2020 has been an unprecedented year - and not in a good way. If we've struggled as adults during the coronavirus crisis, it's important to remember things may have been even more upsetting or confusing for our kids.

Red Flag symptoms

Although there is no hard-and-fast rule for picking up mental distress, your child's behaviour may give a clue to how they're feeling. So what are some of the common signs?

Changes in mood

All children have the odd 'off' day, or spend an occasional afternoon squabbling with their siblings. But sometimes their mood can reveal that another factor may be at play. "Having low mood or apathy can be a sign that your child is feeling ansioso oppure depresso," explains Dr Sharie Coombes. "Children may also get angry more easily than usual."

Other children may display signs of mental rushing around. "Children in distress may do many different things, but seem unsatisfied with the result. Mental rushing around, being unable to sustain one train of thoughts and obsessive multi-tasking may be a sign of ansia, or a symptom of conditions such as Asperger's oppure ADHD," explains Coombes.

Avoidance

Of course, all of us would prefer to avoid certain situations. But if your child is reluctant to carry out some of the activities they used to enjoy, or is overreacting and panicking when an activity or destination is suggested, this may be a sign of something deeper. "If children get angry or panic at the thought of having to do something that they used to enjoy in the past, this can be a sign of anxiety or obsessive compulsive disorder (DOC)," explains Coombes. "However, this is made more complicated by the current crisis."

If your child is avoiding an activity, it's important to talk with them about why and try to find the deeper reasons behind their reluctance.

Physical symptoms

Children aren't always able to describe their feelings, or understand where they are coming from. Sometimes, when they are feeling anxious or stressato they may instead complain of a physical symptom. "Sematic physical symptoms, such as mal di testa, mal di pancia, feeling sick or mal di gola with no apparent cause, may be a sign of distress," agrees Coombes.

With children often lacking the vocabulary to specifically describe their symptoms, it can be difficult to work out whether a tummy ache is caused by a physical issue or emotional distress. However, it's important to be mindful of this possibility.

Sleep issues

When children are anxious or suffering from racing thoughts they may struggle with insonnia. It may be that they find it more difficult to get to sleep, wake up early in the morning or find themselves waking after less than an hour of sleep. Some difficulty sleeping may simply be an ordinary part of childhood. But if your little one is struggling at night, it's important to look out for other signs and symptoms of poor mental health. "If your child is struggling to sleep, look at what it's combined with," says Coombes. "For example, if they are quick to anger or have tears, or are unable to concentrate, this can be sign of something deeper."

Low self-esteem or guilt

Children who are suffering with mental health problems can sometimes complain of feeling guilty - this is especially pronounced in more serious conditions such as disturbo da stress post-traumatico (PTSD). "Sometimes these feelings can be really intense - children may feel they don't deserve anything nice, or shouldn't be going somewhere because they are inherently 'bad or worthless'," explains Coombes.

Many of the symptoms above may indicate stress, anxiety or even depression. However, children who have suffered a period of worry or trauma may also be more susceptible to conditions such as OCD and PTSD.

DOC

OCD can come in many different forms, including unpleasant intrusive thoughts and worries about people's health.

Another symptom can be obsessive attention to hygiene and repetitive rituals. The awareness and fear of germs and hand washing that came with coronavirus may trigger an underlying anxiety in some children, leading to behaviours such as obsessive cleaning or being disproportionately anxious about germs and hygiene.

PTSD

Many of us think of PTSD as being something experienced by people who have had a major trauma - perhaps someone who has served in the army, or been a victim of an attack.

But doctors are increasingly concerned that the current generation of children may be more prone to PTSD because of the trauma of coronavirus and the associated changes in their lives. It's important that any symptoms of mental distress be taken seriously in order for your child to receive the correct treatment if necessary.

Taken individually, many of the above behaviours are normal for children - and ones that many children may exhibit from time to time. So when should we be concerned? "When a child's behaviour begins to interfere with normal life - their own life or family life as a whole - it's a sign that intervention is needed," explains Coombes.

Seeking advice

If your child is displaying several symptoms, or their behaviour is causing you concern, it's sensible to seek medical advice. "Children are generally very resilient, but for some this has been a horrendous, deeply worrying time. For almost all children this experience has been unnerving," explains Coombes. "Putting things in place now will reduce the chance of having a generation of children at risk of developing PTSD as adults because of this negative experience."

Family support

Even if your child isn't displaying signs that cause particular concern, as we parent through the current crisis it's a good idea to develop greater understanding of how to maintain good mental health and overcome obstacles. "We can put things in place and become more psychologically aware as a family," explains Coombes. "By talking openly, we can help our children to process what's gone on and help them to develop coping mechanisms which will stand them in good stead for the rest of their lives."