It has become my favourite past time to watch peoples’ reactions to my answer to the question – “what do you do?” I am a Child and Adolescent Psychiatrist and most people react to this fact in an interesting way –
1.“ you mean kids go crazy and require a psychiatrist? That must happen in western countries with drugs and broken families and all that stuff! Do you actually finds work in India?”
2.“ we read about student suicides all the time. If parents behaved properly and nicely with their kids, professionals like you would not be needed at all”
3.“ oh, so you are the doctor looking after genetically deformed, retarded kids!”
There are many other reactions but these three are most representitive. It just goes on to show that we as a society are still quite naive about concept of mental health and illness.
Adult psychiatry has just started emerging from the closet in India and depression/ anxiety/ phobias have become “okay” illnesses. Still more severe mental health issues like schizophrenia and addictions are struggling for the attention and acceptance they deserve. It is a long way, but atleast we have started.
Child psychiatry is a funny thing. We see adverts selling foods and games that claim to make your child smarter, faster, etc. There are parenting discussions in media involving famous personalities, gurus, teachers,etc. So we are aware of importance of a good, healthy childhood and are willing to put our money where our child is….but are we really aware about mental health issues in childhood?
Some people ask me what kind of kids are my patients? Now that is a question that I can answer. More than 90% of my child patients are brought by their parents for just one of two complaints – poor academic performance and discipline/behavior problems.
There are hundreds of reasons why school performance or behavior deteriorates, but most important thing is that unless one of these parameters takes a hit, there is no acknowledgement of a problem that needs professional help.
Children are like the ozone layer around the earth or tigers in our jungles. Their happiness is a sensitive indicator of society’s attitude towards life ! Following is an easy to understand classification of why things go wrong with children –
1.Problems related to brain development and physical health – like attention and concentration problems, reading and writing difficulties ( dyslexias made famous by “Taare Zameen Par”), speech and language difficulties, etc.
2.Problems perceived due to mis-understanding of normal development – certain things appear in development of a child like bedwetting, restlessness, fear of staying alone or dark places, food fads, defiance, etc. If parents are unaware of this “ normal phase” they may try to find solution to a problem that is going to go away anyway.
3.Problems in relationships – Children’s relations with family members, schools, or even friends may sometime become strained and reflect in behavior or academics or emerge as discipline issues.
4.Problems with social expectations transmitted to child by parents and school system.
5.Problematic emotions like anger, sadness, fear, excess competitiveness, etc.
All of the above issues can be assessed and helped by mental health professionals with the help of family and if necessary, schools.
One more commonly asked question is how to identify a child needing help –
there are some clear indicators –
disturbance in usual sleep, eating, interaction pattern lasting for more than one to two weeks.
Sudden and severe change in emotions like – sadness, anger, fear.
Unpredictable and rapidly changing mood.
Return of habits of younger age like- clinging to parents, excessive fear, babytalk.
Sudden change or unstable pattern of friendships.
If you suspect anythings, do check –
Most importantly – most problems can be solved with the help of family counselling, child counselling and some help from school ! Medications ( from any pathy) are very rarely needed.
Dr. Bhooshan Shukla
MD, DNB, MRCPsych
Child and Adolescent Psychiatrist