Child & Adolescent Mental Health

Mental health difficulties in children and teenagers rarely announce themselves the way they do in adults. Sadness in a child often looks like irritability. Anxiety often looks like stomach aches, school refusal, or clinginess. Depression in a teenager often looks like withdrawal into their room, changes in friendships, or a slow slide in schoolwork that gets attributed to laziness. The signs are quieter and easier to explain away — often for months — before it becomes clear that something is worth taking seriously.

This page is written for parents, guardians, and caregivers to help you recognise when what you're noticing might be more than a phase. Not to diagnose your child, and not to tell you what to do about it. But if some of what's below sounds familiar, that's worth taking seriously.

What to watch for in children

Frequent stomach aches, headaches, or physical complaints without a clear medical cause — often before school, or before specific social situations.

Sleep changes — trouble falling asleep, waking in the night, coming into your bed more often, nightmares.

Clinginess that's newly out of proportion for their age. Difficulty separating.

Sudden avoidance of activities, friends, or places they used to enjoy.

Big feelings that don't fit the trigger — tantrums that last a long time, tears that arrive easily, worries that don't ease with reassurance.

Difficulty concentrating at school, or a drop in academic performance without an obvious cause.

Regression — going back to behaviours you thought they'd grown out of.

What to watch for in adolescents

Withdrawal — into their room, into their phone, out of family life, out of friendships they used to have.

Sleep pattern changes — either much more sleep than usual, or difficulty getting to sleep and daytime tiredness.

Changes in eating — restriction, secretive eating, sudden interest in "clean" eating or exercise.

Loss of interest in things they used to care about — hobbies, sport, music, plans with friends.

Irritability that seems to sit under everything.

Academic slide that doesn't respond to the usual conversations.

Comments — even offhand ones — about being a burden, about not wanting to be here, about feeling like nothing matters. These deserve a serious, non-panicked conversation and, if in doubt, a call to a mental health professional.

Cutting or other self-harm — including on parts of the body that are usually covered.

Substance use, including cannabis and alcohol, that seems to be about coping rather than experimenting.

Changes in social media use that concern you — spending much longer, or seeming distressed after being on it.

How to tell it apart from "just being a teenager"

Some of what's above is part of normal adolescent development. The clinical distinction usually lies in duration (weeks and months, not days), functioning (whether it's affecting school, friendships, family life, sleep, appetite), and change (whether the version of them you're seeing is meaningfully different from the child you know). Trust your instinct on this one. Parents often know before anyone else that something has shifted, and often talk themselves out of that knowledge because they don't want it to be true.

Signs it's time to see a mental health professional

• You've noticed changes lasting more than a few weeks

• Your child's sleep, appetite, or school life is being affected

• Friends, family, or teachers have raised concerns

• Your child has said things that have worried you

• You've found evidence of self-harm

• Your child has been through something difficult and doesn't seem to be recovering

• Your instinct as a parent is telling you something isn't right

• You've been managing this quietly for a long time and are exhausted

A note on urgency: if your child or teenager has spoken about not wanting to be here, has harmed themselves in a way that needs medical attention, or is in immediate distress, please seek help today — through your GP, a mental health professional, or A&E if the situation is acute. Helplines like iCall and Tele MANAS are also available for parents who need to talk to someone sooner. You don't need to have it figured out before you call.

What a first consultation actually involves

Dr Pragya Sharma has additional training in child and adolescent psychiatry. A first appointment usually involves you and your child together, with time for you to speak alone and time for your child to speak alone, in a way that's appropriate for their age. Younger children may spend some of the appointment drawing or playing while the conversation happens around them. For teenagers, the confidentiality of what they share is respected within the limits of safety. The point is to understand your child in their context, and to help you both figure out what makes sense next. Nothing gets decided in the first meeting that you don't have time to think about.

Frequently asked questions

Will my child have to take medication?
No decision like that is made lightly, and it's made with you and, where age-appropriate, with your child. Many children and teenagers don't end up on medication, and where medication is discussed, it's discussed carefully.

My child says they don't want to come. What do I do?
This is common. Sometimes a first appointment happens with just you, so a plan can be made about how to bring them in. Sometimes teenagers surprise their parents once they're in the room. There's no single right answer.

Will everything they say be shared with me?
For younger children, appropriate sharing happens naturally. For adolescents, confidentiality is respected within safety limits — this actually helps them open up. Anything that suggests risk is always brought to you.

Is this something they'll grow out of?
Sometimes yes, sometimes no. Waiting to find out often costs more than getting a proper opinion early.

I feel like a bad parent for needing this.
You aren't. Bringing your child to see someone is one of the more attentive things a parent can do. Taking it seriously is the opposite of failing.

If some of what's above sounds like what you've been noticing, that's a signal worth acting on. You can book a consultation with Dr Pragya Sharma — Consultant Psychiatrist — in person in Mohali or online across India.

Reviewed by Dr Pragya Sharma, MBBS, DPM, DNB Psychiatry — Consultant Psychiatrist, Repose Clinic, Mohali.