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Individuals with Disabilities Education Act (IDEA) 

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Individuals with Disabilities Education Act (IDEA) 

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https://www.mentalhelp.net/articles/individuals-with-disabilities-education-act-idea/

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ASCA Ethical Standards for School Counselors

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ASCA Ethical Standards for School Counselors

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https://www.healthcaretoolbox.org/what-providers-can-do/when-and-how-to-refer-for-mental-health-care.html

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http://www.responseability.org/home/fact-sheets-and-podcasts/mental-illnessdisorders

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National Institute of Mental Health (NIMH)

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National Institute of Mental Health (NIMH)

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https://www.nimh.nih.gov/index.shtml

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Students with Disabilities & Section 504

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Students with Disabilities & Section 504

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Psychosis

Lisa hears voices that tell her secrets. The voices sound just like any other voice, and she can't tell the difference between the voices from real people around her and the ones from inside her head. The secrets her voices tell her involve the government, and she believes that the CIA is monitoring her thoughts and dreams.

Lisa is suffering from a psychotic disorder, or a psychological disorder that is marked by a break from reality. There are many types of psychotic disorders, including schizophrenia and schizophreniform disorder, schizoaffective disorder, brief psychotic disorder, delusional disorder and chronic hallucinatory psychosis.

There are four major symptoms that are seen in psychotic disorders:

Hallucinations: People with a psychotic disorder often see or hear things that are not real. They experience the hallucinations as solidly as they perceive actual stimuli, though, just as Lisa cannot distinguish between actual and hallucinated voices.

Delusions: People with a psychotic disorder also often hold onto false beliefs, even with evidence to the contrary. Some delusions are paranoid in nature, as when Lisa believes that the government is monitoring her. Other delusions may be self-aggrandizing or self-blaming.

Catatonia: When people do not react to the world around them, this is called catatonia, and catatonic states are sometimes present in psychotic disorders.

Thought disorder: Sometimes, people become so distanced from reality that their conscious thoughts become jumbled or disorganized. Since it is impossible to know exactly what people's thoughts are, this is often diagnosed based on speech or writing patterns. When people do not make sense and use words that are just thrown together with no meaning, they are sometimes diagnosed with thought disorder.

Historical Views

We know a lot about effective treatments of psychotic disorders today, but that wasn't always the case. In the mid-19th century, the term ' psychosis' was first introduced to refer to disorders of the brain and mind. Late in the 19th century, Emil Kraepelin divided psychosis into disorders like bipolar and severe depression, which are considered to be mood disorders today, and disorders like schizophrenia, which now make up the psychotic disorders classification.

Throughout most of history, psychotic disorders were treated with hospitalization. Mental institutions were filled with people suffering from psychosis, and most of them were never released once they were committed. In 1955, though, the first antipsychotic drug was introduced on the market. Over the next 10 years, as the drug became more readily available, many people with psychotic disorders were released from hospitals and treated with drug and talk therapy, while being able to live and work in the regular world.

Treatment

There are many ways to treat psychotic disorders. The first line of defense in treating people suffering from psychosis is often pharmaceutical. That is, drugs are usually given to patients first in an attempt to manage the symptoms and provide the least restrictive setting - and the best chance for the patient to be a productive member of society.

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psychotic disorders: definition and perspectives in mental health - video & lesson transcript | study.com

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Psychotic Disorders: Definition and Perspectives in Mental Health - Video & Lesson Transcript | Study.com

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Lisa hears voices that tell her secrets. The voices sound just like any other voice, and she can't tell the difference between the voices from real people around her and the ones from inside her head.

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Development Disorders

Ryan is a bully. At school, he beats other kids up, including sometimes kids who are older and bigger than he is. He steals things, and once he stole his friend's sister's backpack and set fire to it. He also doesn't pay any attention to rules. He's only 11, but he ignores his curfew and stays out until all hours of the night.

Ryan might be suffering from a development disorder. Developmental disorders are psychological disorders that are characterized by being behind in maturity of thoughts, feelings, or actions. Unlike most mental illnesses, developmental disorders are usually diagnosed in childhood or adolescence.

In Ryan's case, he's showing a complete disregard for other people. He also either doesn't understand or care that there are consequences for his actions. In this way, he's emotionally stunted. Not only that, he's behaviorally immature; that is, he acts in ways that are typical of someone who has not yet reached the maturity level that's normal for Ryan's age. Let's look a little closer at two development disorders that involve emotional and behavioral immaturity: conduct disorder and oppositional defiant disorder.

Conduct Disorder

Ryan's parents are really concerned, so they take him to a psychologist. After talking with Ryan and with his parents, the psychologist says that he thinks Ryan might have a conduct disorder, a developmental disorder characterized by a persistent pattern of disregard for other's rights or property.

In order to be diagnosed with conduct disorder, Ryan has to have demonstrated at least three negative behavior patterns during the past year, with at least one during the last six months. Examples of actions that are symptomatic of conduct disorder include:

1. Aggression to people or animals. This includes many behaviors that involve verbally or physically accosting people or animals. Remember that Ryan is a bully who beats other kids up. This is an example of aggression to other people.

2. Destruction of property. This includes setting fires or destroying property in another way. Ryan set his friend's sister's bag on fire and destroyed it.

3. Deceitfulness or theft. This includes lying, stealing, or breaking and entering. Ryan steals things, including the book bag that he set on fire.

4. Serious violation of rules. This includes things like staying out at night, running away, or skipping school. These things have to happen before age 13. Ryan, who is only 11, ignores his curfew and stays out late into the night.

Because Ryan has acted at least three times in an antisocial way, he can be diagnosed with conduct disorder. Conduct disorder is usually diagnosed in late childhood or early adolescence, and it is diagnosed more often in boys than in girls.

Conduct disorder is closely linked to antisocial personality disorder, a disorder usually diagnosed in adults that involves a lack of empathy and violation of the rights of others. Many violent criminals, like serial killers and rapists, display the symptoms of antisocial personality disorder.

Some psychologists see conduct disorder as a precursor to antisocial personality disorder. Since conduct disorder is almost always diagnosed in children and adolescents and antisocial personality disorder is almost always diagnosed in adults, children with conduct disorder are highly likely to develop antisocial personality disorder.

However, this is not an absolute; some children with conduct disorder are able to grow into healthy adults. Treatment for conduct disorder involves therapy to change the thoughts, feelings, and actions of the patient, as well as therapy to teach parents how to reinforce good behaviors.

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oppositional defiant disorder & conduct disorder: definitions

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causes & treatments - video & lesson transcript | study.com

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Oppositional Defiant Disorder & Conduct Disorder: Definitions, Causes & Treatments - Video & Lesson Transcript | Study.com

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Ryan is a bully. At school, he beats other kids up, including sometimes kids who are older and bigger than he is. He steals things, and once he stole his friend's sister's backpack and set fire to it. He also doesn't pay any attention to rules.

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Major Depression

Jim's been feeling down lately. He got fired from his job as a line cook and isn't sure what he'd like to do next. He knows he should try to find more work, but in this economy it doesn't seem worth it to try. He's been sleeping later and later because he doesn't have much to do, and he's been feeling really tired.

As he goes longer without work, he starts feeling sad. Jim tries to go out with friends, but they're all employed and he finds them irritating to be around. They stop calling.

Jim still hasn't found work, and starts feeling like he never will; starts feeling worthless. Now he spends most of his day sleeping. He doesn't have the energy to cook, so he eats junk food all the time.

So what's going on with Jim? If you were Jim's therapist, what diagnosis would you reach?

You might suspect that he's depressed, because he mentions feeling sad. Feeling sad isn't enough on its own, though - we all feel sad sometimes.

But Jim has also mentioned changes in his sleep and eating patterns. He's lost interest in hanging out with his friends, and feels irritable with them. He feels worthless because he hasn't found a job yet. Furthermore, it seems that his depressed mood is preventing him from finding a new job.

Jim is demonstrating most of the signs of major depression, a mood disorder which affects 8%-12% of people at some point during their lives.

Jim does not have recurrent suicidal thoughts. We'll talk more about suicide near the end of this lesson.

Even so, since he has many other items of a depression diagnostic checklist, you might diagnose him as having a 'major depressive episode' anyway.

It's understandable that Jim would feel sad after losing his job - what makes Jim's experience 'major depression' are his other symptoms, and their duration of longer than two weeks.

Major depressive episodes are often set off by traumatizing events, like the loss of a job or the death of a loved one, but it's a reaction that's beyond normal sadness or grief.

Susceptibility to major depression is believed to have biological underpinnings. Low levels of serotonin and norepinephrine have been observed in depressed patients. There are also differences in actual brain structure; the basal ganglia, thalamus and hippocampus are all differently shaped. Interestingly, it's been shown that increasing serotonin levels in the brain can actually stimulate growth in the hippocampus, so it's possible that these things are related.

Depression is associated with certain psychological traits:

Low self-esteem

General negative emotionality

Tendency to blame self for bad things that happen

It's also been associated with social isolation. It's not clear whether social isolation causes depression, or depression causes social isolation.

Dysthymic Disorder

Now let's talk about Sandra. Nothing out of the ordinary has happened to Sandra lately. Still, she's felt unhappy for a long time, with symptoms similar to Jim's but milder.

If you were Sandra's therapist, you might diagnose dysthymic disorder. This is a milder, more long-lasting form of depression. If you experience mild depressive symptoms for over two years, you might have dysthymic disorder. It's treated similarly to depression.

Bipolar Disorder

Now let's imagine mood as a spectrum; depression and dysthymia both make people hang out for longer in the depressive end. Bipolar disorder is just what it sounds like; it makes people hang out at BOTH ends, or 'poles,' of this mood spectrum. They have episodes similar to those in major depressive disorder, followed by periods of mania.

Mania is characterized by:

Feeling of being high

Decreased need for sleep

Inflated self-esteem

Fast speech

General agitation

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mood disorders - video & lesson transcript | study.com

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Mood Disorders - Video & Lesson Transcript | Study.com

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Jim's been feeling down lately. He got fired from his job as a line cook and isn't sure what he'd like to do next. He knows he should try to find more work, but in this economy it doesn't seem worth it to try.

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Most of us have things about our bodies we'd like to change. Maybe it's a nose with a small bump on it; maybe it's hair that never lies flat. Usually these are things that most other people don't notice about us, but that still bother us when we look in the mirror. I think I have big, ugly knuckles on my hands, but if I mention this to friends they think I'm nuts for focusing on it. These little obsessions with our bodies seem to be an unavoidable consequence of owning a mirror. But sometimes, this dissatisfaction with our bodies can turn into something more serious.

Body dysmorphic disorder (BDD) is a term used to describe a preoccupation with the body's faults, to the point of getting in the way of daily life. People with BDD spend way too much time in front of the mirror, obsessing about their 'problem' feature and trying to find the best way to cover or distract from it. BDD is often associated with compulsive grooming behaviors like picking at skin, plucking eyebrows or combing hair; in fact, this combination of body obsession plus grooming compulsion has led many therapists to treat the disorder similarly to a more typical presentation of obsessive compulsive disorder, in which patients experience involuntary, intrusive thoughts and develop ritualistic compulsive behaviors to deal with anxiety (see 'Anxiety Disorders' for more on OCD). BDD is also associated with depressive symptoms and suicidal thoughts. Patients with BDD will often pursue plastic surgery to correct their 'flaw.' A recent Belgian study found that 43% of patients seeking nose-jobs showed signs of BDD.

BDD has gained more attention in recent years due to the fear that young girls are increasingly pressured by media images of models and celebrities to look 'perfect'. There was even a reality show, called 'The Swan,' that can be viewed as an unintentional public service announcement about BDD: in it, 'ugly duckling' contestants are given lots of plastic surgery and compete at the end in a beauty pageant which praises the best 'transformation.' With plastic surgery so mainstreamed, it's easy to imagine that young girls might become more preoccupied with their flaws. Though BDD does exist in areas of the world where access to these kinds of images is limited, it does seem that looking at pictures of 'perfect women' may be a trigger for those already likely to develop the condition.

The media has also been suggested as a trigger for eating disorders. These are related to BDD in that people with both kinds of disorders are obsessed with bodily flaws. Eating disorders are distinguished by specific behaviors toward food that are different than most people's. There are two main eating disorders, and you may have heard of them: anorexia and bulimia. In both cases, patients take extreme measures to reduce weight, even if their weight is already normal or below-normal. You don't have an eating disorder just because you've decided to go on the Atkins diet; healthy weight-loss is healthy, and obesity is a real problem in this country. But just as a person with BDD might always think her nose has a bump on it - or her knuckles are enormous - patients with eating disorders have an unrealistic sense of how much they weigh and how they look.

Anorexic patients severely restrict calorie intake in an effort to lose weight. People who are overweight and want to diet are typically advised to keep their calorie intakes above 1,200; the average anorexic eats more like 600-800 calories a day. Just imagine trying to survive on this. For perspective, most burritos at Chipotle clock it at 800+, and that's just one meal! Because it's really hard to eat so little, many anorexics develop strategies for tricking their bodies into thinking they've eaten more; cutting food into small portions, for example, or eating mainly vegetables like celery.

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eating disorders - video & lesson transcript | study.com

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Eating Disorders - Video & Lesson Transcript | Study.com

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Most of us have things about our bodies we'd like to change. Maybe it's a nose with a small bump on it; maybe it's hair that never lies flat. Usually these are things that most other people don't notice about us, but that still bother us when we look in the mirror.

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Defining Abnormal Anxiety

The feeling of fear is a feeling that every single being can relate to. Fear keeps us safe by activating our minds and bodies for immediate danger. Whether we confront the danger or run, we can thank our brain for the notification.

While fear happens in response to a threat, anxiety is mental distress caused by fear of future dangers or uncertainties. Anxiety is also a very normal emotion. Everyone experiences anxiety when facing or anticipating a challenging situation. The challenge can be anything from a school exam to an upcoming blind date or even concern about paying the bills. Luckily, anxiety, like fear, is adaptive. Anxiety serves to prepare us for future threats or challenges, just as fear does, by arousing the sympathetic nervous system.

Although we may think that having no anxiety would be the best way to operate, a moderate amount of anxiety actually improves performance. For example, think back to Bob's meeting with the bear. What if Bob had experienced little or no anxiety when the bear approached him?

Clearly, having no fear or anxiety is not ideal for this situation. Bob needs a moderate amount of anxiety to react properly. Scientists have found that some anxiety is beneficial to us, not only in reacting to potentially dangerous situations but also in planning and preparing. But, this is only true for lower levels of anxiety. While little or no anxiety can leave us unprepared for challenges, high anxiety can create confusion, distractibility, panic, fatigue and other symptoms that ruin performance.

So, when does anxiety go from a normal, healthy emotion to an unhealthy, disordered one? The answer to this question is different for everyone. Although we would probably all be scared when confronted with a bear, our brains can perceive and react to danger differently. Experiencing a high level of anxiety isn't pleasant. Although it may keep us safe in times of danger, high anxiety can negatively affect our performance.

In some people, high levels of anxiety can become a lasting problem. Instead of returning to normal levels of anxiety after we adjust to a situation, the brain can misfire and continue to send signals of fear. Sometimes, fear, anxiety and even panic can arise for no reason at all.

Anxiety Disorders: Types and Symptoms

Anxiety disorders are a group of mental disorders marked by frequent and excessive fear, anxiety and distress. Those affected by an anxiety disorder feel fear and anxiety symptoms that are extreme for the situation they are in.

Common symptoms of anxiety disorders include:

Fear

Unease and anticipation

Feelings of impending doom

Heart palpitations

Chest pain

Hyperventilation

Muscle tension

Body pains

Stomach upset

Dizziness

Sweating or chills

Irritability

Difficulty concentrating

Insomnia

Fatigue

Weight changes

Nightmares

Looking at these symptoms, it's not hard to imagine that suffering from an anxiety disorder can seriously impair a person's life. Anxiety disorders can make everyday activities, such as work, school or even visiting with friends, very difficult or even impossible. Anxiety disorders share a group of common symptoms, but each disorder is unique in its characteristics and may require different treatments. Let's review the most common disorders in this category:

Generalized anxiety disorder: Generalized anxiety disorder is characterized by chronic and persistent anxiety that lasts at least six months and occurs during everyday activities and events.

Panic disorder: Panic disorder is a disorder in which people experience sudden, frequent and unexplained periods of intense terror.

Phobias: A phobia is a persistent, irrational and disabling fear of a specific object or situation.

Obsessive-compulsive disorder (OCD): OCD is comprised of irrational, unwanted thoughts (obsessions) and often repetitive actions (compulsions).

Post-traumatic stress disorder (PTSD): PTSD is a set of extreme symptoms that arise after experiencing a traumatic event. Symptoms often include irritability and anger, nightmares and flashbacks to the event.

What Causes Anxiety Disorders?

As with all mental disorders, many factors are involved in triggering anxiety disorders. There is rarely a single answer to what causes an anxiety disorder in a certain individual. Most commonly, it is a mix of biology, personal traits and life experiences that combine to trigger these disorders.

We do know that anxiety disorders can be caused by traumatic brain injury, specific medical illnesses or even abuse of stimulants, such as caffeine. However, even with something that seems as clear-cut as a major stimulant overdose, the effects on different people are never the same.

Research suggests a strong genetic correlation in many anxiety disorders. Scientists estimate that heritability can account for 20- 50% of the risk of developing an anxiety disorder! Researchers have also discovered that certain brain structures have some very significant differences in anxiety disorder patients.

A section of the brain known as the fear circuit controls emotional responses, such as fear and anxiety, and has been found to be overactive in people who suffer from anxiety disorders. Alongside biology, psychologists continue to study specific personality traits and ways of thinking that are more common amongst those with anxiety disorders.

Treatment

Anxiety disorders are the most common group of mental disorders. It is estimated that the lifetime odds of developing an anxiety disorder are greater than 25%! That means one in four people are likely to have an anxiety disorder at some point in their lives.

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understanding anxiety disorders: definition and perspectives in mental health - video & lesson transcript | study.com

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Understanding Anxiety Disorders: Definition and Perspectives in Mental Health - Video & Lesson Transcript | Study.com

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The feeling of fear is a feeling that every single being can relate to. Fear keeps us safe by activating our minds and bodies for immediate danger. Whether we confront the danger or run, we can thank our brain for the notification.

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Psychotic disorders are a group of serious illnesses that affect the mind. They make it hard for someone to think clearly, make good judgments, respond emotionally, communicate effectively, understand reality, and behave appropriately.

When symptoms are severe, people with psychotic disorders have trouble staying in touch with reality and often are unable to handle daily life. But even severe psychotic disorders usually can be treated.

Types

There are different types of psychotic disorders, including:

Schizophrenia: People with this illness have changes in behavior and other symptoms -- such as delusions and hallucinations -- that last longer than 6 months. It usually affects them at work or school, as well as their relationships.

Schizoaffective disorder: People have symptoms of both schizophrenia and a mood disorder, such as depression or bipolar disorder.

Schizophreniform disorder: This includes symptoms of schizophrenia, but the symptoms last for a shorter time: between 1 and 6 months.

Brief psychotic disorder: People with this illness have a sudden, short period of psychotic behavior, often in response to a very stressful event, such as a death in the family. Recovery is often quick -- usually less than a month.

Delusional disorder: The key symptom is having a delusion (a false, fixed belief) involving a real-life situation that could be true but isn't, such as being followed, being plotted against, or having a disease. The delusion lasts for at least 1 month.

Shared psychotic disorder (also called folie à deux): This illness happens when one person in a relationship has a delusion and the other person in the relationship adopts it, too.

Substance-induced psychotic disorder: This condition is caused by the use of or withdrawal from drugs, such as hallucinogens and crack cocaine, that cause hallucinations, delusions, or confused speech.

Psychotic disorder due to another medical condition: Hallucinations, delusions, or other symptoms may happen because of another illness that affects brain function, such as a head injury or brain tumor.

Paraphrenia: This condition has symptoms similar to schizophrenia. It starts late in life, when people are elderly.

Symptoms

The main ones are hallucinations, delusions, and disordered forms of thinking.

Continued

Hallucinations means seeing, hearing, or feeling things that don't exist. For instance, someone might see things that aren't there, hear voices, smell odors, have a "funny" taste in their mouth, or feel sensations on their skin even though nothing is touching their body.

Delusions are false beliefs that don't go away after even after they've been shown to be false. For example, a person who is certain his or her food is poisoned, even if someone has shown them that the food is fine, has a delusion.

Other possible symptoms of psychotic illnesses include:

Disorganized or incoherent speech

Confused thinking

Strange, possibly dangerous behavior

Slowed or unusual movements

Loss of interest in personal hygiene

Loss of interest in activities

Problems at school or work and with relationships

Cold, detached manner with the inability to express emotion

Mood swings or other mood symptoms, such as depression or mania

People don't always have the same symptoms, and they can change over time in the same person.

Causes

Doctors don't know the exact cause of psychotic disorders. Researchers believe that many things play a role. Some psychotic disorders tend to run in families, which means that the disorder may be partly inherited. Other things may also influence their development, including stress, drug abuse, and major life changes.

People with certain psychotic disorders, such as schizophrenia, may also have problems in parts of the brain that control thinking, perception, and motivation.

In schizophrenia, experts believe that nerve cell receptors that work with a brain chemical called glutamate may not work properly in specific brain regions. That glitch may contribute to problems with thinking and perception.

These conditions usually first appear when a person is in his or her late teens, 20s, or 30s. They tend to affect men and women about equally.

Diagnosis

To diagnose a psychotic disorder, doctors will talk to the person, give them a checkup, and consider whether something else might be to blame for the symptoms. The person may get blood tests and brain imaging (such as MRI scans) to rule out physical illness or drug use like cocaine or LSD.

If the doctor finds no physical reason for the symptoms, he or she may refer the person to a psychiatrist or psychologist. These mental health professionals will use specially designed interview and assessment tools to decide whether the person has a psychotic disorder.

Continued

Treatment

Most psychotic disorders are treated with a combination of medications and psychotherapy, which is a type of counseling.

Medication: The main type of drug that doctors prescribe to treat psychotic disorders are "antipsychotics." Although these medicines aren't a cure, they are effective in managing the most troubling symptoms of psychotic disorders, such as delusions, hallucinations, and thinking problems.

Older antipsychotics include:

Newer "atypical antipsychotics" include:

Doctors usually first prescribe the newer ones because they have fewer and more tolerable side effects than older antipsychotics. Some of the medications are available by injection and only need to be taken once or twice a month. This can be easier to manage than remembering to take a daily pill.

Psychotherapy: There are different types of counseling -- including individual, group, and family therapy - that can help someone who has a psychotic disorder.

Most people with psychotic disorders are treated as outpatients, meaning they don't live in institutions. But sometimes people need to be hospitalized, such as if they have severe symptoms, are in danger of hurting themselves or others, or can't care for themselves because of their illness.

Recovery

Each person being treated for a psychotic disorder may respond to therapy differently. Some will show improvement quickly. For others, it may take weeks or months to get symptom relief.

Some people may need to continue treatment for an extended period of time. Some, such as those who have had several severe episodes, may need to take medication indefinitely. In these cases, the medication usually is given in as low a dose as possible to minimize side effects.

What Is the Outlook for People With Psychotic Disorders?

The depends on the type of psychotic disorder and the person who has it. But these disorders are treatable, and most people will have a good recovery with treatment and close follow-up care.

Continued

Can Psychotic Disorders Be Prevented?

No. But the sooner treatment starts, the better. It helps to prevent symptoms. Seeking help as soon as possible can help the person's life, family, and relationships.

For people who are at high risk for psychotic disorders, such as those who have a family history of schizophrenia, avoiding drugs such as marijuana and alcohol may help to prevent or delay these conditions.

Sources

SOURCES:

UpToDate: "Overview of Psychosis."

MedLinePlus: "Psychotic Disorders."

National Alliance of Mental Illness: "About the First Episodes of Psychosis."

Janssen Pharmaceuticals Inc.

Next Article
Brief Psychotic Disorder

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Psychotic disorders are a group of serious illnesses that affect the mind. They make it hard for someone to think clearly, make good judgments, respond emotionally, communicate effectively, understand reality, and behave appropriately. When symptoms are severe, people with psychotic disorders have trouble staying in touch with reality and often are unable to handle daily life.

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Conduct disorder is a serious behavioral and emotional disorder that can occur in children and teens. A child with this disorder may display a pattern of disruptive and violent behavior and have problems following rules.

It is not uncommon for children and teens to have behavior-related problems at some time during their development. However, the behavior is considered to be a conduct disorder when it is long-lasting and when it violates the rights of others, goes against accepted norms of behavior and disrupts the child's or family's everyday life.

What Are the Symptoms of Conduct Disorder?

Symptoms of conduct disorder vary depending on the age of the child and whether the disorder is mild, moderate, or severe. In general, symptoms of conduct disorder fall into four general categories:

Aggressive behavior: These are behaviors that threaten or cause physical harm and may include fighting, bullying, being cruel to others or animals, using weapons, and forcing another into sexual activity.

Destructive behavior: This involves intentional destruction of property such as arson (deliberate fire-setting) and vandalism (harming another person's property).

Deceitful behavior: This may include repeated lying, shoplifting, or breaking into homes or cars in order to steal.

Violation of rules: This involves going against accepted rules of society or engaging in behavior that is not appropriate for the person's age. These behaviors may include running away, skipping school, playing pranks, or being sexually active at a very young age.

In addition, many children with conduct disorder are irritable, have low self-esteem, and tend to throw frequent temper tantrums. Some may abuse drugs and alcohol. Children with conduct disorder often are unable to appreciate how their behavior can hurt others and generally have little guilt or remorse about hurting others.

Continued

What Causes Conduct Disorder?

The exact cause of conduct disorder is not known, but it is believed that a combination of biological, genetic, environmental, psychological, and social factors play a role.

Biological: Some studies suggest that defects or injuries to certain areas of the brain can lead to behavior disorders. Conduct disorder has been linked to particular brain regions involved in regulating behavior, impulse control, and emotion. Conduct disorder symptoms may occur if nerve cell circuits along these brain regions do not work properly. Further, many children and teens with conduct disorder also have other mental illnesses, such as attention-deficit/hyperactivity disorder (ADHD), learning disorders, depression, substance abuse, or an anxiety disorder, which may contribute to the symptoms of conduct disorder.

Genetics: Many children and teens with conduct disorder have close family members with mental illnesses, including mood disorders, anxiety disorders, substance use disorders and personality disorders. This suggests that a vulnerability to conduct disorder may be at least partially inherited.

Environmental: Factors such as a dysfunctional family life, childhood abuse, traumatic experiences, a family history of substance abuse, and inconsistent discipline by parents may contribute to the development of conduct disorder.

Psychological: Some experts believe that conduct disorders can reflect problems with moral awareness (notably, lack of guilt and remorse) and deficits in cognitive processing.

Social: Low socioeconomic status and not being accepted by their peers appear to be risk factors for the development of conduct disorder.

How Common Is Conduct Disorder?

It is estimated that 2%-16% of children in the U.S. have conduct disorder. It is more common in boys than in girls and most often occurs in late childhood or the early teen years.

How Is Conduct Disorder Diagnosed?

As with adults, mental illnesses in children are diagnosed based on signs and symptoms that suggest a particular problem. If symptoms of conduct disorder are present, the doctor may begin an evaluation by performing complete medical and psychiatric histories. A physical exam and laboratory tests (for example, neuroimaging studies, blood tests) may be appropriate if there is concern that a physical illness might be causing the symptoms. The doctor will also look for signs of other disorders that often occur along with conduct disorder, such as ADHD and depression.

If the doctor cannot find a physical cause for the symptoms, he or she will likely refer the child to a child and adolescent psychiatrist or psychologist, mental health professionals who are specially trained to diagnose and treat mental illnesses in children and teens. Psychiatrists and psychologists use specially designed interview and assessment tools to evaluate a child for a mental disorder. The doctor bases his or her diagnosis on reports of the child's symptoms and his or her observation of the child's attitudes and behavior. The doctor will often rely on reports from the child's parents, teachers, and other adults because children may withhold information or otherwise have trouble explaining their problems or understanding their symptoms.

Continued

How Is Conduct Disorder Treated?

Treatment for conduct disorder is based on many factors, including the child's age, the severity of symptoms, as well as the child's ability to participate in and tolerate specific therapies. Treatment usually consists of a combination of the following:

Psychotherapy: Psychotherapy (a type of counseling) is aimed at helping the child learn to express and control anger in more appropriate ways. A type of therapy called cognitive-behavioral therapy aims to reshape the child's thinking (cognition) to improve problem solving skills, anger management, moral reasoning skills, and impulse control. Family therapy may be used to help improve family interactions and communication among family members. A specialized therapy technique called parent management training (PMT) teaches parents ways to positively alter their child's behavior in the home.

Medication: Although there is no medication formally approved to treat conduct disorder, various drugs may be used (off label) to treat some of its distressing symptoms (impulsivity, aggression), as well as any other mental illnesses that may be present, such as ADHD or major depression.

What Is the Outlook for Children With Conduct Disorder?

If your child is displaying symptoms of conduct disorder, it is very important that you seek help from a qualified doctor. A child or teen with conduct disorder is at risk for developing other mental disorders as an adult if left untreated. These include antisocial and other personality disorders, mood or anxiety disorders, and substance use disorders.

Children with conduct disorder are also at risk for school-related problems, such as failing or dropping out, substance abuse, legal problems, injuries to self or others due to violent behavior, sexually transmitted diseases, and suicide. Treatment outcomes can vary greatly, but early intervention may help to reduce the risk for incarcerations, mood disorders, and the development of other comorbidities such as substance abuse.

Can Conduct Disorder Be Prevented?

Although it may not be possible to prevent conduct disorder, recognizing and acting on symptoms when they appear can minimize distress to the child and family, and prevent many of the problems associated with the condition. In addition, providing a nurturing, supportive, and consistent home environment with a balance of love and discipline may help reduce symptoms and prevent episodes of disturbing behavior.

Sources

SOURCES:

American Academy of Child & Adolescent Psychiatry: "Conduct Disorder."

MedlinePlus: "Conduct Disorder."

HealthyChildren.org: "Disruptive Behavior Disorders."

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Conduct disorder is a serious behavioral and emotional disorder that can occur in children and teens. A child with this disorder may display a pattern of disruptive and violent behavior and have problems following rules. It is not uncommon for children and teens to have behavior-related problems at some time during their development.

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When you think of mood disorders, depression and bipolar disorder likely come to mind first. That's because these are common, severe illnesses and leading causes of disability. Depression and bipolar disorder can be emotionally crippling, making it difficult to live life to its fullest. Persistent Depressive Disorder, a newer diagnosis that consolidates chronic major depressive disorder and dysthymic disorder, is a condition where a person is depressed for at least 2 years.

Mood Disorders: What Is Persistent Depressive Disorder?

Persistent Depressive Disorder is a less severe form of depression. Although less extreme, Persistent Depressive Disorder (PDD) causes chronic or long-lasting moodiness that ranges in severity. It is marked by a depressed mood for most of the day, for more days than not, for at least 2 years. In children and teens, moods can be irritable for at least 1 year to be called Persistent Depressive Disorder.

PDD can occur alone or with other psychiatric or mood disorders, although not with mania or hypomania. As with depression, PDD is more common in women than in men. A family history of mood disorders is not uncommon. This mood disorder tends to appear earlier than major depression, although it can begin anytime from childhood to later in life.

Up to 4% of the general population is affected by PDD. Its cause is not well understood. A combination of factors likely conspires to create this mood disorder. These factors may include:

Genetics

Abnormalities in the functioning of brain circuits involve in emotional processing

Chronic stress or medical illness

Isolation

Poor coping strategies and problems adjusting to life stresses

These factors can feed off each other. For example, if you always see "the glass as half empty," you may reinforce the symptoms of depression. And a chronic mood disorder can sensitize you to stress, further feeding your risk for depression.

Symptoms of Persistent Depressive Disorder

In addition to chronic low moods, common symptoms of this mood disorder include:

Feelings of hopelessness or helplessness

Trouble sleeping or daytime sleepiness

Poor appetite or eating too much

Poor concentration

Fatigue or low energy

Low self-esteem

Trouble concentrating or making decisions

A diagnosis of PDD in adults requires at least a two-year history of depressed mood for most of the day on most days, along with at least two of the symptoms noted above. Although some symptoms may overlap, you may be less likely to have weight or sleep changes with PDD than with depression. You may also tend to withdraw more and have stronger feelings of pessimism and inadequacy than with major depression.

Continued

Treatment for Persistent Depressive Disorder

Staying in a constant state of moodiness is no way to live. That's one reason to seek treatment. Another is that PDD can also increase your risk for physical diseases. Yet another reason to pursue treatment? If left untreated, this mood disorder can develop into more severe depression. It can also increase your risk for attempting suicide.

Antidepressants, such as selective-serotonin reuptake inhibitors (SSRIs), serotonin norepinephrine reuptake inhibitors (SNRIs), or tricyclic antidepressants, are often used to treat PDD. Because you may need to continue treatment for a lengthy period, it's important to consider which medications not only work well but also ideally have few side effects. You may need to try more than one medication to find the one that works best. But know that it may take several weeks or longer to take effect. Successful treatment for chronic depression often takes longer than for acute (non-chronic) depression.

Take your medications as your doctor instructs. If they're causing side effects or still not working after several weeks, discuss this with your doctor. Don't suddenly stop taking your medications.

Doctors believe treatment for PDD is effective with a combination of antidepressants and psychotherapy.

Specific kinds of talk therapy, such as cognitive behavioral therapy (CBT), psychodynamic psychotherapy, or interpersonal therapy (IPT), are known to be effective forms of psychotherapy that treat PDD. A structured treatment lasting for a certain period of time, CBT involves recognizing and restructuring thoughts. It can help you change your distorted thinking. IPT is also a time-limited, structured treatment. Its focus is on addressing current problems and solving interpersonal conflicts. Psychodynamic psychotherapy involves exploring unhealthy or unsatisfying patterns of behavior and motivations that you may not be consciously aware of which could lead to feelings of depression and negative expectations and life experiences.

Some studies also suggest that aerobic exercise can help with mood disorders. This is most effective when done four to six times a week. But some exercise is better than none at all. Other changes may also help, including seeking social support and finding an interesting occupation. Used for patients with major depressive disorder with seasonal pattern (formerly known as seasonal affective disorder), bright-light therapy may also help some people with PDD.

Continued

Mood Disorders: What Is Cyclothymic Disorder?

Bipolar disorder causes severe, unusual shifts in mood and energy that affect your ability to do normal tasks at home, school, or work. Cyclothymic disorder is often thought of as a mild form of bipolar disorder.

With cyclothymic disorder, you have low-grade high periods (hypomanias) as well as brief, fleeting periods of depression that don't last as long (less than 2 weeks at a time) as in a major depressive episode. The hypomanias in cyclothymic disorder are similar to those seen in bipolar II disorder, and do not progress to full-blown manias. For example, you may feel an exaggerated sense of productivity or power, but you don't lose connection with reality. In fact, some people feel the "highs" of cyclothymic disorder are even enjoyable. They tend to not be as disabling as they are with bipolar disorder.

Up to 1% of the U.S. population -- equal numbers of men and women -- has cyclothymia. Its cause is unknown, but genetics may play a role; cyclothymia is more common in people with relatives who have bipolar disorder. Symptoms usually appear in adolescence or young adulthood. But because symptoms are mild, it is often difficult to tell when cyclothymia begins.

Symptoms of Cyclothymic Disorder

A diagnosis of cyclothymic disorder may result from simply describing symptoms like these:

Episodes that involve brief, recurrent periods of depression and, at other times, episodes of hypomania; this pattern of episodes must be present for at least 2 years.

Symptoms that persist, creating fewer than 2 symptom-free months in a row.

The episodes of cyclothymic disorder are often somewhat unpredictable. Either depression or hypomania can last for days or weeks, interspersed with a month or two of normal moods. Or, you may have no "normal" periods in between. In some cases, cyclothymic disorder progresses to full-blown bipolar disease.

Treatment for Cyclothymic Disorder

Some people with mild symptoms of cyclothymia are able to live successful, fulfilling lives. Others find their relationships troubled by depression, impulsive actions, and strong emotions. For these people, short-term medications may bring relief. However, cyclothymic disorder may not respond as well to medications as does bipolar disorder. A combination of mood stabilizers and psychotherapy is most effective. Mood stabilizers include antiseizure drugs such as lithium, Depakote, Tegretol, or Lamictal.

Sources

SOURCES:

MedlinePlus: "Dysthymia" and "Cyclothymia."

American Academy of Family Physicians: "Dysthymic Disorder: When Depression Lingers."

EMedicine: "Dysthymic Disorder."

Depression and Bipolar Support Alliance: "Types of Depression."

WebMD Medical Reference: "Cyclothymia (Cyclothymic Disorder)."

World Health Organization: "What Is Depression?"

National Institute of Mental Health: "Persistent Depressive Disorder."

American Academy of Family Physicians: "Persistent Depressive Disorder (PDD)."

BASC 3: "Persistent Depressive Disorder (Dysthymia)."

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When you think of mood disorders, depression and bipolar disorder likely come to mind first. That's because these are common, severe illnesses and leading causes of disability. Depression and bipolar disorder can be emotionally crippling, making it difficult to live life to its fullest.

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Eating disorders are a group of conditions marked by an unhealthy relationship with food. There are three main types of eating disorders:

Anorexia nervosa. This is characterized by weight loss often due to excessive dieting and exercise, sometimes to the point of starvation. People with anorexia feel they can never be thin enough and continue to see themselves as "fat" despite extreme weight loss.

Bulimia nervosa. The condition is marked by cycles of extreme overeating, known as bingeing, followed by purging or other behaviors to compensate for the overeating. It is also associated with feelings of loss of control about eating.

Binge eating disorder. This is characterized by regular episodes of extreme overeating and feelings of loss of control about eating.

Eating disorders tend to develop during the teenage and young adult years, and they are much more common in girls and women. No one knows the precise cause of eating disorders, but they seem to coexist with psychological and medical issues such as low self-esteem, depression, anxiety, trouble coping with emotions, and substance abuse.

For some people, a preoccupation with food becomes a way to gain control over one aspect of their lives. Although it may start out as simply eating a bit more or less than usual, the behavior can spiral out of control and take over the person's life. Eating disorders are a serious medical problem that can have long-term health consequences if left untreated.

It's common for people with eating disorders to hide their unhealthy behaviors, so it can be difficult to recognize the signs of an eating disorder, especially early on.

Here's a more detailed look at the symptoms of anorexia, bulimia, and binge eating disorder.

Signs of Anorexia Nervosa

People with anorexia nervosa have an extreme fear of gaining weight. They often diet and exercise relentlessly, sometimes to the point of starvation. About one-third to one-half of anorexics also binge and purge by vomiting or misusing laxatives. People with anorexia have a distorted body image, thinking they are overweight when in fact they are underweight. They may count calories obsessively and only allow themselves tiny portions of certain specific foods. When confronted, someone with anorexia will often deny that there's a problem.

Continued

The signs of anorexia can be subtle at first, because it develops gradually. It may begin as an interest in dieting before an event like a school dance or a beach vacation. But as the disorder takes hold, preoccupation with weight intensifies. It creates a vicious cycle: The more weight the person loses, the more that person worries and obsesses about weight.

The following symptoms and behaviors are common in people with anorexia:

Dramatic weight loss

Wearing loose, bulky clothes to hide weight loss

Preoccupation with food, dieting, counting calories, etc.

Refusal to eat certain foods, such as carbs or fats

Avoiding mealtimes or eating in front of others

Preparing elaborate meals for others but refusing to eat them

Exercising excessively

Making comments about being "fat"

Stopping menstruating

Complaining about constipation or stomach pain

Denying that extreme thinness is a problem

Because people with anorexia are so good at hiding it, the disease may become severe before anyone around them notices anything wrong. If you think someone you care about has anorexia, it's important to have them evaluated by a doctor right away. If left untreated, anorexia can lead to serious complications such as malnutrition and organ failure. However, with treatment, most people with anorexia will gain back the weight they lost, and the physical problems they developed as a result of the anorexia will get better.

Signs of Bulimia Nervosa

People with bulimia nervosa have episodes of eating large amounts of food (called bingeing) followed by purging ( vomiting or using laxatives), fasting, or exercising excessively to compensate for the overeating.

Unlike anorexia, people with bulimia are often a normal weight. But they have the same intense fear of gaining weight and distorted body image. They see themselves as "fat" and desperately want to lose weight. Because they often feel ashamed and disgusted with themselves, people with bulimia become very good at hiding the bulimic behaviors.

The following are common signs of bulimia:

Evidence of binge eating, including disappearance of large amounts of food in a short time, or finding lots of empty food wrappers or containers

Evidence of purging, including trips to the bathroom after meals, sounds or smells of vomiting, or packages of laxatives or diuretics

Skipping meals or avoiding eating in front of others, or eating very small portions

Exercising excessively

Wearing baggy clothes to hide the body

Complaining about being "fat"

Using gum, mouthwash, or mints excessively

Constantly dieting

Scarred knuckles from repeatedly inducing vomiting

If left untreated, bulimia can result in long-term health problems such as abnormal heart rhythms, bleeding from the esophagus due to excessive reflux of stomach acid, dental problems, and kidney problems. However, bulimia can be treated successfully through cognitive-behavioral therapy, certain anticonvulsant medicines, antidepressants, or combinations of these therapies. It's important to seek help if you think someone you care about has bulimia.

Continued

Signs of Binge Eating Disorder

Rather than simply eating too much all the time, people with binge eating disorder have frequent episodes where they binge on large quantities of food. Like people with bulimia, they often feel out of control during these episodes and later feel guilt and shame about it. The behavior becomes a vicious cycle, because the more distressed they feel about bingeing, the more they seem to do it. Because people with binge eating disorder do not purge, fast, or exercise after they binge, they are usually overweight or obese.

Unlike other eating disorders, binge eating disorder is almost as common in men as it is in women. According to statistics from the National Institute of Mental Health, the average age at onset for binge eating disorder is 25, and it is more common in people under age 60.

Common signs of binge eating disorder include:

Evidence of binge eating, including disappearance of large amounts of food in a short time, or finding lots of empty food wrappers or containers

Hoarding food, or hiding large quantities of food in strange places

Wearing baggy clothes to hide the body

Skipping meals or avoiding eating in front of others

Constantly dieting, but rarely losing weight

Because binge eating leads to obesity, it can have serious health consequences if left untreated. Behavioral weight reduction programs can be helpful both with weight loss and with controlling the urge to binge eat. The stimulant drug Vyvanse is FDA-approved for the treatment of binge eating disorder. Also, because depression often goes hand in hand with binge eating disorder, antidepressants and psychotherapy may also help.

Recognizing the signs and symptoms of an eating disorder is the first step toward getting help for it. Eating disorders are treatable, and with the right treatment and support, most people with an eating disorder can learn healthy eating habits and get their lives back on track.

Sources

SOURCES:

National Institute of Mental Health: "Eating Disorders."

Merck Manual: "Anorexia Nervosa;" "Bulimia Nervosa;" and "Binge Eating Disorder."

National Eating Disorders Association.

# data[].attributes.attachment_link.title
Signs of Eating Disorders: Types and Symptoms

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Eating disorders are a group of conditions marked by an unhealthy relationship with food. There are three main types of eating disorders: Anorexia nervosa. This is characterized by weight loss often due to excessive dieting and exercise, sometimes to the point of starvation.

# data[].attributes.attachment_link.readable_text
Eating disorders are a group of conditions marked by an unhealthy relationship with food. There are three main types of eating disorders:

Anorexia nervosa. This is characterized by weight loss often due to excessive dieting and exercise, sometimes to the point of starvation. People with anorexia feel they can never be thin enough and continue to see themselves as "fat" despite extreme weight loss.

Bulimia nervosa. The condition is marked by cycles of extreme overeating, known as bingeing, followed by purging or other behaviors to compensate for the overeating. It is also associated with feelings of loss of control about eating.

Binge eating disorder. This is characterized by regular episodes of extreme overeating and feelings of loss of control about eating.

Eating disorders tend to develop during the teenage and young adult years, and they are much more common in girls and women. No one knows the precise cause of eating disorders, but they seem to coexist with psychological and medical issues such as low self-esteem, depression, anxiety, trouble coping with emotions, and substance abuse.

For some people, a preoccupation with food becomes a way to gain control over one aspect of their lives. Although it may start out as simply eating a bit more or less than usual, the behavior can spiral out of control and take over the person's life. Eating disorders are a serious medical problem that can have long-term health consequences if left untreated.

It's common for people with eating disorders to hide their unhealthy behaviors, so it can be difficult to recognize the signs of an eating disorder, especially early on.

Here's a more detailed look at the symptoms of anorexia, bulimia, and binge eating disorder.

Signs of Anorexia Nervosa

People with anorexia nervosa have an extreme fear of gaining weight. They often diet and exercise relentlessly, sometimes to the point of starvation. About one-third to one-half of anorexics also binge and purge by vomiting or misusing laxatives. People with anorexia have a distorted body image, thinking they are overweight when in fact they are underweight. They may count calories obsessively and only allow themselves tiny portions of certain specific foods. When confronted, someone with anorexia will often deny that there's a problem.

Continued

The signs of anorexia can be subtle at first, because it develops gradually. It may begin as an interest in dieting before an event like a school dance or a beach vacation. But as the disorder takes hold, preoccupation with weight intensifies. It creates a vicious cycle: The more weight the person loses, the more that person worries and obsesses about weight.

The following symptoms and behaviors are common in people with anorexia:

Dramatic weight loss

Wearing loose, bulky clothes to hide weight loss

Preoccupation with food, dieting, counting calories, etc.

Refusal to eat certain foods, such as carbs or fats

Avoiding mealtimes or eating in front of others

Preparing elaborate meals for others but refusing to eat them

Exercising excessively

Making comments about being "fat"

Stopping menstruating

Complaining about constipation or stomach pain

Denying that extreme thinness is a problem

Because people with anorexia are so good at hiding it, the disease may become severe before anyone around them notices anything wrong. If you think someone you care about has anorexia, it's important to have them evaluated by a doctor right away. If left untreated, anorexia can lead to serious complications such as malnutrition and organ failure. However, with treatment, most people with anorexia will gain back the weight they lost, and the physical problems they developed as a result of the anorexia will get better.

Signs of Bulimia Nervosa

People with bulimia nervosa have episodes of eating large amounts of food (called bingeing) followed by purging ( vomiting or using laxatives), fasting, or exercising excessively to compensate for the overeating.

Unlike anorexia, people with bulimia are often a normal weight. But they have the same intense fear of gaining weight and distorted body image. They see themselves as "fat" and desperately want to lose weight. Because they often feel ashamed and disgusted with themselves, people with bulimia become very good at hiding the bulimic behaviors.

The following are common signs of bulimia:

Evidence of binge eating, including disappearance of large amounts of food in a short time, or finding lots of empty food wrappers or containers

Evidence of purging, including trips to the bathroom after meals, sounds or smells of vomiting, or packages of laxatives or diuretics

Skipping meals or avoiding eating in front of others, or eating very small portions

Exercising excessively

Wearing baggy clothes to hide the body

Complaining about being "fat"

Using gum, mouthwash, or mints excessively

Constantly dieting

Scarred knuckles from repeatedly inducing vomiting

If left untreated, bulimia can result in long-term health problems such as abnormal heart rhythms, bleeding from the esophagus due to excessive reflux of stomach acid, dental problems, and kidney problems. However, bulimia can be treated successfully through cognitive-behavioral therapy, certain anticonvulsant medicines, antidepressants, or combinations of these therapies. It's important to seek help if you think someone you care about has bulimia.

Continued

Signs of Binge Eating Disorder

Rather than simply eating too much all the time, people with binge eating disorder have frequent episodes where they binge on large quantities of food. Like people with bulimia, they often feel out of control during these episodes and later feel guilt and shame about it. The behavior becomes a vicious cycle, because the more distressed they feel about bingeing, the more they seem to do it. Because people with binge eating disorder do not purge, fast, or exercise after they binge, they are usually overweight or obese.

Unlike other eating disorders, binge eating disorder is almost as common in men as it is in women. According to statistics from the National Institute of Mental Health, the average age at onset for binge eating disorder is 25, and it is more common in people under age 60.

Common signs of binge eating disorder include:

Evidence of binge eating, including disappearance of large amounts of food in a short time, or finding lots of empty food wrappers or containers

Hoarding food, or hiding large quantities of food in strange places

Wearing baggy clothes to hide the body

Skipping meals or avoiding eating in front of others

Constantly dieting, but rarely losing weight

Because binge eating leads to obesity, it can have serious health consequences if left untreated. Behavioral weight reduction programs can be helpful both with weight loss and with controlling the urge to binge eat. The stimulant drug Vyvanse is FDA-approved for the treatment of binge eating disorder. Also, because depression often goes hand in hand with binge eating disorder, antidepressants and psychotherapy may also help.

Recognizing the signs and symptoms of an eating disorder is the first step toward getting help for it. Eating disorders are treatable, and with the right treatment and support, most people with an eating disorder can learn healthy eating habits and get their lives back on track.

Sources

SOURCES:

National Institute of Mental Health: "Eating Disorders."

Merck Manual: "Anorexia Nervosa;" "Bulimia Nervosa;" and "Binge Eating Disorder."

National Eating Disorders Association.

# data[].attributes.attachment_link.title
Signs of Eating Disorders: Types and Symptoms

# data[].attributes.attachment_link.description
Eating disorders are a group of conditions marked by an unhealthy relationship with food. There are three main types of eating disorders: Anorexia nervosa. This is characterized by weight loss often due to excessive dieting and exercise, sometimes to the point of starvation.