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Depression in Children and Adolescents
Depression in Children and Adolescents
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2% school children and 5% adolescents have depression |
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Suicides amongst adolescents have increased 4 times |
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Suicide is the third leading cause of death for 15 to 24 year olds, and the sixth leading cause of death for five to 14 year olds |
| What are the Symptoms of Depression in Children and Adolescents? |
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Sadness or feeling low |
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Loss of interest and loss of pleasure |
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Withdrawn form social network, avoids friends and family |
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Weight, appetite and sleep changes |
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Deterioration in academic performance |
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Frequent complaints of pains, and aches |
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Crying, irritable, upset |
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Persistent boredom |
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Low energy |
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Poor concentration |
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Absenteeism from school |
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Behavioral problems |
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Conflicts with parents and other authority figures |
| What Causes Depression in Children and Adolescents? |
| Biochemistry - Deficiencies in two chemicals in the brain, serotonin and norepinephrine, are thought to be responsible for certain symptoms of depression, including anxiety, irritability, and fatigue. |
| Genetics - Depression can run in families. For example, if one identical twin has depression, the other twin has a 70% chance of also having the illness sometime in life. |
| Personality - People with low self-esteem, who are easily overwhelmed by stress, or who are generally pessimistic appear to be vulnerable to depression. |
| Environmental factors - Continuous exposure to violence, neglect, abuse, or poverty may make people who are already susceptible to depression all the more vulnerable to the illness. |
| What is the Treatment for Childhood and Adolescent Depression? |
| Medications from a Psychiatrist - Medications that restore chemical imbalances should be considered even in the case of children and adolescent. These are not addictive, they do not have sedation and are not taken life long, and do not have worrisome side effects especially when taken in a therapeutic dosage under the advice of a psychiatrist. |
| Cognitive behavioral therapy - Cognitive behavioral therapy has been shown to be especially effective with children and adolescents whereby help is provided to aid in thought restructuring and bring about behavioral changes as well. Active problem solving, social skills development, activity scheduling, and self-monitoring are often targeted and taught. |
| Family guidance - Education and guidance to parents and families helps them take a supportive role to help the child with his or her problem. |
Depression in Adults
Depression in Adults
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1 in 5 women and 1 if 10 men have depression in their life time. |
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This is going to be the 2nd largest illness in the world by 2010. |
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10-15% patients of depression commit suicide |
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45-70% of all suicides have a mood disorder |
| What Is Depression? |
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Feelings of unhappiness that don't go away |
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Losing interest in life |
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Becoming unable to enjoy anything |
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Finding it hard to make even simple decisions |
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Feeling utterly tired |
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Feeling restless and agitated |
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Losing appetite and weight (some people find they do the reverse and put on weight) |
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Difficulty in sleeping |
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Waking up earlier than usual |
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Going off 'sex' |
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Losing self-confidence |
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Feeling useless, inadequate and hopeless |
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Avoiding other people |
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Feeling irritable |
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Feeling worse at a particular time of day, usually mornings |
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Thinking of suicide |
| What Causes Depression? |
| Biochemistry - Deficiencies in two chemicals in the brain, serotonin and norepinephrine, are thought to be responsible for certain symptoms of depression. |
| Genetics - Depression can run in families. For example, if one identical twin has depression, the other twin has a 70% chance of also having the illness sometime in life. |
| Personality - People with low self-esteem, who are easily overwhelmed by stress, or who are generally pessimistic appear to be vulnerable to depression. |
| Environmental factors - Continuous exposure to violence, neglect, abuse, or poverty may make people who are already susceptible to depression all the more vulnerable to the illness. |
| However, it should be noted that depression could still occur under ideal living circumstances. This is important to understand as there is a feeling that only those who are weak have depression, or that people can self impose the illness and so on. But depression like any other medical illness can happen to anyone. |
| How Is Depression Treated? |
| Depression is among the most treatable of mental disorders. Between 80% and 90% of people with depression respond well to treatment, and almost all patients gain some relief from their symptoms. The treatment tends to be multipronged and includes the following strategies depending upon the individual's symptoms and personal factors. |
| Medication - Antidepressants may be prescribed to correct imbalances in the levels of chemicals in the brain. These medications are not sedatives, "uppers," or tranquilizers; they are not habit-forming and they generally have no stimulating effect on people not experiencing depression. Antidepressants usually take full effect within 3-6 weeks after therapy has begun. Psychiatrists usually recommend that patients continue to take medication for 5 or more months after symptoms have improved. |
| Psychotherapy - Psychotherapy, or "talk therapy," may be used either alone for treatment of mild depression or in combination with antidepressant medications for moderate to severe depression. Psychotherapy can involve only the individual patient or include others. Family or couples therapy helps to address specific issues that can arise within these close relationships. Depending on the severity of the depression, treatment can take a few weeks or substantially longer. There are also techniques like (CBT) Cognitive Behavior Therapy that are very effective in management of depression in which through various exercises and thought changing techniques depression can be resolved. |
| Both the medical and therapeutic treatments when used together have the best result. And if the treating professional has advised you medications then you must take them as advised. Furthermore, good social and family support can be very helpful in the management of depression and improves the prognosis of the patient and helps in faster recovery. |
Obsessive-Compulsive Disorder
Obsessive-Compulsive Disorder
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OCD is an Anxiety disorder |
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4% people have the illness |
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It happens both in men and women and is prevalent across all ages |
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It starts in adolescence and can also happen in children |
| What is Obsessive-Compulsive Disorder? |
| Typically OCD is characterized by what are called obsessions and compulsions. |
| Obsessions - Obsessions are constant, intrusive, unwanted thoughts that cause distressing emotions such as anxiety or disgust. People experiencing obsessions recognize that these persistent images are a product of their own mind and are excessive or unreasonable but they are unable to control them, and feel distressed by them. |
| Compulsions - Compulsions are urges to do something to lessen discomfort, usually discomfort that is caused by an obsession. Rituals are the behaviors in which people engage in response to a compulsion. In the most severe cases, a constant repetition of rituals may fill the day, making a normal routine impossible. |
| Some of the common obsessions and compulsions include the following, |
| Cleaning, contamination and hand washing - Provoked by the fear that real or imagined germs, dirt, or chemicals will "contaminate" them, some spend hours and hours washing themselves or cleaning their surroundings. |
| Repeating - To dispel anxiety, some utter a name, phrase, or behavior several times. They know these repetitions won't actually guard against injury but fear harm will occur if they don't do it. |
| Being meticulous and symmetry preoccupation - While neatness and tidiness don't signify a disorder, some individuals with OCD develop an overwhelming concern about where things go on a desk or the appearance of a room. |
| Checking - The fear of harming oneself or others by forgetting to lock the door or turn off the gas stove develops into the ritual of checking. |
| Brooding or rumination - some people reprt that they have continues thoughts, that are aboiut day to day things, or past events, or interpersonal issues, and these thoughts continue non-stop, making it difficult to rest, sleep or relax. |
| What Causes OCD? |
| The imbalance of brain chemicals, neurotransmitters, specially serotonin is considered the main cause for OCD. And medications that help to increase the levels of this neurotransmitter help in curing the illness. Genetics also seems to play a role, and there have been some studies on some brain structure changes in this illness. The principals of learning like conditioning and observational learning also play an important part in the starting and maintenance of anxiety disorders. |
| What is the Treatment for OCD? |
| Medications - SSRI mediations, that increase levels of serotonin are very useful it this illness, and have a good response. As a result, a psychiatrist must be seen if one has the symptoms of the illness. Other mediations which involve newer combinations are also useful in resistant cases. |
| Cognitive behavioral therapy - CBT(cognitive behavioral therapy), is very effective and useful through the medium of which the person is counseled how to control the compulsions and correct the obsessive thoughts, and when used with medications CBT gives a very good treatment response. |
| It is very important to see the right expert for this illness. The treatment must be under supervision of a psychiatrist and if medications are given they should be taken regularly as advised, and CBT by the clinical psychologist would be beneficial with the medications for a better, effective and long-lasting response. |
Schizophrenia
Schizophrenia
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Schizophrenia is found all over the world -- in all races, in all cultures and in all social classes |
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It affects 1 in 100 people worldwide. |
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Usual age of onset is between 16 and 25. |
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Early diagnosis and stabilization on modern treatment can greatly improve prognosis for the illness. |
| Symptoms of schizophrenia |
| There can be several types of clinical presentation of schizophrenia, and subtypes of the illness, but in general the types of symptoms could be divided into positive and negative symptoms. |
| "Positive" symptoms. - These are psychological features "added" as a result of the disorder, but not normally seen in healthy people: |
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hallucinations (hearing voices is the most common) |
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delusions |
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disorganised thinking |
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agitation |
| "Negative" symptoms - These are psychological capabilities which most people possess, but which people with schizophrenia have "lost": |
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drive or initiative |
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social interaction |
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enthusiasm |
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emotional responsiveness |
| The early signs and changes in an individuals' behavior that may indicate the development of schizophrenia include the following. |
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Deterioration of personal hygiene |
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Bizarre behaviour |
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Irrational statements |
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Sleeping excessively or inability to sleep |
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Talking to self |
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Social withdrawal, isolation, and reclusiveness |
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Shift in basic personality |
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Unexpected hostility |
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Deterioration of social relationships |
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Hyperactivity or inactivity -- or alternating between the two |
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Inability to concentrate or to cope with minor problems |
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Excessive writing without meaning |
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Dropping out of activities -- or out of life in general |
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Extreme reactions to criticism |
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Inability to express joy or Inability to cry, or excessive crying |
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Unusual sensitivity to stimuli (noise, light, colours, textures) |
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Strange posturing |
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Refusal to touch persons or objects; wearing gloves, etc. |
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Staring without blinking -- or blinking incessantly |
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Peculiar use of words or odd language structures |
| What causes schizophrenia? |
| Schizophrenia is a complex illness, and although its exact cause is still unknown but it is thought to be due to a number of different factors acting together. |
| Biochemistry - People with schizophrenia appear to have a neurochemical imbalance. Thus, some researchers study the neurotransmitters that allow communication between brain cells. Modern antipsychotic medications now target three different neurotransmitter systems (dopamine, serotonin, and norepinephrine.) |
| Cerebral Blood Flow - With modern brain imaging techniques (PET scans), researchers can identify areas that are activated when the brain is engaged in processing information. People with schizophrenia appear to have difficulty "coordinating" activity between different areas of the brain. |
| Molecular Biology - People with schizophrenia have an irregular pattern of certain brain cells. |
| Genetic Predisposition - Genetic research continues, but has not yet identified a hereditary gene for schizophrenia. Schizophrenia does appear more regularly in some families. Then again, many people with schizophrenia have no family history of the illness. |
| Stress - Stress does not cause schizophrenia. However, it has been proven that stress makes symptoms worse when the illness is already present. |
| What is the Treatment for Schizophrenia? |
| Medication - Medication is absolutely essential in schizophrenia. All patients who show signs of schizophrenia, must be taken to a psychiatrist and put on medications at the earliest. Early start of medications ensures a significantly better prognosis and recovery. Medications restore the chemical imbalance, and the newer medications that have come up do not have the worrisome side effects of the older medications, and have a better response and do not have serious problems related to long term treatment. These should be taken under regular psychiatry care. |
| Family Counselling - Since the patient and the family are often under enormous emotional strain, it may be advantageous to obtain counselling from professionals who understand the illness. |
| Hospitalization and Regular Follow-up - If someone becomes acutely ill with schizophrenia, they will probably require hospitalization. This allows the patient to be observed, assessed, diagnosed, and started on medication under the supervision of trained staff. The purpose of hospitalization is proper medical care and protection. Once the illness is stabilized and the patient is discharged from hospital, regular follow-up care will reduce the chances of relapse. |
| Residential and Rehabilitation Programs - Social skills training, along with residential, recreational, and vocational opportunities tailored to people with mental illness are very important. Used as part of the treatment plan, they can result in improved outcomes for even the most severely disabled people. |
Substance Abuse
Substance Abuse
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| Despite attempts to limit access to psychoactive substances, the use of substances is growing. Substance use can have profound acute and chronic effects on the behavior and emotional status of the user. Substance abuse can affect the psychosocial life of the individual. |
| What is Substance Abuse? |
| Substance abuse involves regular and continued use of substances (like drugs, alcohol, other chemicals) by the individual that leads to pathological behavioral changes. Some of the changes that take place indicating that the person is getting addicted include the following. |
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Sudden personality changes that include abrupt changes in work, quality of work, work output, etc. |
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Unusual flare-ups or outbreaks of temper |
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Withdrawal from responsibility |
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General changes in overall attitude |
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Loss of interest in what were once favorite hobbies and pursuits |
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Withdrawal or avoidance from family |
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Difficulty in concentration, paying attention |
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Sudden jitteriness, nervousness, or aggression |
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Deterioration of physical health |
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Borrowing of money |
| What may cause a person use substances? |
| Group psychology - Many of the users form groups. There is the 'in group', bonding that is very strong. A process known as 'deindividuation', in which the person loses the sense of self, and has a poor self decision-making and instead has a groupthink, in which his identity is lost to the identity of the group. And this is what makes him do things as a group that would not have been done otherwise. This is common in the stereotypical views about some specific work groups and sometimes one tends to use a substance to merely be recognized as a part of the group. |
| Media - Studies show that watching role models, actors and advertisements of substances results into higher usage of substances. The main effects of viewing violence on TV are disinhibition and desensitization to substance use, and a distortion in reality perception and learning through imitation. But most important is that there is "glamorization" of substances in media. |
| Misinformation - Most people who use any substance be it alcohol, or opiates, they are misinformed about its effect on health and life at large. People have a myth that it is good in small quantities, or that it helps to relax or de-stress, both being wrong notions. Some people also relate it with the glamour, be it as a part of a profession, or self-status, and this too is a stereotypical misconcept. |
| Substance dependence affects physical health in terms of serious medical complications, from cardiac and respiratory illnesses to brain disorders. It also affects the emotional and psychological self, makes the person have depressive symptoms, anxiety, and behavioral problems. Work is affected, job efficiency goes down, and the ability to perform complex, creative, and executive tasks is compromised. Social and family life gets destroyed due to substance indulgence, and for parents who use substances this can be the prime reason for children to experiment with substances. |
| What is the Treatment for Substance Abuse? |
| The most effective intervention for substance use disorders is preventing the initial development of substance use or pathological patterns of use. Although a consensus exists regarding the importance of prevention efforts, there is a lack of agreement of a conceptual goal for prevention; that is, what should be prevented0-use, abuse, or dependence? While some would have interventions directed at the prevention of various use patterns or consequences of substance use, a broader view of prevention would target the risk factors for the development of substance use or substance use disorders. |
| Targeting risk factors likely requires a host of measures involving the educational, mental health, and welfare systems. However, primary prevention efforts aimed at risk factors may prove more effective and influence the development of a wide range of problems and psychosocial dysfunction. |
| These interventions include educational approaches, family-based interventions, and community-based projects. The successful prevention programs appear to be those that target salient risk factors, are skills oriented, have sufficient intensity and duration, have follow-up, and respect the socioeconomic and cultural realities of the targeted communities. |
| Another important aspect of treatment involves the use of medications, counseling and therapy, under the guidance of a psychiatrist and a clinical psychologist which forms the most effective treatment strategy for substance use disorders. |
Anorexia Nervosa
Anorexia Nervosa
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| Anorexia nervosa is an eating problem that occurs when an individual is so afraid of becoming overweight that he or she eats as little as possible. If one has this disorder, one sees one's self as being overweight when one is not. This condition is both a physical illness and a mental illness. This illness occurs most often in young women. The illness can also occur in athletes, dancers, and actors who want to maintain low weight for better performance. Anorexia nervosa can be a very severe illness. Death may occur from starvation or suicide. |
| What are the Symptoms of Anorexia Nervosa? |
| The signs and symptoms of anorexia may include: |
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Weight loss from strict dieting, usually severe |
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Binge eating (eating large amounts of food in a short period of time) and purging (using laxatives, diuretics, or making yourself throw up) |
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Weakness and feeling dizzy |
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Brittle nails |
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Increased body hair |
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Feeling cold all the time |
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Feeling depressed or anxious |
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Trouble sleeping |
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If you are a woman, not having monthly periods when your weight drops below a certain level |
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Fasting or eating very little |
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Fearing weight gain even when you are underweight |
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Thinking about food all the time |
| What are the causes of Anorexia Nervosa? |
| The cause of anorexia nervosa is not very clear. Part of the cause in many cultures is thinking that being thin means being beautiful. An individual may be at risk of developing anorexia nervosa if he or she: |
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Has a family history of anorexia nervosa or other eating disorders
has a family or personal history of mood disorders, such as major depression and bipolar disorder (manic depression), anxiety disorders, or obsessive-compulsive personality disorder |
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Has a family o | | | |
