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How do you know if your child is struggling emotionally?

For many parents, understanding their children's emotions can be challenging. ... Signs include: Changes in mood and behavior. Sleeping too much or not enough. Skipping meals or overeating. Worsening academic performance. Differences in how they interact with friends, family and the community.

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For many parents, understanding their children’s emotions can be challenging. A sullen look could just be courtesy of a bad day at school or it could be a sign of a bigger struggle. While parents don’t want to worry about normal child behaviors, it is important to understand if their kids' habits are signs of a mental illness. “The longer you leave mental health conditions untreated the harder they are to treat,” Nancy E. Cunningham, a psychologist at Nationwide Children’s Hospital in Columbus, told TODAY. “If there is a concern, acting on that sooner rather than later is important.” Symptoms of mental health conditions vary greatly — depression looks different than ADHD, for example. But there are some behaviors that might indicate when children are struggling.

1. More headaches and stomachaches.

Children, especially younger children, will often complain of headaches, fatigue and stomach pains. When it becomes a regular occurrence, parents should talk to a pediatrician to rule out physical problems and then screen for mental health conditions. “We can see that kind of trend of (children) describing more physical symptoms as opposed to emotional symptoms,” Dr. Adelle Cadieux, a pediatric psychologist at Helen DeVos Children’s Hospital in Grand Rapids, Michigan. “Kids might talk more about the physical sensation than their emotional sensations, particularly young children who don’t have the language.” What’s more, some mental health conditions have physical symptoms, too. Anxiety can cause a queasy feeling, for example.

“Mental and physical illnesses are inextricably linked,” Cunningham said.

For some children expressing physical discomfort comes more naturally than explaining emotional changes. “Emotional symptoms are sometimes harder to talk about and also we don’t recognize them within ourselves,” Cadieux said.

2. A long-term change in behavior.

Long-term changes in how your child act could be a sign that something’s amiss. Signs include:

Changes in mood and behavior

Sleeping too much or not enough

Skipping meals or overeating

Worsening academic performance

Differences in how they interact with friends, family and the community

“When you see a change in your child that is real significant change … going on for a week or more — that is a sign that something more is going on,” Cadieux said.

3. Behaviors that impact daily life.

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When the worsening school performance leads to daily arguments or the oversleeping means a child is missing outings with friends, it's probably an indication that they're going through more than just a bad day. “I usually look at are those behaviors starting to interfere with functioning?” Cadieux said. “It is to a point that as a family we are not able to do our day-to-day activities?”

If so, parents might want to seek help.

4. Saying they want to die.

“I don’t think we should ever ignore when a child says, ‘I would be better off dead’ or ‘I wish I were dead,’” Cunningham said. People often worry if they talk to their children about suicide it will give them the idea to try it. But that is not true. “You want to talk about it. There are some kids who have some pretty serious suicidality,” Cunningham explained. “We don’t want to overlook any comment that might be said in an offhanded way.”

5. Too much experimenting.

While it’s normal for children to experiment, when it happens too frequently it could be a sign a child is struggling. “There are risky behaviors that are appropriate and normal at adolescence. It is the way they test limits and develop their own identify and autonomy and distance from their parents,” Cunningham said. But when it become too common or they’re putting their lives or others’ lives at risk, something else might be behind it. “When kids are pushing that safety limit that is a concern,” Cunningham said. She suggests parents chat with their children in a non-judgmental way about their risk taking and try to get them help when needed. “Track it the best you can,” she said. “We know when someone is testing the limits and when someone is acting extremely dangerously.”

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