Views & Opinion Puberty or mental ill health? Comment by Dr ASHA PATEL, CEO of education not-for-profit Innovating Minds
Are they covering up? Children at this age can be self-conscious about their appearance and changing body shape so they may not want to appear in sports kit. Some prefer to disguise their shape with layers of clothes. However, keep an eye out for children with severe weight loss or sudden weight gain, sores and burns around the mouth which could indicate experimentation with drugs and cuts or burn marks on their body. One primary teacher said their school uniform meant children kept their
arms and legs covered all the time. She only realised that a girl was self- harming when she overheard other children talking about it in the playground. Changes to the body can be an extremely difficult time, and even more
so for children that have experienced sexual abuse. It is important to be mindful that puberty can trigger memories and feelings of past abuse, and the children may not be able to process why they are feeling the way they do.
Early onset puberty research This is a tricky area because no one knows exactly what a normal age for puberty is. Research by American Society for Reproductive Medicine has shown that children start puberty in the USA earlier than young people in other parts of the world. This is attributed in part to increasing obesity and more processed food in their diet. However, they also noted that African- American girls may have normal puberty signs as early as the age of six. It was previously thought that early puberty might be linked to sexual
Puberty used to be seen as something which happened in secondary school but young people are maturing at an earlier rate. In Victorian times, menstruation started at about the age of 16 in Europe. Now the average is down to 12 years old and more children than ever are exhibiting signs in primary schools. The physical signs are obvious: body hair, breasts and menstruation in
girls; facial hair and a deepening voice in boys. But what happens to the emotions is just as powerful. We know to expect mood swings, moments of extreme self-doubt, elation and sudden bursts of anger. But puberty can affect mental health too.
Signs to look out for Does the child have friends or are they isolated? At this age relationships can be volatile but children are generally tolerant of their friends' outbursts. Look for the child who is not engaging with their peers, a child who always appears to be spending time alone. Children who are experiencing mental health difficulties can find it difficult to socialise with others. Their tolerance for being around others is low and may find themselves in a position of avoiding others as a coping strategy.
What is their general appearance like? One teacher said he can always smell if year 8s have been in the room before her lesson as they leave a distinctive teenage odour. Adolescence is when the apocrine glands kick in and usually there is an increase in body odour so smell is not necessarily an indicator of poor mental health. A child who adapts their school uniform, turns up in trainers, or ignores strictures about hair is an average teenager. However, if the child appears to be unkempt, neglecting their hair and dental hygiene on a regular basis look into this further. Self-care can be a barometer for a child's mental health and, while adolescents do go through an unwashed phase, many make extra efforts with appearance, if not with their school uniform.
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precocity and that this could be a safeguarding issue. It is often seen as a risk factor for poorer mental health, partly because the younger the child, the less likely they can cope with the transition. However, research in Australia suggests that emotional disadvantages
may trigger early puberty. A study published in 2013 by the Journal of Adolescent Health found children who go through puberty early showed signs of poorer mental health in early childhood. It was based on a cohort of 3,491 children and families from the Longitudinal Study of Australian Children and looked at four surveys undertaken between ages the ages of four, covering behavioural difficulties and emotional, social and school functioning. Around 16% of girls and 6% of boys had begun puberty by age eight
to nine. They found that boys with an earlier onset of puberty had greater behavioural difficulties and poorer emotional and social adjustment. These difficulties began as early as four to five years of age and continued to early adolescence.
Are children more prone to mental health difficulties in puberty? Research by Dr Andrew Curran (neurobiologist) suggests that changes in dopamine levels at the onset of puberty is the reason why adolescence is the commonest time to develop depression, bipolar disorder and for autism spectrum disorder to reveal itself with behavioural problems. The surge in dopamine is normal neurobiology. It is genetically pre- determined. This is because nature wants adolescents to take high-risk decisions with poor judgement. By doing so, it achieves two critical goals. They break free of their dependence on their parents, and they learn how to interface with their peer group by trial and error so they can become successful as adults. The dopamine surge leaves children vulnerable to por decision making. Children experience many changes (physically, emotionally and
neurochemically) during their adolescent years, and so the risk of them experiencing mental health difficulties increases significantly.
November 2021
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