When children struggle at school or at home, there can be pressure to have a child diagnosed and even medicated quickly for their most disruptive symptoms. However, this can sometimes lead to misdiagnosis when similar symptoms fall in more than one type of child’s mental health challenge.

Why Diagnosing a Child’s Mental Health Difficulties is Hard

When children struggle, it can be easy to grow frustrated with their behavior or assume they will grow out of it. Mental health symptoms are often internal, subjective, or resemble other physical issues. However, sometimes parents and teachers do see and discount signs of significant mental illness.

Your child’s mental health can be hard to pin down. Children may not know that what they are experiencing is not normal or be able to explain what they are thinking or feeling. As they grow older, they may avoid talking to parents or role models out of a drive for independence, or because they are afraid of being labeled “weird” or “different.” If your child is struggling, be sure to reassure them that you want to help, and that it is okay to feel or have thoughts, even if those thoughts are upsetting.

Get Help with Your Child’s Mental Health


Talk to a psychotherapist today about how to diagnose and treat your child’s mental health challenges.

Common Misdiagnosis of Symptoms

Many mental health symptoms are shared across several psychological and mood disorders. This can lead to misdiagnosis and challenges getting your child proper mental health treatment.

Inattention as ADHD

When your child has trouble focusing on their work at school, a teacher may suggest that your child be tested for attention deficit hyperactivity disorder (ADHD). However, being easily distracted can also be due to:

  • Sleeping issues
  • Anxiety
  • OCD
  • Learning disorders
  • Troubling life events or post-traumatic stress disorder (PTSD)
  • Concussions or head trauma
  • Visual processing disorders
  • Food sensitivities
  • Environmental issues

Depression & Anxiety

Two common children’s mental health issues are depression and anxiety. Each is commonly understood as an overabundance of a specific emotion: sadness for depression, and fear for anxiety. While these symptoms can be signs of their respective mental illness, they can also be a misdiagnosis of:

  • Environmental stresses
  • Exposure to emotional events
  • Undisciplined thinking
  • Visual processing disorders
  • Diet
  • Hormone imbalances
  • Concussions or head trauma

Self-Destructive or Disruptive Behavior

When children become disruptive, act out, or become defiant, they can be diagnosed with oppositional defiant disorder (ODD). However, tantrums, anger control issues, and even self-destructive behaviors or self-harm can also be a sign of:

  • Anxiety
  • ADHD
  • Learning disorders

Slow or Limited Speech

The rate of autism diagnosis has more than doubled in the past 20 years, up to 1.8% of U.S. children, or one in 160 people worldwide. One common symptom of autism spectrum disorder (ASD) is slow, limited, or delayed speech. However, it may also be misdiagnosed selective mutism, a child’s mental health condition closely connected with anxiety. Children with selective mutism may be talkative in certain circumstances or with certain people, but silent in others. Because it causes a child to shut down, it can be especially difficult for a pediatrician to diagnose, since the doctor only sees the child in one, often highly stressful environment.

The Special Challenge of Diagnosing PTSD in Children and Teens

As children get older, traumatic events at home and at school, including abuse and bullying, are more likely to trigger post-traumatic stress disorder. However, parents may be entirely unaware of the trauma their children have suffered. When that happens, doctors and pediatricians may misdiagnose PTSD as depression or anxiety. This can misdirect treatment away from the traumatic event and toward coping mechanisms better designed for chronic concerns.

Sometimes the Answer is More than One Mental Illness

It is also important to remember that not every child’s mental health condition fit into a single box. If a child has two or more comorbid conditions the treatments that work for one set of symptoms may not correct others. Interactions between medications can create even more challenges or aggravate existing mental health conditions.

If your child has been misdiagnosed or a comorbid condition goes undiagnosed it can slow treatment, or even work against their broader mental health. You should work with your pediatrician or psychotherapist to rule out possible alternative causes for your child’s mental health symptoms before settling on a diagnosis and treatment plan.


David Stanislaw is a psychotherapist with over 30 years of experience. He helps children, teens and adults with misdiagnosed psychological conditions and comorbidity. Contact David Stanislaw to get help for your child today.