By: Silvia Pereira-Smith, MD, FAAP
Mental health is health. We keep track of our child's physical growth and milestones such as learning to walk or talk. And we check in on their mental health and how they are feeling.
Talking about mental health can take practice. The more we do it, the easier it gets. It helps to
start having these conversations when your child is young. They can learn early on that this is something important they can talk to you about and count on for support.
Talking with your child about mental health when things are going well is just as important as talking about it when there are concerns.
By making mental health a part of daily discussions at home, it's easier for families to talk about it at any time—including when your child is
feeling stressed or there is a
mental health concern. Over time, you will be helping your child build resilience by nurturing the use of healthy
mental and emotional coping skills.
Read on for tips to make conversations about mental health a regular part of your family's routine.
1. Set a positive tone.
Parents and caregivers are a child's first and most important teachers. Even before they can speak, children can read others' emotions and follow the example of adults around them. There are a few things to keep in mind to ensure that your child feels
safe and secure when talking about their mental health from an early age.
Voice: Talk about mental health in a calm, neutral way. Don't rush to fill silence. Sometimes a pause in the conversation can help both of you find the words that best fit what you're trying to say.
Facial expressions: Be mindful of your eye contact and overall facial reactions to what your child is saying. A gentle smile and soft eye contact can convey a sense of safety.
Body language: Consider how you physically respond in the
conversation. Sit at your child's level to avoid a power imbalance. This can help your child take ownership of the conversation. Leaning in slightly lets your child know that you are interested in what they are saying.
2. Model your behavior
Help your child learn by modeling what you are doing as you manage your own feelings. Talking about your feelings can help teach children how they, in turn, can talk about their own. For example:
Share with your toddler, "I feel happy because I saw pretty flowers outside."
Tell your teen, "I feel frustrated because I made a mistake."
Take care to focus on modeling how to bring up feelings. Avoid oversharing with your child, which can make them confused or worried.
Academic Anxiety? You're Not Alone. Talking About It Helps!
By: Annie E.
During my junior year of high school, as I sat down to take a standardized test, I had a panic attack. I had spent months preparing for the test, and I went in feeling pretty confident. But when I opened the test booklet and looked at the first few questions, my mind went blank. I started to freak out. My hands began to shake, and my heart beat so loudly in my chest that it physically hurt. Was I having a heart attack? I tried to take deep breaths to calm down. It felt like none of the air was making it to my lungs. After a while, I was able to continue on with the test, but the tight feeling in my chest and shaky feeling lasted several hours.
Like many teenagers, I struggle with anxiety. When I think about the future, my excitement is clouded by myriad worries. What if I don't get into college? What if I don't get good grades? What if I fall short of the goals I set for myself and I let everyone down?
I place a lot of pressure on myself to perform well in school. This test was no exception. I didn't just
want to do well; I felt like I
had to do well. Part of me knew that one test score would not decide my entire future. But in that moment, anxious thoughts took over.
My experience with the panic attack led me to get involved in my school's mental health advocacy club. By talking with other students about mental health, I learned I was not alone. I also spoke to school-based mental health professionals. They helped me learn how to use mindfulness, do breathing exercises, and pause when I notice my thoughts are moving toward feelings of anxiety. I even got certified in
Teen Mental Health First Aid. That way, I can help support others when they have a mental health challenge like a panic attack.
Many teens feel uncertain about the future, and that can cause a lot of anxiety. If you ever experience anxiety or have a panic attack, know that you are not alone. Talking with someone you trust about how you feel can help you get the support you need to care for your mental well-being.
Annie E. is a high school student from Virginia, and a youth representative for the American Academy of Pediatrics National Center for Adolescent and Young Adult Health and Wellbeing Cross-Sector Alliance.
3. Use words and pictures to help them describe how they are feeling.
The way you talk about mental health is much like how you and your child
pick out a book. Choose what would work best for their age, development and how they learn best.
Word choice is important. Use
words and phrases that your child will understand and are accurate. For example,
younger children may be able to identify feeling "happy" or "mad." Older teens might describe their feelings in more detail with words like "joyful" or "anxious."
Pictures as words. Images can help your child let you know
how they are feeling. For example, doctors ask their patients to rate their pain based on a scale that has different facial expressions. Choose a favorite feelings chart online. Look for one that shows pictures of many faces showing a variety of emotions. Have your child match their feelings with the word and facial expression.
Compare. Help your child
identify their emotions by comparing them to something that they understand. For example, weather can be used to help them describe how they are feeling in their body. A warm, sunny afternoon might describe happiness, or a dark and wet thunderstorm might describe sadness.
Ask simple and open-ended questions. Only your child can identify how they are feeling. But with the help of guiding questions, they can learn to share feelings more easily. Questions like, "How are you feeling today?" "What has been on your mind lately?" "What changes are you feeling in your mood or behavior recently?" offer a starting place for you and your child to both share.
4. Provide reassurance and be proactive.
Let your child know that it is okay to ask for help if they feel like they need more support.
If you plan to
ask your pediatrician about your child's mental health, involve your child in the process. Let them take the lead in the conversation, building their confidence and showing them their feelings and voice matters. And be sure to mention your child's/your concerns when setting up the appointment so your pediatrician knows this is important for you to talk about at the visit.
Prepare for the visit by thinking about what your child and you can share with the pediatrician during a visit. For example:
What mental health concerns do you have?
How have you/has your child been feeling lately? Have you noticed any changes in your/their mood or behavior?
What has been going well for you/your child and are there any challenges that you've been feeling/have noticed?
Do you/does your child seem anxious or worried, possibly sad or down?
Do they show a range of emotions?
Do they have trouble coping in stressful situations?
Bring questions that you can ask the pediatrician. For example:
Remember…mental health is health.
Talking about a child's mental health is a regular part of their growth and development. When your child and you feel comfortable talking about mental health, it makes sharing mental health concerns and challenges easier for everyone.
Your pediatrician cares about your child's mental health and can talk with you about concerns or help make a plan to get more help.
More information
About Dr. Pereira-Smith
 Silvia Pereira-Smith, MD, FAAP, is a developmental-behavioral pediatrician and associate professor of pediatrics at the Medical University of South Carolina. Her clinical work centers on supporting children with autism spectrum disorder, ADHD, and other learning and behavioral conditions, especially for those whom English is not their first language. She is trilingual (Spanish, Portuguese and English). Dr. Pereira-Smith is also an Executive Committee member of the American Academy of Pediatrics Council on Healthy Mental and Emotional Development.
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Support for this content comes from the Centers for Disease Control and Prevention.