Download Signs and Symptoms of Mental Illness in Children and Adolescents

Signs and Symptoms of
Mental Illness in Children and
Adolescents
By: Lia Romero y Vigil
Background
What is Mental Illness?
• A wide range of mental health conditions—disorders that affect your mood,
thinking and behavior.
• Any of the various forms of psychosis or severe neurosis
www.mayoclinic.org
www.dictionary.com
Mental Illness in Children
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Nearly 5 million children in the U.S. have some type of serious mental illness
In a given year, 20% of American children will be diagnosed with a mental illness
Children differ from adults in that they experience many physical, mental, and
emotional changes as they progress through their natural growth and
development.
www.webmd.com/mental-health/mental-illness-children
Mental Illness and Alcohol Dependent Families
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Sons of an alcohol dependent parent are more likely to have attention
deficit/hyperactivity disorder
Daughters are more likely to encounter eating disorders or depression in later life.
Kinney, J. (2015). Loosening the Grip: A Handbook of Alcohol Information (11th Ed.).
McGraw-Hill Education.
Disorders that can occur
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Intellectual Developmental Disorder
Global Developmental Delay
Language Disorder
Speech Sound Disorder
DSM-5, 2013, American Psychiatric Association
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Childhood-Onset Fluency Disorder
(Stuttering)
Social (Pragmatic) Communication
Disorder
Autism Spectrum Disorder
Attention-Deficit/Hyperactivity Disorder
Disorders that can occur (con’t)
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Specific Learning Disorder
Motor Disorder
Schizophrenia
Bipolar Disorder
Depressive Disorders
DSM-5, 2013, American Psychiatric Association
• Anxiety Disorder
• Feeding and Eating Disorder
• Elimination Disorders
• Conduct Disorder
Pharmacologic Approaches to Management of
Psychiatric Conditions
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Antipsychotic medications
Antidepressants
Mood stabilizers
Anticonvulsant medications
Antianxiety medications
Electroconvulsive Therapy
Falvo, D.R. (2014). Medical and Psychosocial Aspects of Chronic Illness and Disability. Jones and Bartlett
Learning, LLC.
Early warning signs for psychosis
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Early warning signs of psychosis can be defined as subjective thoughts, behaviors and feelings of
a patient that occur in a phase preceding a psychotic episode or relapse.
Three step model was then introduced in the hope that the young person would understand
their individual pathway.
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Step 1: thinking- changes that were felt in their thinking i.e. thoughts regarding others, speed of thoughts.
Feelings-changes that were felt in the way they felt i.e. irritability, suspicion
behaviors- changes in behavior i.e. energy levels, sleep routines, eating patterns
Step 2: timeline of events proceeding backwards from referral to mental health services
Step 3: potential triggers and stressors and how they would cope with these
Walker, S. & Kelly, M. (2011). The introduction of an early warning signs journal in an adolescent inpatient unit.
Journal of Psychiatric and Mental Health Nursing.
Early warning signs for Bipolar Disorder
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Children
• Severe temper tantrums when told “no”
• Tantrums can last for hours and can become violent
• Showing odd displays of happy or silly moods and behaviors
Teens
• May experience a drop in grades, quit sports teams or other activities
• Be suspended or arrested for fighting or drug use
• Engage in risky sexual behavior
• Talk about death or even suicide
www.nami.org/Learn-More/Mental-Health-Conditions/Bipolar-Disorder
Mental Illness in Children: Know the Signs
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Mental illness in children can be hard for parents to identify, therefore many
children go untreated.
Typically up to the adults in a child’s life to identify mental illness in children,
unfortunately many adults do not know the signs and symptoms of mental illness.
Even knowing the red flags, it can still be difficult to distinguish signs of a problem
from normal childhood behavior.
www.mayoclinic.org
Mental Illness in Children: Know the Signs
Mental Health conditions that affect children
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Anxiety Disorders
Attention-deficit/hyperactivity disorder (ADHD)
Autism Spectrum Disorder
Eating Disorders
Mood Disorders
Schizophrenia
www.mayoclinic.org
Mental Illness in Children: Know the Signs
Warning Signs
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Mood changes
Intense feelings
Behavior changes
Difficulty concentrating
Unexplained weight loss
Physical symptoms-headaches and stomach aches rather than sadness and anxiety
Physical harm
Substance abuse
Warning signs of Mental Illness
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Excessive worrying or fear
Feeling excessively sad or low
Confused thinking or problems
concentrating and learning
Extreme mood changes, including
uncontrollable “highs” or feelings of
euphoria
www.nami.org/Learn-More/Know-the-WarningSigns
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Prolonged or strong feelings of irritability
or anger
Avoiding friends and social activities
Difficulties understanding or relating to
other people
Changes in sleeping habits or feeling tired
and low energy
Changes eating habits such as increased
hunger or lack of appetite
Warning signs of Mental Illness (con’t)
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Changes in sex drive
Difficulty perceiving reality
Inability to perceive changes in one’s own feelings, behavior, or personality
Abuse of substances like alcohol or drugs
Multiple physical ailments without obvious causes
Thinking about suicide
Inability to carry out daily activities or handle daily problems and stress
And intense fear of weight gain or concern with appearance
www.nami.org/Learn-More/Know-the-Warning-Signs
Warning Signs in Children
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Changes in school performance
Excessive worry or anxiety, for instance to avoid bed or school
Hyperactive behavior
Frequent nightmares
Frequent disobedience or aggression
Frequent temper tantrums
www.nami.org/Learn-More/Know-the-Warning-Signs
Warning signs
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Marked change in school performance
Inability to cope with problems and daily activities
Noticeable changes in sleeping and/or eating habits
Many physical complaints
Sexual acting out
Depression shown by sustained, prolonged negative mood and attitude, often
accompanied by poor appetite, difficulty sleeping or thoughts of death
Abuse of alcohol and/or drugs
www.americanpsychiatricfoundation.org
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Warning Signs (con’t)
Intense fear of becoming obese with no relationship to actual body weight, purging food or
restricting eating
Persisting nightmares
Threats of self harm or harm to others
Self injury or self destructive behavior
Frequent outbursts of anger, aggression
Threats to run away
Aggressive or non-aggressive consistent violation of rights of others; opposition to
authority, truancy, thefts, or vandalism
Strange thoughts and feelings; and unusual behaviors
www.americanpsychiatricfoundation.org
11 Warning Signs
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Feeling very sad or withdrawn for 2 or
more weeks
Seriously trying to harm or kill yourself, or
making plans to do so
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Sudden overwhelming fear for no reason,
sometimes with a racing heart or fast
breathing
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Involved in multiple fights, using a
weapon, or wanting badly to hurt others
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Severe, out of control behavior that can
hurt yourself or others
Not eating, throwing up or using laxatives
to make yourself lose weight
Intensive worries or fears that get in the
way of daily activities
Extreme difficulty in concentrating or
staying still that puts you in physical
danger or cause school failure
Repeated use of drugs or alcohol
Severe mood swings that cause problems
in relationships
Drastic changes in your behavior or
personality
m.livescience.com/35938-mental-illnesschildren-warning-signs.html
Symptoms in addition to disorder
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Poor school performance
Persistent boredom
Frequent complaints of physical symptoms (headaches and stomachaches)
Sleep and/or appetite problems like sleeping too much or too little, nightmares, or sleepwalking
Behaviors returning to those of a younger age (regressing), like bedwetting, throwing tantrums, or
becoming clingy
More risk-taking behaviors and/or showing less concern for their own safety
www.medicinenet.com
Warning Signs in Adolescents
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Decrease in enjoyment and time spent
with friends and family
Significant decrease in school
performance
Strong resistance to attending school or
absenteeism
Problems with memory, attention or
concentration
Big changes in energy levels, eating or
sleeping patterns
Physical symptoms (stomach aches,
headaches, backaches)
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Feelings of hopelessness, sadness, anxiety, crying
often
Frequent aggression, disobedience or lashing out
verbally
Excessive neglect of personal appearance or
hygiene
Substance abuse
Dangerous or illegal thrill-seeking behavior
Is overly suspicious of others
Sees or hears things that others do not
http://www.asmfmh.org/resources/publications/normalteenage-behaviour-vs-early-warning-signs-of-mentalillness/
Ways to talk to your teen
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Speak in a calm voice.
Say what you mean and be prepared to
listen.
Try not to interrupt the other person.
Avoid sarcasm, whining, threats and
yelling.
Don’t make personal attacks or be
demeaning.
Don’t assume your answer is the only
answer.
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Try not to use words such as “always” or
“never.”
• Deal with the now, not the past.
• Don’t try to get the last word.
• If things get too heated, take a break
and come back to the discussion later.
• Make allowances for the other person.
• Parents: Remember what it was like to
be a teen.
http://www.asmfmh.org/resources/publicati
ons/normal-teenage-behaviour-vs-earlywarning-signs-of-mental-illness/
Mental Illness and the Family: Recognizing
Warning Signs and How to Cope
In Adolescents
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Confused thinking
In Adolescents
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Prolonged depression (sadness or irritability)
Feelings of extreme highs and lows
Excessive fears, worries and anxieties
Social withdrawal
Dramatic changes in eating or sleeping habits
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Growing inability to cope with daily problems and
activities
Suicidal thoughts
Numerous unexplained physical ailments
Substance abuse
Strong feelings of anger
Strange thoughts (delusions)
Seeing or hearing things that aren’t there (hallucinations)
www.mentalhealthamerica.net
Mental Illness and the Family: Recognizing
Warning Signs and How to Cope (con’t)
In Older Children and PreAdolescents
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Substance abuse
Inability to cope with problems and daily activities
Changes in sleeping and/or eating habits
Excessive complaints of physical ailments
In Older Children and PreAdolescents
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Intense fear
Prolonged negative mood, often accompanied by
poor appetited or thoughts of death
Frequent outbursts of anger
Changes in ability to manage responsibilities- at home
and/or at school
Defiance of authority, truancy, theft, and/or vandalism
www.mentalhealthamerica.net
Mental Illness and the Family: Recognizing
Warning Signs and How to Cope (con’t)
In Younger Children
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Changes in school performance
Poor grades despite strong efforts
Changes in sleeping and/or eating habits
Excessive worry or anxiety (i.e. refusing to go to bed or to school)
Hyperactivity
Persistent nightmares
How to cope
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Accept your feelings
Handling unusual behavior
Establish a support network
Seeking counseling
Taking time out
Persistent disobedience
Frequent temper tantrums
www.mentalhealthamerica.net
Why it’s hard to make a diagnosis of Bipolar
Disorder
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One complexity is related to timing is the age at which the symptoms began.
Kids are more likely to feel irritable and angry than sad or euphoric.
Kids are not as able as adults to verbalize feeling states. They know that they feel bad, but they
may not be able to be more specific.
Children do not have the coping abilities of adults, so when they feel bad they act up in ways
that look like misbehavior. Argumentative, defiant, uncompromising, and impulsive in much the
same way that kids do who have conduct disorder, hyperactivity, or ADD.
Ramirez Basco, M. (2015). The Bipolar Workbook: Tools for Controlling Your Mood Swings. The
Guilford Press.
Bipolar Disorder and its treatment
affects in children
Have different symptoms than adults do
Switch more quickly between manic and depression, more mixed
states
Mania often appears as irritability or rage, may be misdiagnosed as
ADHD
More destructive outbursts, rather than excited or euphoric
What Helps and What Hurts
www.DBSAlliance.org
What Helps
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I know you have a real illness and that’s what causes these
thoughts and feelings.
I may not be able to understand exactly how you feel but I care
about you and want to help.
You are important to me. Your life is important to me.
Tell me what I can do now to help you.
You might not believe it now, but the way you’re feeling will
change.
You are not alone in this. I’m here for you.
Talk to me. I’m listening.
What Hurts
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It’s all in your head.
We all go through times like this.
You have so much to live for—why do you want to die?
What do you want me to do? I can’t change your
situation.
Just snap out of it. Look on the bright side.
You’ll be fine. Stop worrying.
Here’s my advice…
“The Storm in my Brain”
www.DBSAlliance.org
Wellness of Mental Illness
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Good treatment plan
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Medication
Talk therapy to help with coping skills
Support from a peer run group
Just because you seek treatment does not mean you are a weak or a failure; it means you have the strength
and courage to look for a way to feel better.
Wellness, or recovery, is a return to a life that you care about. Recovery happens when your illness stops
getting in the way of your life.
2012, Depression and Bipolar Support Alliance
Creating a Wellness Plan
• Setting Goals
• Creating the Life that You Want: Ten Steps to Accomplishing a Goal
• Wellness Achievement and Maintenance
• Crisis Plan Management
• Getting the most from your health care provider (HCP)
Stigma
Definition
• The bodily signs designed to expose something unusual and bad about the
moral status of the signifier.
(Goffman, E., 1963, 45)
Moral Career
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Two phases
Through which the stigmatized person learns and incorporates the stand-point of the normal, acquiring
thereby the identity beliefs of the wider society and a general idea of what it would be like to possess a
particular stigma.
Through which he learns the he possesses a particular stigma and, and this time in detail, the consequence
of possessing it.
Four patterns are formed to establish the foundation for later development:
(Goffman, E., 1963, 45)
Four Patterns
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Involves those with an inborn stigma who become socialized into their disadvantageous situation even
while they are learning and incorporating the standards against which they fall short.
Derives from the capacity of a family, and to a much lesser extent a local neighborhood, to constitute a
protective capsule for its young.
Illustrated by one who becomes stigmatized late in life, or learns late in life that he has always been
discreditable.
Illustrated by those who are initially socialized in an alien community, whether inside or outside the
geographical boundaries of the normal society, and who then must learn a second way of being that is felt
by those around them to be the real and valid one.
(Goffman, E., 1963, 45-49)
Visibility
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How well or how badly the stigma is adapted to provide means of communicating that the
individual possesses it.
Visibility must be distinguished from three other notions that are often confused with it, before
the term can be safely used in the corrected version.
Must be distinguished from its ‘known-about-ness’.
Must be distinguished from one of its bases, particularly, obtrusiveness.
Must be disentangled from certain possibilities of what can be called its ‘perceived focus’.
(Goffman, 1963, 65-66)
Any Questions?