What to do when kids are feeling depressed or anxious

When a child seems sad, anxious, or distant, it can be hard to know how to help. But learning how to recognize signs like changes in mood, sleep, or behavior is a great first step. 

Karen Wilson, PhD, joins the show to break down the connection between mental health and kids with learning and thinking differences. Find out how learning challenges can cause feelings of anxiety or depression. And get tips on how to support your child through tough times.

We love hearing from our listeners! Email us at opportunitygap@understood.org.

Related resources

• Typical sadness or depression? How to tell the difference in your child

• Signs of depression at different ages

• ADHD and depression

• Signs of anxiety in young kids

• National Alliance on Mental Illness

Timestamps

(01:02) The relationship between learning disabilities and feeling depressed

(06:18) How to recognize signs of depression and anxiety in kids 

(15:15) Support for managing feelings of depression and anxiety

Episode transcript

Julian: Sometimes it's just a bad day. Sometimes it's just a low moment. Sometimes it's something deeper. On today's show, we're talking about what to do when kids are feeling anxious or depressed, or sometimes just having an off day. But most importantly, we're talking about what you can do about it.

What's going on, family? This is the "Opportunity Gap," and I'm your host, Julian. Joining us for this really important conversation is Dr. Karen Wilson. She's a clinical neuropsychologist and an Understood expert. So, I'd like to welcome Dr. Karen Wilson to this show. Welcome.

Karen: Thank you. Thank you, I'm so glad to be here with you, Julian.

Julian: Yeah, definitely. All right, so let's get right into it today. Again, we're talking about anxiety and depression. So, can you speak to what the correlation is between learning and thinking differences and the likelihood of feeling anxiety and or depression?

(01:02) The relationship between learning disabilities and feeling depressed

Karen: Yes, there definitely is a link and thank you so much for bringing this topic to the conversation because I think it's something that's really important, particularly when you have young people whose brains are wired differently and oftentimes the focus is on helping them get through school, helping them to get through academics, can they focus in the classroom, can we teach them how to do math.

And oftentimes when kids struggle over an extended period of time, it can impact their self-concept, impacts the way they feel about themselves, the way that they believe others perceive them, and those negative feelings and the negative narratives that they create about themselves and who they are and the kind of student they are and what they're capable of can contribute to, again, a low self- concept, can contribute feelings of anxiety and worry and can go as far as feeling hopeless and contribute to those feelings of depression as a result.

Julian: So, it sounds like if I'm a child and I might be struggling academically, then naturally I might start to compound some of those feelings, and that can transfer into deeper depression and or that feeling of anxiety or anxiousness in school.

Karen: That's correct.

Julian: I mean, I'm sure it's a really tough spot to be in, right? Where you have a kid who is struggling and emotionally, they're having a hard time. Especially when some signs might be easy to miss or mistaken for something else. What are some signs that a child might be experiencing the anxiety or the depression that you speak of? Like, what are some concrete things that we can look for?

Karen: Yes. And it's what's interesting, Julian, is there's so much overlap because, you know, kids who get frustrated with their schoolwork might have a temper tantrum. They might cry. They might avoid the schoolwork. And you just might think this is some resistance to the school work and to the resistance to doing things that are hard for them, which can absolutely be true, and it is expected. So, when we think about kids with learning and thinking differences, you know when they develop depression and anxiety, it's usually you're noticing changes that go beyond their usual challenges, right?

Julian: Right.

Karen: A child with ADHD who might normally struggle with focus and staying engaged and staying on task, when depression enters the picture, you might see more sadness, more tearfulness, you might see them pulling away from activities, pulling away from friends, things that they used to enjoy. All of a sudden, they don't want to go to soccer practice. They don't wanna have a play date. And so, those are some things that you might see in kids in individ with depression. With anxiety, you might see more avoidance of things that can be anxiety-provoking for them.

So, all of a sudden they might not want to go to school, right? They might resist going to school because that's a place that is anxiety-provoking for them. They might no longer want to do birthday parties. They may not want to do other things that they would normally do. They might start complaining of stomach aches and headaches before school. Might call from the principal's office because they're not feeling well and asked to be picked up. The emotional meltdowns might become more intense and particularly when facing challenging tasks. And when kids are anxious, one of the things that they want to do is to avoid things that cause them anxiety.

So, all of a sudden, they don't want to do those things that they would normally push through, even with support. So, it goes beyond just the typical frustration you might see in kids with learning and thinking challenges. And it goes beyond also just impacting those specific areas, so they might be struggling.

So, a kid, for example, with dyslexia might have a lot of emotional meltdowns around doing things that require reading. But when it persists beyond just the learning difference into mental health, into depression, anxiety, you'll see it be a little more pervasive and impacting multiple areas of a child's life. And you'll also see it occurring across different settings. So, it's happening at school, it's happening at home, it might be happening, you know, when they go to grandma's house, things like that.

Julian: Interesting. So, it's something that impacts the child globally as opposed to the specific area of concern that the disability presents itself. That's a really interesting distinction. And that's something I know a lot of our listeners, they're always wondering the difference between a day where you just might be having a rough day, right? We all know that a lot of our kids, they might just have a rough or they might have a series of days that are just it's a tough stretch, or they might, you know, just, they're just going through it.

How do parents know? All right, it's not just them going through. It's not, just you know. Maybe it's winter time and they're struggling, or something happened. Even for our teenagers, maybe a relationship change,d and they're struggling. How did they know that it's something deeper than that? What's the differentiation? Like, is there a time component? Is there a deeper presentation of these feelings? Like what is it that parents should know to know like this is something more serious.

(06:18) How to recognize signs of depression and anxiety in kids

Karen: Yes, and I think that is so important to ask because, you know, all children will feel sad sometimes, right? Children and teens will find something to be sad about.

Julian: And parents, and adults, all of us, right?

Karen: And parents, and caregivers, yes, because things happen, you know, a kid doesn't want, you, know, another child may not want to sit with them at lunch, they have a disagreement with their best friend, they might have, not get the grade that they wanted on a test, even though they worked really hard. So, there are a lot of things that can contribute to feeling down or having a low mood feeling sad. Everybody is going to feel sad. Sometimes that's completely normal. I think it's important to say that.

Julian: Right.

Karen: The difference between like a temporary sadness that might be related to an event, something that happened, and for example a clinical depression, something that you would definitely want to get some support around really comes down to three things. It's how long it lasts, how intense it is, and also how much it impacts a child and adolescent's daily life. So, normal sadness might resolve within that same day, it might resolve with in a couple days, and it doesn't typically impact the child's daily functioning. So, they're gonna go to school the next day, they're going to get a good night's sleep, they're going to finish their homework, they're going to snuggle with their parents, they're gonna...everything else will be OK.

But with clinical depression, for example, it typically persists for at least two weeks. So, that's again, how long it lasts. And it can make it difficult for a child to engage in other activities. So, it might be hard for them to get out of bed in the morning. It might disrupt their sleep. It might be difficult to get them to go to school. They might not, again, want to do the things that they would normally do. So, then again, that's impacting their daily functioning. And then the intensity is the third piece, right? There's a lot of sadness, a lot of tearfulness, a lot of emotional outbursts. Again, these are things that are persisting for at least two weeks. So, it's gone on for a long period of time.

And I think another thing to keep in mind is that with young children, often depression kind of presents itself like irritability more so than sadness. That's kind of a distinction between adult depression and depression that you would see in children. It presents as more like irritability, right? And also, it can disrupt sleep patterns. All of a sudde,n kids want to sleep with their parents when this is a change.

Again, something, a change from how they were previously. They might not sleep for as long a period of time. They may have disrupted sleep. They may have a hard time falling asleep, staying asleep. You might see changes in appetite. All of a sudden, they don't want to eat as much, or they're eating too much. They're overeating. And again, like one of the things I said was that they start to lose interest in things that they used to really enjoy. You know, things, activities they used to look forward to, all of a sudden, they've lost that interest in doing those things.

Julian: Got it. Let's talk a little bit about how people choose to handle depression and anxiety. In my day job, I'm an assistant principal at a high school in Philadelphia, right? And I've worked in, you know, high needs urban schools for my entire career. And we have a large amount of kids who have IEPs for a variety of learning and thinking differences. And I find that a lot of our students with that designation also sometimes exhibit signs of depression or anxiety, as you say, right? Like it's more prevalent with kids who have learning and thinking differences, right? So, I've experienced that in my own career.

And as we are prepping for this show, I, you know, I have conversations with kids all the time, and I was having this conversation with one of my students a couple of weeks ago about how they choose to manage their feelings of anxiety around school, right? This young man, he has ADHD, I mean, he's known he's had ADHD his entire life. And he used to take medicine. He took a variety of different stimulants when he was in grammar school, and he stopped taking them when he came to high school. And he's chosen to try to manage the like heavy feelings, he says, he calls them heavy feelings, he comes into school and he says, "I, you know, I have these heavy feelings, Mr. Saavedra."

And so, instead of taking the meds the doctor was giving me I'm choosing to smoke. And I'm like "What you mean smoke? He's like "I smoke weed before school to try to help calm me down, so I can get my mind calm, so I can come into school. And that's really helped me." And so, I say all that because I'm wondering from your clinical perspective and your background, one, are you seeing the same thing with kids choosing to self-medicate? And then two, what does self-medicating mean in the context of a teenager or a child doing this to try to manage these emotions and symptoms that they're experiencing? So, when are you saying this? Two, what does it mean in the context of managing themselves?

Karen: Right. And I think it's, you know, in terms of seeing it, I think it's not unusual or atypical for teens in general, regardless of whether or not they have learning and thinking differences to, you know, to experiment, to use alcohol, to use marijuana to cope with emotions in general. And to just to manage life, to fit in socially, and also they might like the way it makes them feel. And a lot of teens will self-medicate who don't have learning differences because they know that the substances they're using makes them feel less anxious, and so they feel more comfortable in situations, and it has nothing to do with the learning difference.

When it comes to teens using substances like marijuana, there is cause for concern for a couple of reasons. One, their brains are still developing, so they're not, you know a full-fledged adult with a fully developed frontal lobe system; those areas of the brain are still developing. When you're taking a substance into your system, you can actually change the way your brain is developing. And the other thing to keep in mind is that teenagers with learning differences are up to 40% more likely to develop substance use problems relative to their peers who also might experiment as well. So, there are greater risks for…

Julian: Wow, can you repeat that statistic again, because that's really important for listeners to hear.

Karen: Yes, I think, so what I was saying is that teenagers with learning differences are up to 40% more likely to develop substance use problems compared to their peers, which means that when they're attempting and experimenting with substances, they're more likely to have difficulties related to the use than their peers who experiment with substances who do not have learning differences.

Julian: Interesting. Interesting.

Karen: And the higher risk for using substances comes from a mix of social challenges. So, you've got students with learning and thinking differences who want to fit in socially. And so, those social challenges put them at greater risk for trying something that makes them feel more comfortable in social situations. School frustrations play a role, so they're trying to find something that will alleviate some of that school frustration. And again, it's their own attempts to manage emotional distress, discomfort. It can be depression, it can be anxiety.

And while some teens will say that they temporarily experience some relief from anxiety, the long-term studies show that it can have a negative impact on their cognitive development in a way that you wouldn't see right away, but you see later on. And part of that is because THC, the active ingredient in marijuana, affects the brain systems that are responsible for planning, for organization, for emotional regulation, and control. And these are areas where students with learning differences are already struggling. So, what happens is you can actually exacerbate difficulties with executive functioning, even though students might be saying it makes them feel more calm.

Julian: Got it. So, speaking of that, let's talk a little bit about support, like ongoing support for managing depression and anxiety over the long term versus an urgent, like almost crisis situation, right? Because there's distinctions between what it looks like over the longer term versus something that has to happen.

So, Dr. Karen, in your experience, what are some effective strategies or best practices parents can use to help their kids manage depression or anxiety over time, right? Because you said, one of the distinctions is these symptoms are happening over time like at least two weeks or more. It's not something that's just gonna go away overnight. What are some strategies that you would recommend for parents or guardians to help their children manage this over the long term?

(15:15) Support for managing feelings of depression and anxiety

Karen: Yeah, I think talking. You know, talking with your child is so important, because then you get a sense of, again, the intensity, how long this has been going on, and how much it's impacting their daily lives, how urgent it is. You know, if they have thoughts of self-harm, then obviously it's much more urgent, may even require hospitalization, but that is again...

Julian: We're gonna get to that in a second, because I'm definitely gonna ask about that.

Karen: That could be a more urgent situation. But in terms of building kind of long-term resilience, right, which is what you want, so when those feelings of sadness, of frustration, of self-deprecation, of hopelessness, worry come that children, our children, and our teens will have resources and tools that they can use to get through some of those hard times. And some of that, in terms of what parents can do is to helping young people develop a growth mindset, help them to know that even though things are hard now, they will not, they don't have to be hard all the time. They don't to have to stay hard.

Julian: So, would you recommend like saying that exact line?

Karen: Yeah, absolutely.

Julian: Like say again, your child comes home and they go right into the room and say, "I don't want to talk" or "I don't feel like talking to you right now." And I know a lot of people listening, they will say like "My teenager" or even "My eight-year-old, they come home and they don't wanna talk to me. They don't talk about anything." And you're recommending, say, "No, you have to have a growth mindset."

Karen: Yeah, no, I wouldn't say it like that. I definitely wouldn't use those words. And so, there's two things. One, if a child needs space, then you want to honor that space, right? Obviously, you want to make sure that they're safe.

Julian: OK.

Karen: But sometimes they just need to be by themselves to blow up steam, blow off steam to think about what happened, and then they'll reemerge, right? And then you have the conversation. And the conversation doesn't have to be "We need to talk. Let's sit down." It can be "Let's go for a walk. Let's go for a drive. Let's go get some ice cream. Let's go grab some dinner." And you have the conversation in, again, the safe space where they can open up about what's happening, maybe not in the moment where they're feeling overwhelmed or they're slamming doors, when they've had time to kind of think about it. And that's really the best time to engage in a conversation.

Julian: Got it. So, over the long term, really creating a space or a practice or even a predictable flow of conversation with your child so that over time, they know that you're not going to give up on them. Like essentially what you're saying is the child needs to know that you are there, that they have somebody that can be safe with them. What about in a crisis situation? And I ask that because again, I've experienced crisis situations more than I care to say, because there's just been so many that have happened.

It can be really overwhelming for everybody involved, right? Not only the parents, but the friends, the teachers, or the school staff, if it's happening at school, wherever it happens at home, it's a lot. And so, I'm wondering from your perspective, Dr. Karen, are there any red flag or emergency signs parents or caregivers can look out for or be alerted to so that they know, "All right, this is a crisis. This is a serious situation."

Karen: Yeah, I think any time a child is engaging in self-harm or they're talking about self-harm or hurting themselves or not wanting to be alive anymore, I think those are significant red flags. And those are situations where you want to get a professional involved. You might need to take a child to an emergency room. You might to call 911 and get an ambulance if you're afraid for their safety, if they said they're going to do something and they've told you what they're going to do, when they're gonna do it, and they've locked themselves in the bathroom, then obviously that's an urgent situation.

Julian: Got it.

Karen: So, I think those are things that you want to be mindful of and look out for. It can be very scary for parents, for caregivers, because you don't know what to do in those moments. But again, being there, just being physically present and being a person who is going to listen to what's happening. And also at the same time making sure that you're reaching out for the support you need, whether that is a crisis hotline, whether that is 911, whatever that might be, just to ensure the safety of the child or adolescent in your care.

I think it's also important to know that not every child who says "I wish I was never born" is having suicide ideation, right? And that's where the listening comes in.

Julian: Yes.

Karen: Because it might be like, you know, "I wish I was never born." Well, what does that mean? What would that look like? Right? You want to get more information because the child might say, "Oh, I'd never hurt myself." I've had kids say, you know, "Sometimes I wish I were never born, but I would never hurt myself. I would do anything like that." And so, it's getting more information so you can determine whether or not your child is at risk for harming themselves.

Julian: Got it. So, the last question I have, or last topic of conversation I want to bring up, as you know, you are a featured guest on the "Opportunity Gap," and the focus of our show is to bring to light the needs and support for children and families of color. Knowing that in our community, mental health and depression, anxiety, historically, there's been a stigma around that, or in some cases, people don't even believe it's a thing. They don't think it's real. I'm wondering what's your experience with that side of it and what would you say to our community, specifically for Black and brown families out there that might have questions about mental health or might have questions about depression or anxiety?

Karen: I think one of the most important things is to seek out professionals who you have a comfort with, seek out people, because oftentimes in our community, you feel more comfortable with people who look like you, right? Because there's some kind of understanding that you may have had similar experiences, that you might see things in similar ways, and there's a comfort there. And so, it may even mean, you know, podcasts like this one are really helpful and provide a lot of information.

There's a lot of Black female therapists who have podcast episodes about different topics. There are groups for Black women with autism, right? Black autistic women. And so, seek out the community who's providing support. That can be really helpful. And again, you know, we're talking about how it can be hard to get in to see a therapist, particularly one that looks like you. But there are a lot of people who provide either YouTube channels about mental health, obviously, you want to make sure that these people have their credentials to be saying what they're saying and they're not just someone with an opinion.

Julian: Yes. Yes. Get the receipts and look up their degrees, exactly.

Karen: Absolutely. Absolutely. There are a lot of really great clinicians of color doing really great work and getting a lot great information out into the world and you just have to do your research to find them and you can get a lot really great information and tips on how to support yourself as a caregiver and how to your child who might be struggling with learning difference or social-emotional challenges and so, that's where I would kind of say to go because I think we're getting better as a community about recognizing mental health. I think there's less stigma now than there was probably even five, 10 years ago.

And we can talk about the downside of social media, but the upside is that more people are being open about mental health challenges. More people are saying, "This helped me," or "This clinician helped me," or "I suffer from depression," or "My child has been experiencing anxiety." And I think when you see that you're not the only one who is experiencing this, then that can be very comforting, and it provides some hope for people who might be struggling in silence.

Julian: I could talk to you all day long, and this lived up and exceeded my expectations. Your expertise is relevant and so prevalent in everything that you speak of. I love that you dropped all these different concrete strategies for our listeners. And I would highly, highly recommend anybody listening to just check out her work. You can Google her, you can find everything that she's done. You've done some really amazing work for the culture and for our children. So, I just wanted to salute you and appreciate you. For everything that you do.

Karen: Thank you so much. Thank you so much, and thank you for the work that you're doing and for having this conversation with me today, so I appreciate it.

Julian: All right, OG family, that wraps today's episode. Until next time, thank you so much.

Thanks so much for listening today. We love hearing from our listeners. So, if you have any thoughts about today's episode, you can email us at opportunitygap@understood.org. And be sure to check out the show notes for links and resources to anything we mentioned in the episode.

This show is brought to you by Understood.org. Understood is a non-profit organization dedicated to empowering people with learning and thinking differences like ADHD and dyslexia. The "Opportunity Gap" is produced by The Tara Drinks and edited by Daniela Tello-Garzon. Our theme music was written by Justin D. Wright, who also mixes the show. Ash Beecher is our supervising producer. Briana Berry is our production director. Neil Drumming is our editorial director. Our executive directors are Laura Key, Scott Cocchiere, and Seth Melnick. Thanks again for listening.