Every child has hard weeks. The question for parents is not whether a child is ever sad, angry, or worried, but whether those feelings are lasting, growing, or getting in the way of daily life.
Look for change, duration and impact
Professionals who assess children tend to ask three questions, and parents can ask them too:
Is this a change? A child who has always been quiet is different from a talkative child who has gone silent.
How long has it lasted? A rough few days after a move or a fight with a friend is expected. Problems that continue for several weeks deserve a closer look.
How much does it interfere? Trouble that affects sleep, school, friendships or family life matters more than a mood that comes and goes.
Emotional signs
Sadness, tearfulness or irritability most days
Worry that the child cannot be talked out of, or fears that keep growing
Loss of interest in activities, friends or hobbies they used to enjoy
Frequent statements such as "I'm stupid", "nobody likes me" or "nothing matters"
Strong reactions that seem out of proportion to what happened
Behavioral signs
Frequent, intense tantrums past the age when they usually fade
Aggression toward people or animals, or destroying things
Refusing to go to school, or a sudden drop in grades
Withdrawing to their room and avoiding the family
Risky behavior in teenagers, including alcohol or drug use
Physical signs
Children often feel emotional distress in their bodies. Repeated stomachaches or headaches with no medical cause, big changes in appetite or sleep, constant tiredness, and returning to younger behaviors such as bedwetting can all be signs of stress. A pediatrician should check physical symptoms first, because some medical problems cause changes in mood and behavior.
When not to wait
Some signs call for help the same day: talk of wanting to die or of hurting themselves, signs of self-harm, hearing or seeing things others do not, or behavior that puts the child or others in danger. In the US, call or text 988 or call 911. Elsewhere, call your local emergency number. See warning signs of self-harm and suicide.
Where to start
For most concerns, the first call is to your child's pediatrician or family doctor. They can check for medical causes, screen for common problems and refer you to a mental health professional. Your child's teacher or school counselor can tell you how your child is doing at school, which is often useful information. Writing down what you have noticed, when it started and how often it happens will make those conversations more productive.
Asking for an evaluation does not mean something is seriously wrong. Often a few sessions give a family new tools and reassurance. When a child does have a condition such as anxiety, depression or ADHD, finding it early usually makes it easier to treat.
How to Choose a Child TherapistThe kinds of professionals who treat children, how to find one, questions to ask, what the first appointment is like, and how to tell if therapy is working.
Depression in Children and TeenagersHow depression looks different in children and teens, warning signs parents can notice, how it is treated, and how to support a child at home.
This guide is general information, not medical or psychological advice. For questions about your child, talk with a pediatrician or a licensed mental health professional. In a crisis in the US, call or text 988 or call 911; elsewhere, call your local emergency number.