‘Is My
Child OK?’
What parents need to
know about the ups and
downs of childhood versus
mood disorders
BY LAURA FARMER
It’s a question we parents ask ourselves all the time: “Is my
child OK?” As parents, we know there are times when our children
do not seem emotionally OK. For example, perhaps a toddler seems
to be throwing tantrums more often and at decibel levels that surely
can’t be normal. What about a sullen teenager who always seems moody
and isolates herself in her room? How about a school-aged child whose
frustration in school prompts him to act out? Are these behaviors within
the realm of “normal,” or should parents be alarmed?
Unfortunately, the answer to this question has been further
complicated by the disruptions of the COVID-19 pandemic. For more
than a year, most students learned at home, virtually. Despite their
heroic teachers’ best efforts, remote learning was a trying experience
for many. Finally, students are back in school and are navigating the
school routine’s pressures: waking up early, being around peers
for six hours a day and encountering new academic demands.

Naturally, we should expect that our kids will need to adjust
to this new experience, which may cause them to act out in
ways we weren’t anticipating.

“Is my child OK?” How do we, as parents,
differentiate between the normal ups and downs
of the younger years versus an actual mood
disorder that needs specialized care? For
help, we turn to the experts.

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20 Washington FAMILY DECEMBER 2021



Dr. Sean D. Pustilnik serves as the clinical
director of child and adolescent psychiatry
at MedStar Georgetown University Hospital.

He shares that, in recent years, the general
public has an increased awareness about the
importance of fostering mental wellness.

But he cautions, “Mental illness and mental
health are not opposites. As with physical
health, the absence of an ailment doesn’t mean
you’re healthy. It simply means you don’t
have a disease.”
So, too, with mental health. “There are
a lot of things that kids need for their well-
being, like physical activity, sleep, socialization,
family time and time spent outdoors,” explains
Pustilnik. “During the pandemic, a lot of those
things were restricted. While children may not
have a diagnosable mental disorder such as
depression or autism, they were not engaging
in the things that we know help create optimal
well-being.” So ar e they OK?
According to Dr. Jason A. Lewis, a psychologist
and section director of mood, anxiety and
trauma disorders at Children’s Hospital of
Philadelphia, parents should consider several
factors to determine whether their child’s
mood swings are normal.

“First, we look at the severity of their
symptoms compared to how their symptoms
appeared in the past,” explains Lewis. “Next,
we consider if their symptoms have a known
cause, or did they develop out of the blue?
We also consider frequency and duration:
Are symptoms occurring more often and for
longer periods of time? Most importantly,
has the child contemplated or engaged in
any self-harm? When this is true, it is always
important to seek professional support.

Finally, do these symptoms impair your
child’s functioning?”
Pustilnik agrees. “You can research
various conditions online and come up with
a list of symptoms. But just the presence of
these symptoms is not enough to diagnose
a mental disorder. Rather, we look at how
these symptoms affect various aspects of your
child’s life.”
Dr. Ronald Lee, service chief of the
Adolescent Male Crisis Stabilization Unit at
Sheppard Pratt, adds that sometimes children
in distress can be especially hurtful to the
people they love most.

“Children may show severe irritability
and be more prone to fighting,” says Lee.

“A lot of times, their anger is directed toward
Child and Adolescent Behavior al Health
Ser vices in the DMV
CHILD AND ADOLESCENT
BEHAVIORAL HEALTH PROGRAM
Montgomery County Department of
Health and Human Services
7300 Calhoun Place, Rockville, Maryland
8818 Georgia Ave.

Silver Spring, Maryland
240-777-1432 montgomerycountymd.gov/HHS-
Program/Program.aspx/?id=BHCS/ BHCSChildAdolMentalHealth-p471.html
CHILDREN’S NATIONAL HOSPITAL
111 Michigan Ave. NW, Washington, D.C.

202-729-3300 childrensnational.org/departments/
psychiatry-and-behavioral-sciences INOVA BEHAVIORAL
HEALTH SERVICES
Locations in Northern Virginia and
Washington, D.C.

855-694-6682 inova.org/our-services/
inova-behavioral-health-services family members and the people with whom
they’re closest. They may not mean the words
they say, but their words come from their
emotional distress.”
OK-ish to A-OK!
What can parents do when they recognize
that their child’s mental health is not
optimal? According to Lee, the first step
is communication.

“Parents should make themselves available
to talk with their child about how they’re
feeling. Actively listen to them, without any
distractions, to understand where they are
coming from,” he advises.

He also recommends that parents reach out
to other people in your child’s network.

“Many kids already have a baseline hard time
communicating and may shut down further as
a result of poor mental functioning,” says Lee.

“Therefore, it may be helpful to reach out to the
child’s teachers, school counselor or friends to
find out how they are doing in other settings.”
Model the coping skills you’d like your
children to use.

“Kids learn a lot from what they see around
MEDSTAR HEALTH GEORGETOWN
UNIVERSITY HOSPITAL, OUTPATIENT
CHILD AND ADOLESCENT
PSYCHIATRY CLINIC
2115 Wisconsin Ave. NW, Suite 200
Washington, D.C.

202-944-5400 medstargeorgetown.org/
our-services/division-of-child-and- adolescent-psychiatry
THE ROSS CENTER
5225 Wisconsin Ave. NW, Suite 400
Washington, D.C.

202-363-1010 1595 Spring Hill Road, Suite 520
Vienna, Virginia
703-687-6610 rosscenter.com
them,” says Lewis. “We’re all stressed. But
parents should try to model successful ways
of coping, (which) includes a variety of skills,
such as using good problem-solving strategies,
effective self-care, engaging in prosocial
activities, getting good sleep, eating well and
taking care of your physical self.”
Parents should also model healthy screen
use habits.

“(Social media) use is like tobacco use 50
years ago! If we could put a Surgeon General’s
warning on it, we would!” says Pustilnik. “Its
overuse has had a huge public health impact.

It detracts from all of the healthy things kids
should be doing.

“Social connection through a screen is not
the same as in-person interaction,” he says.

“Parents should monitor screen time and try
to limit it to two hours per day.”
Growing up is tough. But adult-ing is tough,
too! Just as you have good days and bad days,
expect that your child will, too.

If it seems like she or he is having more bad
days than good, don’t hesitate to raise your
concerns with your child’s pediatrician or a
mental health professional. n
WashingtonFAMILY.com 21
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OK-ish