CHARLOTTE, N.C. -- When it comes to caring for a child, it’s easy to spot a physical injury, like a broken bone, because it can be seen.

However, many mental health disorders are more difficult to recognize, and as a result, can go years without treatment.

According to Purva Grover, M.D., a pediatric emergency care physician at Cleveland Clinic Children’s, there are warning signs for depression that parents can be on the lookout for.

“When you see certain patterns change in your child; you see grades suddenly fall down, you see him or her not having any friends, you see him or her mostly in his or her room, playing solo games or just kind of lying around; those are all signs of depression, said Dr. Grover.

Dr. Grover said often times, mental health has a stigma around it. Many parents don’t want to talk about it or think that it couldn’t possibly happen to their child.

Meanwhile, new research says that the number of children and adolescents admitted to children’s hospitals for thoughts of suicide or self-harm has more than doubled in the past 10 years.

Dr. Grover said there really is no standard age for onset of mental illness — it can happen at any age, at any time. She said sometimes children are crying out for help and we don’t recognize it.

She said warning signs of a mental or behavioral health issue can include children or adolescents ingesting pills or cutting themselves.

When it comes to teenagers, Dr. Grover said they will often express how they feel on social media before coming to mom or dad to discuss their problems. In these cases, she said talking with the child’s teacher regularly can give parents a better picture of their behavior, since children spend so much of their time at school.

Dr. Grover said the most important thing that parents can do is to keep the lines of communication open with their child and to enlist the help of the child’s pediatrician.

What happens when you do feel like something is not right, and I don’t know what to do; I don’t even know where to start;’ I think the perfect start is to talk to your physician,” said Dr. Grover.

Dr. Grover said, as a society, we’ve come a long way in treating childhood mental health issues, but she believes there is room for improvement when it comes to recognition of symptoms, initiation of help, and the acceptance that there is a problem, which can get children the help they need sooner.