Watch for symptoms in children

This week has been filled with preparations for the upcoming school year. An intern I’m working with and I gave a presentation about symptoms of mental health problems to teachers for professional development. Children are not immune to emotional problems. We need to watch them for symptoms of things such as depression, anxiety, or inattention.
When we see symptoms in our children, it is wise to pay attention, but not panic right away. First of all, consider the obvious possible explanations of variations in behavior before turning to diagnoses such as depression or anxiety.
First check if the child has been sleeping well. That doesn’t mean that they go into the bedroom at the proper time, or even laid down in the bed with the light off. Many times when a parent brings a child to my office, the parent says the child sleeps enough. Then the child will admit that it takes him a long time to fall asleep, or many she wakes up in the middle of the night and can’t go back to sleep. A lot of events can affect one’s ability to sleep, but if sleep is interrupted chronically, it’s best to take a closer look.
Both anxiety and depression can impact the quality of sleep. It’s a good idea to check with children in the morning. Ask them how they slept.
As I mentioned in an earlier blog, insomnia was one of the long-term effects from the brain injury I had as a child. I didn’t see it as a problem. I would wake up at 4:00 in the morning, turn on the light, and read until it was time to get ready for school. Unfortunately, I shared a room with my older sister. She didn’t find it humorous when I kept turning on the light at 4:00 in the morning. I was moved to a bedroom in the basement where I couldn’t bother anyone.
Anyway, lack of sleep can be cumulative over time.
Another area that has become more and more important to me over the last three years or so is nutrition. Forgive me if I repeat myself, but it’s important to know that a lot of those chemicals we need to fight anxiety and depression are made in the gut, not just the brain. If the gut is not the correct environment, the neurotransmitters such as serotonin and dopamine cannot be manufactured. Then we are depressed…or anxious.
I now recommend to all patients that come see me that they keep a food diary for at least a month. They then note when they have good days and bad. What works for one person might not work for another, but after reading three books on psychoneuroimmunology, (isn’t that a cool word!!??), I believe that most people would benefit from taking probiotics. Please note, however, that neurobiology is not my field of expertise. I’ll share more of what I learned in the future, though! It’s actually pretty interesting.
The reason I got into learning about the gut what that I had a patient that began exhibiting symptoms of Bipolar Disorder in her mid-thirties. Typically, Bipolar Disorder “rears its ugly head” in the early twenties. I always allow for exceptions, but because she suffered from depression that then morphed into mania, a doctor diagnosed her with Bipolar Disorder and prescribed medication for it.
I never like to contradict another professional, but having sudden-onset Bipolar Disorder at that time in her life would be unusual. I suggested tests for other explanations.
To make a long story at least a little shorter, it was discovered that she had Hashimoto’s disease—an autoimmune disorder of the thyroid. With her thyroid medications as well as NO gluten, her Bipolar symptoms are gone.
It took a while to figure out the gluten connection, and again, the same would not necessarily be the case for everyone. I am certainly NOT suggesting that actual Bipolar Disorder does not exist!! I am saying that in some people, symptoms that appear to be a mental health disorder might actually be something else.

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