Child and Adolescent Mental Health: A Parent's Guide

This article is general information published by the practice of Dr. Sholeh Toobaei, Specialist Psychiatrist, Dubai. It has not yet been individually reviewed by a clinician and is not a substitute for personal medical advice. Published: 1 September 2026.

Scope: This article is general information about child and adolescent mental health. It is not a diagnosis or treatment plan. If you are concerned about a child's mental health, a professional assessment can help.

Children are not small adults

The most important thing to understand about child and adolescent mental health is that children experience, express, and process emotional difficulties very differently from adults. A depressed six-year-old does not look like a depressed adult. A six-year-old with depression may present as irritability, physical complaints ("my tummy hurts"), regression to earlier behaviours (bed-wetting, thumb-sucking), or a decline in school performance. An adult with depression may present with tearfulness, loss of interest, and changes in sleep and appetite.

This is not because children are being dramatic or attention-seeking. It is because their brains are still developing. The emotional regulation circuits — primarily the prefrontal cortex and its connections to the amygdala (fear and emotional processing) — are far from mature in childhood. Children literally do not have the neurological infrastructure to process emotions the way adults do. This means their symptoms look different, and their treatments must be different too.

What is normal?

Every parent worries about whether their child's behaviour is normal. The answer depends on age, but three questions are generally helpful:

How old is the child? A three-year-old who throws tantrums is typical. A twelve-year-old who throws tantrums is a signal. Developmental stage matters enormously.

How intense, how frequent, and how long-lasting? All children have bad days. A pattern of difficult behaviour lasting more than a few weeks, that is more intense than peers, or that is interfering with school, friendships, or family life is a signal that something may be wrong.

Is it affecting function? The single best question: is this behaviour preventing the child from doing what a typical child of their age can do? Not thriving academically, socially, or emotionally — that is the threshold for a professional assessment.

Common conditions

ADHD. Attention deficit hyperactivity disorder affects approximately 5–7% of children worldwide. It is not a behavioural problem or a result of poor parenting. It is a neurodevelopmental condition characterised by difficulties with attention, hyperactivity, and impulsivity. ADHD makes the world feel over-stimulating and under-structuring. Children with ADHD can focus on things that interest them — the problem is regulating attention, not an absolute inability to focus. Treatment includes behavioural strategies, school accommodations, and sometimes medication.

Anxiety disorders. Anxiety is the most common mental health condition in children and adolescents. It can present as separation anxiety (inability to be away from parents), school refusal, panic attacks, phobias, or generalised worry. In Dubai's school environment — where academic pressure can be significant — anxiety is particularly common. Many children who refuse school are not being difficult; they are genuinely frightened.

Depression. Childhood and adolescent depression are increasingly recognised. In children, it often presents as irritability rather than sadness. In teenagers, it can present as anger, risk-taking, or withdrawal. Adolescent depression is a significant risk factor for adult depression, which makes early identification and treatment important.

Autism spectrum. Autism is not a mental health condition — it is a neurodevelopmental difference. But autistic children have significantly higher rates of co-occurring mental health conditions (anxiety, depression, ADHD), and these are often missed because they are attributed to the autism. An autistic child who is anxious deserves treatment for their anxiety, not just acceptance of it as "part of the autism."

Eating disorders. Eating disorders increasingly affect children and adolescents, with onset often in mid-to-late adolescence. Anorexia nervosa, bulimia nervosa, and binge-eating disorder all have significant medical and psychological risks. Early intervention improves outcomes dramatically.

Behavioural disorders. Oppositional defiant disorder (ODD) and conduct disorder (CD) involve patterns of angry/irritable mood, argumentative/defiant behaviour, or aggression and rule-breaking. These are not simply "bad behaviour" — they are patterns that suggest underlying emotional distress, often in the context of family difficulty, trauma, or undiagnosed neurodevelopmental conditions.

How children express distress

Young children (0–5). Regression (bed-wetting, speech regression), physical complaints, separation anxiety, sleep problems, aggressive play, changes in appetite.

School-age children (6–12). School refusal or declining performance, somatic complaints (headaches, stomach aches), changes in friendships, irritability, withdrawal, changes in eating or sleeping, "being difficult."

Teenagers (13–18). Anger and irritability, withdrawal from family, changes in peer groups, decline in school performance, risk-taking, substance use, changes in appearance or hygiene, self-harm, talk of hopelessness or worthlessness.

Note that in teenagers, irritability is often the primary symptom of both depression and anxiety. Many parents describe their teenager as "angry" without realising that the anger is a mask for fear or sadness.

Causes and risk factors

Biological. Genetics play a significant role — children of parents with mental health conditions are at higher risk. Neurodevelopmental differences (autism, ADHD, learning difficulties) increase vulnerability. Hormonal changes during puberty create a second vulnerable period, similar in risk to pregnancy for mental health.

Psychological. Temperament matters — children who are naturally more inhibited, more sensitive to stimulation, or more perfectionistic are at higher risk for anxiety. Children who experience trauma or adverse childhood experiences (ACEs) are at significantly higher risk for mental health difficulties.

Social. Family conflict, bullying, academic pressure, social media, and cultural displacement all increase risk. In Dubai's expatriate context, children face unique stressors: frequent moves, cultural identity confusion, pressure to perform academically (in some cultures especially), and distance from extended family.

Treatment approaches

Play therapy. For younger children, talk therapy is developmentally inappropriate. Play therapy uses play — the child's natural mode of expression — to help them process emotions, develop coping skills, and work through difficult experiences. It is evidence-based for anxiety, trauma, and behavioural difficulties in children aged approximately 3–10.

Cognitive behavioural therapy (CBT). CBT adapted for children and adolescents is the most evidence-based psychotherapy for childhood anxiety and depression. It uses age-appropriate language, activities, and tools. For children, CBT often incorporates more visual aids, games, and stories. For teenagers, it looks more like adult CBT.

Family therapy. Because children exist within a family system, the most effective treatments involve the family. Parent-child interaction therapy (PCIT), parent management training (PMT), and family therapy all teach families skills to support the child's mental health more effectively. In cultures where the family is the primary unit of identity (South Asian, Middle Eastern, East Asian), family involvement in treatment is not just helpful — it is essential.

Medication. For some conditions in children and adolescents — particularly ADHD, severe depression, severe anxiety, and autistic self-harm — medication is appropriate and evidence-based. The principles of "start low, go slow" are especially important with children, whose bodies process medication differently from adults. Medication decisions for children require a paediatric psychiatrist or a psychiatrist with paediatric experience.

School involvement. A child's mental health is deeply affected by their school environment. School-based interventions — additional support, accommodations, a safe space to go when overwhelmed — can be as important as clinical treatment. In Dubai's school system, many schools have counsellors who can work alongside external clinicians.

Navigating care in Dubai

Dubai has a growing number of child and adolescent mental health specialists — child psychiatrists, paediatric psychologists, speech and occupational therapists, and behavioural therapists. Qualifications vary, so check carefully. Look for:

• Board certification in child and adolescent psychiatry (not just general psychiatry)
• Specialised training in child psychological therapies
• Experience with the specific population or condition
• Multilingual capability if language is important

Insurance coverage for child therapy can be limited — session limits are often lower than for adults. Check your policy in advance.

Cultural considerations

In many cultures represented in Dubai, mental health difficulties in children carry additional stigma. Children are expected to be "good," and behavioural or emotional difficulties are seen as parenting failures or character flaws. This creates barriers to assessment and treatment.

Children's mental health conditions are real. They are not behavioural problems or bad habits. A child with anxiety is genuinely frightened. A child with ADHD genuinely struggles with self-regulation. A child with depression genuinely suffers. Recognising this is the first step to helping the child.

Family involvement — particularly in South Asian and Middle Eastern cultures — can be the single most powerful thing for a child's recovery. But it requires the extended family to understand that mental health difficulties are not shameful and that seeking help is a sign of good parenting, not bad parenting.

What parents can do now

Validate their feelings. "You are feeling scared about school, and that makes sense. Let's talk about what is scary." This communicates that the child's feelings are real and discussable.

Maintain routines. Children thrive on predictability. Consistent sleep, meal, and activity routines provide a sense of safety and stability.

Limit screen time. Excessive screen time, especially social media for teenagers, is associated with increased rates of anxiety and depression in adolescents. Set boundaries that are reasonable and consistent.

Talk about mental health. Normalise the conversation the way you would about physical health. Children who grow up able to talk about their emotions are better equipped to seek help when they need it.

Model help-seeking. When children see their parents taking care of their own mental health — going to therapy, practising self-care, talking about feelings — they learn that mental health care is normal and accessible.

When should I seek help?

If you are worried about your child's mental health, seek a professional assessment. You do not need certainty that there is a problem. If your parental instinct is saying something is wrong, trust it. Early intervention in child mental health produces dramatically better outcomes than waiting to see if things improve on their own.

Seek urgent help — call 999 (police) or 998 (ambulance) in the UAE, or go to the nearest emergency department — if your child is having thoughts of self-harm, is severely distressed, is in any way a danger to themselves or others, or if you suspect they have been abused. For non-urgent enquiries, use the appointment request form on this website. This practice does not operate a monitored telephone line, and a message sent through the form may not be read straight away.