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Glossery of Syptoms and Mental Illness Affecting Teenagers
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By Arthur Buchanan
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Being a teenager is not easy. Adolescents feel all kinds ofpressures -- to do well in school, to be popular with peers, togain the approval of parents, to make the team, to be cool. Inaddition, many teenagers have other special problems. Forexample, they may worry about a parent being out of work or thefamily's financial problems.
Adolescents may be hurt or confused by their parents' divorce,or they may have to learn how to live with a parent's alcoholismor mental illness. Despite these pressures, it is important toremember that most teenagers develop into healthy adults.
Unfortunately, some teenagers develop serious emotional problemsrequiring professional help. This glossary of brief definitionswas developed to help teenagers, parents, teachers, and otherslearn more about the major mental illnesses, symptoms, andmental health issues which affect teenagers. Please remember:All the problems described in the glossary are treatable andsome can be prevented. In every case, the sooner a teenager getshelp, the better.
ALCOHOL AND DRUG ABUSE
Use and abuse of drugs and alcohol by teens is very common andcan have serious consequences. In the 15-24 year age range, 50%of deaths (from accidents, homicides, suicides) involve alcoholor drug abuse. Drugs and alcohol also contribute to physical andsexual aggression such as assault or rape. Possible stages ofteenage experience with alcohol and drugs include abstinence(non-use), experimentation, regular use (both recreational andcompensatory for other problems), abuse, and dependency.
Repeated and regular recreational use can lead to other problemslike anxiety and depression. Some teenagers regularly use drugsor alcohol to compensate for anxiety, depression, or a lack ofpositive social skills. Teen use of tobacco and alcohol shouldnot be minimized because they can be "gateway drugs" for otherdrugs (marijuana, cocaine, hallucinogens, inhalants, andheroin). The combination of teenagers' curiosity, risk takingbehavior, and social pressure make it very difficult to say no.This leads most teenagers to the questions: "Will it hurt to tryone?"
A teenager with a family history of alcohol or drug abuse and alack of pro-social skills can move rapidly from experimentationto patterns of serious abuse or dependency. Some other teenagerswith no family history of abuse who experiment may also progressto abuse or dependency. Therefore, there is a good chance that"one" will hurt you. Teenagers with a family history of alcoholor drug abuse are particularly advised to abstain and notexperiment. No one can predict for sure who will abuse or becomedependent on drugs except to say the non-user never will.
Warning signs of teenage drug or alcohol abuse may include:
a drop in school performance,
a change in groups of friends,
delinquent behavior, and
deterioration in family relationships.
There may also be physical signs such as red eyes, a persistentcough, and change in eating and sleeping habits. Alcohol or drugdependency may include blackouts, withdrawal symptoms, andfurther problems in functioning at home, school, or work.
ANOREXIA NERVOSA
Anorexia Nervosa occurs when an adolescent refuses to maintainbody weight at or above a minimal normal weight for age andheight. The weight loss is usually self-imposed and is usuallyless than 85% of expected weight. The condition occurs mostfrequently in females, however, it can occur in males.
Generally, the teenager has an intense fear of gaining weight orbecoming fat even though underweight. Self evaluation of bodyweight and shape may be distorted and there may be denial of thepotential health hazards caused by the low body weight.
Physical symptoms can include:
absence of regular menstrual cycles
dry skin
low pulse rate, and
low blood pressure
Behavioral changes commonly occur such as:
social withdrawal
irritability
moodiness, and
depression
Without treatment, this disorder can become chronic and withsevere starvation, some teenagers may die.
ANXIETY
Anxiety is the fearful anticipation of further danger orproblems accompanied by an intense unpleasant feeling(dysphoria) or physical symptoms. Anxiety is not uncommon inchildren and adolescents. Anxiety in children may present as:
Separation Anxiety Disorder: Excessive anxiety concerningseparation from home or from those to whom the child isattached. The youngster may develop excessive worrying to thepoint of being reluctant or refusing to go to school, beingalone, or sleeping alone. Repeated nightmares and complaints ofphysical symptoms (such as headaches, stomach aches, nausea, orvomiting) may occur.
Generalized Anxiety Disorder: Excessive anxiety and worry aboutevents or activities such as school. The child or adolescent hasdifficulty controlling worries. There may also be restlessness,fatigue, difficulty concentrating, irritability, muscle tension,and sleep difficulties. Panic Disorder: The presence ofrecurrent, unexpected panic attacks and persistent worries abouthaving attacks. Panic Attack refers to the sudden onset ofintense apprehension, fearfulness, or terror, often associatedwith feelings of impending doom.
There may also be shortness of breath, palpitations, chest painor discomfort, choking or smothering sensations, and fear of"going crazy" or losing control. Phobias: Persistent, irrationalfears of a specific object, activity, or situation (such asflying, heights, animals, receiving an injection, seeing blood).These intense fears cause the child or adolescent to avoid theobject, activity, or situation.
ATTENTION DEFICIT/ HYPERACTIVITY DISORDER (ADHD)
ADHD is usually first diagnosed during the elementary schoolyears. In some cases, symptoms continue into adolescence. Ateenager with Attention Deficit/Hyperactivity Disorder hasproblems with paying attention and concentration and/or withhyperactive and impulsive behavior. Despite good intentions, ateenager may be unable to listen well, organize work, and followdirections. Cooperating in sports and games may be difficult.Acting before thinking can cause problems with parents,teachers, and friends. These teens may be restless, fidgety, andunable to sit still.
Attention Deficit/Hyperactivity Disorder occurs more commonly inboys and symptoms are always present before the age of seven.Problems related to ADHD appear in multiple areas of ayoungster's life and can be very upsetting to the teen, his/herfamily, and people at school. Symptoms of ADHD frequently becomeless severe during the late teen years and in young adulthood.
BIPOLAR DISORDER (MANIC DEPRESSION)
Bipolar Disorder is a type of mood disorder with marked changesin mood between extreme elation or happiness and severedepression. The periods of elation are termed mania. During thisphase, the teenager has an expansive or irritable mood, canbecome hyperactive and agitated, can get by with very little orno sleep, becomes excessively involved in multiple projects andactivities, and has impaired judgment.
A teenager may indulge in risk taking behaviors, such as sexualpromiscuity and anti-social behaviors. Some teenagers in a manicphase may develop psychotic symptoms (grandiose delusions andhallucinations). For a description of the depressive phase seedepression. Bipolar disorder generally occurs before the age of30 years and may first develop during adolescence.
BULIMIA NERVOSA (BULIMIA)
Bulimia Nervosa occurs when an adolescent has repeated episodesof binge eating and purging. Binges are characterized by eatinglarge quantities of food in a discrete period of time. The teenalso has feelings of being unable to stop eating and loss ofcontrol over the amount of food being eaten. Usually, afterbinge eating, they attempt to prevent weight gain byself-induced vomiting, laxative use, diuretics, enemas,medications, fasting, or excessive exercise. These teen'sself-esteem is strongly affected by weight and body shape.
Serious medical problems can occur with Bulimia Nervosa (e.g.esophageal or gastric rupture, cardiac arrhythmias, kidneyfailure, and seizures). Other psychological problems such asdepression, intense moods, and low self-esteem are common. Earlydiagnosis and treatment can improve outcome and decrease therisk of worsening depression, shame, and harmful weightfluctuations.
CONDUCT DISORDER
Teenager's with conduct disorder have a repetitive andpersistent pattern of behavior in which they violate the rightsof others, or violate norms or rules that are appropriate totheir age. Their conduct is more serious than the ordinarymischief and pranks of children and adolescents.
Severe difficulties at home, in school, and in the community arecommon, and frequently there is very early sexual activity.Self-esteem is usually low, although the adolescent may projectan image of "toughness." Teenagers with this disorder have alsobeen described as "delinquent" or "anti-social." Some teenagerswith conduct disorder may also have symptoms of otherpsychiatric disorders (see ADHD, depression, alcohol and drugabuse).
DEPRESSION
Though the term "depression" can describe a normal humanemotion, it also can refer to a psychiatric disorder. Depressiveillness in children and adolescents includes a cluster ofsymptoms which have been present for at least two weeks.
In addition to feelings of sadness and/or irritability, adepressive illness includes several of the following:
Change of appetite with either significant weight loss (when notdieting) or weight gain
Change in sleeping patterns (such as trouble falling asleep,waking up in the middle of the night, early morning awakening,or sleeping too much)
Loss of interest in activities formerly enjoyed
Loss of energy, fatigue, feeling slowed down for no
reason, "burned out" Feelings of guilt and self blame for thingsthat are not one's fault
Inability to concentrate and indecisiveness
Feelings of hopelessness and helplessness
Recurring thought of death and suicide, wishing to die, orattempting suicide Children and adolescents with depression mayalso have symptoms of irritability, grumpiness, and boredom.They may have vague, non-specific physical complaints(stomachaches, headaches, etc.). There is an increased incidenceof depressive illness in the children of parents withsignificant depression.
LEARNING DISORDERS
Learning Disorders occur when the child or adolescent's reading,math, or writing skills are substantially below that expectedfor age, schooling, and level of intelligence. Approximately 5%of students in public schools in the United States areidentified as having a learning disorder.
Students with learning disorders may become so frustrated withtheir performance in school that by adolescence they may feellike failures and want to drop out of school or may developbehavioral problems. Special testing is always required to makethe diagnosis of a learning disorder and to develop appropriateremedial interventions. Learning disorders should be identifiedas early as possible during school years.
OBSESSIVE- COMPULSIVE DISORDER (OCD)
Teenagers with OCD have obsessions and/or compulsions. Anobsession refers to recurrent and persistent thoughts, impulses,or images that are intrusive and cause severe anxiety ordistress. Compulsions refer to repetitive behaviors and rituals(like hand washing, hoarding, ordering, checking) or mental acts(like counting, repeating words silently, avoiding). Theobsessions and compulsions also significantly interfere with theteen's normal routine, academic functioning, usual socialactivities, or relationships.
PHYSICAL ABUSE
Physical abuse occurs when a person responsible for a child oradolescent's welfare causes physical injury or harm to thechild. Examples of abusive treatment of children include:hitting with an object, kicking, burning, scalding, punching,and threatening or attacking with weapons. Children andadolescents who have been abused may suffer from depression,anxiety, low selfesteem, inability to build trustingrelationships, alcohol and drug abuse, learning impairments, andconduct disorder.
POST- TRAUMATIC STRESS DISORDER (PTSD)
PTSD can occur when a teenager experiences a shocking,unexpected event that is outside the range of usual humanexperience. The trauma is usually so extreme that it canoverwhelm their coping mechanisms and create intense feelings offear and helplessness.
The traumatic event may be experienced by the individualdirectly (e.g. physical or sexual abuse, assault, rape,kidnaping, threatened death), by observation (witness of traumato another person), or by learning about a trauma affecting aclose relative or friend. Whether teens develop PTSD depends ona combination of their previous history, the severity of thetraumatic event, and the amount of exposure.
Symptoms include:
Recurrent, intrusive, and distressing memories of the eventRecurrent, distressing dreams of the event.
Acting or feeling as if the traumatic event were recurringIntense psychological distress when exposed to reminders of thetraumatic event and consequent avoidance of those stimuli.
Numbing of general responsiveness (detachment, estrangement fromothers, decreased interest in significant activities) Persistentsymptoms of increased arousal (irritability, sleep disturbances,poor concentration, hyper-vigilance, anxiety).
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