Friday, July 15, 2011

Childhood mental health problems

Most common mental health issues encountered in 6 to 12 year olds
Reported by school psychologists

Anxiety - 73.1%
Challenging behaviour - 71.8%
Family/parenting concerns - 65.4%
Peer relationships - 59%
Anger and conflict - 55.8%
Bullying - 41.7%
Self esteem - 38.5%
Child safety and protection - 31%
Depression - 21.1%
Trauma - 19.2%

Challenging behaviour = Autism spectrum disorder, ADHD, oppositional disorder, learning difficulties and conduct disorder

Ref: [Inpsych - Bulletin of the Australian Psychological Society, June 2011]

Snake girl

My work with children has mainly been in the private practice setting. Children are brought to me by their parents usually. The list cited above would be quite similar to how I would rate the children I have seen over the years.

One thing that has always interested me in my work with children, and what this data supports, is the low rate of depression as compared to the other mental health problems presented. I have found this surprising as I expected it to be higher. I expected anxiety to be as high as it is but I also expected depression to be the same. Which it is not. The rate of depression is much lower.

Why I expected this is because with adults and adolescents they tend to be about the same.

Adults in Australia (Department of health and ageing statistics)
10% anxiety at some point in adult life
20% depression (6% major depression)

One needs to be careful with such statistics as they can vary quite considerably depending on how one defines depression and anxiety. However, it seems safe to say that in adults there are similar amounts of depression compared to anxiety unlike in childhood. They are at similar rates whereas in childhood that is not the case with anxiety being much more prevalent than depression. According to the research above anxiety is three to four times more prevalent than depression in children seeking help from school psychologists.

Hijab girl

This of courses raises the question as to why this would be so. I don’t know of any explanation that has been given to answer this question. So I thought I might do some hypothesising of my own.

Anxiety in childhood
It could be that diagnosing depression in children is harder than in adults. Thus the rates of depression are higher in children but are not recognised because the children do not present to school psychologists with that difficulty. I suppose this could be the case but it seems a bit dodgy to me as depression is not that hard to diagnose. Even if the child does not report the problem emotions found in depression the body language of a depressed child is not that hard to detect. It would also seem reasonable that a depressed child is just as likely to report unpleasant emotions as an anxious child. Why should there be any difference between those two?

It seems more reasonable to me that childhood by its very nature is more likely to produce reactions of anxiety rather than depression, whereas in adulthood this is not the case. It is simply a matter of when god made us, she stuffed up. The way humans reproduce the species is by giving birth to very small versions of adults that take almost two decades to fully mature.

As adults it is easy to forget just how vulnerable a child is. A child is like living in the land of the giants. Take a minute to lie face up on the floor, get someone to stand over you and remind yourself of how a child sees her relationships with adults.


One of my favourite TV shows in childhood - Land of the giants.

This could partly explain why anxiety is the highest of all mental health issues in childhood. A child’s life is on the line each day. Its actual physical existence is out of its control and is determined by those adults around her. Indeed a threatening state of affairs even if the child is treated well. Those around it can kill it at any time and of course children don’t understand about laws against murder and so forth until much later in life.

It has been postulated that you can roughly determine the difference in strength between two people by taking the fourth power of the ratio of their heights.
Ref: [S. Gould. 1977. Ever Since Darwin. New York: W.W. Norton Company.]

The height of the average female is twice that of the average two year old so she is (24 = 16) sixteen times stronger than the child (2 to the power of 4). A very large difference in power and strength I think one could say. It has been postulated that around that age of 10 - 12 years is the first time where a child could probably start to look after itself in terms of acquiring the food and shelter necessary to live. Up until that time the child’s physical well being in terms of food and shelter is dependent on the adults around it. Of course the child knows that the adults can withdraw that food and shelter should they choose to do so.

Chop melon

Despite these physical threats we also have all the psychological causes of anxiety. If a child is psychologically abandoned in some way, which many are to varying degrees, anxiety is a common reaction to such abandonment. Children are much more psychologically dependent on those around them than adults are and thus anxiety may be more prevalent in childhood as a result.

Every parent also has a Child ego state of their own. Sooner or later there are going to be situations where their own Child ego state needs are going to take priority over the needs of their biological child. A classic example is post natal depression. In this case the mother’s own Child ego state needs may be to sleep for extended periods of time in bed as a consequence of the depression. When she does this her biological children’s psychological needs are secondary and thus anxiety can result when the children experience this psychological abandonment.

Finally normal human development requires the child to master scary developmental tasks. Most obviously the separations from mother and father. Such as going to school, handling difficult circumstances without mother’s help, getting a job and just becoming psychologically independent is an anxiety producing process.

dog & kid

There we have it. This could explain to some degree why childhood is more of an anxiety producing stage of human development as compared to adulthood. It does not seem possible to develop an argument for why childhood would be a more depression producing stage of development. Indeed the level of depression in childhood in the first piece of research cited put it at 21%. The statistics from the Department of health and ageing put the level of depression in adulthood at 20%. They are the same. Whereas anxiety in children seeking help was around 70% and in adulthood put around 10% of adults in general.

Nothing like a bit of hypothesising on a Friday!



  1. Also children are allowed to express anger vigorously - tantrums and so on.

    I think depression is anger turned inwards. So being allowed to put it out leads to less depression.

  2. Yes Evan,
    that may also be one of the reasons for the difference in Childhood


  3. Interesting, and such a sad report on the state of modern living.

    I often wonder if its "us" that need fixing, or the infrastructure that has been created. We are no longer natural and free. In the right conditions parents wouldn't feel the need to "correct" their children all the time, or be so stressed themselves that they dont really have time for them.

    The Land of the Giants is not only likened to the parent & child, but also the state rulers and its citizens, employers and employees etc. None of us are free, we dont even have the freedom to think. Also most of our environment is now non-natural, and certainly void of much choice. would this not cause any living organism to suffer from depression and anxiety?

    Who really stuffed up? "god" or us? I also dont beleive it takes 2 decades to fully form. If we were taught REAL life essentials from our parents, had a REAL bond with them like other animals in nature then I think we would be pretty much fully formed by age 12-15.

  4. Your last point is a good one Anon.

    it is possible that once upon a time people did fully form earlier but as society has changed so has the time to fully form. I may do another post on that.


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