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Mental illness is many things. Like physical illness, mental illness can affect anyone and has many forms. The first important point to see is that mental illness is not just one illness but is many illnesses.

It will help you to think about it in this way. There is the part of the young person that thinks and understands. You can call this part the child's mind. There is the part that feels happy and sad, frightened and calm, angry and joyful. You can call this part the emotions. Also there is the part that does things and takes action based on what the youngster thinks and feels. You can call this part behavior.

What is mental illness? The child's mind, emotions, and behavior normally work together as a team. When children become mentally ill, the three members of the team stop working together. They each start doing their thing and the child cannot get them to start working together again.

Some kinds of mental illness affect the mind the most. The youngster is unable to think clearly and understand things the way they really are. The world becomes a strange and confusing place for him.

Other kinds of mental illness affect emotions more and other kinds affect behavior more. Here is another important point. All types of mental illness affect the child's mind, emotions, and behavior to some extent and in some way. When this happens, the young person finds it very hard to keep the three members of the team under control and working together. Keep this problem of teamwork in mind as you think about these signs of mental illness.

39. Their moods jump from one extreme to the other and they cannot control them.

It is important to make this point. When you see any of the signs in this section, your foster child needs a mental health evaluation and likely needs professional care. Having said that, it also is important for you to understand the signs and have some ideas about how to help the child at your home.

There are several reasons why your foster child might have trouble controlling his mood and emotions. The most likely is stress or excitement. The child feels upset or very excited; and his emotions are a little out of hand. Here is the important part of the sign. He cannot control his feelings and mood.

When a child gets excited or upset, he normally can settle down, at least for a few minutes. What you see is that he is having part of this sign. Both parts need to be there before you would say he has this sign. His moods are jumping to the extremes and he cannot control it.

A hyperactive child or a child with serious behavior problems often shows both sides of the sign. He may be happy and full of energy one minute and flip into near violence the next. He may be happy one minute and withdrawn the next. The change can be dramatic. He cannot control this flipping back-and-forth without professional help. This has nothing to do with mental illness but needs your caring concern.

Another cause of the problem is depression. A depressed child often does not act like you might expect her to act. You might think she would be in a down mood and not very active. Her depression may look like this but is just as likely to look quite different.

One look of a child's depression fits this sign well. Her moods and emotions flip around. For example, she may be very up and have a lot of energy and then down and withdrawn. She may be friendly and then angry for no reason you can see. The important thing is to see she cannot stop it and needs help with her depression.

Another cause of this sign is serious mental illness. If this is what is happening with your foster child, you would likely see one or more of the other signs in this section.

Here is what to know. Arguing and getting upset with the child only makes things worse.

Sometimes children get so confused about what is going on in their lives and so down on themselves that they can hardly stand it. They may feel like running away or just giving up on themselves. These are awful feelings. They feel afraid, angry, and very upset. They have more stress than they can handle and their self-esteem is very low. They cannot get their thoughts straightened out or figure out their problems. There seems no end to their bad feelings. They believe they have come to the end of the road and don’t fit or belong anywhere.

Killing themselves seems like their only choice. Looking at these signs that a child may be suicidal will be useful. As you consider the signs, give some thought to how vulnerable foster children are.

Sometimes children get so confused about what is going on in their lives and so down on themselves that they can hardly stand it. They may feel like running away or just giving up on themselves. These are awful feelings. They feel afraid, angry, and very upset. They have more stress than they can handle and their self-esteem is very low. They cannot get their thoughts straightened out or figure out their problems. There seems no end to their bad feelings. They believe they have come to the end of the road and don't fit or belong anywhere.

Killing themselves seems like their only choice. Looking at these signs that a child may be suicidal will be useful. As you consider the signs, give some thought to how vulnerable foster children are.

32. They have lost an important relationship and can hardly live without it.

The first idea to think about is "perception." This is how things seem from the child's point of view. Feeling she cannot live without a relationship is her perception of how she would be without the relationship. Seeing the relationship as important also is her perception. When you see this sign in your foster child, she perceives the relationship she lost was important, thinks it is gone, and believes she cannot live without it. It does not matter how others see or think about her and the relationship. Her perceptions are how it is for her. Perception is her reality and the only reason for her actions.

When working with her, start where she is, start with her perceptions.

It is easy to just say that what she thinks and feels is not true. Some people start by deciding that the relationship was not really so important. Others start by deciding that she has not really lost the relationship. They say to her, "Things will work out." Either way, these people think the child is wrong when she thinks she cannot live without the relationship.

Helping means getting inside her skin so you can see how she perceives what happened. Why does she think the relationship was so important? What makes her think she lost the relationship? Here is the most important question. Why does she think she cannot live without it?

Say to her," I want to understand. Please help me understand. What about the relationship was so important for you? What have you lost that is so very important to you? Will you talk to me about what you are thinking and feeling?"

This is your goal. Her grief, anger, fear, and emptiness are real and painful. Her loss is real; and living past the pain feels impossible to her. To help, you need to share her grief, her strong feelings, and her pain. It is as if you take part of it into yourself. The child cannot handle it by herself. But between the two of you, you can.

Here is how you tell if you are helping. Can you feel her loss, her emptiness, her grief, and her pain? Is it a little as if the feelings were yours? If so, it is empathy.

Don't tell her how she should think or feel. More important, don't say her feelings and how she thinks about what happened are wrong. Listen and feel until empathy comes for you. You can then honestly say, "I am afraid for you. I am afraid for me. Maybe I do not totally understand; but I feel awful and hurt as if it happened to me. I want to be close to you and help us get through this. Can I share your grief with you and struggle through it with you?" Holding or touching her physically may make her and you feel better; but holding her emotionally is the key to helping her.

33. They became very embarrassed over something and cannot face it.

This sign begins to get at the main problem. Losing a relationship and feeling unable to live without it makes it seem like losing the relationship is the main problem. Thinking about her feeling unable to handle an embarrassment makes her pain more understandable.

The signs here are serious. Each one means the child needs professional help. As his foster parent, you will be asked to join him in his treatment. It is important for him for you to cooperate. Also, you will be given ideas about how to work with him at home. Be sure to follow the suggestions.

You will not find specific suggestions here about how to limit or control the child’s behavior. For children with serious problems, this takes careful thought and a plan. Also, the plan has to be tailored to the individual child. What works for one child can make another child worse. This needs discussed with the child’s caseworker to be sure you have the right plan for your foster child. There are no quick fixes.

Thinking about these signs will help you better understand the child and his problems. It also will help you see that, as his foster parent, your main job is to understand, be firm with him, and keep an open and gentle attitude toward him.

The signs here are serious. Each one means the child needs professional help. As his foster parent, you will be asked to join him in his treatment. It is important for him for you to cooperate. Also, you will be given ideas about how to work with him at home. Be sure to follow the suggestions.

You will not find specific suggestions here about how to limit or control the child's behavior. For children with serious problems, this takes careful thought and a plan. Also, the plan has to be tailored to the individual child. What works for one child can make another child worse. This needs discussed with the child's caseworker to be sure you have the right plan for your foster child. There are no quick fixes.

Thinking about these signs will help you better understand the child and his problems. It also will help you see that, as his foster parent, your main job is to understand, be firm with him, and keep an open and gentle attitude toward him.

23. They do not follow the rules or behave like most children do.

Your foster child might follow the family rules and do what other family members do. Still, family outsiders may find fault. Following "the rules" depends on which rules are to be followed and the value placed on following them. If they are important, the child will usually follow the rules, whether or not most people see doing so as good. Children do as they are taught.

24. They do not accept the authority of foster parents, teachers, or others in charge.

Understanding this sign when you see it in your foster child can be hard. Why? There is a lot of difference between authority and power. Children learn to respect authority, people in authority, and learn to accept authority. This becomes a value. Power is different. It gets its importance from who is bigger and stronger. Power is something to fear; and people with power are to be feared.

How your foster child sees you, teachers, and other adults is important. Does she see you as people in authority or as people with power? She may say, "You can't make me do it." That is what she really means. "You cannot or will not use power to make me do it." She likely is right.

How can you respond to this? Say, "You are right. Even if I could make you do it, I won't. I will not treat you that way. I will help you learn it is better for you to do what I ask than to refuse. You can still refuse. Please do what I ask so we do not have to figure out what other choices we have."

25. They behave in socially inappropriate ways.

Think about whether your foster child really knows the socially appropriate ways to behave. Remember, this takes time. Just telling him is not nearly enough. He needs to try, behave inappropriately, try again, and maybe do it wrong again. Like other children, he also will sometimes act badly even though he knows better. You are looking for successive approximation. This means he comes closer to what you want as time goes on. No one always behaves well. Your goal is only for him to act more appropriately more of the time.

26. They use illegal drugs.

This is a very complicated problem. Think about it in terms of values: right and wrong, good and bad. Peer pressure is often a strong part of illegal drug use. The child gives in to peer pressure. From a value point of view, here is the idea. If the value of following the law, avoiding dangerous things, and doing what is right is stronger, the youngster says, "No." If not, peer pressure wins.

What was the child taught about following the law, using alcohol and drugs, and about what will be good for him in the long-term? He values what he was taught. Also, if he has been mistreated and got little respect, his struggle is up-hill. His stress is high and his self-esteem is low. His social skills are limited and his school success poo...

Your foster child’s fit with you is not the only relationship she has that needs your help. She has relationships with other people in your family and with children and adults at school. She needs to get along with people in your neighborhood and in your community. Being able to get along with people may have more to do with her future success than anything else.

Here is the key. Because of abuse, neglect, or other bad life-experiences, foster children often have problems getting along with people. Maybe this comes up every day and maybe only once in a while. However often your foster child has problems, she needs your help.

Here are some signs of foster children having trouble getting along. Your concern and help with these problems are a start to a better life for them.

Your foster child's fit with you is not the only relationship she has that needs your help. She has relationships with other people in your family and with children and adults at school. She needs to get along with people in your neighborhood and in your community. Being able to get along with people may have more to do with her future success than anything else.

Here is the key. Because of abuse, neglect, or other bad life-experiences, foster children often have problems getting along with people. Maybe this comes up every day and maybe only once in a while. However often your foster child has problems, she needs your help.

Here are some signs of foster children having trouble getting along. Your concern and help with these problems are a start to a better life for them.

1. They pout and are hard to live with.

All children have some way of handling it when they don't get their way. They have their own ways of reacting when things do not work out as they want. They have ways of dealing with a world they think is sometimes unfair.

Two of their choices are temper tantrums and pouting. Most children use one or the other of these once in a while. If you watch your foster child for a while, you likely will see that she uses one more than the other.

Just to be fair, answer this question. When you get angry or frustrated, are you more likely to pout or have a little temper tantrum? Now, if you had lived your foster child's life, would you feel angry and frustrated? If so, would you be more likely to pout about it or have a temper tantrum once in a while?

Take a minute to think about a foster child who neither pouts nor has temper tantrums. This can be much worse than either pouting or temper tantrums. Why? Because it often means the child is just accepting whatever happens. Even worse, she has gotten to where she no longer has any feelings about what happens to her. She does not care or thinks what she feels does not matter. This is a very bad sign.

What is your foster child doing when she pouts? She is angry, frustrated, or upset about something. She mainly feels angry. She does not talk about it or try to work out her problem. Instead, she pouts and makes it rough for other people.

What can you do? Think about what upset her. Maybe what happened was unfair or she really was treated badly. Either way, pouting about it is a problem.

Say, "I have thought about what happened. We can talk about it if you want to. Here is my problem right now. You have a right to feel how you feel but pouting about it is not your best choice. I think it would be better if you either got up and over it or at least talked about it. It is your choice. Here is what I am going to do. I am going to do nothing unless you choose to talk with me about it. You can pout or talk. It's your choice. If you choose to pout, please do it in your room." Now leave it alone. Her only choice is to behave more appropriately or be by herself.

2. They are hateful and in a bad mood.

Everyone gets in a bad mood sometimes. Even so, it is not okay to take it out on everyone around. Instead, it is a good time to get better at managing thoughts, feelings, and relationships.

Managing feelings and relationships takes skills children mostly learn by example. Your foster child likely had bad examples set for him. Also, he can bottle-up his anger about what happened to him. It then can easily come spilling out. It may not take much to set him off.

The point is this. Your foster child may have more than a little reason to be in a bad mood and hateful. He needs extra tolerance and patience. More than the usual amount of sensitivity and understanding from you are in order for him.

Here is something that usually helps. Leave his bad mood alone at first.

Learning is not simple. There are three important areas you need to think about. First, your foster child’s abilities are where learning starts. Some children learn easier than others. However easily your foster child learns, he learns some things more easily than other things. Some assignments and subjects are easier and others are harder. Even if he is a very good learner, learning is hard work at times.

Next, his attitude is important. Does he want to learn? Is he willing to do what he needs to do to get the job done? It comes down to this. Does he think he is important enough to work at it? Is his future important enough to him to bother learning? Learning takes self-discipline and hard work. It also takes an attitude that says, “I am important enough to do what I have to do.”

Third, your foster child needs learning skills. Some of these skills help him pay attention and study. Some help him listen and try to understand. Others help him cooperate. Still others help him follow the rules. He also learns about what adults expect and about the rights of others. If your foster child has problems learning, look at his abilities, attitudes, and behavior.

How do you think foster children fare with school and learning? Some do better than others. Still, they have more than their share of learning problems. Understanding this will help you as you think about your foster child. Here are some signs of learning and school problems. They will help you develop a learning plan for your foster child.

Learning is not simple. There are three important areas you need to think about. First, your foster child's abilities are where learning starts. Some children learn easier than others. However easily your foster child learns, he learns some things more easily than other things. Some assignments and subjects are easier and others are harder. Even if he is a very good learner, learning is hard work at times.

Next, his attitude is important. Does he want to learn? Is he willing to do what he needs to do to get the job done? It comes down to this. Does he think he is important enough to work at it? Is his future important enough to him to bother learning? Learning takes self-discipline and hard work. It also takes an attitude that says, "I am important enough to do what I have to do."

Third, your foster child needs learning skills. Some of these skills help him pay attention and study. Some help him listen and try to understand. Others help him cooperate. Still others help him follow the rules. He also learns about what adults expect and about the rights of others. If your foster child has problems learning, look at his abilities, attitudes, and behavior.

How do you think foster children fare with school and learning? Some do better than others. Still, they have more than their share of learning problems. Understanding this will help you as you think about your foster child. Here are some signs of learning and school problems. They will help you develop a learning plan for your foster child.

17. They often have trouble making choices and decisions.

How many choices and decisions does your foster child make in a day? When you stop to think about it, there are a lot. He decides whether to brush his teeth and what clothes to wear to school. His choices include when to talk or stay quiet. He decides who he will hang around with and who he will avoid. Does what his teacher is saying make any difference to him? Will he get even with whoever he thinks got into his stuff? Almost everything in his day requires decisions and choices.

Most signs of school and learning problems have choices and decisions as an ingredient. Give this some thought. Has he had a chance to learn what he needs to know? This does not have much to do with whether he can learn.

Homework is a good example. Greg is twelve and in the sixth grade. He is not doing his homework. Is he lazy? Is he being difficult? Is he not doing it because he does not know how? Is it because he does not have a good place to do it? These are important questions but are not the place to start.

Has Greg had a chance to learn to do his homework? Has he decided it is important? Can he choose a good place and time to do it? Has he learned how to start? Doing homework requires many choices and decisions. It is not common sense or something a child just knows. It is a mix of skills he has to learn before he has them.

Think about problems your foster child is having. Is she having trouble with homework? Does she have problems with other children? Is it a hassle to get her to brush her teeth? Does she have problems listening and paying attention?

What choices and decisions does she have to make? If she made better choices and decisions, would the problem go away? If so, this sign needs your attention.

Especially for foster children, making good choices and decisions may be very hard. Their lives have not taught them much about making decisions. It is not easy for them to learn, make mistakes, and learn from their mistakes.

The point is this. First help the child learn what to do and how to do it. It is not fair to insist he do it until he knows how. Children do what they know how to do. If there is a problem, they likely do not know how.

This is true for making good choices and decisions.

What is self-esteem? It is who children think they are. You can see it in how they treat themselves. It is there when they feel valued and important. It is missing when they feel unworthy or put themselves down.

Self-esteem can be high or low. When children think they are important and valued, their self-esteem is high. When they feel good about themselves, are comfortable with who they are, and like themselves, their self-esteem is high. When they treat themselves with respect and avoid doing things that are not good for them, their self-esteem is high.

What is low self-esteem? Children have bad thoughts about themselves. They do not think they are worthwhile people who will be successful. They do not feel good about who they are. This makes them sad and angry. They do not take care of themselves and they do things that are not good for them.

Here is the important part. Children have good days and bad days. Sometimes their self-esteem is higher and sometimes lower. It depends on how things are going for them at the time. Low self-esteem is only a serious problem if your foster child gets extremely down on himself. More so if he is down on himself most of the time.

Here is the main problem. Abuse and neglect are killers when it comes to self-esteem. Foster children have low self-esteem. It is as simple and as tragic as that. It may be harder to see in younger children but is hard to miss in older foster children. Keep this in mind as you think about these signs of low self-esteem.