Signs of Mental Health Issues in Kids That Most Physicians Miss w/ Dr. Shivana Naidoo (Ep. 51)

Recognizing and Responding to Mental Health Challenges in Adolescents: A Guide for Physicians

Today’s adolescents face unique challenges that can significantly impact their mental health, ranging from academic pressures and social complexities to the pervasive influence of digital culture. For physicians—who may not only face demanding professional lives but also the responsibilities of parenthood—recognizing mental health warning signs in their own children is often difficult.

Dr. Sivana Naidu, a psychiatrist specializing in child and adolescent mental health, offers insights and tools to help physician parents identify when their children may need support, as well as guidance on how to respond effectively.

Why Mental Health in Children & Teens is So Often Overlooked

Adolescents today are navigating a complex web of social and psychological pressures that may lead to anxiety, depression, and even suicidal ideation. Many symptoms in teens, such as mood changes, fatigue, and social withdrawal, can easily be attributed to “typical” teenage behavior, making it challenging for parents to discern when a normal developmental phase has turned into something more serious. The issue is further complicated by an era of social media, where online interactions often substitute for in-person connection and where self-esteem is frequently linked to likes and follows rather than personal relationships.

Dr. Naidu emphasizes that this environment can make it difficult for parents—even those with medical expertise—to detect the early signs of mental health distress. For busy physicians, these red flags might go unnoticed until a crisis emerges. By understanding specific warning signs and seeking support proactively, however, physician parents can make a profound difference in the well-being of their adolescents.

Recognizing the Signs With the FIND Method

To help parents systematically assess changes in a child’s behavior or mood, Dr. Naidu developed the “FIND” method, a tool for identifying mental health issues before they escalate:

1. Frequency: How often does the behavior occur? Look for patterns rather than isolated incidents. Are mood swings or negative behaviors becoming part of a daily or weekly routine?

2. Intensity: Assess the strength of the behavior or mood shift. Is it a mild reaction, or does it seem out of proportion? For instance, feeling anxious before an exam might be typical, but experiencing crippling anxiety that prevents the child from attending school is a sign of concern.

3. Number: How many phases of life does this behavior affect? Adolescents’ lives are often broken into phases—like school semesters or sports seasons—so a shift in behavior that persists across these different settings can signal deeper issues.

4. Dysfunction: Finally, examine whether this behavior disrupts daily life. If an adolescent is no longer participating in activities they once enjoyed or if academic performance is deteriorating, these are strong indicators of underlying distress.

Using the FIND method allows parents to differentiate between typical adolescent ups and downs and more concerning patterns that may require intervention.

Sleep, Anxiety, and Withdrawal: Subtle Signs of Mental Health Struggles

Dr. Naidu points out that certain warning signs are often missed in adolescents, particularly sleep disturbances, increased anxiety, and social withdrawal. While teenagers are prone to irregular sleep patterns, persistent insomnia or excessive sleep can indicate deeper mental health issues. Similarly, while some degree of anxiety is normal, ongoing, debilitating anxiety or chronic avoidance of activities can signal a larger problem. If these symptoms appear in combination—such as social withdrawal, ongoing fatigue, or failure to keep up with school—it is essential to consider professional help.

Anxiety and sleep disturbances are also two of the most common early risk factors for adolescent suicide, making them critical points of focus for parents concerned about their child’s mental health.

Seeking the Right Level of Support

If the FIND method reveals concerning patterns, the next step is deciding which type of professional help is appropriate. Dr. Naidu recommends beginning with a pediatrician, who is often familiar with the child’s medical history and can assess whether the behaviors might be related to an underlying health issue or if they suggest a mental health concern. For more persistent or severe symptoms, a mental health specialist can provide further assessment and interventions that might include therapy or even a neuropsychological evaluation for more complex cases.

Dr. Naidu notes that early assessments are critical, but parents should also approach these diagnoses with caution. A “diagnostic label” in adolescence can affect self-esteem and identity development, so choosing a thoughtful, measured approach with professionals experienced in adolescent mental health can provide clarity without unnecessary labeling.

Preventing Suicide: The Role of Proactive Steps in the Home

Physicians who are parents may also need to address the possibility of self-harm or suicide. Dr. Naidu shares several immediate, practical actions that parents can take to create a safer home environment, summarizing them through her GO SECURE checklist. This simple framework includes the following key steps:

• G stands for Guns: If firearms are present in the home, they should be secured in a locked cabinet with ammunition stored separately.

• O is for Over-the-counter and prescription medications: Secure all pills, including everyday items like pain relievers, which are common in adolescent overdoses.

• S stands for Sharps: Items such as kitchen knives and razor blades should be kept out of reach or locked up, as these are often used for self-harm.

• E is for Electric cords: Cords or any item that could be used to hang oneself should be safely stored.

• C stands for Car keys: Many adolescents engage in impulsive behaviors when under severe mental strain, and access to a car can pose additional risks.

• U stands for Underage drinking: Keep alcohol locked up, as impaired judgment from alcohol increases the likelihood of impulsive actions.

• R is for Reattempt: If a child has attempted self-harm, parents should ensure that the means they previously used are securely stored.

• E for Exits: Preventing access to rooftops or other high-risk areas where a teen might impulsively act on suicidal thoughts.

Securing the home environment can significantly reduce the risk of impulsive acts, especially for adolescents who may be navigating strong emotional impulses without fully developed self-regulation skills.

Promoting Connection and Open Communication

Dr. Naidu emphasizes that open communication is the cornerstone of effective mental health support. Adolescents need to feel heard, valued, and accepted by their parents, especially when expressing difficult emotions. Physicians may struggle to find time for these conversations amid their demanding schedules, but prioritizing such moments can provide a lifeline for adolescents struggling silently.

Dr. Naidu suggests that parents engage in regular conversations with their teens, addressing not only school and social issues but also checking in on their emotional health. Simple expressions of interest, understanding, and support can foster the trust needed for teens to open up about deeper concerns. Encouraging adolescents to communicate with trusted adults beyond the family—such as school counselors or coaches—can also help create a support network they feel comfortable turning to in times of need.

How Physicians Can Support Adolescents' Mental Health

For physician parents, who often bear the pressures of a high-stakes career alongside family responsibilities, addressing adolescent mental health can seem like an added challenge. Yet Dr. Naidu’s advice is clear: detecting early signs of distress and creating a safe, open environment for support are achievable and can make a life-changing impact.

By understanding how to recognize the signs of mental health struggles and acting on them proactively, physicians can provide a foundation of resilience and understanding for their children, helping them navigate adolescence with the mental and emotional support they need to thrive.