Surviving Pre-adolescence
- A Children’s Day Mental Health Series -

Dr. Mona Nongmeikapam / Dr. Meesha Haorongbam *

Most of us are aware of and understand the significance of adolescence or teenage years. Parents and teachers often buckle up as their child or ward becomes a teenager. There are innumerable books and content on the internet on how to deal with or raise a teenager.

Yet we rarely discuss about the turbulent years leading up to adolescence. Pre-adolescence, or the tween years, is commonly defined as the period between 6-12 years. A preadolescent undergoes a myriad of changes.

With the age of onset of puberty gradually declining all across the world, a preadolescent will be dealing with puberty and all the physical changes it brings along- change in voice, change of hair pattern, and other changes in secondary sexual characteristics. Another critical change during this period is cognitive change.

This is the period when a child develops the ability to be aware of their own thoughts as well as others’ thoughts and the awareness that people may have differing thoughts and opinions. There are also profound changes in their social landscape. They start asserting their independence from their parents.

They start trying to fit in with their peers, trying to flesh out their self-identity, trying to keep up with the ever-changing trends. They become aware of social hierarchy and cliques. They go from being blissfully uninhibited to constantly worrying about what their peers think of them.

This is also a period of marked emotional changes. Their rational brain, however, is unable to keep up with their emotional brain and they constantly fumble with their ability to interpret their own as well as others’ emotion. This chaotic feeling may often manifest as mood swings.

With all these external and internal changes simultaneously developing in a tween’s life, it should come as no surprise that many mental health related issues emerge at this volatile junction of life. The exact cause of mental disorders in preadolescence cannot be identified. Multitudes of factors can interact and lead to these disorders- genetics, child’s temperament, parental techniques, abuse, neglect, poverty etc.

Some of the common mental disorders seen in this developmental phase are:

1. Oppositional Defiant Disorder (ODD)- ODD is characterised by markedly defiant, disobedient, provocative behaviours such as verbal or physical hostility towards others, refusal to comply with instructions or rules, lack of respect for authority etc.

There is, however, an absence of more severe dissocial or aggressive acts that violate the law or rights of others. If left untreated, ODD can progress to Conduct Disorder which is a more severe type of behavioural disorder.

2. Conduct Disorder (CD)- More severe than ordinary childish mischief or rebelliousness, CD is characterised by repetitive and persistent pattern of dissocial, aggressive, or defiant conduct. Common symptoms include extreme levels of fighting or bullying, cruelty to animals/people, stealing, repeated lying, truancy at school, defiant provocative behaviour, etc

3. Attention Deficit Hyperactive Disorder (ADHD)- With inattention and overactivity being the hallmark of ADHD, children with ADHD are reckless and impulsive, prone to accidents and often find themselves in disciplinary trouble because of unthinking (rather than deliberately defiant) breaches of rules.

Their relationships with adults are often socially disinhibited and they are often unpopular with their peers. All of these can lead to low self-esteem and failure to thrive academically as well as socially.

4. Sibling rivalry- Almost every child shows some degree of emotional disturbance following the birth of a younger sibling, especially an immediate younger sibling. In sibling rivalry, however, there is marked competition with siblings for the attention and affection of their parents.

In less severe cases, they show reluctance to share, they lack positive regard and there’s paucity of friendly interaction with their sibling. In more severe cases, though, they show overt hostility; constantly undermine the sibling, and may even cause physical trauma.

5. Learning disorder (LD)- Another important yet often misunderstood disorder commonly seen in this age group is LD. It is an umbrella term for various types of learning difficulties in the absence of lack of opportunities, such as specific reading disorder, specific spelling disorder, specific arithmetic disorder etc.

Symptoms vary based on the type of disorder- difficulty with spelling, poor reading comprehension skill, difficulty with reading word recognition, poor oral reading skill, weak mental arithmetic skills, poor sense of numbers and estimations, etc.

It is important to note that learning disorders can affect a person’s life beyond academics. It can impact the person’s relationship with their friends and family and can often lead to social adjustment problems and poor quality of life.

6. Anxiety- With pre-teens constantly seeking new experiences and more independence, and with the added turmoil of emotional, physical and social changes occurring at once, it is natural for them to feel anxious about navigating the world.

Parents should, however, be concerned if their child is constantly nervous or anxious for weeks or months on end. When their anxious feelings interfere with their school or their relationship with their parents and friends, then parents should consider seeking help.

7. Depression- It is often difficult to draw the line between clinical depression and the mood swings of a pre-teen dealing with their conflicting emotions. Not every “moody” tween is depressed. So, it is imperative upon parents to identify warning signs such as- change in appetite and/or sleep, decline in academic performance, frequent anger or emotional outburst, body aches that can’t be explained, withdrawal from friends or family, reluctance to participate in school or social activities, etc.

While it is easy to dismiss depressive symptoms as a part of “growing up” or “developing resilience”, untreated depression can lead to other serious issues such as drug and alcohol misuse, social isolation, family conflicts and difficulties in school.

Management of psychological and behavioural disorders in pre-adolescents may involve family therapy, parent training, social skills therapies, and if required, medications.

Any crossroad in life comes with its own share of trials and tribulations and pre-adolescence is no different. Children will be struggling with identity crisis and peer pressure while parents will be left wondering how their sweet, innocent child turned into a moody, distant person almost overnight.

No matter how much they claim otherwise, your child still needs your help, guidance, and support as they prepare for their transition into teens. Parent-tween conflicts that cause insecure and unstable feelings can create an insecure adult. No matter how flimsy their problems seem, they are real and they need your presence, and non-judgmental love and support.

Pre-adolescence should be a wonderful and learning experience, one both you and your child can look back upon with fondness. So here’s wishing you the very best as you navigate these bumpy but magical years!

Dr. Mona Nongmeikapam (pukningpothasang(AT)
Assistant Professor,
Department of Psychiatry,
Regional Institute of Medical Sciences

Dr. Meesha Haorongbam (meeshahao(AT)
Senior Resident,
Department of Psychiatry,
Shija Academy of Health Sciences

* Dr. Mona Nongmeikapam wrote this article for
The writer is an Assistant Professor, Department of Psychiatry, Regional Institute of Medical Sciences, Imphal, Manipur
and can be contacted at pukningpothasang(AT)gmail(DOT)com
This article was webcasted on November 15 2023.

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