The 4 Most Common Mental Health Misdiagnoses in Children
If your child fell down and hurt their arm badly, you’d take them to the ER or an urgent care facility for an X-ray. The images would help the physician diagnose whether or not the arm is broken and would guide the treatment plan. Broken bone? That’ll be at least 6 weeks in a cast. Just a sprain? That’s more likely the “RICE” protocol—rest, ice, compression, elevation. Without imaging, your doctor wouldn’t know whether or not the bone was broken, and if they made the wrong guess, it could lead to prolonged pain for your child or a bone that doesn’t heal correctly and could cause problems for a lifetime.
Why are mental health and behavioral health problems treated differently? In traditional psychiatry, mental health professionals typically never look at the organ they treat—the brain. This means psychiatrists and psychologists must guess when making a diagnosis based solely on symptoms. This results in many children being misdiagnosed and treated with the wrong plan. And that leads to unnecessary suffering.
At Amen Clinics, which uses brain SPECT imaging as part of a complete evaluation, we see many children who have been previously misdiagnosed. Based on tens of thousands of patients, here are some of the most common misdiagnoses in children.
1. Symptom: Inattention
Commonly diagnosed as: ADD/ADHD Inattention is one of the classic symptoms of ADD/ADHD. When a child has trouble focusing, is easily distracted, or frequently daydreams, parents and clinicians often suspect that it’s due to this common condition. But not all inattention is due to ADD/ADHD. Some of the other causes of inattention include:- Poor sleep: Inadequate sleep can make it harder for children, tween, and teens to pay attention. A single night of tossing and turning or going to bed too late can impair the ability to concentrate. Up to 50% of children will experience a sleep problem, according to research in American Family Physician.
- Distressing life events: Parents divorcing, losing a beloved pet, or having a best friend move away can take an emotional toll on youngsters and lead to distractibility and inattention.
- Food sensitivities: Foods like gluten, dairy, corn, soy, and artificial dyes and preservatives can cause issues with focus and attention in some children.
- Anxiety: When children have anxiety, they may be so wrapped up in their anxious thoughts or in feeling uncomfortable in their own skin that they seem distracted.
- Obsessive compulsive disorder: Children with OCD are often so distracted by their obsessive thoughts and compulsions that they aren’t able to pay attention in school or at home.
- Post-traumatic stress disorder (PTSD): Children who have experienced trauma and who have developed PTSD may be subject to intrusive thoughts or memories about the event, which pulls their attention away from the present moment.
- Learning disorder: Kids who look like they’re spacing out or who can’t seem to concentrate on the books assigned to them in school may have underlying learning disabilities.
- Head injuries: One of the most important lessons from 160,000 brain scans at Amen Clinics is that mild traumatic brain injuries (TBIs) can cause psychiatric problems, but few people know it. Inattention is a common symptom in children who have experienced concussions or other head trauma.
- Irlen syndrome: Irlen Syndrome is a visual processing problem, where certain colors of the light spectrum irritate the brain. It runs in families and is common after traumatic brain injuries. Any child experiencing symptoms of decreased concentration should be screened for it.
- Exposure to environmental toxins: Being exposed to everyday chemicals or to mold and other toxins can cause inattention.
2. Symptom: Sadness, negativity, fatigue
Commonly diagnosed as: Depression All kids go through periods where they feel blue or lethargic, but when sadness, negativity, or fatigue last for longer periods of time, it can be diagnosed as depression. Unfortunately, that isn’t always the accurate diagnosis. Some of the other causes of sadness, negativity, and fatigue include:- Sleep problems: Research shows that teenagers who on average get an hour less sleep at night were 38% more likely to feel sad and hopeless, 42% more likely to consider suicide, and 58% more likely to attempt suicide.
- Thyroid imbalances: Hormones can affect moods, energy levels, and irritability. For example, when thyroid activity is low, which is called hypothyroidism, it is associated with depression, fatigue, irritability, and more. SPECT scans of people with hypothyroidism show overall decreased brain activity, which often leads to depression and other issues. Low thyroid and depression have been linked in over 430,000 scientific articles. Foundational research on hormones shows that in some cases, depression can be one of the first signs of thyroid disorder.
- Poor diet: Research shows that high-sugar diets, blood sugar issues, and obesity are associated with depression and other issues. In addition, depression is 2-3 times higher in patients with Type 2 diabetes than in the general population.
- Undisciplined thinking: Unfortunately, children are never taught that they don’t have to believe every stupid thought they have. Children who appear negative may be filled with ANTs (automatic negative thoughts) that loop in the brain and steal their happiness. Learning to question their thoughts can reduce symptoms of depression.
- Head injuries: Head trauma increases the risk of depression, according to research in Frontiers in Psychiatry. Treating the underlying brain trauma can help alleviate depressive symptoms.
- Irlen syndrome: This condition (see above) is also associated with symptoms of depression.
- Exposure to toxins: (see above)
3. Symptom: Anxiousness, panic, fear
Commonly diagnosed as: Anxiety Anxiety is one of the most common mental health problems seen in children, tweens, and teens. But having anxious thoughts, feeling panicky, or being especially fearful can be related to many other things. Some of the other causes of anxiousness, panic, and fear include:- Emotional issues: Children who are dealing with emotional upheaval at home may develop symptoms of anxiety. Learning how to deal with their emotions can help.
- High-glycemic diet: Eating too many sweets, which causes blood sugar levels to spike and then crash, can increase feelings of anxiety and panic, according to a 2016 study.
- Irlen syndrome: (see above)
- Head injuries: A 2015 study shows that concussions and other TBIs (see above) are also associated with an increased risk of anxiety.
- Exposure to toxins: (see above)
- Undisciplined thinking: (see above)
4. Symptom: Anger, argumentative, disruptive behavior
Commonly diagnosed as: Oppositional Defiant Disorder (ODD) or Intermittent Explosive Disorder (IED) Some kids never seem to outgrow the “terrible twos.” They remain oppositional, have a short temper, and can explode into a rage, which often leads to a diagnosis of ODD or IED. But there may be other underlying issues at play. Some of the other causes of anger, argumentative, and disruptive behavior include:- High-glycemic diet: (see above)
- Food sensitivities: (see above)
- ADD/ADHD: Amen Clinics has identified 7 types of ADD/ADHD and kids with Overfocused ADD are frequently oppositional and tend to be inflexible and argumentative. They often have trouble shifting attention, frequently get stuck in loops of negative thoughts or behaviors, and have obsessive or excessive worrying.
- OCD: Kids who have OCD are often rigid in their thinking, argumentative, hold grudges, and are likely to automatically say “no” first. On SPECT scans, this is often associated with overactivity in the anterior cingulate gyrus (the brain’s gear shifter).
- Head injuries: When head injuries affect the temporal lobes (a brain region associated with mood stability, learning, memory, and temper control), it can lead to irritability and anger issues.
