s teacher to see how their child is acting in the classroom and compare this to their home environment. There is often a difference between home life and school. Kids can be very calm and happy in the home environment, but very fearful at school.
Why might a child become anxious or defiant regarding school?
Children may become defiant at school because they don’t understand their teacher or what the teacher is saying, which is very difficult for children to deal with and also difficult to explain to their parents. Sometimes, a child has a learning disability that hasn’t been recognized or diagnosed, and it’s very difficult for the kids to explain that they have a learning disability. Parents often think the kids are just defiant and don’t do their homework, and in this situation school can become a stressor for the child. For example, we know that ADHD is a developmental problem that we can measure in the brain, and if it’s severe enough the child may need to be on medication. It seems unfair to require a kid with ADHD to struggle in school when a medication exists that can help them improve their school experience.
What are the most common psychiatric issues that you address?
The most common struggles that kids have are with anxiety, depression and, of course, ADHD. I also work with some teens in the co-occurring program that addresses both mental health and substance abuse issues. There are other mood disorders to be evaluated. These include bi-polar disorder, or other disorders on the psychotic spectrum. There are also children who have stressors in the family because of parents separating and other home issues. These are often triggers for anxiety, mood disorders like depression and other psychiatric issues.
It is important to note that many people are predisposed to depression, anxiety or other mental conditions. When a traumatic event happens, this can trigger an episode of these pre-existing conditions. However, if children receive mental health treatment, they will often have the tools they need later in life to successfully deal with these events.
What are some common stressors among young children?
A stressor might be that kids don’t know how to express their unhappiness or that they want something, or don’t like something. So the most common way the kids show these feelings is to act out, by having a temper tantrum or something similar. I often spend time explaining these behaviors to the parents. The parents sometimes don’t understand why the kids are acting this way, and kids are unable to explain to their parents in any other way except by acting out. A child might get diagnosed with something like Oppositional Defiance Disorder because they don’t want to go to school or to soccer practice. So they throw a huge tantrum, but often the tantrum isn’t about soccer practice at all but rather some source of anxiety or fear related to that particular activity. These conditions cause anxiety and fear for the kids. Think of a young child being fearful and not knowing how to explain to their parents that they don’t want to go to a certain place. Often their only response is to fight back.
A lot of people (parents) don’t recognize these behaviors or know where these behaviors come from, and they are often times very grateful and happy when the situation is explained to them.
If you have concerns or questions, you may call Ryther at 206.517.0234 or visit our website for information or to make an appointment with one of Ryther’s psychiatrists.
Dr. Elina Durchman