Mental Illness in Children and
Adolescents
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.
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/GettingHelp/Briefoverview.asp
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.
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.
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.
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.
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.
Additional Information about OCD:
National Alliance for the Mentally Ill
http://www.nami.org/helpline/ocd.htm
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.
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.
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
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/health/topics/depression/depression-in-children-and-adolescents.shtml
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/
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
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.
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.
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
National Institute of Mental Health
http://www.nimh.nih.gov/health/topics/attention-deficit-hyperactivity-disorder-adhd/index.shtml
Mental Health: A Report of the Surgeon
General
http://www.surgeongeneral.gov/library/mentalhealth/chapter3/sec4.html
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