*This is a continuation from "The Tired Teen, Part One." Please read the original entry for additional information*

If your child’s tiredness seems unrelated to scheduling or environment; if it comes on suddenly or continues despite your making sensible changes; or if it just feels wrong to you, do see your pediatrician to determine whether there is a physical cause. If there isn’t, or if the tiredness in accompanied by other changes in mood or behavior, then you should have your child evaluated by a child psychiatrist.

When parents come to me concerned about tiredness, I first go over the suggestions I have shared above. While it is true tiredness is a symptom of depression, being tired can also cause a child to feel overwhelmed and depressed. So can major life changes, like divorce, separation, illness, and death. Problems in school or with friends can also affect sleep. So can worries about the state of the world. I urge parents to not underestimate how deeply such concerns can affect a child at night as well as during the day.

In my evaluations I also rule out the possibility of depression, drug use or other disturbances in a child’s mental health. We do live in a complex world and sometimes we all can benefit from a little extra understanding and help. Even if there are other problems present, I still find that encouraging sufficient, healthy sleep helps both the child and the parents to deal with them in a more rational and constructive manner.