| 
Child and Adolescent Mental Health Issues
 Anxiety
Disorders in Children and Adolescents:
All children experience anxiety. Anxiety in children is expected
and normal at specific times of development. For example, from
approximately age 8 months through the preschool years, healthy
children may show intense distress (anxiety) at times of separation
from their parents or other persons with whom they are close.
Young children may have short-lived fears (such as fear of the
dark, storms, animals or strangers). If anxieties become severe
and begin to interfere with the daily activities of childhood,
such as separating from parents, attending school or making friends,
parents should consider seeking an evaluation from a mental health
professional.
Separation Anxiety Disorder:
Although separation anxieties are normal among infants and toddlers,
they are not appropriate for older children or adolescents and
may represent symptoms of separation anxiety disorder. For children
and teens with separation anxiety disorder, the anxiety or fear
causes distress or affect social, academic or job functioning
for at least one month.
Children with separation anxiety disorder may cling to their
parent and have difficulty falling asleep by themselves at night.
They become extremely afraid that something terrible will happen
to their parent or caregiver. Their need to stay close to their
parent or home may make it difficult for them to attend school
or camp, stay at friends' houses, or be in a room by themselves.
Fear of separation can lead to dizziness, nausea, or heart palpitations.
What are the symptoms of Separation Anxiety Disorder?
Symptoms of Separation
Anxiety include:
- Constant thoughts and fears about the safety of self and parents
- Refusing to go to school
- Frequent stomachaches and other physical complaints
- Extreme worries about sleeping away from home
- Overly clingy
- Panic or tantrums at times of separation from parents
- Trouble sleeping or nightmares
- Separation anxiety is often associated with symptoms of depression,
such as sadness, withdrawal, apathy, or difficulty concentrating.
These children often fear that they or a family member might
die even when everyone is healthy.
How Common Is Separation Anxiety disorder?
About 4% of children and young adolescents suffer from separation
anxiety disorder. Among those who seek treatment, separation anxiety
disorder is equally distributed between boys and girls. In survey
samples, the disorder is more common in girls.
What Causes Separation Anxiety disorder?
The cause of Separation Anxiety disorder is not completely understood,
however some risk factors have been identified. Affected children
tend to come from families that are very close-knit. The disorder
might develop after a stress such as a death or illness in the
family, or a move. Trauma, especially physical and sexual abuse
might bring on the disorder. The disorder sometimes runs in families,
but the precise role of genetic and environmental factors has
not been established.
Separation Anxiety should not be diagnosed when children or adolescents
are living in truly dangerous situations where their fears are
justified.
Treatment
Treatment for any of the Anxiety Disorders in children and adolescents
involves a young person meeting individually with a therapist
for talk therapy and also with a psychiatrist if medication is
part of the treatment. Parents meet with their child's therapist
to learn ways to manage their child's anxieties and to help reduce
them. Treatment for adolescents usually involves the therapist
working with the parents, but to a lesser extent.
(Back to top)
Generalized Anxiety Disorder:
Children with generalized anxiety disorder (or overanxious disorder
in childhood) worry excessively. For example, they may worry unduly
about their academic performance or sporting activities, about
being on time, or even about natural disasters such as earthquakes.
The worry persists even when the child is not being judged and
has always performed well in the past.
Because of their anxiety children may be overly conforming, perfectionist,
or unsure of themselves. They tend to redo tasks if there are
any imperfections. They tend to seek approval and need a great
deal of reassurance.
Treatment
Treatment for Anxiety Disorders in children and adolescents involves
a young person meeting individually with a therapist for talk
therapy and also with a psychiatrist if medication is part of
the treatment. Parents meet with their child's therapist to learn
ways to manage their child's anxieties and to help reduce them.
Treatment for adolescents usually involves the therapist working
with the parents, but to a lesser extent.
(Back to top)
Panic Disorder in Children and Adolescents:
Panic disorder is a common and treatable disorder. Children and
adolescents with panic disorder have unexpected and repeated periods
of intense fear or discomfort, along with other symptoms such
as a racing heartbeat or feeling short of breath. These periods
are called "panic attacks" and may last minutes to hours.
Panic attacks frequently develop without warning.
Symptoms of a Panic Attack Include:
- Intense fearfulness (a sense that something terrible is happening)
- Racing or pounding heartbeat
- Dizziness or lightheadedness
- Shortness of breath or a feeling of being smothered
- Trembling or shaking
- Sense of unreality
- Fear of dying, losing control or losing your mind
How
common is Panic Disorder? More than 3 million American
will experience panic disorder during their lifetime. Panic disorder
often begins during adolescence, although it may start earlier.
This disorder sometimes runs in families.
What Types of Problems Does Untreated Panic Disorder Cause?
If not recognized or treated, panic disorder and its complications
can be devastating. Panic attacks can interfere with a young persons
relationships, schoolwork or normal development. Children and
adolescents with panic disorder may begin to feel anxious most
of the time, even when they are not having panic attacks. Some
begin to avoid situations where they fear a panic attack may occur,
situations where they perceive that help is not available. For
example, a child may be reluctant to go to school or be separated
form his or her parents.
In severe cases, the young person may be afraid to leave home.
This pattern of avoiding certain places or situations is called
"agoraphobia." Some children and adolescents with panic
disorder can develop severe depression and may be at risk of suicidal
behavior. As an attempt to decrease anxiety, some adolescents
with panic disorder will use alcohol and drugs.
Treatment
When properly evaluated and diagnosed, panic disorder usually
responds well to treatment. First, the family doctor should evaluate
the young person who exhibits symptoms of panic attacks. If no
other physical illness or condition is found as a cause of the
symptoms, a comprehensive evaluation by a mental health professional
with expertise in children's mental health should be consulted.
Several types of treatment are effective.
Specific medications may stop panic attacks.
Psychotherapy may also help the child and family learn ways to
reduce stress or conflict that could otherwise cause a panic attack.
With techniques taught in "cognitive behavioral therapy'"
the child can learn new ways to control anxiety or panic attacks
when they occur.
Many children with panic disorder respond well to a combination
of medication and psychotherapy. With treatment, the panic attacks
can usually be stopped. Early treatment can prevent the complications
of panic disorder such as agoraphobia, depression and substance
abuse.
(Back to top)
Social Phobia:
Children with social phobia (also known as social anxiety disorder)
have a persistent fear of being embarrassed in social situations,
during a performance, or if they have to speak in class or in
public, get into conversations with others, or eat drink or write
in public.
Feelings of anxiety in these situations produce physical reactions,
which include:
- Heart palpitations
- Tremors
- Sweating
- Diarrhea
- Blushing
- Muscle tension
Reactions can range from a full-blown anxiety attack to much more
mild reactions. Adolescents and adults are able to recognize that
fear is excessive or unreasonable, but this recognition does not
prevent the fear. Children might not recognize that their reaction
is excessive, although they may be afraid that others will notice
their anxiety and consider them odd or babyish.
Young children do not articulate their fears, but may:
- Cry
- Have tantrums
- Cling
- Appear extremely timid especially in strange social settings
- Try to stay close to familiar adults
They
may also:
- Fall behind in school
- Avoid school completely
- Avoid social situations with children their age
How common is Social Phobia? Social phobia is
common, the lifetime prevalence ranges from 3% to 13%.
Treatment
Treatment for Anxiety Disorders in
children and adolescents involves the young person meeting individually
with a therapist for talk therapy and also with a psychiatrist
if medication is part of the treatment. Parents meet with their
child's therapist to learn ways to manage their child's anxieties
and to help reduce them. Treatment for adolescents usually involves
the therapist working with the parents, but to a lesser extent.
(Back to top)
Obsessive-Compulsive
Disorder (OCD)
Obsessive-Compulsive Disorder (OCD),
usually begins in adolescence or young adulthood. It is characterized
by recurrent intense obsessions and/or compulsions that cause
severe discomfort and interfere with day-to-day functioning.
Obsessions are recurrent and persistent thoughts,
impulses, or images that are unwanted and cause marked anxiety
or distress. Frequently, they are unrealistic or irrational. They
are not simply excessive worries about real-life problems or preoccupations.
Compulsions are repetitive behaviors or rituals
(like hand washing, hoarding, keeping things in order, checking
something over and over) and mental acts (like counting, repeating
words silently, avoiding).
In OCD, the obsessions or compulsions cause
significant anxiety or distress, or they interfere with the child's
normal routine, academic functioning, social activities or relationships.
To cope with his/her feelings, a child may develop "rituals"
(a behavior or activity that gets repeated). Sometimes the obsession
and compulsion are linked; "I fear this bad thing will happen
if I stop checking or hand washing, so I can't stop even if it
doesn't make any sense."
How common is OCD in Children and Adolescents?
It is estimated that between .2% to .8% children have OCD,
and up to 2% of adolescents have this disorder.
What Causes OCD?
Research shows that OCD is a brain disorder
and tends to run in families, although this doesn't mean the child
will definitely develop symptoms if a parent has the disorder.
Recent research suggests that some children develop OCD
after experiencing one type of streptococcal infection. A child
may also develop OCD with no previous family
history.
Treatment
Children and adolescents often feel ashamed and embarrassed
about their OCD. Many fear it means they're crazy
and are hesitant to talk about their thoughts and behaviors. Good
communication between parents and children can increase understanding
of the problem and help parents appropriately support their child.
Most children with OCD can be treated effectively
with a combination of psychotherapy (especially cognitive and
behavioral techniques), and certain medications for example, serotonin
reuptake inhibitors (SSRI's). Family support and education are
also central to successful treatment. Antibiotic therapy may be
useful in cases where OCD is linked to streptococcal
infection.
(Back to top)
Post-traumatic
Stress Disorder (PTSD)
All children and adolescents experience stressful events, which
can affect them both emotionally and physically. Their reactions
to stress are usually brief, and they recovery without further
problems. A child or adolescent who experiences a catastrophic
event may develop ongoing difficulties know as post-traumatic
stress disorder (PTSD). A child's risk of developing
PTSD is related to the seriousness of the trauma,
whether the trauma is repeated, the child's proximity to the trauma,
and his/her relationships to the victim(s).
Following a trauma, children may initially seem agitated or confused.
They also may show intense fear, helplessness, anger, sadness,
horror or denial. Children who experience repeated trauma may
develop a kind of emotional numbing to deaden or block the pain
and trauma. This is called dissociation. Children with PTSD
avoid situations or places that remind them of the trauma. They
may also become less responsive emotionally, depressed, withdrawn,
and more detached from their feelings.
A child with PTSD may also re-experience the traumatic
event by:
- Having frequent memories of the event
- Having upsetting and frightening dreams
- Acting or feelings like the experience is happening again
- Developing repeated physical or emotional symptoms when reminded
of the event
Children with PTSD may also show the following symptoms:
- Worry about dying at an early age
- Losing interest in activists
- Having physical symptoms such as headaches and stomachaches
- Having problems falling or staying asleep
- Having problems concentrating
- Acting younger than their age (for example, clingy or whiny
behavior, thumb sucking)
- Showing increased alertness to the environment, or being easily
startled
- Repeating behavior that reminds them of the trauma
Treatment The symptoms of PTSD
may last from several months to many years. Early intervention
is essential. Support from parents, the school and peers are important.
Emphasis needs to be placed on establishing a feeling of safety.
Psychotherapy (individual, group, or family), which allows the
child to speak, draw, play or write about the event is helpful.
Behavior modification techniques and cognitive therapy may help
reduce fears and worries. Medication can also be useful to help
with agitation, anxiety, or depression.
Additional Information about Anxiety Disorders:
Mental Health: A Report of the Surgeon General:
http://www.surgeongeneral.gov/library/mentalhealth/chapter3/sec6.html
Anxiety Disorders Association of America:
http://
www.adaa.org/AnxietyDisorderInfor/ChildrenAdo.cfm
National Institute of Mental Health (NIMH):
http://www.nimh.nih.gov/publicat/violence.cfm
National Alliance for the Mentally Ill:
http://www.nami.org/helpline/ocd.htm
American Academy of Child and Adolescent Psychiatry:
http://www.aacap.org/clinical/Anxtysum.htm
(Back to top)
Suicide
Suicide among young people nationwide has increased
dramatically in recent years. Each year in the U.S. thousands
of teenagers commit suicide. Suicide is the third
leading cause of death for 15-24 year olds, and the sixth leading
cause of death for 5-14-year-olds.
Teenagers especially experience strong feelings of stress, confusion,
self-doubt, pressure to succeed, financial uncertainty, and other
fears while growing up.
Many of the symptoms of suicidal feelings are similar to those
of depression. Adults who care for children should be aware of
the following signs of adolescents who may try to kill themselves:
- Change in eating or sleeping habits
- Withdrawal from friends, family, and regular activities
- Violent actions, rebellious behavior or running away
- Drug and alcohol use
- Unusual neglect of personal appearance
- Marked personality change
- Persistent boredom, difficulty concentrating, or a decline
in the quality of schoolwork
- Frequent complaints about physical symptoms, often related
to emotions, such as stomachaches, headaches, and fatigue
- Loss of interest in pleasurable activities
- Not tolerating praise or reward
A teenager
who is planning to commit suicide may also:
- Complain of being a bad person or feeling "rotten inside"
- Give verbal hints with statements such as: "I won't be
a problem for you much longer," " nothing matters,"
It's no use," and "I won't see you again"
- Puts his or her affairs in order, for example, gives away
favorite possessions, cleans his or her room, or throws away
important belongings.
- Become suddenly cheerful after a period of depression
- Have signs of psychosis (hallucinations or bizarre thoughts)
If a child or adolescent says, "I want to kill myself,"
or "I'm going to commit suicide," always take the statement
seriously and seek evaluation from a mental health professional.
People often feel uncomfortable talking about death, but asking
the young person whether he or she is depressed or thinking about
suicide can be helpful. Rather than "putting thoughts in the
child's head," such a question will provide assurance that
somebody cares and will give the young person the chance to talk
about problems.
If one or more of the signs listed above is observed, parents
need to talk to their child about their concerns and seek professional
help when the concerns persist. With support from family and professional
help, children and teenagers who are suicidal can heal and return
to a healthier path of development.
(Back to top)
Depression in Children and Adolescents
Not only adults get depressed. Children and teenagers also may
have depression, which is a treatable illness. Depression is defined
as an illness when the feelings of depression persist and interfere
with a child or adolescents ability to function.
How common is Depression in Children and Adolescents?
About 5 percent of children and adolescents suffer from depression
at any given point in time. Children under stress, who experience
loss, or who have attentional, learning, conduct or anxiety disorders
are at a higher risk for depression. Depression also tends to
run in families.
The behavior of depressed children and adolescents may differ
from the behavior of depressed adults.
If one or more of these signs of depression persist, parents should
seek help:
- Frequent sadness, tearfulness, crying
- Hopelessness
- Decreased interest in activities; or inability to enjoy previously
favorite activities
- Persistent boredom; low energy
- Social isolation; or poor communication
- Low self esteem and feelings of guilt
- Extreme sensitivity to rejection or failure
- Increased irritability, anger, or hostility
- Difficulty with relationships
- Frequent complaints or physical illnesses such as headaches
and stomachaches
- Frequent absences from school or poor school performance
- Poor concentration
- A major change in eating and/or sleeping patterns
- Talk of or efforts to run away from home
- Thoughts or expressions of suicide or self destructive behavior
Children and adolescents who cause trouble at home or at school
may actually be depressed. Because the youngster may not always
seem sad, parents and teachers may not realize that troublesome
behavior is a sign of depression. When asked directly, these children
can sometimes state they are unhappy or sad.
Treatment
Early diagnosis and medical treatment are essential for depressed
children. This is a real illness that requires professional help.
Comprehensive treatment often includes both individual and family
therapy. It may also include the use of antidepressant medication.
Additional Information About Clinical Depression:
American Academy of Child and Adolescent Psychiatry:
http://www.aacap.org/publications/factsfam/depressd.htm
http://www.aacap.org/clincal/Depres~1.htm
Mental Health: A Report of the Surgeon General
http://www.surgeongeneral.gov/library/mentalhealth/chapter3/sec5.html
National Institute of Mental Health (NIMH):
http://www.nimh.nih.gov/publicat/depchildresfact.cfm
(Back to top)
Bipolar Disorder in Children and Adolescents
What is Bipolar Disorder or Manic Depression?
Bipolar disorder (also called manic depression)
is a serious mental illness that affects a child's or adolescent's
mood and behavior. Young people with Bipolar Disorder
have dramatic changes in their moods, alternating between feeling
very depressed and feeling high or manic. They may have more normal
moods between these episodes. The periods of depression or mania
can last for days, weeks or even months.
Symptoms of Depression Include:
- Intense feelings of sadness, despair and worthlessness
- Lack of interest in play with friends
- An increase or decrease in sleeping and/or eating
- Feeling tired all the time
- Thoughts of death and/or suicide
- Extreme sensitivity to rejection or failure
- Crying spells
- Irritability and/or fighting
- Physical complaints, like headaches or stomachaches
- Failing grades in school
- In young children, having great difficulty separating from
parents
Symptoms
of Mania Include:
- Extreme irritability or silliness
- Sleeping very little or not feeling tired
- Hyperactivity and distractibility
- Increased talking- talking a lot, talking fast, changing topics
quickly
- Defiance and rage
- An increase in sexual behavior
- Reckless or dangerous behavior
What
Causes Bipolar Disorder? Research indicates that Bipolar
Disorder is genetic and tends to run in families. The chances
of a child or adolescent having Bipolar disorder are much greater
if their parents and/or grandparents have it. Bipolar disorder
is believed to be associated with a chemical imbalance in the
brain. The start of Bipolar disorder can be triggered by extreme
stress, such as the death of a loved one, substance abuse or an
illness. Bipolar disorder may occur without an obvious cause.
How Can Bipolar Disorder Be Treated?
There are many treatments that can reduce depression and mania
and allow the child or adolescent to enjoy their family and friends,
to learn, and to prepare to have productive adult lives. Treatments
include play therapy for children, talking therapies for older
children and adolescents, and medications. Counseling with parents
helps them to understand their young person's difficulties and
helps them manage their child's symptoms. A combination of these
treatments is usually most effective.
A child or adolescent who appears to be depressed or shows signs
of manic or hyperactive behavior, excessive temper outburst and
mood changes should be evaluated by a mental health professional
who has experience treating bipolar disorder. An accurate evaluation
is especially important since medication used to treat ADHD and
those used for clinical depression may worsen symptoms of mania.
A major problem is that children and adolescents with Bipolar
Disorder often go years before they get the treatment they need.
If your child, or a young person you care about is displaying
the symptoms described above, please consult a mental health professional,
or call 1-800-LifeNet (1-800-543-3638) for further information
and a referral for help.
Additional Information About Bipolar Disorder:
Child and Adolescent Bipolar Foundation (CABF)
http://www.bpkids.org/frontdesk/about.htm
National Institute of Mental Health:
http://www.nimh.nih.gov/publicat/bipolarupdate.cfm
American Academy of Child and Adolescent Psychiatry:
http://www.aacap.org/publications/factsfam/bipolar.htm
http://www.aacap.org/clincial/Depres~1.htm
(Back to top)
Schizophrenia:
Children over the age of five can develop schizophrenia, but
it is very rare for the disorder to develop before adolescence.
Schizophrenia is an uncommon psychiatric illness in children and
is hard to recognize in its early phases. It is an illness that
causes strange thinking, feelings and behaviors, and the behavior
of young people with schizophrenia may be quite different than
adults with this illness.
Some of the warning signs of schizophrenia in young people include:
- Trouble telling dreams from reality
- Seeing things and hearing voices which are not real
- Confused thinking
- Vivid and bizarre thoughts and ideas
- Extreme moodiness
- Odd behavior
- Ideas that people are “out to get them”
- Behaving like a younger child
- Severe anxiety and fearfulness
- Confusing television with reality
- Severe problems in making and keeping friends
What causes schizophrenia? There is no known
single cause of schizophrenia, however, schizophrenia does tend
to run in families. People with a close relative with schizophrenia
are more likely to develop the disorder than are people who have
no relatives with the illness. Researchers are closely studying
the role that genetics, environment and individual characteristics
have in the development of this disorder.
Are people with schizophrenia likely to be violent?
News and entertainment media tend to link mental illness and
criminal violence; however, studies indicate that except for those
persons with a record of criminal violence before becoming ill,
and those with substance abuse or alcohol problems, people with
schizophrenia are not especially prone to violence.
How is schizophrenia treated?
Schizophrenia is a serious psychiatric illness. Early diagnosis
and treatment are very important. Children with the problems and
symptoms listed above need to be evaluated. A combination of medication,
individual and family therapy, and special programs (e.g. in school)
are often necessary. With proper treatment, many of the symptoms
described above can be lessened or eliminated. It is important
to remember that many people with this illness improve enough
to lead independent, meaningful, and satisfying lives.
Although progress has been make toward better understanding and
treatment of schizophrenia, continued research is urgently needed.
(Back to top)
Eating Disorders:
Dieting to a body weight that is thinner than needed for health
is highly promoted by current fashion trends, sales campaigns
for special foods, and in some activities and professions. Eating
disorders involve serious disturbances in eating behavior, such
as extreme and unhealthy reduction of food intake or severe overeating,
as well as feelings of distress or extreme concern about body
shape or weight. The three main types of eating disorders are
anorexia nervosa and bulimia nervosa, and binge-eating disorder.
Eating disorders frequently develop during adolescence or early
adulthood, but some reports indicate that they can begin in childhood
or later in adulthood.
How common are eating disorders?
Females are much more likely than males to develop an eating
disorder. An estimated 85% to 95% of people with anorexia or bulimia,
and an estimated 65% of those with binge-eating disorder are females.
Anorexia
Nervosa
An estimated .5% to 3.7% of females suffer from anorexia nervosa
in their lifetime.
Symptoms of anorexia nervosa include:
- Resistance to maintaining body weight at or above a minimally
normal weight for age and height
- Intense fear of gaining weight or becoming fat, even though
underweight
- Distortion in the way in which one views their body weight
or shape, undue influence of body weight or shape on ones self-esteem,
or denial of the seriousness of current low weight
- Infrequent or absent menstrual periods (in females who have
reached puberty)
People with this disorder see themselves as overweight even though
they are dangerously thin. Young people with anorexia nervosa are
typically perfectionistic and high achieving. Desperately needing
to feel a sense of mastery over their lives, teenagers with anorexia
nervosa gain a sense of control by saying “no” to the
normal food demands of her body. In a relentless pursuit to be thin,
they starve themselves. This often reaches a point of serious damage
to the body, and in a small number of cases may lead to death.
Bulimia
How common is bulimia?
An estimated 1.1% to 4.2% of females have bulimia nervosa in
their lifetime.
The symptoms of bulimia include:
Recurrent episodes of eating an excessive amount of food within
a discrete period of time, and by a sense of lack of control over
eating during these episodes
Recurrent self-induced vomiting or misuse of laxatives, diuretics,
enemas, fasting, or excessive exercise in an attempt to prevent
weight gain
Self-esteem is unduly influenced by body shape and weight
The symptoms of bulimia are different from those of anorexia
nervosa. The person with bulimia binges on huge quantities of
high-caloric food and then purges her body of dreaded calories
by self-induced vomiting and often by using laxatives. These binges
may alternate with severe diets, resulting in dramatic weight
fluctuations. The purging of bulimia presents a serious threat
to the person’s physical health, including dehydration,
hormonal imbalance, the depletion of important minerals, and damage
to vital organs.
Binge Eating
Disorder
Community surveys have estimated that between 2% and 5% of Americans
experience binge-eating disorder in a 6-month period.
Symptoms of binge-eating disorder include:
Recurrent episodes of binge eating, characterized by eating
an excessive amount of food within a discrete period of time and
by a sense of lack of control over eating during these episodes
The binge-eating episodes are associated with at least 3 of
the following: eating much more rapidly than normal; eating until
feeling uncomfortably full; eating large amounts of food when
not feeling physically hungry; eating alone because of embarrassment
by how much one is eating; feeling disgusted with oneself, depressed,
or very guilty after overeating
Marked distress about the binge-eating behavior
People with this disorder experience frequent episodes of out-of-control
eating, with the same binge-eating symptoms as those with bulimia.
The main difference is that individuals with binge-eating disorder
do not purge their bodies of excess calories. Therefore, many
with the disorder are overweight for their age and height. Feelings
of self-disgust and shame associated with this illness can lead
to bingeing again, creating a cycle of binge eating.
What causes eating disorders?
The causes of eating disorders are not entirely known, but are
thought to be a combination of genetic, brain chemistry, and environmental
influences.
Treatment
Eating disorders can be treated and a healthy weight restored.
The sooner these disorders are diagnosed and treated, the better
the outcomes are likely to be. Because of their complexity, eating
disorders require a comprehensive treatment plan involving medical
care and monitoring, psychosocial interventions, nutritional counseling,
and when appropriate medication. At the time of diagnosis, the
clinician must determine whether the person is in immediate danger
and in need of hospitalization.
People with eating disorders often do not recognize or admit
that they are ill. As a result, they may strongly resist getting
and staying in treatment. Family members or other trusted individuals
can be helpful in ensuring that the person with an eating disorder
receives rehabilitation and needed care. For some people, treatment
may be long term.
(Back to top)
Attention
Deficit Hyperactivity Disorder (ADHD)
Any child may show inattention, distractibility, impulsivity,
or hyperactivity at times, but the young person with ADHD shows
these symptoms and behaviors more frequently and severely than
other children of the same age or developmental level.
How common is ADHD?
ADHD occurs in 3% to 5% of school age children.
ADHD must begin before the age of seven and can
continue into adulthood. ADHD often runs in families.
About 25% of biological parents also having this medical condition.
A child with ADHD often shows some of the following:
- Trouble paying attention
- Inattention to details and makes careless mistakes
- Easily distracted
- Loses school supplies, forgets to turn in homework
- Trouble finishing class work and homework
- Trouble listening
- Trouble following multiple adult commands
- Blurts out answers
- Impatience
- Fidgets or squirms
- Leaves seat and runs about or climbs excessively
- Seems "on the go"
- Talks too much and has difficulty playing quietly
- Interrupts or intrudes on others
A child presenting with ADHD must have a comprehensive evaluation.
A child with ADHD may have other psychiatric disorders such as conduct
disorder, anxiety disorder, depressive disorder, or manic-depressive
disorder.
Without proper treatment, the child may fall behind in schoolwork,
and friendships may suffer. These children experiences more failure
than success and are frequently criticized by adults who don't
recognize that they have a real health problem.
Treatment
Research clearly demonstrates that medication can be helpful.
Stimulant medication can improve attention, focus, goal directed
behavior, and organizational skills. Other medications such as
antidepressants may also be helpful.
Other types of treatment include cognitive-behavioral therapy,
social skills training, parent education, and modification to
the child's educational program. Behavioral therapy can help a
child control aggression, modulate social behavior, and be more
productive. Cognitive therapy can help a child build self-esteem,
reduce negative thoughts, and improve problems solving skills.
Parents can learn management skills such as issuing instructions
one-step at a time rather than making multiple requests at once.
Education modifications, can address ADHD symptoms
along with any coexisting learning disabilities.
A child who is diagnosed with ADHD and who is treated appropriately
can have a productive and successful life.
Additional Information about ADHD
CHADD Online (Children and Adults with
Attention Deficit Disorder):
http://www.chadd.org
American Academy of Child and Adolescent Psychiatry
http://www.aacap.org/clinical
/adhdsum.htm
National Institute of Mental Health:
http://www.nimh.nih.gov/publicat/adhdqa.cfm
Mental Health: A Report of the Surgeon General:
http://www.surgeongeneral.gov/library/mentalhealth/chapter3/sec4.html
(Back to top)
Conduct Disorder
What is conduct disorder?
Conduct disorders are described as persistent patterns of antisocial
behaviors exhibited over time that violates fundamental social
rules and the basic rights of others. Children and adolescents
with this disorder have great difficulty following rules and behaving
in socially acceptable ways.
What are the Symptoms of a conduct disorder?
Typically a person suffers from a conduct disorder if they persistently
engage in any of the following activities: aggression to people
or animals, destruction of property, deceitfulness or theft, and
serious rule violations. Students that are initiating physical
fights, bullying others, lying and stealing are displaying signs
that they may have a conduct disorder.
What Causes Conduct Disorder?
Many factors may contribute to a child developing conduct disorder,
including brain damage, child abuse, genetic vulnerability, school
failure, and traumatic life experiences.
Treatment:
Children with conduct disorder should receive a comprehensive
evaluation. Many children with a conduct disorder may have coexisting
conditions such as mood disorders, anxiety, PTSD, substance abuse,
ADHD, learning problems, or thought disorders which can also be
treated.
Behavior therapy and psychotherapy are usually necessary to help
the child appropriately express and control anger. Special education
may be needed for youngsters with learning disabilities. Parents
often need expert assistance in developing and carrying out special
management and educational programs for home and school. Treatment
may also include medication in some youngsters, such as those
wit difficulty paying attention, impulse problems or those with
depression.
Treatment is rarely brief since establishing new attitudes and
behavior patterns takes time. However, early treatment offers
a child a better chance for improvement and a better future.
Without treatment, many young people with conduct disorder are
unable to adapt to the demands of adulthood and continue to have
problems with prelateships and keeping a job. They often break
laws or behavior in an antisocial manner.
Additional Information About Conduct Disorders:
Mental Health: A report of the Surgeon General:
http://www.surgeongeneral.gov/library/mentalhealth/chapter3/sec6.html
National Mental Health Association (NMHA):
http://www.nmha.org/infoctr/factsheets/74.cfm
American Academy of Child and Adolescent Psychiatry:
http://www.aacap.org/publications/factsfam/72.htm
http://www.aacap.org/publications/factsfam/condut.htm
At least 1 in 20 young people has a "serious emotional disturbance."
This term is commonly used to describe a child or adolescent who
has a mental health problem or mental illness that severely disrupts
his or her ability to function socially, academically and emotionally
at home, in school, or in the community. We've prepared information
summaries for you for you on the most common child and adolescent
emotional, behavioral and mental disorders including:
- depression
- attention-deficit/hyperactivity disorder (ADHD),
- anxiety disorders
- bipolar disorder
- eating disorders
- schizophrenia
(Back to top) |
