Mental health conditions in children and teens can present as physical symptoms but it can be hard for them to explain what’s wrong.

We strive to share insights based on diverse experiences without stigma or shame. This is a powerful voice.

When I was in sixth grade, I lost all interest in school, though I had previously been a high achiever. I began failing tests and developed a series of stomachaches and headaches, which I was accused of inventing as a reason to stay home.

Fifteen years later, as an adult, I was formally diagnosed with depression and began seeing a therapist.

I learned that I’d probably been experiencing depression on and off for years, starting around sixth grade, and that depression and anxiety in children often manifest as physical symptoms like stomachaches and headaches.

Research suggests more than 16% of children ages 6 to 18 have at least one mental health condition, and half of those children receive no treatment.

Many people with mental health conditions don’t just have one, especially in children with depression. About 3 in 4 children with depression also have anxiety, and nearly half also have a behavioral disorder.

As a parent now, I want to help my child get mental health help should they need it. But it can be hard to decipher whether certain symptoms have physical causes or are related to mental health conditions — and they may be both.

Plus, children may be unable to vocalize what hurts, or lack the vocabulary to do so.

Finding support can help you care for your child and their needs.

If you’re noticing unusual and unexplained physical or behavioral symptoms in your child or teen, they may have signs of a mental health condition.

Anxiety

Children and teenagers with anxiety may appear excessively stressed, worried, or inflexible. There are several anxiety disorders children and adolescents may experience, including:

Symptoms of anxiety in children and teens

  • stomachaches and headaches
  • dizziness
  • muscle tension or fatigue
  • trouble sleeping
  • worries about school, family, friends, or activities, or increased concern over people or activities they previously enjoyed without reservation
  • loss of self-esteem

Depression

Depression is characterized by persistent feelings of sadness, hopelessness, and worthlessness. It can often interfere with day-to-day functioning.

Symptoms of depression in children and teens

  • stomachaches or headaches
  • irritability
  • changes in eating or sleeping habits
  • lack of interest in activities they previously enjoyed, like sports and hanging out with friends
  • loss of interest in school and schoolwork
  • reduced self-esteem

Younger children often have physical symptoms like stomachaches and headaches, but may not be able to articulate a connection between the physical and psychological symptoms they’re having.

It’s important to be aware that some children and adolescents experience irritability as a prominent symptom rather than depressed mood.

Ask your child’s doctor to explore a psychological cause for physical symptoms in addition to looking at underlying physical causes.

Teens with depression may experiment with drugs or alcohol as a way of self-medicating or coping.

If thoughts of suicide arise

Adolescents with depression (and other mental health conditions) may develop suicidal thoughts.

Take suicidal thoughts very seriously if your child expresses them to you, and seek help immediately.

Obsessive-compulsive disorder (OCD)

When unwanted, persistent thoughts (obsessions) result in behaviors driven by the thoughts (compulsions), someone may be diagnosed with obsessive-compulsive disorder (OCD).

These thoughts and behaviors may be all-consuming, interfere with daily activities, and be upsetting to the child.

Symptoms of OCD in children and teens

  • unwanted thoughts that cause distress and anxiety
  • thinking or saying something over and over, including repeating words or counting aloud
  • repetitive behaviors like handwashing, putting objects in a certain order in a certain place, or checking locks on doors or windows
  • following certain rules and believing that not doing so will result in disaster

Eating disorders

You may think of eating disorders as physical disorders but they’re considered mental health conditions since they often have mental health components such as fear of bodily changes.

Treatment almost always involves mental health professionals.

Three of the most well-known eating disorders are:

Each of these disorders has different symptoms, but a person can experience more than one eating disorder at a time and show a variety of symptoms.

A lesser-known eating disorder that’s exclusively diagnosed in children is avoidant restrictive food intake disorder (ARFID).

In ARFID, an adolescent refuses to eat due to concerns about the appearance or texture of foods, or out of fear of becoming sick.

ARFID is more common in children with developmental disorders like autism spectrum disorder.

Symptoms of anorexia nervosa in children and teens

  • weight loss
  • preoccupation with weight, body image, or dieting
  • loss of menstrual period
  • brittle hair and nails
  • developing rituals around food
  • skipping meals or avoiding mealtime
  • rigid thinking around food and weight

Symptoms of bulimia nervosa in children and teens

  • binge eating that’s followed by purging, such as by vomiting or using laxatives
  • excessive, rigid exercise routine
  • damage to teeth from vomiting
  • sore throat

Symptoms of binge eating disorder in children and teens

  • eating alone or in secret
  • eating to excess, including continuing to eat when full
  • feeling a loss of control when eating

Symptoms of ARFID in children and teens

  • significant, rapid weight loss
  • malnutrition
  • gastrointestinal distress like stomach cramps or acid reflux
  • fear of choking or vomiting
  • dizziness
  • frequently feeling cold

Attention deficit hyperactivity disorder (ADHD)

It’s estimated that 9.4% of children ages 4–17 have ADHD, a condition characterized by inattentiveness, hyperactivity, and impulsive behavior.

Depending on the type of ADHD, symptoms may vary.

Symptoms of ADHD in children and teens

  • inability to focus
  • engaging in impulsive behaviors or behavior that may not be safe
  • trouble completing simple assignments or following directions
  • losing items repeatedly
  • fidgeting
  • difficulty sitting still or seeming like they’re always on the go

Schizophrenia

Schizophrenia symptoms often develop between the late teens to early adulthood, but the condition can be difficult to diagnose since it can resemble depression or anxiety in its early stages.

Symptoms of schizophrenia in children and teens

  • withdrawing or isolating
  • obsessive thoughts
  • lack of emotion (emotional flatness, aka “flat affect”)
  • disorganized thoughts (inability to keep thoughts in order)
  • delusions or hallucinations

Autism spectrum disorder (ASD)

Autism spectrum disorder (ASD) is a developmental disorder that affects a person’s ability to socialize and communicate. Other characteristics of ASD may include:

  • restrictive or repetitive behaviors
  • sensory differences
  • rigid adherence to structures and routines

How common and severe the symptoms are will vary greatly between individuals.

About 1 in every 54 U.S. children is believed to be autistic, and 4 times as many boys as girls show symptoms.

Autism symptoms typically show up before a child turns 3, and many kids are screened for ASD at 18 months and again at 2 years old.

Symptoms of ASD in children and teens

  • language delays
  • difficulty making eye contact
  • over- or under-stimulation of the senses
  • difficulty reading and using nonverbal cues
  • absence of pretend play
  • difficulty socializing with non-autistic children
  • using repetitive self-stimulation to soothe

Substance use disorder (SUD)

Substance use disorder (SUD) is the repeated misuse of alcohol, drugs, or other substances. It’s sometimes the result of an attempt to self-medicate for another mental illness.

Symptoms may both resemble those of other disorders and point to an underlying condition beyond substance use.

Symptoms of SUDs in older children and teens

  • withdrawing from friends and family
  • extreme changes in mood
  • inability to focus
  • taking unhealthy risks
  • suicidal thoughts

According to NAMI, half of all mental health conditions begin by age 14, but the average delay between onset of mental health symptoms and receiving treatment is 11 years.

Educating yourself as a parent or caregiver about your child’s condition and its treatment may help you help them and prevent a long lag in diagnosis and treatment.

When a mental health condition also presents with physical symptoms, it can be even more confusing to detect and treat.

But if you believe your child may have a mental health condition, it’s a good idea to speak with your child’s pediatrician to rule out physical causes for the symptoms.

If no physical reason for symptoms is evident, the pediatrician may refer you to a pediatric psychiatrist or psychologist for evaluation.

Once you have a better idea of which mental health condition (or conditions) you’re dealing with, it’s a good idea to do some research and learn about possible treatment options, including talk therapy and medications.

One thing you can do is work with your child’s treatment team. Collaboration between parents, pediatricians, and mental health professionals is key to helping your child feel their best and cope.

It can also be beneficial to create a supportive home environment where your child is encouraged to discuss their feelings, emotions, and symptoms openly.

Together with your kid’s treatment team and school, you may also want to develop a support plan to ensure they’re supported at home as well as at school.

Consider checking in frequently with your child’s teachers and school support staff, and update them about your child’s treatment.

However, if your child is older, consider talking with them first about your intention to speak with their school. While support from the school is important, your teen may feel hesitant to let people in their school life know. Be respectful of their feelings and develop a solution together.

Here are some additional resources for seeking treatment and support for you and your child:

  • SAMHSA. The National Helpline of the Substance Abuse and Mental Health Services Administration (SAMHSA) is available 24 hours a day, 365 days a year at 800-662-4357. This treatment referral and information service is available in English and Spanish.
  • NAMI HelpLine. The HelpLine provided by the National Alliance for Mental Health (NAMI) is available from 10 a.m. until 8 p.m. ET at 800-950-6264. Trained volunteers can help offer support, answer questions, and provide practical next steps.
  • SAHM resources. The Society for Adolescent Health and Medicine offers a detailed list of mental health resources for parents of teenagers and young adults.
  • NAMI support groups. NAMI also offers support groups for people with mental health conditions and their families. You can click on the type of support you need to find a meeting near you.

The physical and behavioral symptoms of depression I experienced as a child were often downplayed by those around me, and I never received mental healthcare back then.

What I know now that I didn’t know then is that my symptoms were very real, even though neither I, my parents, nor my teachers could pinpoint the reason for them.

The best thing you can do when you’re unsure about physical symptoms your child has is the same thing you do when your child has a fever or a broken arm: Take it seriously and talk with a pediatrician.

Opening a dialogue with your child’s doctor about whether mental or behavioral conditions could be behind the physical symptoms is a good first step to getting them the help they need.

Your child benefits the most when you advocate for them. Don’t hesitate to ask for a referral to a mental health professional.

Once you have a diagnosis, consider learning all you can about your child’s condition, symptoms, and treatment options. Education helps reduce the stigma around mental illness and can help your child and others receive faster and better treatment.