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Mental Health Challenges for Adoptees

Studies show that the odds of an adopted child being diagnosed with psychological conditions are four times higher than for biological children (12% vs 3%). This could simply be because adoptive parents are more vigilant for signs of concern and have their children diagnosed and treated.  The vast majority of adoptees will not struggle with any of the following issues; however, it is useful for adoptive parents to be aware of potential mental health challenges.

Oppositional Defiant Disorder (ODD)

Most children behave badly at times; however, if your child or teenager is frequently angry, argumentative or vindictive, they may have ODD.  Behavioral treatment of ODD includes fostering positive family interactions and correcting negative behaviors. Please seek professional help if you suspect your child has ODD.

Major Depressive Disorder

Your child may suffer from Major Depressive Disorder if he/she exhibits several of these symptoms: 

  • depressed mood most of the day and nearly every day
  • loss of interest or pleasure
  • significant weight changes
  • insomnia or hypersomnia nearly every day
  • fatigue or loss of energy nearly every day
  • feelings of worthlessness or excessive or inappropriate guilt
  • diminished ability to think or concentrate, or indecisiveness
  • recurrent thoughts of death, recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide.

Please seek professional help if you suspect your child has major depressive disorder.

Obsessive Compulsive Disorder (OCD)

OCD manifests as unreasonable thoughts and obsessions that lead you to do repetitive behaviors (compulsions). OCD behaviors can interfere with daily life and cause a lot of distress. These compulsions may include behaviors such as hand washing until hands are raw, picking skin around nails until they bleed, etc. OCD usually starts in teens or young adults and gets worse during period of stress. If the condition starts to negatively affect your child’s life, please seek professional help.

Separation Anxiety Disorder

If your child has intense and persistent fear of separation from parents that is excessive for the child’s developmental level (taking adoption-related developmental delays into account) then your child may have this disorder. It is usually treated with cognitive behavioral therapy. Please seek professional help for this disorder.

Bipolar Disorder

Bipolar disorder is characterized by extreme mood swings – emotional highs (mania or hypomania) or lows (depression). When your child is depressed, he/she will lose interest in activities and may sleep excessively. In the manic phase, he/she may feel euphoric and full of energy. He/she may talk excessively, have impaired judgement or find it hard to sleep. Your child may have these mood swings frequently or once in several months. Bipolar disorder is usually treated with medications and psychotherapy. Bipolar disorder can look different in very young children who might exhibit an ongoing, continuous mood disturbance, which is a mix of mania and depression. A young child may have other symptoms such as lengthy destructive rages, bed wetting and night terrors or the uncontrollable desire to keep talking. In an adopted child, early onset bipolar can get misdiagnosed as reactive attachment disorder (RAD.) Please seek professional help if you feel your child may have this disorder.

Reactive Attachment Disorder (RAD) and Disinhibited Social Engagement Disorder (DSED)

RAD (inhibited, emotionally withdrawn) and DSED (indiscriminate familiarity with strangers) are different types of attachment disorders, which often stem from a failure to form normal attachments to primary care giving figures in early childhood.


  1. “Disabilities and challenges links” (nacac.org)
  2. “Separation anxiety disorder” (mayoclinic.org)

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