Download Mood Disorders

Mood & Anxiety Disorders
General Information
Interventions
Q&A
"But when the melancholy fit shall fall
Sudden from heaven like a weeping cloud,
That fosters the droop-headed flowers all,
And hides the green hill in an April shroud;
Then glut thy sorrow on a morning rose."
John Keats, Ode on Melancholy
Mood Disorders
A mood disorder is a mental illness
characterized primarily by mood swings or
an abnormally high or low mood.
Most mood disorders are defined and
diagnosed by the occurrence of one or
more mood episodes, or periods of
abnormal happiness or sadness. Such
episodes are not mood disorders in
themselves.
Types of Mood Disorders
major depression,
dysthymia and
bipolar disorder
How Prevalent are Mood Disorders
in Children and Adolescents?
7-14% of children will experience an
episode of major depression before the
age of 15.
20-30% of adult bipolar patients report
having their first episode before the age of
20.
Out of 100,000 adolescents, two to three
thousand will have mood disorders out of
which 8-10 will commit suicide.
http://www.nationalyouth.com/mooddisorders.html
Depression-Description
When a person's feelings of sadness
persist beyond a few weeks, he or
she may have depression.
According to the National Institute for
Mental Health, three to four million
men are affected by depression; it
affects twice as many women.
Depression-Symptoms
Sadness
Fatigue
Despair
Dejection
Changes in
appetite
Loss of interest
Difficulty sleeping
Hopelessness
Sense of inferiority
Exaggerated guilt
Feelings of
incompetence
Inability to function
effectively
The Dos and Don’ts of
Communicating - Depression
DON’T
Blame or criticize.
Discipline with shame.
Make assumptions about a child’s behavior.
Force a conversation before a child is ready.
Lecture.
Lose your temper.
Dismiss a child’s concern.
2006, Instant Help Charts. Childswork Childsplay
The Dos and Don’ts of
Communicating - Depression
DO
Focus on solutions and positive aspects of the
child’s reality.
Use positive reinforcement for good behavior.
Educate yourself and ask questions of the child.
Be extremely patient in keeping lines of
communication open.
Use short statements expressing love and
commitment.
Speak calmly and lovingly.
Listen carefully for issues possibly causing the
depression.
2006, Instant Help Charts. Childswork Childsplay
Bipolar - Description
Extreme mood swings punctuated by periods of
generally even-keeled behavior characterize this
disorder.
Bipolar disorder tends to run in families.
This disorder typically begins in the mid-twenties
and continues throughout life.
Without treatment, people who have bipolar
disorder often go through devastating life events
such as marital breakups, job loss, substance
abuse, and suicide.
Mania and depression may vary in both duration
and degree of intensity.
Bipolar – Symptoms - Mania
expansive or
irritable mood
inflated self-esteem
decreased need for
sleep
increased energy
racing thoughts
feelings of
invulnerability
poor judgment
heightened sex
drive
denial that anything
is wrong
Bipolar – Symptoms - Depression
Feelings of
hopelessness
Guilt
Worthlessness
Melancholy
Fatigue
loss of appetite for
food or sex
sleep disturbances
thoughts of death
or suicide
suicide attempts
Patients with a childhood onset of
bipolar symptoms may have a course of
illness that is more severe, chronic, and
refractory than that of patients with a
later onset of symptoms of bipolar
disorder.
In addition, an early onset of bipolar
symptoms seems to be associated with
increased risk of mixed mood states
(combined symptoms of depression and
mania simultaneously) and rapid
cycling (>3 episodes of mania in 1 y).
Comorbidities
Disorders that can occur
simultaneously with Bipolar Disorder
Attention Deficit Hyperactivity Disorder
(ADHD) primarily Hyperactivity
Obsessive-Compulsive Disorder (OCD)
Oppositional Defiant Disorder (ODD)
Conduct Disorder (CD)
Tourette’s syndrome (TS)
ADHD, BIPOLAR or BOTH?
That is the question researchers are trying
hard to answer.
Dr. Charles Popper, MD,
Pediatric/Adolescent Psychiatry, reports
that “All of the features of ADHD can be
seen in mood disorders at times, so ADHD
is a diagnosis reached only after ruling out
a mood disorder.” (p. 39)
Papolos, D. & Papolos, J., (2006). The Bipolar
Child: The Definitive and Reassuring Guide to
Childhood’s Most Misunderstood Disorder.
Broadway Books: New York.
Estimation
“It is estimated that one-third of all the
children in this country who are being
diagnosed with attention-deficit
disorder with hyperactivity are actually
suffering from early symptoms of
bipolar disorder.” (Papolas, 2006, p.
6)
“Children who are striving to feel safe when the
world around them feels threatening, who are
distractible, who have difficulty switching from one
activity to another, who are easily aroused by
novel stimuli, or who frequently misrepresent the
intentions of others are prime candidates to use
oppositional behavior to protect themselves and
establish some semblance of control in the world.
They try to accomplish this by constantly standing
their ground – admitting no new stimuli, no
changes, and no transitions – with absolute
resolve.” (Papolos, 2006, p. 195)
Causes
Researchers believe most serious
mental illnesses are caused by
complex imbalances in the brain's
chemical activity.
They also believe environmental
factors can play a part in triggering, or
cushioning against, the onset of
mental illness.
Treatment
Medication
Psychotherapy
Combined treatment of medication
and psychotherapy
The following medications are used to
treat Depression and Bi-polarity:
Anafranil
Asendin
Aventyl
Desyrel
Effexor
Elavil
Ludiomil
Luvox (SSRI)
Marplan (MAOI)
Nardil (MAOI)
Norpramin
Pamelor
Parnate (MAOI)
Paxil (SSRI)
Pertofrane
Prozac (SSRI)
Remeron
Serzone
Sinequan
Surmontin
Tofranil
Vivactil
Wellbutrin
Zoloft (SSRI)
SSRI – Selective Serotonin Reuptake Inhibitors
MAOI - Monoamine Oxidase Inhibitor
Medications Specific to
Bi-Polar Disorder
Aripiprazole
Clozapine
Depakote
Lithium
Olanzapine
Prozac
Risperidone
Quetiapine
Wellbutrin
Ziprasidone
Zoloft
The Dos and Don’ts of
Communicating - Bipolar
DON’T
Ignore statements
like “I want to be
dead.”
Blame the child or
yourself.
Focus on minor
issues.
Emphasize
negative behaviors.
Overreact to manic
symptoms.
DO
Take suicidal
statements
seriously.
Stay positive.
Let go of less
important matters.
Acknowledge
accomplishments.
Maintain a calm,
consistent attitude.
2006, Instant Help Charts. Childswork Childsplay
The Bipolar Child:
The Definitive and
Reassuring Guide
to Childhood's
Most
Misunderstood
Disorder
Authors:
Demitri Papolos, MD
& Janice Papolos
Anxiety Disorders
Anxiety disorders range from feelings of
uneasiness to immobilizing bouts of terror.
An anxiety disorder may make you feel
anxious most of the time, without any
apparent reason. Or the anxious feelings
may be so uncomfortable that to avoid
them you may stop some everyday
activities.
http://www.nimh.nih.gov/health/topics/anxiety-disorders/index.shtml
Types of Anxiety Disorders
Generalized Anxiety Disorder (GAD)
Obsessive-Compulsive Disorder
(OCD)
Panic Disorder
Post-Traumatic Stress Disorder
(PTSD)
Social Phobia (or Social Anxiety
Disorder)
Generalized Anxiety Disorder
an anxiety disorder characterized by
chronic anxiety, exaggerated worry and
tension, even when there is little or nothing
to provoke it
People with generalized anxiety disorder
can't seem to shake their concerns.
Their worries are accompanied by physical
symptoms, especially fatigue, headaches,
muscle tension, muscle aches, difficulty
swallowing, trembling, twitching, irritability,
sweating, and hot flashes.
The Dos and Don’ts of
Communicating - GAD
DON’T
Belittle children’s concerns or make fun of them. To the
children, they’re real and not at all funny.
Set unrealistic expectations for children’s behavior or
achievements.
Compare children with others or point out their
shortcomings.
Focus on children’s anxiety so much that you fail to
encourage and support normal, everyday activities.
Reinforce the idea that there is something to be afraid of
by giving in to children’s fears. For example, don’t go out
of your way to avoid a dog that the child is afraid of;
instead, offer a few gentle words of support as you
approach the animal.
Tell children to relax or be calm. They would if they could.
2006, Instant Help Charts. Childswork Childsplay
The Dos and Don’ts of
Communicating - GAD
DO
Talk to the children about their feelings. Getting their
emotions out in the open can help children feel more in
control.
Encourage children to learn to think positively and to
counter persistent negative thoughts with more hopeful
thoughts.
Help children break down overwhelmingly large tasks
into smaller, more achievable ones.
Point out facts that contradict or offer alternative
explanations for things that children worry about.
Encourage children to accept less than perfect
performances in school and at home.
Teach children to repeat positive, self-encouraging
statements to themselves (e.g., “I can do this.”) to
counter their fear.
2006, Instant Help Charts. Childswork Childsplay
Obsessive-Compulsive Disorder (OCD)
an anxiety disorder and is characterized by
recurrent, unwanted thoughts (obsessions)
and/or repetitive behaviors (compulsions).
Repetitive behaviors such as handwashing,
counting, checking, or cleaning are often
performed with the hope of preventing
obsessive thoughts or making them go
away.
Performing these so-called "rituals,"
however, provides only temporary relief,
and not performing them markedly
increases anxiety.
The Dos and Don’ts of
Communicating - OCD
DON’T
Make negative comments about OCD-related
behaviors.
Ignore the signs and symptoms of OCD.
Refuse to participate in the symptoms.
Criticize thoughts or actions associated with the
child’s OCD.
Make unexpected changes in the child’s
routine.
Blame the child for the OCD behaviors.
Assume you know how the child is feeling.
2006, Instant Help Charts. Childswork Childsplay
The Dos and Don’ts of
Communicating - OCD
DO
Offer calm, understanding support.
Learn as much as you can about the disorder and
discuss it with the child.
Work with the child in developing a strategy to disengage
you from participating in OCD-related behaviors.
Praise successful attempts to resist OCD.
Discuss any changes that may directly or indirectly affect
the child.
Reassure the child that the symptoms can be overcome.
Listen to the child and ask what you can do to help.
2006, Instant Help Charts. Childswork Childsplay
Mr. Worry: A Story About OCD
Author: Holly L Niner
Albert Whitman &
Company
ISBN: 978-0-8075-5182-0
Panic Disorder
an anxiety disorder and is
characterized by unexpected and
repeated episodes of intense fear
accompanied by physical symptoms
that may include chest pain, heart
palpitations, shortness of breath,
dizziness, or abdominal distress
Post-Traumatic Stress Disorder (PTSD)
an anxiety disorder that can develop after
exposure to a terrifying event or ordeal in which
grave physical harm occurred or was threatened
Traumatic events that may trigger PTSD include
violent personal assaults, natural or humancaused disasters, accidents, or military combat.
People with PTSD have persistent frightening
thoughts and memories of their ordeal and feel
emotionally numb, especially with people they
were once close to. They may experience sleep
problems, feel detached or numb, or be easily
startled.
Social Phobia
(or Social Anxiety Disorder)
an anxiety disorder characterized by
overwhelming anxiety and excessive selfconsciousness in everyday social
situations
Social phobia can be limited to only one
type of situation — such as a fear of
speaking in formal or informal situations, or
eating or drinking in front of others — or, in
its most severe form, may be so broad that
a person experiences symptoms almost
anytime they are around other people.
People with social phobia have a
persistent, intense, and chronic fear of
being watched and judged by others and
being embarrassed or humiliated by their
own actions.
Their fear may be so severe that it
interferes with work or school, and other
ordinary activities.
Physical symptoms often accompany the
intense anxiety of social phobia and
include blushing, profuse sweating,
trembling, nausea, and difficulty talking.
Questions and Answers