How do you know if your kids are OK? 

Even before the pandemic, many families were concerned about their kids’ mental health. And with the difficulties of the last few years, more children and teens are experiencing anxiety and depression.

“Children and adolescents are continuing to recover from the pandemic and are working to get back to ‘normalcy’ in their social, academic, and emotional lives,” said Karyn Horowitz, MD, Chief Medical Officer at Bradley Hospital and Director of Child Outpatient Psychiatry at Brown University Health.

Dr. Horowitz has been helping families through this challenging time and explains how you can support your children—and take care of yourself. 

Look for clues that show your child is struggling. 
Everyone feels sad and worried sometimes. “However, if that sadness or worry is affecting your child’s ability to function, that’s a sign they need help,” said Dr. Horowitz. “You know your child better than anyone. Some clues to look for are changes in their sleep, loss of appetite or overeating, grades slipping, and anger or irritability that’s out of character.” (See a longer list of warning signs at the end of this article.)

Remember that anxiety and depression are medical conditions (and are no one’s fault). 
These are brain diseases the same way that asthma is a lung disease, and they can run in the family just like other medical conditions. Dr. Horowitz said they also improve with treatment like other diseases. “If you have depression or anxiety and your child does too, you can recognize that and get them help early. The skills they learn can help for the rest of their life—and that’s a wonderful thing.” 

Be involved in your child’s treatment. 
“If your child is going to therapy, that’s typically only an hour a week, and the rest of the time they’re with your family or in school,” said Dr. Horowitz. “So it’s important to work with the therapist on understanding your child and to learn the ways you can support your child at home and at school.” 

Self-care for the whole family 

“The number one thing I tell everyone is to get a good night of sleep. It is also important to get outside. I tell kids and their families to work to spend 20 minutes a day outdoors,” Dr. Horowitz said. “It just makes you feel better.” 

Eating balanced meals and avoiding mood-altering drugs are key for mental and physical health. In addition, Dr. Horowitz recommended spending less time on social media, especially for kids, as it can lead to cyberbullying and fear of missing out. “The rate of depression has gone up significantly in teenage girls over the last few years, and social media may be related to that rise.” 

She suggests doing one activity a day that makes you feel confident, capable, and accomplished. That could be anything from making a new recipe to writing in a journal to checking in on a loved one. You and your child can do that individually or together. 

Where to find help 

As a BCBSRI member, your child (or you) doesn’t need a referral to see a therapist or a psychiatrist. To find help: 

• Start with your child's physician. “They know when things are outside the normal range and can often give you the name of therapists or doctors who they trust,” said Dr. Horowitz. 
   
• Call BCBSRI Care Management at 1-800-274-2958. Our licensed clinicians can assist you with identifying a provider. You can also use our Find a Doctor tool. 
   
• Schedule a video visit with a therapist or psychiatrist through BCBSRI Doctors Online*, if that service is available with your plan. Learn more at drs-online.com or by calling 1-800-345-1419. 

24/7 resources for kids in crisis 

• Kids’ Link RI™: 1-855-543-5465 
• Suicide & Crisis Lifeline: 988

Warning signs that your child needs help

“The more clues and signs you see, the greater risk your child is in,” said Dr. Horowitz. “Be sure to take all these signs seriously. It’s most important to listen to your child and it is also important to keep medications and firearms locked up or to remove them from your home.”

Behavioral clues

• Increased risk-taking
• Consistently sad or distressed postings on social media
• Writing about death, dying, dark themes
• Self-destructive acts
• Anger, aggression, and irritability that is out of character
• Not attending school or running away
• Withdrawing from peers and activities

Situational clues/risk factors

• Public embarrassment or humiliation
• Legal problems
• Change in school performance: slipping grades, behavior problems
• Recent disappointment/family problems/extreme loneliness/rejection  
• Food or housing insecurity
• Loss of any major relationship
• Death or anniversary of the loss of a friend or family member, especially if by suicide
• Bullying/cyberbullying/feeling unsafe at school 
• "Coming out” experience for LGBTQ+ youth  

Physical clues

• Eating disturbances (loss of appetite, overeating)
• Changes in sleep patterns
• Chronic headaches
• Stomach problems
• Menstrual irregularities
• Visible scarring

*Doctors Online is a telemedicine service provided by American Well^®, an independent company that administers Doctors Online on behalf of BCBSRI.