Warning Signs of Mental Illness in Children: A Parent's Guide
By Dr. Prerna Kohli | Clinical Psychologist, Gurugram | Updated June 2026
Children do not always have the language to describe what they are feeling— and even when they do, they may not have the awareness that what they are experiencing is unusual, or the confidence that telling an adult will help. This means that, far more than with adults, the responsibility for noticing falls on the adults around them: parents, teachers, and caregivers.
This is a genuinely difficult task. Childhood is a time of constant change— moods shift, behaviours emerge and disappear, and what looks alarming one week can be entirely forgotten the next. Distinguishing between normal developmental turbulence and a genuine warning sign requires understanding what to actually look for— not just individual behaviours in isolation, but their duration, intensity, and impact.
Every child will, at some point, show some of the signs I describe in this article. That is normal— childhood involves big feelings, difficult phases, and behaviours that can look concerning in isolation. What distinguishes a genuine warning sign is not any single behaviour, but its duration, its intensity, and whether it is genuinely interfering with your child's ability to function— at school, with friends, at home. The question is rarely 'is this happening at all?' It is 'has this become the new normal, and is it getting in the way of my child's life?'Dr. Prerna Kohli, PhD— Clinical Psychologist, in practice since 1993
Eight Warning Signs Parents Should Know— and What to Watch For
Persistent Mood Changes
Children do not yet have full control over, or understanding of, their emotions— so some mood variability is expected. What warrants attention is persistent sadness or withdrawal lasting two weeks or more, or mood swings extreme enough to disrupt school, friendships, or family life. A child who seems "down" for a few days after a disappointment is having a normal reaction. A child who has seemed flat, irritable, or withdrawn for weeks, with no clear cause and no improvement, is showing something different.
Intense Fears, Worry, or Overthinking
Anxiety in children frequently presents as worry that is disproportionate to the actual situation, or fears that interfere with normal activities— refusing to go to school, avoiding situations that involve separation from a parent, or becoming preoccupied with "what if" scenarios. Children experiencing significant anxiety often appear to adults as simply "sensitive" or "a worrier"— labels that can obscure a genuine and treatable difficulty.
Significant Changes in Appetite or Weight
Sudden changes in eating patterns— whether increased, decreased, or accompanied by secretive behaviour around food— can indicate mood disorders or, in some cases, the early stages of an eating disorder. Unexplained weight loss, frequent trips to the bathroom after meals, or rigid rules around food deserve attention, particularly in adolescents.
Difficulty Concentrating
Difficulty sitting still, sustaining attention, or completing tasks can have many explanations— but when it represents a clear change from a child's previous baseline, or is severe enough to significantly affect schoolwork and daily functioning, it deserves assessment. This can be a sign of ADHD, but can equally be a sign of anxiety, depression, or other difficulties— concentration is one of the first casualties of almost any significant emotional distress in children.
Unexplained Physical Symptoms
Children frequently express psychological distress through their bodies rather than their words— a phenomenon clinicians call somatisation. Frequent headaches, stomach aches, or fatigue with no identifiable medical cause— particularly when they cluster around specific times, such as before school— are often a child's way of communicating distress they cannot yet articulate verbally.
Self-Harm or Talk of Self-Harm
This is the sign that requires the most immediate and serious attention, with no exceptions. Unexplained injuries— cuts, burns, bruises in unusual locations— or any mention of self-harm or suicidal thoughts, however casual it may seem, must always be taken seriously. Children and adolescents sometimes test the waters with indirect comments before disclosing more directly; dismissing these comments, even if they seem like "attention-seeking," can close the door to a conversation that genuinely needs to happen.
Sudden Behavioural Changes
A child or adolescent who undergoes a significant shift in personality, behaviour, or judgement— becoming someone parents describe as "not like themselves"— may be communicating distress through behaviour rather than words. This can include increased aggression, risk-taking, rule-breaking, or withdrawal from previously close relationships. Adolescence involves change, but a marked, sustained shift from a child's established patterns is worth examining rather than attributing solely to "growing up."
Substance Use
When a child or adolescent is struggling to cope with difficult emotions and has not been given— or has not found— healthier ways to manage them, substance use can emerge as a form of self-medication, often compounded by peer pressure. This is rarely the root issue itself, but rather a sign that something underlying needs attention. Treating substance use in isolation, without addressing what it may be masking, is rarely sufficient.
"His parents brought him to me at age eleven because his teachers had reported a sudden drop in concentration and participation— a child previously described as bright and enthusiastic had become, in his teacher's words, 'somewhere else.' His parents were confused: at home, he seemed fine. He ate normally, slept normally, didn't complain about anything."
"What emerged, over a few sessions, was that he had been experiencing significant anxiety related to a teacher who frequently humiliated students for wrong answers— something he had never told his parents, because he didn't think of it as something to tell. To him, it was just how school was. He had begun avoiding raising his hand, then avoiding eye contact with that teacher entirely, and the avoidance had generalised into difficulty concentrating across his whole school day."
"His parents' instinct— that 'he seems fine at home' meant nothing was wrong— is one I hear constantly. Many children compartmentalise distress remarkably well, presenting normally in the environment where they feel safe while struggling significantly in the environment where the distress originates. The teacher's report was not an overreaction. It was the only visible thread of something that, at home, was completely invisible."
Why Indian Parents Often Miss These Signs
The Cultural Lens That Can Obscure What's Really Happening
"It's just a phase" or "they're being difficult." Behavioural changes in children are frequently interpreted through a discipline lens rather than a mental health lens. A child who has become withdrawn or irritable may be labelled "moody" or "rude"— descriptions that locate the problem in the child's character rather than considering what might be driving the change.
Academic performance as the only metric. Many Indian parents— understandably, given the cultural weight placed on academic achievement— use grades as the primary indicator of how a child is doing. A child who continues to perform academically while showing other significant signs of distress can go unnoticed for a long time, because the metric being watched looks fine.
The stigma barrier. Even when signs are noticed, the idea that a child might have a mental health condition remains, for many families, something to resist rather than explore— out of fear of labelling, of social judgement, or of what it might "mean" about the family. This resistance often delays assessment by months or years.
No framework for what to look for. Most parents were never taught what childhood mental health difficulties actually look like— and without that framework, signs that would be obvious to a trained eye can simply blend into the background of ordinary childhood.
Any indication of self-harm or suicidal thoughts in a child or adolescent— including comments that seem casual, indirect, or "not serious"— should be addressed immediately and without delay. This does not mean panic, but it does mean a direct, calm conversation with your child and prompt consultation with a mental health professional. Do not wait to see if it passes. Early response saves lives.
What to Do If You Notice These Signs
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Observe without panicking
Note what you are seeing— which signs, how long they have been present, in what situations they appear or worsen. This information will be valuable, whether to a professional or simply to your own understanding.
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Have a calm, open conversation
Ask your child how they are feeling, without leading with concern that might make them feel they have done something wrong. "I've noticed you seem [observation] lately— how are you feeling about things?" opens a door without assigning blame.
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Consult a child psychologist
An assessment does not commit you to any particular treatment— it provides clarity. A professional can help distinguish between normal developmental variation and something that needs further support, and can identify what kind of support would be most appropriate if needed.
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Involve the school where relevant
If the signs are showing up at school— academic difficulties, behavioural changes reported by teachers— open communication with the school, alongside professional support, gives everyone involved a more complete picture.
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Resist the urge to wait and see
"Let's see if it improves on its own" is the most common reason early signs become entrenched difficulties. Early professional input— even just for assessment— is significantly more effective than delayed intervention, and carries no downside.
The parents I see who feel the most regret are not the ones whose children turned out to have a serious condition— early identification, in almost every case, leads to good outcomes. The regret comes from parents who say: 'looking back, the signs were there for a long time, and we kept telling ourselves it would pass.' I want every parent reading this to know: noticing is not overreacting. Asking for an assessment is not labelling your child. It is simply giving yourself— and your child— accurate information, as early as possible.Dr. Prerna Kohli, PhD— Clinical Psychologist, in practice since 1993
Frequently Asked Questions
What are the main warning signs of mental illness in children?
According to Dr. Prerna Kohli, the key warning signs include: persistent sadness or withdrawal lasting two weeks or more, extreme mood swings that disrupt home or school life, intense fears or worry that interfere with daily activities, significant changes in appetite or weight, difficulty concentrating that affects schoolwork, physical complaints like headaches or stomach aches with no medical cause, any self-harm or talk of self-harm, sudden behavioural changes or risk-taking, and substance use. No single sign confirms a mental health condition, but persistence, severity, or combination of signs warrants professional evaluation.
How can I tell the difference between normal childhood behaviour and a warning sign?
The key distinctions are duration, intensity, and impact on functioning. All children experience mood swings, worries, and difficult phases— this is normal development. What distinguishes a warning sign is when these experiences persist beyond what is typical (generally two weeks or more for mood changes), are disproportionate to the situation, or are significantly impairing the child's ability to function at school, with friends, or at home. A single bad week is rarely concerning. A sustained change in a child's baseline functioning, mood, or behaviour deserves attention.
Why do Indian parents often miss or dismiss warning signs in children?
Several cultural factors contribute: behavioural changes are frequently attributed to discipline issues, attention-seeking, or "a phase" rather than considered as potential mental health signs; the stigma around child mental health makes many parents reluctant to consider it; academic performance is often used as the primary indicator of wellbeing, meaning other significant signs in a high-performing child can go unnoticed; and many parents simply lack a framework for what mental health difficulties in children actually look like.
What should I do if I notice warning signs in my child?
Dr. Prerna Kohli recommends: first, observe without panicking— note what you're seeing, how long it's been happening, and in what contexts. Second, have a calm, non-judgmental conversation with your child about how they're feeling. Third, consult a child psychologist for an assessment— this doesn't commit you to any particular treatment, but provides clarity about what's happening. Early professional input, even just for assessment, is significantly more effective than waiting to see if things improve on their own.
Is it normal for children to have mental health conditions?
Mental health conditions in children are far more common than most parents realise— anxiety disorders, depression, ADHD, and other conditions affect a significant proportion of children and adolescents globally, including in India. These conditions are not a reflection of parenting failure, and they are, in the vast majority of cases, treatable— particularly when identified early. The stigma that surrounds child mental health conditions often causes more harm than the conditions themselves, by delaying the support that could help.
Noticing Is Not Overreacting
If you have read this far because something about your child has felt different, and you have been unsure whether it warrants attention— let this be the permission you may have been looking for. Trust what you have noticed. You know your child better than any checklist can capture, and your instinct that something has changed is information worth acting on.
Early assessment costs you nothing but a conversation. The alternative— years of unanswered questions, or a child who learns that their distress goes unnoticed— costs considerably more.
Concerned About Your Child?
If you have noticed changes in your child's mood, behaviour, or wellbeing and would like a professional assessment, I offer confidential consultations from my practice in Gurugram, with online sessions available across India and internationally.
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About the author — Dr. Prerna Kohli
Dr. Prerna Kohli is a clinical psychologist with over 30 years of practice, based in Gurugram. She holds a PhD from Aligarh Muslim University, where she was a four-time gold medalist, and received the “100 Women Achievers of India” award from the President of India in 2016. A TEDx speaker and published author, she works with individuals, couples, and families through her private practice — in-clinic in Gurugram and online worldwide — with a particular speciality in NRI mental health.