Introduction

Health does not mean the absence of disease, rather it is a person’s physical, mental and psychosocial wellbeing. Therefore, it is important that we understand this broader concept of health and concentrate on the overall well-being of people not just trying to be disease-free. In this context, it is fitting with the theme of this magazine to talk about mental health which

has become an extremely important matter, particularly in children. In a world that is moving very fast people are caught in an increasing pace of rat race for survival and success, this

inevitably increases stress in life leading to mental health issues. Further, covid induced lockdown, online dependency for various day to day activities including online school classes and children spending many hours on the electronic screen, all have further complicated the mental health issues-particularly in children.

Recognizing mental health problems

Deterioration in mental health is difficult to recognize by the person affected by poor mental health. Unlike physical disease where the symptoms and signs are well defined, well known

and easy to identify, the signs and symptoms of poor mental health are very insidious in onset and difficult to recognize even by the person affected by mental health. Further, the impact of mental health on the quality of life and the achievement of people are so damaging that it should be recognized and managed successfully for further advancement of human

achievement and civilization.

In addition, it should be noted that mental health issues cover a wide range of the problem from stress to psychotic problems. Although psychotic problems like depression, manic

depressive psychosis and schizophrenia are relatively easy to recognize, there remains a large group of disorders that remain undiagnosed until it seriously affects the person’s personality and behaviour completely destroying the person.

Signs and symptoms of mental health problems in children

Children affected by stress and mental health problems show a wide variety of signs and symptoms that may not point directly to mental health. It is well recognized in paediatric

literature that when children are affected by psychological stress or emotional trauma causing poor mental health, they may show signs and symptoms directed to their body and

behaviour. Thus, it is said that emotionally affected children speak with their body and behaviour.

A. Emotional trauma, mental stress presenting as disorders of the body.

In my paediatric clinical practice, I have seen thousands of children who presented to me with a wide variety of symptoms and signs of the body where the underlying

problem was not in the body but emotional trauma or mental stress. This type of illness is known as psycho-somatic disorder. Common symptoms of psycho-somatic

disorders include headache, abdominal pain, nausea, vomiting, fever, and many other non-specific symptoms like generalized aches and pains. At times the physical symptoms may become so severe with debilitating consequences.

B. Emotional trauma, mental stress presenting as behavioural disorders. Yet another way the children manage their disturbed mental health is by changing their behaviour. The behaviour changes may be subtle or very obvious. Affected by stress and emotional trauma, they may become very aggressive or go very quiet. Attention Deficit Hyperactive Disorder (ADHD) is recognized as one of the behaviour patterns of children with affected mental health, in this condition, children are unable to focus and sit in one place and instead run around pulling things putting the place they live upside down. The difficulty in focusing on things leads to learning difficulties too.

Further, it is said that children discharge their stress via the rectum, which means when in distress children may pass stool inappropriately in their trousers, under a table, in

school while in the classroom and so on. This situation is called ‘encopresis’. Similarly, there can be a number of abnormal behaviours that can be described in relation to

Disturbed mental health in children.

C. Long term consequences of disturbed mental health in children. Children who left unattended, unloved, uncared and neglected become the victims of the effects of long term chronically disturbed mental health issue. In this, they get chronic changes like growth retardation, a complete change in their personalities making them chronically underachievers. It costs them their future opportunities to a promised life.

In conclusion, it should be noted that it is not only food and nutrition that make children grow. More importantly, children should be nurtured through love, respect and care away

from mental stresses so that their maximum potentials can be tapped and nurtured to achieve the best.

Dr.Rayes Musthafa

Consultant Paediatrician