Diagnoses

Diagnoses

There are a multitude of mental health disorders diagnosed in childhood. The list below gives brief descriptions of the more common disorders. The following information has been adapted from the American Academy of Child and Adolescent Psychiatry, “Facts for Families.” For more detailed information, or to find information on other mental health disorders, go to the American Academy of Child and Adolescent Psychiatry’s web site www.aacap.org and click on “Facts for Families.”

Alcohol and Substance Abuse
Experimentation with alcohol and drugs during adolescence is common. While some teens will experiment and stop, or continue to use occasionally without significant problems, others will develop a substance abuse problem and some may become dependent upon substances.
Alcohol and drug abusers are those who use alcohol or drugs despite recurrent social, interpersonal, and legal problems that stem from their use of alcohol or drugs. Those who are alcohol or drug dependent meet all of the criteria of abuse, but they will also exhibit some or all of the following:

• Narrowing of the drinking or drug repertoire (drinking only one brand or type of alcoholic beverage or using one type of drug)
• Drink/drug-seeking behavior (only going to places that will include drinking/drugs or only hanging out with others who drink or use drugs)
• Increased tolerance (having to drink increasing amounts or use more drugs to achieve previous effects).
• Compulsion or craving for alcohol or drugs
• A return to drinking or drugs after a period of abstinence (deciding to quit and not being able to follow through)
• Withdrawal symptoms (getting physical symptoms after going a short period without drinking or using drugs)

Typically, those who abuse substances can be helped with a brief intervention, including education concerning the dangers of binge drinking and drugs.
Those who have become alcohol or drug dependent generally require outside help to stop, which could include detoxification, medical treatment, professional rehab or counseling and/or self-help group support.

Parents can support their children by talking to them about alcohol and drugs, keeping lines of communication open, modeling responsible behavior, and recognizing if problems are developing.
Warning signs of teenage alcohol and drug abuse may include:

• Physical: Fatigue, repeated health complaints, red and glazed eyes, and a lasting cough
• Emotional: Personality change, sudden mood changes, irritability, irresponsible behavior, low self-esteem, poor judgment, depression, and a general lack of interest
• Family: Starting arguments, breaking rules, or withdrawing from the family
• School: Decreased interest, negative attitude, a drop in grades, many absences, truancy, and discipline problems
• Social Problems: New friends who are less interested in standard home and school activities, problems with the law, and changes to less conventional styles in dress and music

Some of the warning signs listed above can also be signs of other problems. It is common for alcohol and drug abuse to accompany a mental health disorder. This is called “dual-diagnosis” or “co-occurring disorders.” Parents may recognize signs of trouble. The first step is to discuss the use and possible abuse of alcohol and other drugs with your teenager. If you have concerns you may want to consult a physician to rule out physical causes of the warning signs. This should often be followed or accompanied by a comprehensive evaluation by a mental health professional. Alcohol and substance abuse can be treated.

Attention Deficit/Hyperactivity Disorder (ADHD)
Any child may show inattention, distractibility, impulsivity, or hyperactivity at times, but the child with ADHD shows these symptoms and behaviors more frequently and severely than other children of the same age or developmental level.
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

ADHD can be treated with therapy or a combination of both therapy and medication.

Anxiety Disorder
Anxiety in children is expected and normal at specific times in development. Parents should be alert to the signs of severe anxiety so they can intervene early to prevent complications. There are different types of anxiety in children:

• Separation Anxiety – symptoms include:
  • Constant thoughts and intense fears about the safety of parents and caretakers
  • Refusing to go to school
  • Frequent stomachaches and other physical complaints
  • Extreme worries about sleeping away from home
  • Being overly clingy
  • Panic or tantrums at times of separation from parents
  • Trouble sleeping or nightmares
• Phobia – symptoms include:
  • Extreme fear about a specific thing or situation (ex. dogs, insects, or needles)
  • The fears cause significant distress and interfere with usual activities
• Social Anxiety – symptoms include
  • Fears of meeting or talking to people
  • Avoidance of social situations
  • Few friends outside the family
• Other symptoms of Anxiety in children include:
  • Many worries about things before they happen
  • Constant worries or concerns about family, school, friends, or activities
  • Repetitive, unwanted thoughts (obsessions) or actions (compulsions)
  • Fears of embarrassment or making mistakes
  • Low self esteem and lack of self-confidence

Anxiety Disorders can be treated with therapy or a combination of both therapy and medication.

Bipolar Disorder
Children and teenagers with Bipolar Disorder have manic and/or depressive symptoms. Some may have mostly depression and others a combination of manic and depressives symptoms. Highs may alternate with lows.
Manic symptoms include:

• Severe changes in mood – either unusually happy or silly, or very irritable, angry, agitated or aggressive
• Unrealistic highs in self-esteem
• Great increase in energy and the ability to go with little or no sleep for days without feeling tired
• Increase in talking – the adolescent talks too much, too fast, changes topics too quickly, and cannot be interrupted
• Distractibility – the teen’s attention moves constantly from one thing to the next
• Repeated high risk-taking behavior, such as abusing alcohol and drugs, reckless driving, or sexual promiscuity

Depressive symptoms include:

• Irritability, depressed mood, persistent sadness, frequent crying
• Thoughts of death or suicide
• Loss of enjoyment in favorite activities
• Frequent complaints of physical illnesses such as headaches or stomach aches
• Low energy level, fatigue, poor concentration, complaints of boredom
• Major change in eating or sleeping patterns, such as oversleeping or overeating

Bipolar Disorder can be treated. Treatment usually consists of therapy and medications.

Conduct Disorder
“Conduct disorder” refers to a group of behavioral and emotional problems in youngsters. Children and adolescents with this disorder have great difficulty following rules and behaving in a socially acceptable way. They are often viewed by other children, adults, and social agencies as “bad” or delinquent, rather than mentally ill. Many factors may contribute to a child developing conduct disorder, including brain damage, child abuse, genetic vulnerability, school failure, and traumatic life experiences.
Children or adolescents with conduct disorder may exhibit some of the following behaviors:

• Aggression to people and animals
• Destruction of Property
• Deceitfulness, lying, or stealing
• Serious violations of rules

Conduct Disorder can be treated, although treatment typically takes a long time. Treatment usually consists of therapy and sometimes includes medications.

Depression
Depression is defined as an illness when the feelings of depression persist and interfere with a child’s or adolescent’s ability to function.
If one or more of these signs of depression persist, parents should seek help:

• Frequent sadness, tearfulness, crying
• Decreased interest in activities, or inability to enjoy previously favorite activities
• Hopelessness
• Persistent boredom, low energy
• Social isolation, poor communication
• Low self esteem and guilt
• Extreme sensitivity to rejection or failure
• Increased irritability, anger, or hostility
• Difficulty with relationships
• Frequent complaints of physical illnesses such as headaches and stomachaches
• 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

Depression can be treated with therapy or a combination of both therapy and medication.

Obsessive-Compulsive Disorder (OCD)
OCD 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. Compulsions are repetitive behaviors or rituals (like hand washing, hoarding, keeping things in order, checking something over and over) or 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.
OCD can be treated with therapy or a combination of both therapy and medication.

Oppositional Defiant Disorder (ODD)
In children with ODD, there is an ongoing pattern of uncooperative, defiant, and hostile behavior toward authority figures that seriously interferes with the youngster’s day to day functioning. Symptoms of ODD may include:

• Frequent temper tantrums
• Excessive arguing with adults
• Often questioning rules
• Active defiance and refusal to comply with adult requests and rules
• Deliberate attempts to annoy or upset people
• Blaming others for his or her mistakes or misbehavior
• Often being touchy or easily annoyed by others
• Frequent anger and resentment
• Mean and hateful talking when upset
• Spiteful attitude and revenge seeking

ODD can be treated with therapy or a combination of both therapy and medication.

Panic Disorder
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. Episodes may last minutes to hours. Symptoms of 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

Panic Disorder can be treated with therapy or a combination of both therapy and medication.

Posttraumatic 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 recover without further problems. A child or adolescent who experiences a catastrophic event may develop ongoing difficulties known as posttraumatic 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 or her relationship to the victim(s).

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 re-experience the traumatic event by:

• Having frequent memories of the event, or in young children, play in which some or all of the trauma is repeated over and over
• Have upsetting and frightening dreams
• Acting or feeling like the experience is happening again
• Developing repeated physical or emotional symptoms when the child is reminded of the event

Children with PTSD may also show the following symptoms:

• Worry about dying at an early age
• Losing interest in activities
• Having physical symptoms such as headaches and stomachaches
• Showing more sudden and extreme emotional reactions
• Having problems falling or staying asleep
• Showing irritability or angry outbursts
• Having problems concentrating
• Acting younger than their age
• Showing increased alertness to the environment
• Repeating behavior that reminds them of the trauma.

PTSD can be treated with therapy or a combination of both therapy and medication.

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