APA Expert Opinion
Ask a Psychiatrist: An APA expert answers common questions about children's mental health.

This month's expert: Adelaide Robb, M.D. a psychiatrist at Children's National Medical Center in Washington, DC.

My son is going to summer camp. I was thinking I should give him a break from his medication. Could this create any problems?

If your child has been diagnosed with depression, attention deficit hyperactivity disorder (ADHD), or another illness, it's important to work with your child's physician before stopping or starting any medication. Many studies have demonstrated the importance of keeping a child on medication and on schedule year round as the best way to manage symptoms. In general, symptoms don't take a break and so neither should effective treatment of those symptoms.

If you want to change medications or try reducing the dose you should discuss it with the doctor before making any changes in the dose of your child's medication. Going off medication at sleep away camp and away from parents and his physician is the worst time to do a parental decision taper. Also, some parents report that a "medication vacation" hurts the child's routine, has a yo-yo effect, or makes the child feel more awkward about their treatment. In the worst cases, the child's symptoms return full-force, and they can feel like a failure.

You can find out more summer camp tips for parents here.

My child is a bit more active than other children her age. Does this mean that she has Attention Deficit Hyperactivity Disorder (ADHD)?

Not necessarily. Most young children are very active in their early years. The main features of ADHD include hyperactivity, impulsiveness, and an inability to sustain attention or concentration. These and other symptoms occur at levels far more severe than typically found in children of similar ages and developmental levels. If you have concerns as to your child's behavior and he or she is displaying some of these features, or if you would like more information on ADHD, you should consult your pediatrician or mental health professional.

My child is beginning to show signs of a mental illness. What should I do?

Though it seems obvious, try talking to the child or teen and ask if there is anything bothering them. If the child or teen denies that anything is wrong and begins to act in a more normal manner again, continue to be watchful of any strange behavior which may return. Also, consider the child or teen's family history - does anyone in the family have a history of a mood or psychiatric disorder? If a child or teen is exhibiting symptoms, you may want to see a psychiatrist. A child and adolescent psychiatrist will be able to diagnose a mental illness and provide you with treatment options.

If my child is suffering from depression, what are some of the warning signs I should look for?

Depression, one of the two main mood disorders, can sometimes be difficult to see in children, especially children who are going through puberty. Teenagers can appear irritable or angry when they are really feeling sad or bored. With these behaviors can come a loss of interest in favorite activities, being with friends and doing things they used to enjoy. There may also be changes in sleeping, energy level and appetite. A parent may notice a decrease in work or school performance (eg.: it may take the child or teenager longer to do the same amount of work.) houghts of suicide or suicide attempts may also be present in a child or teen suffering from depression.

Is there anything I should look for in their behavior at school?

Warning signs at school may include a lack of interaction with classmates, an inability to understand complex assignments, giving answers that don't make sense or have nothing to do with the question asked, talking to themselves during down times in the classroom, or acting or dressing in a bizarre manner. These could all be signs of depression.

I've noticed that my teen often has very different mood shifts. Could it be more than depression?

Bipolar disorder, which may also be known as manic depression, is when a child or teen's mood alternates between two extremes - depression and mania. Symptoms of depression in a child or teen with bipolar disorder are similar to that of regular depression - changes in sleeping habits, energy level and appetite. When a child or teen is experiencing the 'mania' portion of bipolar disorder, they may exhibit a decreased need for sleep, lots of energy and changes in appetite (either eating less or more than usual). They may start talking more or faster and have complaints of ideas racing through their heads. There may be an increase in reckless, dangerous behaviors such as drug use, breaking the law, and an increased interest or preoccupation with sex.

I have heard a lot about the FDA and suggested "black box" warnings on psychiatric medications for children. Where can I find more information on this?

The American Psychiatric Association (APA), in conjunction with several allied groups, launched a comprehensive Web site, www.ParentsMedGuide.org in early 2005. In light of the great deal of information released regarding antidepressants and children, the ParentsMedGuide helps parents understand the information that is available, so that they can make an informed decision about getting the most appropriate care for their child.

How would I find a child psychiatrist?

The American Academy of Child and Adolescent Psychiatry (AACAP) a voluntary membership organization with over 7,000 of the nation's child and adolescent psychiatrists, many of whom are also APA members. You can visit their Web site www.aacap.org to find more information child and adolescent psychiatrists. When you are ready to locate a doctor in your area, you may search their public referral directory for a doctor using your own specific search criteria. You can search by city and state, languages spoken and practice interests.