It may be easier to acknowledge a son or daughter has diabetes than reveal a psychiatric disorder. Despite more worldwide awareness about mental illness, a psychiatric diagnosis can come with stigma. And though physical illnesses can often be pinpointed to a certain cause, the causes of mental illness typically are murky, a blend of inherited traits, life experience and disposition.

In children, mental illness can be more challenging to diagnose and treat because as their brains develop, their behavior and mood problems often change. What may appear to be an attention problem at age five may, by adolescence, turn into a diagnosis of bipolar disorder, which comes with severe mood shifts from elation or intense agitation to depression and back again.

Sometimes a child has no history of depression or anxiety in his family, but is consistently defiant and aggressive due to parents who offer little warmth or affection or don’t set sufficient limits. Regardless of the cause of a child or adolescent’s behavioral problem, recovery can and does happen.

The diagnosis of a developmental disorder often prompts an anguished parent to ask: ‘What did I do wrong?’ Frequently, the response is: ‘Nothing.’ Often the cause is at the gene level. Sometimes an unborn baby inherits an abnormal gene, or in the process of developing in the womb, one or more genes change. This can result in a lag in development of the brain and/or other organs, which can hinder a child’s ability to speak, learn, walk, clutch a bottle, smile.

Most developmental disorders occur before a baby is born, but some happen during or after birth and most are chronic. A developmental delay could include physical, mental and/or behavioral challenges such as lower intelligence, seeing or hearing disabilities, or frequent tantrums and anxiety.

The fastest growing developmental disorder in the United States is autism spectrum disorder, affecting an estimated one in every 68 people. A child with ASD often has repetitive behaviors and trouble interacting with others, speaking, learning and maintaining attention. Significant advances in screening and treatment for autism and other developmental disorders have vastly improved how children learn and behave.

Physical and mental health are so closely connected that a young person diagnosed with a serious or chronic medical illness, such as cancer, diabetes or inflammatory bowel disease, may also suffer emotionally.

A young patient might hide chemotherapy pills under the couch instead of taking them, refuse to take insulin shots at school out of embarrassment, or become anxious or depressed as a result of a diagnosis of cystic fibrosis. Whether a patient experiences emotional problems depends in part on the child’s personality, support available to the family, and their ability to manage the associated stressors. By acknowledging and treating both the psychological and physical aspects of an illness, we can better help a child or adolescent and his or her family at every stage.

Though we do not all react the same way to the same or similar calamities, violence, crime, abuse, or chronic poverty can have serious detrimental effects on the emotional and even intellectual development of young people.

We know more and more about the impact of trauma on a child or adolescent, whether it be the effect of one ordeal or a series of them. As a result, we can better lead a young person triggered by trauma back out of the torment of not sleeping, of isolating, of having frequent moments of panic or aggression. A distressed child or adolescent, treated thoroughly and early after a trauma, may not be destined to develop a mental illness.

Substance abuse and mental illness all too often mix in complex and insidious ways. Many who grapple with a mental illness drink excessively or do drugs, and many who abuse drugs and alcohol also wrestle with a mental illness. Those at the highest risk of addiction are children who drink or use drugs before they are 14. The adolescent brain undergoes so many developmental changes that drugs or alcohol can be overpowering.

Who gets addicted to drugs or alcohol hinges in part on whether an individual has inherited a genetic predisposition to addiction as the nature of his or her upbringing and access to drugs or alcohol.

The recent surge in the availability of heroin, driven by the relatively cheap price tag and the cunning allure of its high prevalance in Ohio, has led to a disturbing trend in increasing overdoses statewide.

It is beyond comprehension that an adolescent could feel so trapped that the best solution to them, perhaps the only solution to them, seems to be death. Even more baffling are the cases of young children - 8 years old, 6 years old - who try to or do kill themselves. Why, we ask. And the answer is seldom clear.

This disheartening pattern needs to shift. Suicide is preventable, so we are all challenged to be aware of the signs and seek help. Mental and behavioral health illness, left untreated, can result into death by suicide or a suicide attempt. This harsh reality is what motivates mental and behavioral health providers to identify and support young people who are troubled and their families.