# data[].attributes.body
https://www.nimh.nih.gov/health/topics/anxiety-disorders

# data[].attributes.attachment_link.provider_name
National Institute of Mental Health (NIMH)

# data[].attributes.attachment_link.readable_text
What is anxiety?

Occasional anxiety is a normal part of life. Many people worry about things such as health, money, or family problems. But anxiety disorders involve more than temporary worry or fear. For people with an anxiety disorder, the anxiety does not go away and can get worse over time. The symptoms can interfere with daily activities such as job performance, schoolwork, and relationships.

There are several types of anxiety disorders, including generalized anxiety disorder, panic disorder, social anxiety disorder, and various phobia-related disorders.

What are the signs and symptoms of anxiety?

What are the risk factors for anxiety?

How is anxiety treated?

How can I find a clinical trial for anxiety?

Where can I learn more about anxiety?

# data[].attributes.attachment_link.description
Learn about anxiety disorders, including signs and symptoms, types, risk factors, and potential treatments and therapies.

# data[].attributes.body
https://whatisanxiety.adaa.org/?gclid=Cj0KCQjw1N2TBhCOARIsAGVHQc65fw4pqQwdr10yQdcfLT3fKU08Aaj7lOpjAigPq40wz6s59shqw5saAuT7EALw_wcB

# data[].attributes.attachment_link.description
Explore the different types of anxiety and anxiety disorders by clicking on each below.

# data[].attributes.body
https://www.mayoclinic.org/diseases-conditions/anxiety/symptoms-causes/syc-20350961

# data[].attributes.attachment_link.readable_text
Overview

Experiencing occasional anxiety is a normal part of life. However, people with anxiety disorders frequently have intense, excessive and persistent worry and fear about everyday situations. Often, anxiety disorders involve repeated episodes of sudden feelings of intense anxiety and fear or terror that reach a peak within minutes (panic attacks).

These feelings of anxiety and panic interfere with daily activities, are difficult to control, are out of proportion to the actual danger and can last a long time. You may avoid places or situations to prevent these feelings. Symptoms may start during childhood or the teen years and continue into adulthood.

Examples of anxiety disorders include generalized anxiety disorder, social anxiety disorder (social phobia), specific phobias and separation anxiety disorder. You can have more than one anxiety disorder. Sometimes anxiety results from a medical condition that needs treatment.

Whatever form of anxiety you have, treatment can help.

Symptoms

Common anxiety signs and symptoms include:

Feeling nervous, restless or tense

Having a sense of impending danger, panic or doom

Having an increased heart rate

Breathing rapidly (hyperventilation)

Sweating

Trembling

Feeling weak or tired

Trouble concentrating or thinking about anything other than the present worry

Having trouble sleeping

Experiencing gastrointestinal (GI) problems

Having difficulty controlling worry

Having the urge to avoid things that trigger anxiety

Several types of anxiety disorders exist:

Agoraphobia (ag-uh-ruh-FOE-be-uh) is a type of anxiety disorder in which you fear and often avoid places or situations that might cause you to panic and make you feel trapped, helpless or embarrassed.

Anxiety disorder due to a medical condition includes symptoms of intense anxiety or panic that are directly caused by a physical health problem.

Generalized anxiety disorder includes persistent and excessive anxiety and worry about activities or events - even ordinary, routine issues. The worry is out of proportion to the actual circumstance, is difficult to control and affects how you feel physically. It often occurs along with other anxiety disorders or depression.

Panic disorder involves repeated episodes of sudden feelings of intense anxiety and fear or terror that reach a peak within minutes (panic attacks). You may have feelings of impending doom, shortness of breath, chest pain, or a rapid, fluttering or pounding heart (heart palpitations). These panic attacks may lead to worrying about them happening again or avoiding situations in which they've occurred.

Selective mutism is a consistent failure of children to speak in certain situations, such as school, even when they can speak in other situations, such as at home with close family members. This can interfere with school, work and social functioning.

Separation anxiety disorder is a childhood disorder characterized by anxiety that's excessive for the child's developmental level and related to separation from parents or others who have parental roles.

Social anxiety disorder (social phobia) involves high levels of anxiety, fear and avoidance of social situations due to feelings of embarrassment, self-consciousness and concern about being judged or viewed negatively by others.

Specific phobias are characterized by major anxiety when you're exposed to a specific object or situation and a desire to avoid it. Phobias provoke panic attacks in some people.

Substance-induced anxiety disorder is characterized by symptoms of intense anxiety or panic that are a direct result of misusing drugs, taking medications, being exposed to a toxic substance or withdrawal from drugs.

Other specified anxiety disorder and unspecified anxiety disorder are terms for anxiety or phobias that don't meet the exact criteria for any other anxiety disorders but are significant enough to be distressing and disruptive.

When to see a doctor

See your doctor if:

You feel like you're worrying too much and it's interfering with your work, relationships or other parts of your life

Your fear, worry or anxiety is upsetting to you and difficult to control

You feel depressed, have trouble with alcohol or drug use, or have other mental health concerns along with anxiety

You think your anxiety could be linked to a physical health problem

You have suicidal thoughts or behaviors - if this is the case, seek emergency treatment immediately

Your worries may not go away on their own, and they may get worse over time if you don't seek help. See your doctor or a mental health provider before your anxiety gets worse. It's easier to treat if you get help early.

Causes

The causes of anxiety disorders aren't fully understood. Life experiences such as traumatic events appear to trigger anxiety disorders in people who are already prone to anxiety. Inherited traits also can be a factor.

Medical causes

For some people, anxiety may be linked to an underlying health issue. In some cases, anxiety signs and symptoms are the first indicators of a medical illness. If your doctor suspects your anxiety may have a medical cause, he or she may order tests to look for signs of a problem.

Examples of medical problems that can be linked to anxiety include:

Heart disease

Diabetes

Thyroid problems, such as hyperthyroidism

Respiratory disorders, such as chronic obstructive pulmonary disease (COPD) and asthma

Drug misuse or withdrawal

Withdrawal from alcohol, anti-anxiety medications (benzodiazepines) or other medications

Chronic pain or irritable bowel syndrome

Rare tumors that produce certain fight-or-flight hormones

Sometimes anxiety can be a side effect of certain medications.

It's possible that your anxiety may be due to an underlying medical condition if:

You don't have any blood relatives (such as a parent or sibling) with an anxiety disorder

You didn't have an anxiety disorder as a child

You don't avoid certain things or situations because of anxiety

You have a sudden occurrence of anxiety that seems unrelated to life events and you didn't have a previous history of anxiety

Risk factors

These factors may increase your risk of developing an anxiety disorder:

Trauma. Children who endured abuse or trauma or witnessed traumatic events are at higher risk of developing an anxiety disorder at some point in life. Adults who experience a traumatic event also can develop anxiety disorders.

Stress due to an illness. Having a health condition or serious illness can cause significant worry about issues such as your treatment and your future.

Stress buildup. A big event or a buildup of smaller stressful life situations may trigger excessive anxiety - for example, a death in the family, work stress or ongoing worry about finances.

Personality. People with certain personality types are more prone to anxiety disorders than others are.

Other mental health disorders. People with other mental health disorders, such as depression, often also have an anxiety disorder.

Having blood relatives with an anxiety disorder. Anxiety disorders can run in families.

Drugs or alcohol. Drug or alcohol use or misuse or withdrawal can cause or worsen anxiety.

Complications

Having an anxiety disorder does more than make you worry. It can also lead to, or worsen, other mental and physical conditions, such as:

Depression (which often occurs with an anxiety disorder) or other mental health disorders

Substance misuse

Trouble sleeping (insomnia)

Digestive or bowel problems

Headaches and chronic pain

Social isolation

Problems functioning at school or work

Poor quality of life

Suicide

Prevention

There's no way to predict for certain what will cause someone to develop an anxiety disorder, but you can take steps to reduce the impact of symptoms if you're anxious:

Get help early. Anxiety, like many other mental health conditions, can be harder to treat if you wait.

Stay active. Participate in activities that you enjoy and that make you feel good about yourself. Enjoy social interaction and caring relationships, which can lessen your worries.

Avoid alcohol or drug use. Alcohol and drug use can cause or worsen anxiety. If you're addicted to any of these substances, quitting can make you anxious. If you can't quit on your own, see your doctor or find a support group to help you.

# data[].attributes.attachment_link.description
Learn the symptoms of this mental health condition, and ways to manage worry and fear that interfere with your daily activities.

# data[].attributes.body
https://www.nimh.nih.gov/health/topics/eating-disorders

# data[].attributes.attachment_link.provider_name
National Institute of Mental Health (NIMH)

# data[].attributes.attachment_link.readable_text
Overview

There is a commonly held misconception that eating disorders are a lifestyle choice. Eating disorders are actually serious and often fatal illnesses that are associated with severe disturbances in people's eating behaviors and related thoughts and emotions. Preoccupation with food, body weight, and shape may also signal an eating disorder. Common eating disorders include anorexia nervosa, bulimia nervosa, and binge-eating disorder.

Signs and symptoms

Risk factors

Treatments and therapies

Join a study

# data[].attributes.attachment_link.description
Learn about eating disorders, including types (e.g., anorexia nervosa, bulimia nervosa), signs and symptoms, risk factors, and treatments and therapies.

# data[].attributes.body
https://psychiatry.org/patients-families/eating-disorders/what-are-eating-disorders

# data[].attributes.body
https://www.webmd.com/mental-health/eating-disorders/signs-of-eating-disorders

# 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.

Avoidant/restrictive food intake disorder (ARFID). This condition is characterized by eating very little and/or avoiding certain foods. It usually begins in childhood. People with ARFID may avoid certain foods because of their texture or odor.

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.

Continued

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.

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

Continued

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.

# 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.

# data[].attributes.body
https://www.nami.org/About-Mental-Illness/Mental-Health-Conditions/Anxiety-Disorders

# data[].attributes.attachment_link.title
Anxiety Disorders | NAMI: National Alliance on Mental Illness

# data[].attributes.attachment_link.description
Discover the symptoms, causes, diagnosis advice, treatment options and related conditions of anxiety disorders.

# data[].attributes.body
https://www.verywellmind.com/mood-disorder-1067175

# data[].attributes.attachment_link.readable_text
A mood disorder, also referred to as an affective disorder, is a condition that severely impacts your mood and its related functions. Mood disorder is a broad term that's used to include all the different types of depressive and bipolar disorders, both of which affect your mood. If you have symptoms of a mood disorder, your moods may range from extremely low ( depressed) to extremely high or irritable (manic).

Types of Mood Disorders

With the most recent update of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) in 2013, mood disorders are now separated into bipolar disorder and related disorders and depressive disorders.

In general, the main types of mood disorders include:

Major depressive disorder: This is what we often hear referred to as major depression or clinical depression. It involves periods of extreme sadness, hopelessness, or emptiness accompanied by a variety of physical, cognitive, and emotional symptoms.

Bipolar I disorder: Also referred to in the past as "manic depression," if you have mania, you experience euphoric and/or irritable moods and increased energy or activity. During manic episodes, you also regularly engage yourself in activities that can very result in painful consequences for you and/or someone else.

Bipolar II disorder: For diagnosis, you must have had at least one episode of current or past hypomania, which is a less severe form of mania, and at least one episode of current or past major depression, but no history of any manic episodes. The criteria for episodes of mania, hypomania, and major depression remain the same.

Cyclothymic disorder:Diagnosis requires a two-year history minimum of many episodes of not-quite hypomania and not-quite major depression.

Other: There are other categories of mood disorders that include substance/medication and medically induced mood disorders. There are also the diagnosis of "other specified" and "unspecified" mood disorders that don't exactly meet criteria for the other mood disorders.

New Mood Disorders

There are three new depressive disorders included in the DSM-V, including:

Disruptive mood dysregulation disorder: This depressive disorder was added to the DSM-Vfor children up to 18 years of age who exhibit persistent irritability and anger and frequent episodes of extreme temper outbursts without any significant provocation.

Persistent depressive disorder: This diagnosis is meant to include both chronic major depressive disorder that has lasted for two or more years and what was previously known as dysthymic disorder or dysthymia, a lower grade form of depression.

Premenstrual dysphoric disorder: This diagnosis is based on the presence of specific symptoms in the week before the onset of menstruation, followed by the resolution of these symptoms after onset. The symptoms must include one or more of the following: mood swings, irritability or anger, depressed mood or hopelessness, and anxiety or tension, as well as one or more of an additional seven symptoms, with a total of at least five symptoms.

Mood disorders can lead to difficulty in keeping up with the daily tasks and demands of life. Some people, especially children, may have physical symptoms of depression, like unexplained headaches or stomachaches. Because there are various types of mood disorders, they can have very different effects on your life.

In general, symptoms may include:

Loss of interest in activities you once enjoyed

Eating more or less than usual

Difficulty sleeping or sleeping more than usual

Fatigue

Crying

Anxiety

Feeling "flat," like you just don't have the energy to care

Feeling isolated, sad, hopeless, and worthless

Difficulty concentrating

Problems making decisions

Feelings of guilt

Irritability

Thoughts of dying and/or suicide

With mood disorders, these symptoms are ongoing and eventually start to affect your daily life in a negative way. They're not the sporadic thoughts and feelings that everyone has on occasion.

No one knows the exact causes of mood disorders, but a variety of factors seem to contribute to them and they tend to run in families. Chemical imbalances in your brain are the most likely cause. Stressful life events like death, divorce, or trauma can also trigger depression, especially if you've already had it before or there's a genetic component.

Mood disorders should be properly evaluated and treated by a mental health professional, such as a psychiatrist. If any of the symptoms above have been interfering with your life, particularly if you are having suicidal thoughts, you should seek help immediately.

Your doctor will be able to diagnose you by performing a physical exam and lab tests to rule out any physical reasons for your symptoms, as well as a psychiatric evaluation.

Millions of people experience mood disorders and are successfully treated, helping them live a better quality of life. Treatments for mood disorders can include psychotherapy, also known as talk therapy, as well as medications to help regulate the chemical imbalances in your brain. A combination of psychotherapy and medication is often the best course of action to get you on the road to feeling better.

# data[].attributes.attachment_link.title
Mood Disorders Classifications According to the DSM-V

# data[].attributes.attachment_link.description
A mood disorder, also referred to as an affective disorder, is a condition that severely impacts your mood and its related functions. Mood disorder is a broad term that's used to include all the different types of depressive and bipolar disorders, both of which affect your mood.

# data[].attributes.body
https://www.mhanational.org/conditions/mood-disorders

# data[].attributes.attachment_link.readable_text
Mood disorders are a category of illnesses that describe a serious change in mood. Illness under mood disorders include: major depressive disorder, bipolar disorder (mania - euphoric, hyperactive, over inflated ego, unrealistic optimism), persistent depressive disorder (long lasting low grade depression), cyclothymia (a mild form of bipolar disorder), and SAD (seasonal affective disorder).

The following links provide additional information about these categories

How Common Are Mood Disorders?

About 20% of the U.S. population reports at least one depressive symptom in a given month, and 12% report two or more in a year. A survey conducted in 1992 found rates of major depression reaching 5% in the previous 30 days, 17% for a lifetime. Bipolar disorder is less common, occurring at a rate of 1% in the general population, but some believe the diagnosis is often overlooked because manic elation is too rarely reported as an illness.

The Relationship Between Psychiatric Disorders and Mood Disorders

Depression is a common feature of mental illness, whatever its nature and origin. A person with a history of any serious psychiatric disorder has almost as high a chance of developing major depression as someone who has had major depression itself in the past.

Alcohol, Substance Abuse and Depression

Alcoholism and other forms of drug dependence are also related to depression. Dual diagnosis - substance abuse and another psychiatric disorder, usually a mood disorder - is an increasingly serious psychiatric concern. Whether drug abuse causes depression, depression leads to drug abuse, or both have a common cause, a vicious spiral ensues when addicts use the drugs to relieve symptoms the drugs have caused. Cocaine and other stimulants act on neurotransmitters in the brain's pleasure center, causing elation that is followed by depression as the effect subsides. Sometimes what appears to be major depression clears up after abstinence from alcohol or drugs. People with serious mood disorders also have twice the average rate of nicotine addiction, and many become depressed when they try to stop smoking.

Personality and Mood Disorders

People are more easily demoralized by depression and slower to recover if they are withdrawn and unreasonably self-critical or irritable, impulsive, and hypersensitive to loss. Most people with major depression also show some signs of anxiety, and 15-30% have panic attacks. As a biological mechanism for coping with danger, anxiety creates a need for help or protection that may give way to despair if it is disappointed. Chronically anxious people may also medicate themselves with alcohol or drugs that can cause depression.

Depression and Physical Illness

Depression is associated with physical illness as well. Some 25% of hospitalized medical patients have noticeable depressive symptoms and about 5% are suffering from major depression. Chronic medical conditions associated with depression include heart disease, cancer, vitamin deficiencies, diabetes, hepatitis, and malaria. Depression also is a common effect of neurological disorders, including Parkinson's and Alzheimer's diseases, multiple sclerosis, strokes, and brain tumors. Even moderate depressive symptoms are associated with a higher than average rate of arteriosclerosis, heart attacks, and high blood pressure. Depression can mimic medical illness and any illness feels worse to someone suffering from depression.

Other Resources

National Mental Health Consumer Self-Help Clearinghouse
Phone Number: (215) 751-1810
Toll Free Number: (800) 553-4539
Fax Number: (215) 636-6312
Email address: info@mhselfhelp.org
Website URL: http://www.mhselfhelp.org/

Department of Health and Human Services
200 Independence Avenue, S.W.
Washington, DC 20201
Website URL: http://www.mentalhealth.gov/

# data[].attributes.attachment_link.description
What Are Mood Disorders? Mood disorders are a category of illnesses that describe a serious change in mood. Illness under mood disorders include: major depressive disorder, bipolar disorder (mania - euphoric, hyperactive, over inflated ego, unrealistic optimism), persistent depressive disorder (long lasting low grade depression), cyclothymia (a mild form of bipolar disorder), and SAD (seasonal affective disorder).

# data[].attributes.body
https://www.cedars-sinai.org/health-library/diseases-and-conditions/o/overview-of-mood-disorders.html

# data[].attributes.attachment_link.readable_text
What are mood disorders?

A mood disorder is a class of serious mental illnesses. The term broadly describes all types of depression and bipolar disorders.

Children, teens, and adults can all have mood disorders. But children and teens don't always have the same symptoms as adults. It's harder to diagnose mood disorders in children. That's because they can't always express how they feel.

Therapy, medicines, and support and self-care can help treat mood disorders.

What are the different types of mood disorders?

These are the most common types of mood disorders:

Major depression. Having less interest in normal activities, feeling sad or hopeless, and other symptoms for at least 2 weeks may mean depression.

Dysthymia. This is an ongoing (chronic), low-grade, depressed, or irritable mood that lasts for at least 2 years.

Bipolar disorder. With this condition a person has times of depression alternating with times of mania or a higher mood.

Mood disorder linked to another health condition. Many health conditions (including cancer, injuries, infections, and chronic illnesses) can trigger symptoms of depression.

Substance-induced mood disorder.Symptoms of depression that are due to the effects of medicine, drug abuse, alcoholism, exposure to toxins, or other forms of treatment.

What causes mood disorders?

Many factors help lead to mood disorders. They are likely caused by an imbalance of brain chemicals. Life events (such as stressful life changes) may also help lead to a depressed mood. Mood disorders also tend to run in families.

Who is at risk for mood disorders?

Anyone can feel sad or depressed at times. But mood disorders are more intense and last longer. They are also harder to manage than normal feelings of sadness. Children, teens, or adults who have a parent with a mood disorder have a greater chance of also having a mood disorder. But life events and stress can expose or worsen feelings of sadness or depression. This makes the feelings harder to manage.

Sometimes life's problems can trigger depression. Things such as being fired from a job, getting divorced, losing a loved one, having a death in the family, and financial trouble, all can be difficult. Coping with the pressure may be troublesome. These life events and stress can bring on feelings of sadness or depression. Or they can make a mood disorder harder to manage.

The risk of depression in women is nearly twice as high as it is for men. Once a person in the family has this diagnosis, their siblings and their children have a higher chance of the same diagnosis.

What are the symptoms of mood disorders?

Depending on age and the type of mood disorder, a person may have different symptoms when they become depressed. The following are the most common symptoms of a mood disorder:

Ongoing sad, anxious, or "empty" mood

Feeling hopeless or helpless

Having low self-esteem

Feeling inadequate or worthless

Excessive guilt

Not interested in normal activities or activities that were once enjoyed, including sex

Relationship problems

Trouble sleeping or sleeping too much

Changes in appetite or weight

Decreased energy

Trouble focusing

Less able to make decisions

Frequent physical complaints (for example, headache, stomachache, or tiredness) that don't get better with treatment

Running away or threats of running away from home

Very sensitive to failure or rejection

Irritability, hostility, or aggression

Repeated thoughts of death or suicide, planning for death, or wishing to die

In mood disorders, these feelings are more intense than what a person may normally feel from time to time. It's also of concern if these feelings continue over time. Or if they interfere with someone's interest in family, friends, community, or work.

Any person who has thoughts of suicide should get medical help right away. If you can't get in immediately to your primary care provider, go to a reputable mental health facility in your community. Don't put it off.

The symptoms of mood disorders may seem like other conditions or mental health problems. Always talk with a healthcare provider for a diagnosis.

When suicide is a risk

Mood disorders can cause repeated thoughts of death or suicide, planning for death, or wishing to die. People with these symptoms should get treatment right away. Call 911 if a person has suicidal thoughts, a suicide plan, and the means to carry out the plan. Don't leave the person alone, even for a moment. Call the National Suicide Prevention Lifeline at 800-273-8255.

How are mood disorders diagnosed?

Mood disorders are serious illnesses. A psychiatrist or other mental health provider often diagnoses mood disorders with a complete health history and psychiatric evaluation.

How are mood disorders treated?

Mood disorders can often be treated with success. Treatment may include:

Antidepressant and mood-stabilizing medicines.These medicines work very well in treating mood disorders, especially when combined with psychotherapy.

Psychotherapy (most often cognitive-behavioral or interpersonal therapy). This kind of therapy is focused on changing the person's distorted view of themselves and their environment. It also helps to improve relationship skills. And it can help the person find stressors in the environment and learn how to stay away from them.

Family therapy. A mood disorder can affect all aspects of a family (emotional, physical, and financial). Professional support can help both the person with the diagnosis and family members.

Other therapies. These may include electroconvulsive therapy and transcranial stimulation.

Families play a vital supportive role in any treatment process.

Someone with a mood disorder may have times of stability and times when symptoms return. Long-term, continuous treatment can help the person stay healthy and control symptoms.

When correctly diagnosed and treated, people with mood disorders can live, stable, productive, healthy lives.

Can mood disorders be prevented?

At this time, there are no ways to prevent or reduce mood disorders. But early diagnosis and treatment can reduce the severity of symptoms. It can also enhance the person's normal growth and development, and improve their quality of life.

Key points about mood disorders

A mood disorder is a class of serious mental illnesses. The term broadly describes all types of depression and bipolar disorders.

Children, teens, and adults can all have mood disorders.

Many factors help lead to mood disorders. They are likely caused by an imbalance of brain chemicals.

Most people with a mood disorder have ongoing feelings of sadness. They may feel helpless and hopeless.

Without treatment, symptoms can last for weeks, months, or years. They can affect quality of life.

Mood disorders are most often treated with medicine, psychotherapy or cognitive behavioral therapy, family therapy, or a combination of medicine and therapy.

Long-term, comprehensive follow-up care will help ensure the support needed for a full, productive life.

Next steps

Tips to help you get the most from a visit to your healthcare provider:

Know the reason for your visit and what you want to happen.

Before your visit, write down questions you want answered.

Bring someone with you to help you ask questions and remember what your provider tells you.

At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you.

Know why a new medicine or treatment is prescribed, and how it will help you. Also know what the side effects are.

Ask if your condition can be treated in other ways.

Know why a test or procedure is recommended and what the results could mean.

Know what to expect if you do not take the medicine or have the test or procedure.

If you have a follow-up appointment, write down the date, time, and purpose for that visit.

Know how you can contact your provider if you have questions.

Medical Reviewer: Paul Ballas MD

Medical Reviewer: Marianne Fraser MSN RN

Medical Reviewer: L Renee Watson MSN RN

© 2000-2021 The StayWell Company, LLC. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare professional's instructions.

# data[].attributes.attachment_link.description
A mood disorder is a class of serious mental illnesses. The term broadly describes all types of depression and bipolar disorders. Children, teens, and adults can all have mood disorders. But children and teens don't always have the same symptoms as adults. It's harder to diagnose mood disorders in children.

# data[].attributes.body
https://www.mayoclinic.org/diseases-conditions/mood-disorders/symptoms-causes/syc-20365057

# data[].attributes.attachment_link.readable_text
Overview

If you have a mood disorder, your general emotional state or mood is distorted or inconsistent with your circumstances and interferes with your ability to function. You may be extremely sad, empty or irritable (depressed), or you may have periods of depression alternating with being excessively happy (mania).

Anxiety disorders can also affect your mood and often occur along with depression. Mood disorders may increase your risk of suicide.

Some examples of mood disorders include:

Major depressive disorder - prolonged and persistent periods of extreme sadness

Bipolar disorder - also called manic depression or bipolar affective disorder, depression that includes alternating times of depression and mania

Seasonal affective disorder (SAD) - a form of depression most often associated with fewer hours of daylight in the far northern and southern latitudes from late fall to early spring

Cyclothymic disorder - a disorder that causes emotional ups and downs that are less extreme than bipolar disorder

Premenstrual dysphoric disorder - mood changes and irritability that occur during the premenstrual phase of a woman's cycle and go away with the onset of menses

Persistent depressive disorder (dysthymia) - a long-term (chronic) form of depression

Disruptive mood dysregulation disorder - a disorder of chronic, severe and persistent irritability in children that often includes frequent temper outbursts that are inconsistent with the child's developmental age

Depression related to medical illness - a persistent depressed mood and a significant loss of pleasure in most or all activities that's directly related to the physical effects of another medical condition

Depression induced by substance use or medication - depression symptoms that develop during or soon after substance use or withdrawal or after exposure to a medication

For most people, mood disorders can be successfully treated with medications and talk therapy (psychotherapy).

When to see a doctor

If you're concerned that you may have a mood disorder, make an appointment to see your doctor or a mental health professional as soon as you can. If you're reluctant to seek treatment, talk to a friend or loved one, a faith leader, or someone else you trust.

Talk to a health care professional if you:

Feel like your emotions are interfering with your work, relationships, social activities or other parts of your life

Have trouble with drinking or drugs

Have suicidal thoughts or behaviors - seek emergency treatment immediately

Your mood disorder is unlikely to simply go away on its own, and it may get worse over time. Seek professional help before your mood disorder becomes severe - it may be easier to treat early on.

Products & Services

Mood disorders care at Mayo Clinic

Show references

1. Mood disorders fact sheet. National Institutes of Health. http://report.nih.gov/NIHfactsheets/ViewFactSheet.aspx?csid=48. Accessed Sept. 23, 2017.

2. Brown A. Allscripts EPSi. Mayo Clinic, Rochester, Minn. Aug. 3, 2017.

3. Overview of mood disorders. Merck Manual Professional Version. http://www.merckmanuals.com/professional/psychiatric-disorders/mood-disorders/overview-of-mood-disorders. Accessed Sept. 23, 2017.

4. Mood disorders. MentalHealth.gov. http://www.mentalhealth.gov/what-to-look-for/mood-disorders/index.html. Accessed Sept. 23, 2017.

5. Depressive disorders. In: Diagnostic and Statistical Manual of Mental Disorders DSM-5. 5th ed. Arlington, Va.: American Psychiatric Association; 2013. http://dsm.psychiatryonline.org. Accessed Sept. 23, 2017.

6. Bipolar and related disorders. In: Diagnostic and Statistical Manual of Mental Disorders DSM-5. 5th ed. Arlington, Va.: American Psychiatric Association; 2013. http://dsm.psychiatryonline.org. Accessed Sept. 23, 2017.

7. Hall-Flavin DK (expert opinion). Mayo Clinic, Rochester, Minn. Oct. 2, 2017.

Related

Products & Services

Show more products and services from Mayo Clinic

# data[].attributes.attachment_link.description
Specialists in psychiatry and psychology at Mayo Clinic diagnose and treat adults and children with depression, bipolar disorder and other mood disorders.

# data[].attributes.body
https://my.clevelandclinic.org/health/diseases/17843-mood-disorders

# data[].attributes.attachment_link.readable_text
Overview

What is a mood disorder?

A mood disorder is a mental health problem that primarily affects a person's emotional state. It is a disorder in which a person experiences long periods of extreme happiness, extreme sadness, or both.

It is normal for someone's mood to change, depending on the situation. However, to be diagnosed with a mood disorder, symptoms must be present for several weeks or longer. Mood disorders can cause changes in your behavior and can affect your ability to deal with routine activities, such as work or school.

Two of the most common mood disorders are depression and bipolar disorder. This article will review these disorders and some of their many subtypes.

Depression (major or clinical depression). Depression is a common mental disorder. Grief or sadness is a typical response to a traumatic life event or crisis, such as the death of a spouse or family member, loss of a job, or a major illness. However, when the depression continues to be present even when stressful events are over or there is no apparent cause, physicians would then classify the depression as clinical or major depression. For a person to be diagnosed with clinical depression, symptoms must last for at least two weeks.

There are several different types of depression. Symptoms may vary depending on the form of the disorder.

Postpartum depression (peripartum depression) - This type of depression occurs during pregnancy or after delivery

Persistent depressive disorder (dysthymia) - This is a chronic form of depression that can last for at least two years. Symptoms may occasionally lessen in severity during this time.

Seasonal affective disorder (SAD) - This is another type of depression that occurs during certain seasons of the year. It typically starts in the late autumn or early winter and lasts until spring or summer. Less commonly, SAD episodes may also begin during the late spring or summer. Symptoms of winter seasonal affective disorder may resemble those of a major depression. They tend to disappear or lessen during spring and summer.

Psychotic depression - This is a type of severe depression combined with psychotic episodes, such as hallucinations (seeing or hearing things that others do not) or delusions (having fixed but false beliefs). The episodes may be upsetting or disturbing and often have a theme.

Depression related to a medical condition, medication, or substance abuse

Bipolar disorder (manic-depressive disorder). Bipolar disorder is defined by swings in mood from periods of depression to mania. When someone experiences a low mood, symptoms may resemble those of a clinical depression. Depressive episodes alternate with manic episodes or mania. During a manic episode, a person may feel elated or can also feel irritable or have increased levels of activity.

There are four basic types of bipolar disorder.

Bipolar I - This is the most severe form. Manic episodes last at least seven days or may be severe enough to require hospitalization. Depressive episodes will also occur, often lasting for at least two weeks. Sometimes symptoms of both mania and depression are present at the same time.

Bipolar II disorder - This disorder causes cycles of depression similar to those of bipolar I. A person with this illness also experiences hypomania, which is a less severe form of mania. Hypomanic periods are not as intense or disruptive as manic episodes. Someone with bipolar II disorder is usually able to handle daily responsibilities and does not require hospitalization.

Cyclothymia disorder (cyclothymia) - This type of bipolar disorder has sometimes been defined as a milder form of bipolar disorder. People with cyclothymia experience continuous irregular mood swings - from mild to moderate emotional "highs" to mild to moderate "lows" - for extended periods of time. In addition, changes in mood can occur quickly and at any time. There are only short periods of normal mood. For an adult to be diagnosed with cyclothymic, symptoms have to be experienced for at least 2 years. For children and adolescents, the, symptoms must persist for at least one year.

"Other" or "unspecified" bipolar disorder - Symptoms of this type of bipolar disorder do not meet the criteria for one of the other types but people still have significant, abnormal changes in mood.

Other mood disorders

Premenstrual dysphoric disorder - This type of mood disorder occurs seven to 10 days before menstruation and goes away within a few days of the start of the menstrual period. Researchers believe this disorder is brought about by the hormonal changes related to the menstrual cycle. Symptoms may include anger, irritability, tension, decreased interest in usual activities, and sleep problems.

Intermittent explosive disorder - This is a lesser-known mood disorder marked by episodes of unwarranted anger. It is commonly referred to as "flying into a rage for no reason." In an individual with intermittent explosive disorder, the behavioral outbursts are out of proportion to the situation.

Symptoms and Causes

What causes mood disorders?

There may be several underlying factors, depending on the type of the disorder. Various genetic, biological, environmental, and other factors have been associated with mood disorders.

Risk factors include:

Family history

Previous diagnosis of a mood disorder

Trauma, stress or major life changes in the case of depression

Physical illness or use of certain medications. Depression has been linked to major diseases such as cancer, diabetes, Parkinson's disease and heart disease.

Brain structure and function in the case of bipolar disorder

What are the symptoms of common mood disorders?

Symptoms depend on the type of mood disorder that is present.

Symptoms of major depression may include:

Feeling sad most of the time or nearly every day

Lack of energy or feeling sluggish

Feeling worthless or hopeless

Loss of appetite or overeating

Gaining weight or losing weight

Loss of interest in activities that formerly brought enjoyment

Sleeping too much or not enough

Frequent thoughts about death or suicide

Difficulty concentrating or focusing

Symptoms of bipolar disorder may include both depression and mania. Symptoms of hypomanic or manic episodes include:

Feeling extremely energized or elated

Rapid speech or movement

Agitation, restlessness, or irritability

Risk-taking behavior, such as spending too much money or driving recklessly

Unusual increase in activity or trying to do too many things at once

Racing thoughts

Insomnia or trouble sleeping

Feeling jumpy or on edge for no apparent reason

Diagnosis and Tests

How are mood disorders diagnosed?

Your doctor may perform a physical examination to rule out physiological causes for symptoms, such as a thyroid problem, other illnesses, or a vitamin deficiency. The doctor will ask about your medical history, any medications you are taking, and whether you or any family members have been diagnosed with a mood disorder. A mental health professional, such as a psychologist or psychiatrist, will conduct an interview or survey, asking questions about your symptoms, sleeping and eating habits, and other behavior.

Management and Treatment

How are mood disorders treated?

Treatment will depend on the specific illness and symptoms that are present. Usually, therapy involves a combination of medication and psychotherapy (also called "talk therapy"). Therapy sessions may be conducted by a psychologist, psychiatrist, or other health professional.
Medications to treat depression and/or bipolar disorders

Antidepressants - Many different medications are available to treat depression and depressive episodes of bipolar disorder. Some of the most widely used drugs are selective serotonin reuptake inhibitors (SSRIs). These include citalopram (Celexa®), escitalopram (Lexapro®), sertraline (Zoloft®), fluoxetine (Prozac®), and paroxetine (Paxil®). Serotonin and norepinephrine reuptake inhibitors (SNRIs) such as duloxetine (Cymbalta®) and venlafaxine (Effexor®) also are commonly prescribed and are similar to SSRIs in their action. Bupropion (Wellbutrin®) is used to treat depression and seasonal affective disorder. It works differently than SSRIs or SNRIs. Older types of antidepressants include tricylic antidepressants, monoamine oxidase inhibitors, and tetracyclic antidepressants. Although different types are found to work equally well, some antidepressants may be more effective depending on the individual. It is important to take the antidepressants as prescribed and continue taking them even if you feel better. Usually an antidepressant must be taken as prescribed for 4 to 6 weeks before it begins to work.

Mood stabilizers - These medications help to regulate the mood swings that occur with bipolar disorder or other disorders. They reduce abnormal brain activity. Mood stabilizers may also be prescribed along with antidepressants in some cases. Some of the most widely used mood stabilizers include lithium and anticonvulsant drugs, such as valproic acid (Valproic®), lamotrigine (Lamictal®), carbamazepine (Tegretol®), and oxecarbazepine (Trileptal®).

Antipsychotics - Patients with bipolar disorder who experience mania or mixed episodes may be treated with an atypical antipsychotic drug, such as aripiprazole (Abilify®). Atypical antipsychotics may also sometimes be used to treat depression, if symptoms are not controlled with an antidepressant alone.

Psychotherapy (talk therapy)
Patients with depression and other mood disorders may benefit from various types of psychotherapy or counseling sessions. Types of therapy include:

Cognitive-behavioral therapy

Interpersonal therapy

Problem-solving therapy

Brain stimulation therapies
Brain stimulation therapies are thought to work by causing changes in the chemicals in the brain that are known to be associated with symptoms of depression and bipolar disorders. There are several types of brain stimulation therapies including:

Electroconvulsive therapy (ECT) - ECT has long been used to treat severe depression or bipolar disorder in cases when medication or psychotherapy have been unsuccessful. Before having ECT, a patient is placed under general anesthesia and is given a muscle relaxant. Electrodes are placed in certain locations on the scalp or forehead. An electric current is passed through the brain to induce a seizure. The patient awakens after five to 10 minutes. The ECT sessions can be performed on an outpatient basis. Usually, two or three sessions per week are required, over a period of two weeks or more. Generally, six to 12 sessions are required.

Repetitive Transcranial Magnetic Stimulation (rTMS) - This noninvasive procedure uses a magnetic coil to apply short electromagnetic pulses to specific nerve cells in the brain. The magnet is positioned against the forehead, while pulses are sent through the skull. The procedure is used to treat major depression for patients who do not respond to at least one antidepressant drug.

Treatments for seasonal depression
Antidepressant medications, such as SSRIs and bupropion, and psychotherapy are used to treat seasonal affective disorder. In addition, patients may benefit from light therapy and vitamin D supplements.

Light therapy - This technique has long been used to treat SAD. It is based on the idea of supplementing natural sunlight with bright artificial light during the fall and winter. Patients may use a light box that provides cool-white fluorescent light. Each morning, the person is exposed to the artificial light for about 20 to 60 minutes. The light is about 20 times more intense than regular indoor lighting.

Outlook / Prognosis

What's the outlook for people with mood disorders?

Mood disorders such as depression and bipolar disorder may recur or be ongoing and therefore may require long-term or lifetime treatment. It is important to take your medications as prescribed. After starting your medications, it may take two to six weeks before you begin to notice a change in your symptoms. Do not stop taking your medication, even if you begin to feel better.

Discuss any concerns you have about changing or stopping medications with your doctor or another health professional. Ask your doctor whether you might need to try a different medication or have the dosage adjusted, if the one you are taking is ineffective or causes unpleasant side effects such as headaches, nausea, vomiting, or diarrhea.

Psychotherapy has been shown to be helpful treatment approach and is often used together with medication or brain stimulation therapy. Minor forms of depression can be treated with psychotherapy alone. Brain stimulation therapies are usually tried when other treatment options have not been successful, in people with severe symptoms, and in those who cannot tolerate the side effects of drug therapy. Every therapy has its potential role, as each patient with a mood disorder is unique.

Seek help immediately if you feel suicidal or have thoughts of harming yourself or others.

# data[].attributes.attachment_link.title
Mood Disorders; Causes, Symptoms, Management & Treatment

# data[].attributes.attachment_link.description
A mood disorder is a mental health problem that primarily affects a person's emotional state. It is a disorder in which a person experiences long periods of extreme happiness, extreme sadness, or both. It is normal for someone's mood to change, depending on the situation.

# data[].attributes.body
https://tea.texas.gov/sites/default/files/Pub_2018_Texas-Model_5th-Edition.pdf

# data[].attributes.body
https://childfindtx.tea.texas.gov/initial_eval.html

# data[].attributes.attachment_link.readable_text
The Individuals with Disabilities Education Act (IDEA) requires local education agencies (LEAs) to conduct an initial evaluation when there is suspicion that a child has a disability and, as result of the disability, needs special education and related services. The full and individual initial evaluation (FIIE) includes procedures that are used selectively with an individual child.

Once a district determines an initial evaluation is necessary, IDEA regulations require LEAs to provide parents with prior written notice and obtain their informed consent for the proposed evaluation. In addition, parents are provided with procedural safeguards that explain the rights afforded to the parents and the child throughout the evaluation process.

Special Education Initial
Referral Timeline

The Special Education Initial Referral Timeline provides an overview of the timeline and legal requirements for a referral for an initial special education evaluation from the point of campus or parent request for a referral for an initial evaluation to the initial ARD committee meeting where eligibility is determined, and may be another helpful resource for ensuring timelines and legal requirements are implemented.

Parental consent for initial evaluation.

1. i. The public agency proposing to conduct an initial evaluation to determine if a child qualifies as a child with a disability under §300.8 must, after providing notice consistent with §§300.503 and 300.504, obtain informed consent, consistent with §300.9, from the parent of the child before conducting the evaluation.

1. Parental consent for initial evaluation must not be construed as consent for initial provision of special education and related services.

2. The public agency must make reasonable efforts to obtain the informed consent from the parent for an initial evaluation to determine whether the child is a child with a disability.

2. For initial evaluations only, if the child is a ward of the State and is not residing with the child's parent, the public agency is not required to obtain informed consent from the parent for an initial evaluation to determine whether the child is a child with a disability if-

1. Despite reasonable efforts to do so, the public agency cannot discover the whereabouts of the parent of the child;

2. The rights of the parents of the child have been terminated in accordance with State law; or

3. The rights of the parent to make educational decisions have been subrogated by a judge in accordance with State law and consent for an initial evaluation has been given by an individual appointed by the judge to represent the child.

3. i. If the parent of a child enrolled in public school or seeking to be enrolled in public school does not provide consent for initial evaluation under paragraph (a)(1) of this section, or the parent fails to respond to a request to provide consent, the public agency may, but is not required to, pursue the initial evaluation of the child by utilizing the procedural safeguards in subpart E of this part (including the mediation procedures under §300.506 or the due process procedures under §§300.507 through 300.516), if appropriate, except to the extent inconsistent with State law relating to such parental consent.

4. The public agency does not violate its obligation under §300.111 and §§300.301 through 300.311 if it declines to pursue the evaluation.

1. General. Each public agency must conduct a full and individual initial evaluation, in accordance with §§300.304 through 300.306, before the initial provision of special education and related services to a child with a disability under this part.

2. Request for initial evaluation. Consistent with the consent requirements in §300.300, either a parent of a child or a public agency may initiate a request for an initial evaluation to determine if the child is a child with a disability.

3. Procedures for initial evaluation. The initial evaluation-

1. i Must be conducted within 60 days of receiving parental consent for the evaluation; or
If the State establishes a timeframe within which the evaluation must be conducted, within that timeframe; and

2. Must consist of procedures-

1. To determine if the child is a child with a disability under §300.8; and

2. To determine the educational needs of the child.

4. Exception. The timeframe described in paragraph (c)(1) of this section does not apply to a public agency if-

1. The parent of a child repeatedly fails or refuses to produce the child for the evaluation; or

2. A child enrolls in a school of another public agency after the relevant timeframe in paragraph (c)(1) of this section has begun, and prior to a determination by the child's previous public agency as to whether the child is a child with a disability under §300.8.

5. The exception in paragraph (d)(2) of this section applies only if the subsequent public agency is making sufficient progress to ensure a prompt completion of the evaluation, and the parent and subsequent public agency agree to a specific time when the evaluation will be completed.

19 TAC §89.1011. Full Individual and Initial Evaluation

1. Referral of students for a full individual and initial evaluation for possible special education services must be a part of the district's overall, general education referral or screening system. Prior to referral, students experiencing difficulty in the general classroom should be considered for all support services available to all students, such as tutorial; remedial; compensatory; response to evidence-based intervention; and other academic or behavior support services. If the student continues to experience difficulty in the general classroom after the provision of interventions, district personnel must refer the student for a full individual and initial evaluation. This referral for a full individual and initial evaluation may be initiated by school personnel, the student's parents or legal guardian, or another person involved in the education or care of the student.

2. If a parent submits a written request to a school district's director of special education services or to a district administrative employee for a full individual and initial evaluation of a student, the school district must, not later than the 15th school day after the date the district receives the request:

1. provide the parent with prior written notice of its proposal to conduct an evaluation consistent with 34 Code of Federal Regulations (CFR), §300.503; a copy of the procedural safeguards notice required by 34 CFR, §300.504; and an opportunity to give written consent for the evaluation; or

2. provide the parent with prior written notice of its refusal to conduct an evaluation consistent with 34 CFR, §300.503, and a copy of the procedural safeguards notice required by 34 CFR, §300.504.

3. (c) Except as otherwise provided in this section, a written report of a full individual and initial evaluation of a student must be completed as follows:

1. not later than the 45th school day following the date on which the school district receives written consent for the evaluation from the student's parent, except that if a student has been absent from school during that period on three or more school days, that period must be extended by a number of school days equal to the number of school days during that period on which the student has been absent; or

2. for students under five years of age by September 1 of the school year and not enrolled in public school and for students enrolled in a private or home school setting, not later than the 45th school day following the date on which the school district receives written consent for the evaluation from the student's parent.

4. The admission, review, and dismissal (ARD) committee must make its decisions regarding a student's initial eligibility determination and, if appropriate, individualized education program (IEP) and placement within 30 calendar days from the date of the completion of the written full individual and initial evaluation report. If the 30th day falls during the summer and school is not in session, the student's ARD committee has until the first day of classes in the fall to finalize decisions concerning the student's initial eligibility determination, IEP, and placement, unless the full individual and initial evaluation indicates that the student will need extended school year services during that summer.

5. Notwithstanding the timelines in subsections (c) and (d) of this section, if the school district received the written consent for the evaluation from the student's parent at least 35 but less than 45 school days before the last instructional day of the school year, the written report of a full individual and initial evaluation of a student must be provided to the student's parent not later than June 30 of that year. The student's ARD committee must meet not later than the 15th school day of the following school year to consider the evaluation. If, however, the student was absent from school three or more days between the time that the school district received written consent and the last instructional day of the school year, the timeline in subsection (c)(1) of this section applies to the date the written report of the full individual and initial evaluation is required. If an initial evaluation completed not later than June 30 indicates that the student will need extended school year services during that summer, the ARD committee must meet as expeditiously as possible.

6. If a student was in the process of being evaluated for special education eligibility by a school district and enrolls in another school district before the previous school district completed the full individual and initial evaluation, the new school district must coordinate with the previous school district as necessary and as expeditiously as possible to ensure a prompt completion of the evaluation in accordance with 34 CFR, §300.301(d)(2) and (e) and §300.304(c)(5). The timelines in subsections (c) and (e) of this section do not apply in such a situation if:

1. the new school district is making sufficient progress to ensure a prompt completion of the evaluation; and

2. the parent and the new school district agree to a specific time when the evaluation will be completed.

# data[].attributes.attachment_link.description
The Individuals with Disabilities Education Act (IDEA) requires local education agencies (LEAs) to conduct an initial evaluation when there is suspicion that a child has a disability and, as result of the disability, needs special education and related services. The full and individual initial evaluation (FIIE) includes procedures that are used selectively with an individual child.

# data[].attributes.body
https://tea.texas.gov/academics/special-student-populations/section-504#:~:text=To%20be%20protected%20under%20Section,as%20having%20such%20an%20impairment.

# data[].attributes.attachment_link.description
The U.S. Department of Education enforces Section 504 of the Rehabilitation Act of 1973, as amended, (Section 504) a civil rights statute which prohibits discrimination against individuals with disabilities. The Office for Civil Rights (OCR) also enforces Title II of the Americans with Disabilities…

# data[].attributes.body
https://tea.texas.gov/academics/special-student-populations/special-education

# data[].attributes.attachment_link.readable_text
Special Education in Texas

Together, we are committed to high expectations and strong systems that achieve equitable outcomes for every student with a disability.

Special Education Strategic Plan

In early 2018, TEA worked with stakeholders across Texas to develop the Strategic Plan for Special Education in Texas. This plan was informed by more than 7,000 voices and lays out an ambitious set of activities aimed at dramatically improving special education programs in Texas. Click on each circle below to see TEA's progress in completing the activities laid out in the various areas within the strategic plan.

Stay Informed

Explore Our Work

TEA is committed to providing families, students, and schools with high quality supports to enable students with disabilities to achieve the highest outcomes. The links below lead to information and resources provided by TEA toward achieving that goal.

# data[].attributes.attachment_link.description
Together, we are committed to high expectations and strong systems that achieve equitable outcomes for every student with a disability. In early 2018, TEA worked with stakeholders across Texas to develop the Strategic Plan for Special Education in Texas.

# data[].attributes.body
https://www.schoolcounselor.org/

# data[].attributes.attachment_link.title
Home - American School Counselor Association (ASCA)

# data[].attributes.body
https://www.nationwidechildrens.org/conditions/conduct-disorders#:~:text=Conduct%20disorder%20refers%20to%20a,hostile%20and%20sometimes%20physically%20violent.

# data[].attributes.attachment_link.readable_text
What Symptoms Should Parents Look for?

There are four basic types of behavior that characterize conduct disorder:

Physical aggression (such as cruelty toward animals, assault or rape).

Violating others' rights (such as theft or vandalism).

Lying or manipulation.

Delinquent behaviors (such as truancy or running away from home).

Conduct disorder is characterized by aggression toward others and a callous disregard for their rights and needs. Adolescents and teens with conduct disorder can find acts of aggression, deceit and coercion to be gratifying. Your child may meet the criteria for conduct disorder if you find them engaging in several of the below behaviors:

Many young people with conduct disorder will have trouble:

Feeling and expressing empathy or remorse.

Showing emotion toward others.

Performing well in the school or community and blaming others for poor performance.

They often misinterpret the actions of others as being hostile or aggressive. They respond by escalating the situation into verbal or physical conflict.

In adolescents and teens, conduct disorder may be associated with other difficulties, including:

In younger children, it can be more of a challenge to distinguish signs of conduct disorder from more typical "acting out".

At times, these same symptoms can be seen in children without the disorder. The difference is frequency, intensity, and duration, as well as to what extent it impacts their functioning. In children with conduct disorder, these behaviors happen much more frequently.

# data[].attributes.attachment_link.description
There are four basic types of behavior that characterize conduct disorder: Physical aggression (such as cruelty toward animals, assault or rape). Violating others' rights (such as theft or vandalism). Lying or manipulation. Delinquent behaviors (such as truancy or running away from home).

# data[].attributes.body
https://www.webmd.com/mental-health/mental-health-conduct-disorder

# data[].attributes.attachment_link.readable_text
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, dysregulated mood), 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."

# data[].attributes.attachment_link.description
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.

# data[].attributes.body
https://childmind.org/guide/quick-guide-to-conduct-disorder/

# data[].attributes.attachment_link.title
Quick Guide to Conduct Disorder - Child Mind Institute

# data[].attributes.attachment_link.description
Download our free guide to conduct disorder. Children who have conduct disorder are unkind and often violent, and they don’t care about other people’s feelings. Conduct disorder can also involve crimes like theft and vandalism.

# data[].attributes.body
https://www.healthline.com/health/conduct-disorder

# data[].attributes.attachment_link.readable_text
Conduct disorder is a group of behavioral and emotional problems that usually begins during childhood or adolescence. Children and adolescents with the disorder have a difficult time following rules and behaving in a socially acceptable way. They may display aggressive, destructive, and deceitful behaviors that can violate the rights of others. Adults and other children may perceive them as "bad" or delinquent, rather than as having a mental illness.

If your child has conduct disorder, they may appear tough and confident. In reality, however, children who have conduct disorder are often insecure and inaccurately believe that people are being aggressive or threatening toward them.

There are three types of conduct disorder. They're categorized according to the age at which symptoms of the disorder first occur:

Childhood onset occurs when the signs of conduct disorder appear before age 10.

Adolescent onset occurs when the signs of conduct disorder appear during the teenage years.

Unspecified onset means the age at which conduct disorder first occurs is unknown.

Some children will be diagnosed with conduct disorder with limited prosocial emotions. Children with this specific type of conduct disorder are often described as callous and unemotional.

Children who have conduct disorder are often hard to control and unwilling to follow rules. They act impulsively without considering the consequences of their actions. They also don't take other people's feelings into consideration. Your child may have conduct disorder if they persistently display one or more of the following behaviors:

aggressive conduct

deceitful behavior

destructive behavior

violation of rules

Aggressive Conduct

Aggressive conduct may include:

intimidating or bullying others

physically harming people or animals on purpose

committing rape

using a weapon

Deceitful Behavior

Deceitful behavior may include:

Destructive Behavior

Destructive conduct may include arson and other intentional destruction of property.

Violation of Rules

Violation of rules may include:

skipping school

running away from home

drug and alcohol use

sexual behavior at a very young age

Boys who have conduct disorder are more likely to display aggressive and destructive behavior than girls. Girls are more prone to deceitful and rule-violating behavior.

Additionally, the symptoms of conduct disorder can be mild, moderate, or severe:

Mild

If your child has mild symptoms, it means they display little to no behavior problems in excess of those required to make the diagnosis. Conduct problems cause relatively minor harm to others. Common issues include lying, truancy, and staying out after dark without parental permission.

Moderate

Your child has moderate symptoms if they display numerous behavior problems. These conduct problems may have a mild to severe impact on others. The problems may include vandalism and stealing.

Severe

Your child ha severe symptoms if they display behavior problems in excess of those required to make the diagnosis. These conduct problems cause considerable harm to others. The problems may include rape, use of a weapon, or breaking and entering.

Genetic and environmental factors may contribute to the development of conduct disorder.

Genetic Causes

Damage to the frontal lobe of the brain has been linked to conduct disorder. The frontal lobe is the part of your brain that regulates important cognitive skills, such as problem-solving, memory, and emotional expression. It's also home to your personality. The frontal lobe in a person with conduct disorder may not work properly, which can cause, among other things:

a lack of impulse control

a reduced ability to plan future actions

a decreased ability to learn from past negative experiences

The impairment of the frontal lobe may be genetic, or inherited, or it may be caused by brain damage due to an injury. A child may also inherit personality traits that are commonly seen in conduct disorder.

Environmental Factors

The environmental factors that are associated with conduct disorder include:

child abuse

a dysfunctional family

parents who abuse drugs or alcohol

poverty

The following factors may increase your child's risk of developing conduct disorder:

being male

living in an urban environment

living in poverty

having a family history of conduct disorder

having a family history of mental illness

having other psychiatric disorders

having parents who abuse drugs or alcohol

having a dysfunctional home environment

having a history of experiencing traumatic events

being abused or neglected

If your child is showing signs of conduct disorder, they should be evaluated by a mental health professional. They'll ask you and your child questions about their behavioral patterns to make a diagnosis. For a conduct disorder diagnosis to be made, your child must have a pattern of displaying at least three behaviors that are common to conduct disorder. Your child must also have shown at least one of the behaviors within the past six months. The behavioral problems must also significantly impair your child socially or at school.

Children with conduct disorder who are living in abusive homes may be placed into other homes. If abuse isn't present, your child's mental healthcare provider will use behavior therapy or talk therapy to help your child learn how to express or control their emotions appropriately. The mental healthcare provider will also teach you how to manage your child's behavior. If your child has another mental health disorder, such as depression or ADHD, the mental healthcare provider may prescribe medications to treat that condition as well.

Since it takes time to establish new attitudes and behavior patterns, children with conduct disorder usually require long-term treatment. However, early treatment may slow the progression of the disorder or reduce the severity of negative behaviors.

The long-term outlook for conduct disorder depends on the severity and frequency of your child's behavioral and emotional problems. Children who continuously display extremely aggressive, deceitful, or destructive behavior tend to have a poorer outlook. The outlook is also worse if other mental illnesses are present. However, getting a prompt diagnosis and receiving comprehensive treatment can significantly improve your child's outlook. Once treatment is received for conduct disorder and any other underlying conditions, your child has a much better chance of considerable improvement and hope for a more successful future.

Without treatment, your child is likely to have ongoing problems. They may be unable to adapt to the demands of adulthood, which can cause them to have problems with relationships and holding a job. They're also at an increased risk for substance abuse and problems with law enforcement. Your child may even develop a personality disorder, such as antisocial personality disorder, when they reach adulthood. This is why early diagnosis and treatment are critical. The earlier your child receives treatment, the better their outlook for the future will be.

# data[].attributes.attachment_link.title
Conduct Disorder: Types, Causes, and Symptoms

# data[].attributes.attachment_link.description
Conduct disorder is a group of behavioral and emotional problems that usually begins during childhood or adolescence. Children and adolescents with the disorder have a difficult time following rules and behaving in a socially acceptable way. They may display aggressive, destructive, and deceitful behaviors that can violate the rights of others.

# data[].attributes.body
https://www.cdc.gov/ncbddd/adhd/facts.html#:~:text=ADHD%20is%20one%20of%20the,)%2C%20or%20be%20overly%20active.

# data[].attributes.attachment_link.provider_name
Centers for Disease Control and Prevention

# data[].attributes.attachment_link.readable_text
ADHD is one of the most common neurodevelopmental disorders of childhood. It is usually first diagnosed in childhood and often lasts into adulthood. Children with ADHD may have trouble paying attention, controlling impulsive behaviors (may act without thinking about what the result will be), or be overly active.

Signs and Symptoms

It is normal for children to have trouble focusing and behaving at one time or another. However, children with ADHD do not just grow out of these behaviors. The symptoms continue, can be severe, and can cause difficulty at school, at home, or with friends.

A child with ADHD might:

daydream a lot

forget or lose things a lot

squirm or fidget

talk too much

make careless mistakes or take unnecessary risks

have a hard time resisting temptation

have trouble taking turns

have difficulty getting along with others

Learn more about signs and symptoms
Types

There are three different ways ADHD presents itself, depending on which types of symptoms are strongest in the individual:

Predominantly Inattentive Presentation: It is hard for the individual to organize or finish a task, to pay attention to details, or to follow instructions or conversations. The person is easily distracted or forgets details of daily routines.

Predominantly Hyperactive-Impulsive Presentation: The person fidgets and talks a lot. It is hard to sit still for long (e.g., for a meal or while doing homework). Smaller children may run, jump or climb constantly. The individual feels restless and has trouble with impulsivity. Someone who is impulsive may interrupt others a lot, grab things from people, or speak at inappropriate times. It is hard for the person to wait their turn or listen to directions. A person with impulsiveness may have more accidents and injuries than others.

Combined Presentation: Symptoms of the above two types are equally present in the person.

Because symptoms can change over time, the presentation may change over time as well.

Causes of ADHD

Scientists are studying cause(s) and risk factors in an effort to find better ways to manage and reduce the chances of a person having ADHD. The cause(s) and risk factors for ADHD are unknown, but current research shows that genetics plays an important role. Recent studies link genetic factors with ADHD.

In addition to genetics, scientists are studying other possible causes and risk factors including:

Brain injury

Exposure to environmental risks (e.g., lead) during pregnancy or at a young age

Alcohol and tobacco use during pregnancy

Premature delivery

Low birth weight

Research does not support the popularly held views that ADHD is caused by eating too much sugar, watching too much television, parenting, or social and environmental factors such as poverty or family chaos. Of course, many things, including these, might make symptoms worse, especially in certain people. But the evidence is not strong enough to conclude that they are the main causes of ADHD.

Diagnosis

Deciding if a child has ADHD is a process with several steps. There is no single test to diagnose ADHD, and many other problems, like anxiety, depression, sleep problems, and certain types of learning disabilities, can have similar symptoms. One step of the process involves having a medical exam, including hearing and vision tests, to rule out other problems with symptoms like ADHD. Diagnosing ADHD usually includes a checklist for rating ADHD symptoms and taking a history of the child from parents, teachers, and sometimes, the child.
Learn more about the criteria for diagnosing ADHD
Treatments

In most cases, ADHD is best treated with a combination of behavior therapy and medication. For preschool-aged children (4-5 years of age) with ADHD, behavior therapy, particularly training for parents, is recommended as the first line of treatment before medication is tried. What works best can depend on the child and family. Good treatment plans will include close monitoring, follow-ups, and making changes, if needed, along the way.
Learn more about treatments
Managing Symptoms: Staying Healthy

Being healthy is important for all children and can be especially important for children with ADHD. In addition to behavioral therapy and medication, having a healthy lifestyle can make it easier for your child to deal with ADHD symptoms. Here are some healthy behaviors that may help:

Get Help!

If you or your doctor has concerns about ADHD, you can take your child to a specialist such as a child psychologist, child psychiatrist, or developmental pediatrician, or you can contact your local early intervention agency (for children under 3) or public school (for children 3 and older).

The Centers for Disease Control and Prevention (CDC) funds the National Resource Center on ADHD, a program of CHADD - Children and Adults with Attention-Deficit/Hyperactivity Disorder. Their website has links to information for people with ADHD and their families. The National Resource Center operates a call center (1-866-200-8098) with trained staff to answer questions about ADHD.

For more information on services for children with special needs, visit the Center for Parent Information and Resources. To find the Parent Center near you, you can visit this website.

ADHD in Adults

ADHD can last into adulthood. Some adults have ADHD but have never been diagnosed. The symptoms can cause difficulty at work, at home, or with relationships. Symptoms may look different at older ages, for example, hyperactivity may appear as extreme restlessness. Symptoms can become more severe when the demands of adulthood increase. For more information about diagnosis and treatment throughout the lifespan, please visit the websites of the National Resource Center on ADHD and the National Institutes of Mental Health.

More Information

Reference

Faraone, S. V., Banaschewski, T., Coghill, D., Zheng, Y., Biederman, J., Bellgrove, M. A., . . . Wang, Y. (2021). The World Federation of ADHD International Consensus Statement: 208 evidence-based conclusions about the disorder. Neuroscience & Biobehavioral Reviews. doi:10.1016/j.neubiorev.2021.01.022

# data[].attributes.attachment_link.description
ADHD is one of the most common neurobehavioral disorders of childhood. It is usually first diagnosed in childhood and often lasts into adulthood. Children with ADHD have trouble paying attention, controlling impulsive behaviors (may act without thinking about what the result will be), and in some cases, are overly active.

# data[].attributes.body
https://www.nimh.nih.gov/health/topics/attention-deficit-hyperactivity-disorder-adhd

# data[].attributes.attachment_link.provider_name
National Institute of Mental Health (NIMH)

# data[].attributes.attachment_link.readable_text
What is ADHD?

Attention-deficit/hyperactivity disorder (ADHD) is marked by an ongoing pattern of inattention and/or hyperactivity-impulsivity that interferes with functioning or development. People with ADHD experience an ongoing pattern of the following types of symptoms:

Inattention means a person may have difficulty staying on task, sustaining focus, and staying organized, and these problems are not due to defiance or lack of comprehension.

Hyperactivity means a person may seem to move about constantly, including in situations when it is not appropriate, or excessively fidgets, taps, or talks. In adults, hyperactivity may mean extreme restlessness or talking too much.

Impulsivity means a person may act without thinking or have difficulty with self-control. Impulsivity could also include a desire for immediate rewards or the inability to delay gratification. An impulsive person may interrupt others or make important decisions without considering long-term consequences.

What are the signs and symptoms of ADHD?

What are the risk factors of ADHD?

How is ADHD treated?

How can I find a clinical trial for ADHD?

Where can I learn more about ADHD?

# data[].attributes.attachment_link.description
Learn about attention-deficit/hyperactivity disorder, including signs and symptoms, risk factors, treatments, and tips for staying organized with ADHD.

# data[].attributes.body
https://www.psychiatry.org/patients-families/adhd/what-is-adhd

# data[].attributes.body
https://www.nimh.nih.gov/health/topics/obsessive-compulsive-disorder-ocd#:~:text=Obsessive%2DCompulsive%20Disorder%20(OCD),to%20repeat%20over%20and%20over.

# data[].attributes.attachment_link.provider_name
National Institute of Mental Health (NIMH)

# data[].attributes.attachment_link.readable_text
Overview

Obsessive-Compulsive Disorder (OCD) is a common, chronic, and long-lasting disorder in which a person has uncontrollable, reoccurring thoughts ( obsessions) and/or behaviors ( compulsions) that he or she feels the urge to repeat over and over.

Signs and Symptoms

Risk Factors

Treatments and Therapies

Join a Study

# data[].attributes.attachment_link.description
Obsessive-Compulsive Disorder (OCD) is a common, chronic, and long-lasting disorder in which a person has uncontrollable, reoccurring thoughts ( obsessions) and/or behaviors ( compulsions) that he or she feels the urge to repeat over and over. Signs and Symptoms Risk Factors Treatments and Therapies Join a Study

# data[].attributes.body
https://psychiatry.org/patients-families/obsessive-compulsive-disorder/what-is-obsessive-compulsive-disorder

# data[].attributes.body
https://www.webmd.com/mental-health/obsessive-compulsive-disorder

# data[].attributes.attachment_link.readable_text
Obsessive-compulsive disorder (OCD) is a mental illness that causes repeated unwanted thoughts or sensations (obsessions). It also can give you an urge to do something over and over again (compulsions). Some people have both obsessions and compulsions.

OCD isn't about habits like biting your nails or thinking negative thoughts. An obsessive thought might be that certain numbers or colors are "good" or "bad." A compulsive habit might be to wash your hands seven times after touching something that could be dirty. Although you may not want to think or do these things, you feel like you can't stop.

Everyone has habits or thoughts that repeat sometimes. People with OCD have thoughts or actions that:

Take up at least an hour a day

Are beyond your control

Aren't enjoyable

Interfere with work, your social life, or another part of life

OCD comes in many forms, but most cases fall into at least one of four general categories:

Checking, such as locks, alarm systems, ovens, or light switches, or thinking you have a medical condition like pregnancy or schizophrenia.

Contamination, a fear of things that might be dirty or a having a compulsion to clean (you may hear this called "obsessive cleanliness disorder"). Mental contamination involves feeling like you've been treated like dirt.

Symmetry and ordering, the need to have things lined up in a certain way.

Ruminations and intrusive thoughts, an obsession with a line of thought. Some of these thoughts might be violent or disturbing.

[Self-Test] Do You Have Symptoms of OCD?

Many people who have OCD know that their thoughts and habits don't make sense. They don't do them because they enjoy them, but because they can't quit. And if they stop, they feel so bad that they start again.

Obsessive thoughts can include:

Worries about yourself or other people getting hurt

Constant awareness of blinking, breathing, or other body sensations

Suspicion that a partner is unfaithful with no reason to believe it

Worries about germs and dirt touching your body

Compulsive habits can include:

Doing tasks in a specific order every time or a certain "good" number of times

Needing to count things, like steps or bottles

Fear of touching doorknobs, using public toilets, or shaking hands

Rituals of washing and cleaning

Doctors aren't sure why some people have OCD. Stress can make symptoms worse.

It's a bit more common in women than in men. Symptoms often appear in teens or young adults.

OCD risk factors include:

A parent, sibling, or child with OCD

Physical differences in certain parts of your brain

Depression, anxiety, or tics

Experience with trauma

A history of physical or sexual abuse as a child

Sometimes, a child might have OCD after a streptococcal infection. This is called pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections, or PANDAS.

What Causes the Compulsion to Wash?

Experts believe OCD is caused by an abnormality in the brain's circuitry. Brain scans show brain activity is different in people with OCD. There's probably a genetic component too, especially when OCD begins in childhood. Of all adults with OCD, 1/3 to 1/2 say their illness started in childhood or adolescence.

Why is someone with the disease compelled to wash, as opposed to check or count or hoard? That's not known. It's true that with all types of OCD, you may act out a compulsion to relieve anxiety produced by an obsessive, intrusive thought.

Your doctor may do a physical exam and blood tests to make sure something else isn't causing your symptoms. They will also talk with you about your feelings, thoughts, and habits.

There's no cure for OCD. But you may be able to manage how your symptoms affect your life through medicine, therapy, or a combination of treatments.

Treatments include:

Psychotherapy. Cognitive behavioral therapy (CBT) can help change your thinking patterns. In a form called exposure and response prevention, your doctor will put you in a situation designed to create anxiety or set off compulsions. You'll learn to lessen and then stop your OCD thoughts or actions.

Relaxation. Simple things like meditation, yoga, and massage can help with stressful OCD symptoms.

Medication. Psychiatric drugs called selective serotonin reuptake inhibitors help many people control obsessions and compulsions. They might take 2 to 4 months to start working. Common ones include citalopram (Celexa), clomipramine (Anafranil), escitalopram (Lexapro), fluoxetine (Prozac), fluvoxamine, paroxetine (Paxil), and sertraline (Zoloft). If you still have symptoms, your doctor might give you antipsychotic drugs like aripiprazole (Abilify) or risperidone (Risperdal).

Neuromodulation. In rare cases, when therapy and medication aren't making enough of a difference, your doctor might talk to you about devices that change the electrical activity in a certain area of your brain. One kind, transcranial magnetic stimulation, is FDA-approved for OCD treatment. It uses magnetic fields to stimulate nerve cells. A more complicated procedure, deep brain stimulation, uses electrodes that are implanted in your head.

The Role of Family Members

Families often make the mistake of enabling loved ones with OCD. For instance, a person who sees their partner cleaning the house 3 or 4 hours a day may at first think they've got the world's greatest partner.

But that same person may later see their partner is irritable, exhausted, and their cleaning patterns are bizarre. So they may ask whether they think there's an issue. The partner may agree to get treatment because the person spoke up.

In this way, family members can play an important role in supporting a person with OCD. They may steer a loved one toward a diagnosis or help with treatment. They may participate in therapy. There are also support groups for people who have a loved one with OCD.

Some separate conditions are similar to OCD. They involve obsessions with things like:

Your looks (body dysmorphic disorder)

Collecting, arranging, or ordering things(hoarding disorder)

Pulling out/eating your hair(trichotillomania)

Picking at your skin (excoriation)

Worrying about your physical health (hypochondriasis)

Body odor or how you smell (olfactory reference syndrome)

# data[].attributes.attachment_link.description
Unwanted thoughts or habits that stand in the way of everyday life may be obsessive-compulsive disorder (OCD). Learn about its symptoms and treatment.

# data[].attributes.body
https://www.mayoclinic.org/diseases-conditions/obsessive-compulsive-disorder/symptoms-causes/syc-20354432

# data[].attributes.attachment_link.readable_text
Overview

Obsessive-compulsive disorder (OCD) features a pattern of unwanted thoughts and fears known as obsessions. These obsessions lead you to do repetitive behaviors, also called compulsions. These obsessions and compulsions get in the way of daily activities and cause a lot of distress.

Ultimately, you feel driven to do compulsive acts to ease your stress. Even if you try to ignore or get rid of bothersome thoughts or urges, they keep coming back. This leads you to act based on ritual. This is the vicious cycle of OCD.

OCD often centers around certain themes, such as being overly fearful of getting contaminated by germs. To ease contamination fears, you may wash your hands over and over again until they're sore and chapped.

If you have OCD, you may be ashamed, embarrassed and frustrated about the condition. But treatment can be effective.

Symptoms

Obsessive-compulsive disorder usually includes both obsessions and compulsions. But it's also possible to have only obsession symptoms or only compulsion symptoms. You may or may not know that your obsessions and compulsions are beyond reason. But they take up a great deal of time, reduce your quality of life, and get in the way of your daily routines and responsibilities.

Obsession symptoms

OCD obsessions are lasting and unwanted thoughts that keeping coming back or urges or images that are intrusive and cause distress or anxiety. You might try to ignore them or get rid of them by acting based on ritual. These obsessions usually intrude when you're trying to think of or do other things.

Obsessions often have themes, such as:

Fear of contamination or dirt.

Doubting and having a hard time dealing with uncertainty.

Needing things to be orderly and balanced.

Aggressive or horrific thoughts about losing control and harming yourself or others.

Unwanted thoughts, including aggression, or sexual or religious subjects.

Examples of obsession symptoms include:

Fear of being contaminated by touching objects others have touched.

Doubts that you've locked the door or turned off the stove.

Intense stress when objects aren't orderly or facing a certain way.

Images of driving your car into a crowd of people.

Thoughts about shouting obscenities or not acting the right way in public.

Unpleasant sexual images.

Staying away from situations that can cause obsessions, such as shaking hands.

Compulsion symptoms

OCD compulsions are repetitive behaviors that you feel driven to do. These repetitive behaviors or mental acts are meant to reduce anxiety related to your obsessions or prevent something bad from happening. But taking part in the compulsions brings no pleasure and may offer only limited relief from anxiety.

You may make up rules or rituals to follow that help control your anxiety when you're having obsessive thoughts. These compulsions are beyond reason and often don't relate to the issue they're intended to fix.

As with obsessions, compulsions usually have themes, such as:

Washing and cleaning.

Checking.

Counting.

Ordering.

Following a strict routine.

Demanding reassurance.

Examples of compulsion symptoms include:

Hand-washing until your skin becomes raw.

Checking doors over and over again to make sure they're locked.

Checking the stove over and over again to make sure it's off.

Counting in certain patterns.

Silently repeating a prayer, word or phrase.

Trying to replace a bad thought with a good thought.

Arranging your canned goods to face the same way.

Severity varies

OCD usually begins in the teen or young adult years, but it can start in childhood. Symptoms usually begin over time and tend to vary in how serious they are throughout life. The types of obsessions and compulsions you have also can change over time. Symptoms generally get worse when you are under greater stress, including times of transition and change. OCD, usually thought to be a lifelong disorder, can have mild to moderate symptoms or be so severe and time-consuming that it becomes disabling.

When to see a doctor

There's a difference between being a perfectionist - someone who needs flawless results or performance - and having OCD. OCD thoughts aren't simply excessive worries about real issues in your life or liking to have things clean or arranged in a specific way.

If your obsessions and compulsions affect your quality of life, see your doctor or mental health professional.

From Mayo Clinic to your inbox

Sign up for free and stay up to date on research advancements, health tips, current health topics, and expertise on managing health. Click here for an email preview.

Email field is required

Include a valid email address

Learn more about Mayo Clinic's use of data.

We use the data you provide to deliver you the content you requested. To provide you with the most relevant and helpful information, we may combine your email and website data with other information we have about you. If you are a Mayo Clinic patient, we will only use your protected health information as outlined in our Notice of Privacy Practices. You may opt out of email communications at any time by clicking on the unsubscribe link in the email.

Thank you for subscribing!

You'll soon start receiving the latest Mayo Clinic health information you requested in your inbox.

Sorry something went wrong with your subscription

Please, try again in a couple of minutes

Causes

The cause of obsessive-compulsive disorder isn't fully understood. Main theories include:

Biology. OCD may be due to changes in your body's natural chemistry or brain functions.

Genetics. OCD may have a genetic component, but specific genes have yet to be found.

Learning. Obsessive fears and compulsive behaviors can be learned from watching family members or learning them over time.

Risk factors

Factors that may raise the risk of causing obsessive-compulsive disorder include:

Family history. Having parents or other family members with the disorder can raise your risk of getting OCD.

Stressful life events. If you've gone through traumatic or stressful events, your risk may increase. This reaction may cause the intrusive thoughts, rituals and emotional distress seen in OCD.

Other mental health disorders. OCD may be related to other mental health disorders, such as anxiety disorders, depression, substance abuse or tic disorders.

Complications

Issues due to obsessive-compulsive disorder include:

Excessive time spent taking part in ritualistic behaviors.

Health issues, such as contact dermatitis from frequent hand-washing.

Having a hard time going to work or school or taking part in social activities.

Troubled relationships.

Poor quality of life.

Thoughts about suicide and behavior related to suicide.

Prevention

There's no sure way to prevent obsessive-compulsive disorder. However, getting treated as soon as possible may help keep OCD from getting worse and disrupting activities and your daily routine.

# data[].attributes.attachment_link.title
Obsessive-compulsive disorder (OCD) - Symptoms and causes

# data[].attributes.attachment_link.description
OCD features unwanted thoughts and fears, or obsessions. These obsessions lead to repetitive behaviors, also known as compulsions, that get in the way of daily activities.

# data[].attributes.body
https://www.nami.org/About-Mental-Illness/Mental-Health-Conditions/Obsessive-compulsive-Disorder

# data[].attributes.attachment_link.readable_text
Obsessive-compulsive disorder (OCD) is characterized by repetitive, unwanted, intrusive thoughts (obsessions) and irrational, excessive urges to do certain actions (compulsions). Although people with OCD may know that their thoughts and behavior don't make sense, they are often unable to stop them.

Symptoms typically begin during childhood, the teenage years or young adulthood, although males often develop them at a younger age than females. 1.2% of U.S. adults experience OCD each year.

Symptoms

Most people have occasional obsessive thoughts or compulsive behaviors. In an obsessive-compulsive disorder, however, these symptoms generally last more than an hour each day and interfere with daily life.

Obsessions are intrusive, irrational thoughts or impulses that repeatedly occur. People with these disorders know these thoughts are irrational but are afraid that somehow they might be true. These thoughts and impulses are upsetting, and people may try to ignore or suppress them.

Examples of obsessions include:

Thoughts about harming or having harmed someone

Doubts about having done something right, like turning off the stove or locking a door

Unpleasant sexual images

Fears of saying or shouting inappropriate things in public

Compulsions are repetitive acts that temporarily relieve the stress brought on by an obsession. People with these disorders know that these rituals don't make sense but feel they must perform them to relieve the anxiety and, in some cases, to prevent something bad from happening. Like obsessions, people may try not to perform compulsive acts but feel forced to do so to relieve anxiety.

Examples of compulsions include:

Hand washing due to a fear of germs

Counting and recounting money because a person is can't be sure they added correctly

Checking to see if a door is locked or the stove is off

"Mental checking" that goes with intrusive thoughts is also a form of compulsion

Causes

The exact cause of obsessive-compulsive disorder is unknown, but researchers believe that activity in several portions of the brain is responsible. More specifically, these areas of the brain may not respond normally to serotonin, a chemical that some nerve cells use to communicate with each other. Genetics are thought to be very important. If you, your parent or a sibling, have obsessive-compulsive disorder, there's around a 25% chance that another immediate family member will have it.

Diagnosis

A doctor or mental health care professional will make a diagnosis of OCD. A general physical with blood tests is recommended to make sure the symptoms are not caused by illicit drugs, medications, another mental illness, or by a general medical condition. The sudden appearance of symptoms in children or older people merits a thorough medical evaluation to ensure that another illness is not causing of these symptoms.

To be diagnosed with OCD, a person must have must have:

Obsessions, compulsions or both

Obsessions or compulsions that are upsetting and cause difficulty with work, relationships, other parts of life and typically last for at least an hour each day

Treatment

A typical treatment plan will often include both psychotherapy and medications, and combined treatment is usually optimal.

Medication, especially a type of antidepressant called a selective serotonin reuptake inhibitor (SSRI), is helpful for many people to reduce the obsessions and compulsions.

Psychotherapy is also helpful in relieving obsessions and compulsions. In particular,cognitive behavior therapy (CBT) and exposure and response therapy (ERT) are effective for many people. Exposure response prevention therapy helps a person tolerate the anxiety associated with obsessive thoughts while not acting out a compulsion to reduce that anxiety. Over time, this leads to less anxiety and more self-mastery.

Though OCD cannot be cured, it can be treated effectively. Read more on our treatment page.

Related Conditions

There are related conditions that share some characteristics with OCD but are considered separate conditions.

Body Dysmorphic Disorder. This disorder is characterized by an obsession with physical appearance. Unlike simple vanity, BDD is characterized by obsessing over one's appearance and body image, often for many hours a day. Any perceived flaws cause significant distress and ultimately impede on the person's ability to function. In some extreme cases, BDD can lead to bodily injury either due to infection because of skin picking, excessive exercise, or from having unnecessary surgical procedures to change one's appearance.

Hoarding Disorder. This disorder is defined by the drive to collect a large amount of useless or valueless items, coupled with extreme distress at the idea of throwing anything away. Over time, this situation can render a space unhealthy or dangerous to be in. Hoarding disorder can negatively impact someone emotionally, physically, socially and financially, and often leads to distress and disability. In addition, many hoarders cannot see that their actions are potentially harmful, and so may resist diagnosis or treatment.

Trichotillomania. Many people develop unhealthy habits such as nail biting or teeth grinding, especially during periods of high stress. Trichotillomania, however, is the compulsive urge to pull out (and possibly eat) your own hair, including eyelashes and eyebrows. Some people may consciously pull out their hair, while others may not even be aware that they are doing it. Trichotillomania can create serious injuries, such as repetitive motion injury in the arm or hand, or, if the hair is repeatedly swallowed, the formation of hairballs in the stomach, which can be life threatening if left untreated. A similar illness is excoriation disorder, which is the compulsive urge to scratch or pick at the skin.

# data[].attributes.attachment_link.description
Obsessive-compulsive disorder (OCD) is characterized by repetitive, unwanted, intrusive thoughts (obsessions) and irrational, excessive urges to do certain actions (compulsions). Although people with OCD may know that their thoughts and behavior don't make sense, they are often unable to stop them.

# data[].attributes.body
https://my.clevelandclinic.org/health/diseases/9490-obsessive-compulsive-disorder

# data[].attributes.attachment_link.readable_text
Overview

What is obsessive-compulsive disorder (OCD)?

Obsessive-compulsive disorder (OCD) is a mental illness, with a chronic (long-lasting) state of anxiety. It traps people in a constant cycle of repeated obsessions and compulsions:

OCD obsessions: People with OCD have repetitive and distressing fears or urges they can't control. These obsessive thoughts cause intense anxiety.

OCD compulsions: To control obsessions and anxiety, people with OCD turn to certain behaviors, rituals or routines. They do so repeatedly. They don't want to perform these compulsive behaviors and don't get pleasure from them. But they feel like they have to follow along or their anxiety will get worse. Compulsions only help temporarily, though. The obsessions soon come back, triggering a return to the compulsions. This loop leads to a constant cycle of anxiety.

Who gets obsessive-compulsive disorder (OCD)?

Everyone experiences obsessions and compulsions at some point. For example, it's common to occasionally double-check the stove or the locks. Some people also just like things neat. But OCD is more extreme. It can take up hours of a person's day. It gets in the way of normal life and activities.

OCD is fairly common, affecting about 1% of the population. It happens among people of all races and backgrounds, as well as both sexes. It usually starts when people are younger, from childhood to early adulthood.

Symptoms and Causes

What causes obsessive-compulsive disorder?

Scientists don't understand exactly what causes OCD. Certain factors or events may increase a person's chances of developing the condition, or cause an episode of OCD:

Changes in living situation, such as moving, getting married or divorced, or starting a new school or job.

Death of a loved one or other emotional trauma.

History of abuse.

Illness (if you get the flu, for example, you may start a cycle of obsessing about germs and washing compulsively).

Low levels of serotonin, a natural substance in the brain that maintains mental balance.

Overactivity in areas the brain.

Problems at work or school.

Problems with an important relationship.

What are the symptoms of obsessive-compulsive disorder?

The symptoms of OCD are obsessions and compulsions that interfere with normal activities. For example, symptoms may often prevent you from getting to work on time. Or you may have trouble getting ready for bed in a reasonable amount of time. A person with OCD may know they have a problem but can't stop.

What are examples of obsessive thoughts?

Obsessions are unwanted, intrusive thoughts that cause intense anxiety. Examples include:

Fear of germs or dirt.

Fear of causing harm to someone else.

Fear of making a mistake.

Fear of being embarrassed in public.

Feelings of doubt or disgust.

Need for order, neatness, symmetry or perfection.

Need for constant reassurance.

Sexual thoughts that society may consider unacceptable.

What are examples of compulsive behaviors?

Compulsions are actions someone takes in an attempt to get rid of obsessions or anxiety. Examples include:

Arranging things in a very specific way, such as items on your dresser.

Bathing, cleaning or washing hands over and over.

Checking certain things repeatedly, such as a lock or the stove.

Collecting or hoarding things that have no personal or financial value.

Constantly checking that you haven't done someone harm.

Counting repeatedly or saying certain words or prayers while doing other tasks.

Eating food in a specific order.

Refusing to shake hands or touch objects that other people touch a lot, like doorknobs.

Performing a task a specific number of times, such as always flipping a light switch seven times.

People with OCD may also have tics - brief, sudden, repetitive movements or actions, like:

Blinking their eyes.

Grunting.

Jerking their head.

Shrugging their shoulders.

Sniffling their nose or clearing their throat.

Diagnosis and Tests

How is obsessive-compulsive disorder (OCD) diagnosed?

There's no test for OCD. A healthcare provider makes the diagnosis after asking you about your symptoms. The provider uses criteria explained in the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition ( DSM-V).

People often use the phrases "obsessing," "obsessed" and "OCD" very casually in everyday conversations. But OCD, according to the DSM-V, is diagnosed based on specific factors:

The person has obsessions, compulsions or both.

The obsessions or compulsions take up a lot of time (more than an hour per day).

The obsessions or compulsions cause distress or affect participation in social activities, work responsibilities or other life events.

The symptoms aren't caused by drugs, alcohol, medications or another medical problem.

The symptoms aren't explained by another mental disorder (such as generalized anxiety disorder, eating disorder or body image disorder).

Management and Treatment

What treatments are available for obsessive-compulsive disorder (OCD)?

If you have symptoms of OCD that interfere with your daily life, you should talk to a healthcare provider. A professional who is specially trained in mental illness can offer several strategies:

Cognitive-behavioral therapy (CBT): Cognitive-behavioral therapy is a type of psychotherapy. You will talk to a therapist, who will help you examine and understand your thoughts and emotions. Over several sessions, CBT can help you stop negative habits, perhaps replacing them with healthier ways to cope.

Medications: Drugs called serotonin reuptake inhibitors (SRIs), selective SRIs (SSRIs) and tricyclic antidepressants may help. They increase levels of serotonin. Examples include clomipramine, fluoxetine, fluvoxamine, paroxetine and sertraline.

Exposure and response prevention (EX/RP): With this therapy, you do the thing that causes anxiety. The healthcare provider then prevents you from responding with a compulsion. For example, the provider may ask you to touch dirty objects but then stop you from washing your hands.

What happens if CBT and medications don't work for OCD? If OCD doesn't respond to CBT and medication, a healthcare provider may try to improve mood, specifically depression, with these therapies:

Electroconvulsive therapy (ECT): Electroconvulsive therapy uses electrodes that get attached to the head. These wires deliver electric shocks to the brain. The shocks cause small seizures, which help the brain release helpful chemicals.

Transcranial magnetic stimulation (TMS): Transcranial magnetic stimulation uses a magnetic device placed on the head. It delivers electrical impulses to the brain. The impulses cause the brain to release chemicals known to improve mood.

Your provider might suggest using mindfulness to treat OCD and to improve the usefulness of other OCD treatments.

Prevention

Can I prevent obsessive-compulsive disorder (OCD)?

You can't prevent OCD. But early diagnosis and treatment can help you reduce its symptoms and its effects on your life.

Outlook / Prognosis

What is the outlook for people with obsessive-compulsive disorder (OCD)?

With medication, CBT or both, most people with OCD can manage obsessions and compulsions and enjoy life.

Living With

When should I talk to my healthcare provider about obsessive-compulsive disorder (OCD)?

Talk to your healthcare provider if you have obsessions or compulsions. Make sure to mention:

How often you have symptoms.

How long they last.

Whether they make you late for work or social activities.

Whether you avoid social situations because of anxiety.

Whether you are using drugs or alcohol to cope.

Be honest with your healthcare provider about how the symptoms influence your life. Treatments are more effective when your provider understands how the condition affects you.

A note from Cleveland Clinic
OCD doesn't go away by itself, so talk to your healthcare provider about your symptoms. Be honest about any obsessions and compulsions and how they're affecting your life. CBT and medications can help control your symptoms, so you can work, enjoy social activities and feel more productive.

# data[].attributes.attachment_link.title
Obsessive Compulsive Disorder (OCD): Symptoms & Treatment

# data[].attributes.attachment_link.description
Obsessive-compulsive disorder (OCD) is a mental illness, with a chronic (long-lasting) state of anxiety. It traps people in a constant cycle of repeated obsessions and compulsions: OCD obsessions: People with OCD have repetitive and distressing fears or urges they can't control. These obsessive thoughts cause intense anxiety.

# data[].attributes.body
https://www.medicalnewstoday.com/articles/early-signs-of-schizophrenia-in-children

# data[].attributes.attachment_link.readable_text
Schizophrenia is a chronic, severe disorder that impacts the brain in a way that alters how someone feels, thinks, and acts. Childhood schizophrenia is incredibly rare, but it can occur.

Most people start to experience symptoms of schizophrenia between the ages of 16 and 30 years old, but in rare cases, children can develop schizophrenia.

Childhood schizophrenia is much less common than adult schizophrenia. Around 0.04% of people experience schizophrenia as children, while some 0.25%-0.64% of adults in the United States experience the disorder. That said, as researchers learn more about schizophrenia in children, and discover better ways to identify it, childhood-onset schizophrenia may become more common.

Keep reading to learn more about the early signs of schizophrenia in children, as well as the general symptoms of the condition, diagnosis, and the outlook for this condition.

Early signs of schizophrenia can be very difficult to detect in children and adolescents, because symptoms often overlap with adolescent changes in behavior and other more common childhood conditions.

Symptoms of schizophrenia may also be different in children and adolescents than in adults, and they may develop or worsen gradually over time.

Early signs of schizophrenia in children and adolescents include:

changing friends or having trouble keeping them

increase in unusual ideas and thoughts

hallucinations (seeing, smelling, hearing, or feeling things that are not real)

odd speech or behavior

confusing things from television and dreams from reality

personality changes

confused thinking

severe fearfulness and anxiety

trouble relating to peers

reduced self-care and hygiene

increased isolation or social withdrawal

paranoia (thinking that people are discussing them or out to get them)

attention problems

drop in academic performance and grades

irritability or extreme moodiness

problems sleeping

Schizophrenia can cause a wide range of symptoms that can drastically change someone's behaviors, thoughts, and feelings. Different people can also experience different symptoms of schizophrenia.

Some common symptoms of schizophrenia include:

delusions (believing something that is not true and often not realistic)

hallucinations

hearing voices that are not real

problems putting thoughts together in a cohesive way or struggling to make sense of what someone is saying

odd repetitive actions, strange mannerisms, or clumsiness

reduction or loss of the ability to speak, express emotion, find pleasure in things, and make plans

lack of expression

reduced ability to start and complete planned activities

social withdrawal

memory or attention problems

paranoia

No one knows why schizophrenia occurs. However, researchers think schizophrenia develops due to a combination of genetics, environmental factors, brain changes, and biochemical factors.

When early signs of schizophrenia develop in young people, they are experiencing a stage of the disorder known as the "prodromal" period. When someone is experiencing symptoms of schizophrenia such as delusions or hallucinations, they are in the "acute" or "relapse" stage. Once symptoms resolve they are in the "remission" stage.

While researchers still do not fully understand why people develop schizophrenia, there are certain risk factors that seem to increase someone's chances of experiencing it.

Risk factors for schizophrenia include:

family history of schizophrenia

brain chemistry, structure, and development

environmental factors stressful environments, exposure to viruses or nutritional deficiencies before birth, having an autoimmune disorder, and living in poverty

substance use, in particular taking mind-altering drugs

In most cases, a child psychiatrist will diagnose schizophrenia in a child if they experience symptoms or early warning signs of the disorder for at least 6 months.

For a proper diagnosis, two or more of the symptoms of schizophrenia someone experiences - such as hallucinations, disorganized speech or behavior, or delusions - must be severe and last for a minimum of 1 month. Before they diagnose a child with schizophrenia, a doctor will likely also perform a complete physical and neurological exam to rule out the potential of other conditions.

If someone's delusions are very bizarre, or if their hallucinations include a voice that is continuously commenting on their thoughts or behavior, or multiple voices that seem to be talking to each other, a doctor may diagnose schizophrenia even without any other symptoms being present.

Researchers are currently trying to find markers of schizophrenia - such as certain blood chemicals or abnormalities in brain scans - that doctors can use to detect the disorder earlier and allow for early treatment.

There is no cure for schizophrenia, but using a mix of medications and behavioral therapy can help manage the disorder.

Antipsychotic medications are the treatment of choice for schizophrenia because they reduce symptoms by impacting how nerves in the brain communicate. Someone taking antipsychotic medications to manage schizophrenia should never stop taking the medications without talking with a doctor first.

To find a treatment center that focuses on helping young people with schizophrenia, click here.
Learn more about treatment here.
Researchers and psychiatrists are still trying to understand many details about childhood schizophrenia, also known as very early onset schizophrenia. Some research suggests that people who experience symptoms of psychosis as children, such as delusions and hallucinations, may develop a more severe case of schizophrenia.

People who develop schizophrenia as children or young adolescents (under the age of 18) may also experience longer periods of untreated psychosis, and lower education levels.

If a child receives proper treatment after their first psychotic episode, the frequency and severity of future episodes are often drastically reduced. By some estimates, if someone receives proper treatment within 2-3 years after their first episode of psychosis, their risk of further episodes reduces by more than 50%, and prevents much of the disability linked with schizophrenia. For these reasons, early detection is incredibly important.

While it is very rare, children can develop psychosis and schizophrenia.

Childhood-onset schizophrenia is typically very difficult to recognize early because many of the hallmark symptoms are common in children without schizophrenia.

In particular, these include becoming more socially withdrawn, being very irritable or moody, becoming less successful at academics, changing friend groups, having trouble sleeping, and having reduced self-hygiene.

If a child's behavior, speech, or cognitive abilities start to change, talk with a doctor. Parents who notice changes in their children's behaviors or abilities should also talk with the child openly about what they are experiencing, as some children may decide to hide their internal symptoms out of fear of rejection or stigma.

# data[].attributes.attachment_link.keywords[]
early signs of schizophrenia in children

# data[].attributes.attachment_link.title
Schizophrenia in children: Signs and symptoms, causes, and more

# data[].attributes.attachment_link.description
Schizophrenia is a chronic, severe disorder that impacts the brain in a way that alters how someone feels, thinks, and acts. Childhood schizophrenia is incredibly rare, but it can occur. Most people start to experience symptoms of schizophrenia between the ages of 16 and 30 years old, but in rare cases, children can develop schizophrenia.

# data[].attributes.body
https://www.verywellmind.com/identifying-schizophrenia-in-children-4155780

# data[].attributes.attachment_link.readable_text
Learning your child has schizophrenia-or suspecting your child may have it-can feel overwhelming and scary. But early identification and treatment are important in managing the symptoms and improving your child's long-term prognosis.

Schizophrenia is a mental illness that causes people to interpret reality abnormally. It involves a range of cognitive, emotional, and behavioral problems that impair a child's ability to function.

Prevalence

Onset usually occurs between the late teens and the mid-thirties. The peak age of onset for males is the early twenties and for females the late twenties, but it may occur at any age. According to the Institute of Mental Health, about .25 to .64% of Americans have schizophrenia.﻿﻿

Childhood schizophrenia, characterized by onset before age 13, is only found in 1 in 40,000 children. Childhood schizophrenia presents special challenges in terms of diagnosis and treatment.﻿﻿

Scientists haven't found a single set of causes for schizophrenia. It's suspected that there are multiple genetic and environmental factors that play a role:﻿﻿

Genetic Factors - Family, twin, and adoption studies support a strong genetic component in schizophrenia. Parents of children with schizophrenia are ten times as likely to also develop schizophrenia.﻿﻿ If an identical twin has the illness, the likelihood that the other twin will develop schizophrenia is over 40 percent.﻿﻿

Environmental Factors - There may be some environmental factors that contribute to schizophrenia in children, especially if there are already genetic components at play. Prenatal infections, obstetric complications, and maternal famine may play a role.﻿﻿

Childhood schizophrenia is often associated with cognitive delays. Cognitive decline typically occurs at the time of onset of schizophrenia. Intellectual deficits appear to be stable over time without continued deterioration.﻿﻿

Hallucinations - Seeing or hearing things that aren't actually there

Delusions - False ideas that are believed by the individual but not by others

Disorganized thinking - Evidenced by derailed or incoherent speech

Flat affect - Monotone, diminished facial expressions, and appear apathetic

Paucity of speech or thought - Only speaking when prompted and replying with short answers

Bizarre behavior - Inappropriate, disorganized, or odd behavior inappropriate for a child's age

The course of schizophrenia varies from person to person. But, there are hallmark phases that individuals tend to experience.

Prodrome phase - Most individuals with schizophrenia experience some functional deterioration before the onset of psychotic symptoms.﻿﻿ Social withdrawal, bizarre preoccupations, unusual behavior, academic failure, or a decline in hygiene and self-care may begin before any signs of psychosis.

Acute phase - This phase is marked by prominent symptoms, such as hallucinations, delusions, disorganized speech and behavior, and a serious deterioration in functioning. This phase may last several months depending on the response to treatment.﻿﻿

Recuperative/Recovery phase - After the acute psychosis subsides, there is generally a several-month period when the individual continues to experience a significant impairment. Flat affect and social withdrawal are often present.﻿﻿

Residual phase - Children with schizophrenia may have several months or more between acute phases. However, most individuals will continue to be at least somewhat impaired. Some individuals never progress to residual symptoms and continue to have symptoms despite treatment.﻿﻿

When to See a Doctor

It's hard to identify schizophrenia in children. Young children have excellent imaginations so it's common for them to have imaginary friends with whom they carry on conversations. That type of pretend play doesn't mean your child is having hallucinations.

Kids also aren't good at telling adults about their symptoms. When young children are asked questions about hallucinations or delusions, many of them say yes. But, that doesn't mean they have psychosis.

Instead, in a paper published in 2013, researchers believe kids may report having those symptoms because they have overactive imaginations, cognitive limitations, or they simply misunderstand the question. So asking your child questions like, "Do you ever see things that no one else sees?" isn't likely to give you much insight into whether your child should see a doctor.﻿﻿

Symptoms also tend to begin gradually. Over time, however, a child may develop psychosis and the symptoms become much more obvious. If you notice developmental delays, strange eating rituals, bizarre behavior or ideas, change in academic performance, or social isolation, consult your child's doctor.

Since schizophrenia in children is rare, there's a good chance the symptoms may stem from something else. But it's important to find out the reasons for the changes that you're seeing.

There isn't a lab test that identifies schizophrenia. Mental health professionals make the diagnosis based on several factors, after gathering a full history, observing the child, and interviews with the parent and child. Other conditions must also be ruled out.

Schizophrenia Discussion Guide

Get our printable guide to help you ask the right questions at your next doctor's appointment.

Many of the symptoms of schizophrenia in children are also found in other disorders, such as autism spectrum disorders, mood disorders with psychotic features, or obsessive compulsive disorder.﻿﻿

Medical conditions may also result in psychosis. Central nervous system infections, endocrine disorders, genetic syndromes, autoimmune disorders, and toxic exposures may cause children to exhibit symptoms similar to those found in schizophrenia.﻿﻿

Drug use may also cause psychosis. Hallucinogenic mushrooms, stimulants, inhalants, and cannabis are just a few of the drugs that may lead to psychotic symptoms. Prescription drug misuse may also lead to acute psychosis. Symptoms resolve within a few days to weeks after the drug is discontinued.﻿﻿

All of those other conditions must be ruled out before a diagnosis of schizophrenia can be made.

Treatments

Antipsychotic medication is the primary treatment for schizophrenia in children as well as adults. Individuals with schizophrenia are at significant risk of relapse if antipsychotic medication is discontinued. It's essential for parents to maintain contact with physicians to monitor symptoms, side effects, and adherence.﻿﻿

Talk therapy may also be helpful to children with schizophrenia. Children and their parents may benefit from psychoeducation and problem-solving sessions. It may be important for siblings to get involved in therapy so they can understand their brother or sister's behavior.﻿﻿

Social skills training, relapse prevention, and basic life skills training may be helpful. Some children with schizophrenia may need specialized education programs or vocational training programs.

If a child becomes a danger to herself or others, a psychiatric hospitalization may be necessary. Inpatient treatment can be helpful in getting symptoms under control.

Childhood-onset schizophrenia is associated with low intellectual functioning and higher rates of negative symptoms across the lifespan. According to a 2011 study published in Pediatric Clinics of North America, childhood-onset schizophrenia is associated with greater social deficits in adulthood compared to those with other mental illnesses.﻿﻿

It's also been linked to lower level of employment and a lesser likelihood of living independently, compared to other psychiatric disorders.﻿﻿

Adolescents are at a higher risk of suicidal behavior during their first episode of psychosis. At least 5 percent of people who exhibited symptoms of schizophrenia before age 18 die by suicide or accidental death directly related to behaviors caused by their psychotic thinking.﻿﻿

If your child is having suicidal thoughts, contact the National Suicide Prevention Lifeline at 1-800-273-8255 for support and assistance from a trained counselor. If you or a loved one are in immediate danger, call 911.

Individuals with schizophrenia also are at a higher risk of physical health conditions such as heart disease, obesity, hepatitis, diabetes, and HIV. There isn't a cure for schizophrenia, but symptoms can be managed with treatment. Early intervention is key to improving the outcome for children with schizophrenia.﻿﻿

Coping and Support

Learning your child has schizophrenia-or suspecting that he or she may have it-can feel scary and overwhelming. It's important to learn as much as you can about schizophrenia in children, however, so you can best support and advocate for your child.

Ask your child's doctor for resources on schizophrenia. Attending support groups for people who have a family member diagnosed with schizophrenia could serve as a wealth of information.

The National Alliance on Mental Illness, NAMI, may also be a valuable resource. NAMI is a mental health organization who has local affiliates who provide support, education, and services in communities throughout the United States. NAMI may be able to help you locate the resources, tools, and information you need to help your child.

It's important to take care of yourself as well. Attend a support group or seek therapy for yourself. Managing your stress level will be key to helping you be best equipped to support your child.

# data[].attributes.attachment_link.title
Here Are the Warning Signs of Schizophrenia in Children

# data[].attributes.attachment_link.description
Learning your child has schizophrenia-or suspecting your child may have it-can feel overwhelming and scary. But early identification and treatment are important in managing the symptoms and improving your child's long-term prognosis. Schizophrenia is a mental illness that causes people to interpret reality abnormally.

# data[].attributes.body
https://childrensnational.org/visit/conditions-and-treatments/mental-health-behavioral-disorders/schizophrenia

# data[].attributes.attachment_link.readable_text
What is schizophrenia?

Schizophrenia is one of the most complex mental health disorders. It is a severe, chronic, and disabling disturbance of the brain that causes distorted thinking, strange feelings, unusual behavior, and use of language and words.

What causes schizophrenia?

There is no known single cause responsible for schizophrenia. It is believed that a chemical imbalance in the brain is an inherited factor which is necessary for schizophrenia to develop. it is more likely, however, that many factors - genetic, behavioral, and environmental - play a critical role in the development of this condition.

Schizophrenia is considered to be multifactorially inherited. Multifactorial inheritance means that many factors are involved. The factors usually are both genetic and environmental where a combination of genes from both parents, in addition to unknown environmental factors, produce the trait or condition. Often, one gender (either males or females) is affected more frequently than the other in multifactorial traits. There appears to be a different threshold of expression, which means that one gender is more likely to show the problem, over the other gender. Slightly more males develop schizophrenia in childhood; however, by adolescence, schizophrenia affects males and females equally.

Who is affected by schizophrenia?

Schizophrenia is uncommon in children under the age of 12 and hard to identify in the early phases. A sudden onset of the psychotic symptoms of schizophrenia frequently occurs in middle to late adolescence. Statistics indicate that schizophrenia affects 1 percent of the population in the United States. A child born into a family with one or more family members affected by schizophrenia has a greater chance of developing schizophrenia than a child born into a family with no history of schizophrenia.

After a person has been diagnosed with schizophrenia in a family, the chance for a sibling to also be diagnosed with schizophrenia is 7 to 8 percent. If a parent has schizophrenia, the chance for a child to have the disorder is 10 percent. Risks increase with multiple affected family members.

What are the symptoms of schizophrenia?

In children with schizophrenia, behavior changes may occur slowly, over time, or have a sudden onset. The child may gradually become more shy and withdrawn. They may begin to talk about bizarre ideas or fears and begin to cling more to parents. One of the most disturbing and puzzling characteristics of schizophrenia is the sudden onset of its psychotic symptoms. Psychotic refers to ideas, perceptions, or feelings that are grossly distorted from reality. The following are the most common symptoms of schizophrenia. Each child, however, may experience symptoms differently.

Early warning signs of schizophrenia in children may include:

distorted perception of reality (difficulty telling dreams from reality)

confused thinking, for example, confusing television with reality

detailed and bizarre thoughts and ideas

suspiciousness or paranoia (fearfulness that someone, or something, is going to harm them)

hallucinations (seeing, hearing, or feeling things that are not real such as hearing voices telling them to do something)

delusions (ideas that seem real but are not based in reality)

extreme moodiness

severe anxiety or fearfulness

flat affect (lack of emotional expression when speaking)

difficulty in performing schoolwork

social withdrawal (severe problems in making and keeping friends)

disorganized or catatonic behavior (suddenly becoming agitated and confused, or sitting and staring, as if immobilized)

odd behaviors, for example, an older child may regress significantly and begin acting like a younger child

The symptoms of schizophrenia often are classified as positive (symptoms including delusions, hallucinations and bizarre behavior), negative (symptoms including flat affect, withdrawal, and emotional unresponsiveness), disorganized speech (including speech that is incomprehensible), and disorganized or catatonic behavior (including marked mood swings, sudden aggression, or confusion, followed by sudden motionlessness and staring).

Symptoms of schizophrenia in children are similar to adults, however, children, more often (in 80 percent of diagnosed cases), experience auditory hallucinations and typically do not experience delusions or formal thought disorders until mid-adolescence or older. These symptoms of schizophrenia may resemble other problems or psychiatric conditions. Always consult your child's physician for a diagnosis.

How is schizophrenia diagnosed?

Schizophrenia in children and adolescents usually is diagnosed by a child and adolescent psychiatrist. Other mental health professionals usually participate in the completion of a comprehensive mental health evaluation to determine individualized treatment needs.

Treatment for Schizophrenia

Specific treatment for schizophrenia will be determined by your child's physician based on:

Your child's age, overall health, and medical history

Extent of the condition

Type of schizophrenia

Your child's tolerance for specific medications or therapies

Expectations for the course of the condition

Your opinion or preference

Schizophrenia is a major psychiatric illness. Treatment for schizophrenia is complex. A combination of therapies often is necessary to meet the individualized needs of the child or adolescent with schizophrenia. Treatment is aimed at reducing the symptoms associated with the disorder. Types of treatment that may be helpful to a child or adolescent with schizophrenia may include:

Medications (also called psychopharmacological management; to reduce the symptoms of schizophrenia), including the following:

Antipsychotic medications (previously known as neuroleptics) - medications that act against the symptoms of psychotic illness, but do not cure the illness. This specialized class of medications can reduce symptoms or reduce the severity of symptoms, and is used primarily to treat the pervasive, intrusive, and disturbing thoughts of a person with schizophrenia. They are designed to help minimize the severity of delusions and hallucinations the child is experiencing.

Mood stabilizing agents, such as lithium or valproic acid, especially in the initial phase of an illness episode

Individual and family psychotherapy

Specialized educational or structured activity programs which can include. social skills training, vocational training, speech and language therapy

Self-help and support groups

Prevention of Schizophrenia

Preventive measures to reduce the incidence of schizophrenia are not known at this time. Identification and early intervention, however, can improve the quality of life experienced by children and adolescents with schizophrenia. Treatment is most successful when symptoms of the first psychotic episode are addressed properly and promptly. It is crucial for a child or teen who is prescribed medications for the treatment of schizophrenia to remain adherent to the regimen. Dosages and types of medications may need to be adjusted periodically to maintain effectiveness. Always consult your child's physician for more information.

# data[].attributes.attachment_link.title
Pediatric Schizophrenia | Children's National Hospital

# data[].attributes.attachment_link.description
Schizophrenia is one of the most complex mental health disorders. It is a severe, chronic, and disabling disturbance of the brain that causes distorted thinking, strange feelings, unusual behavior, and use of language and words. There is no known single cause responsible for schizophrenia.

# data[].attributes.body
https://www.understood.org/en/articles/individuals-with-disabilities-education-act-idea-what-you-need-to-know?utm_source=google-search-grant&utm_medium=paid&utm_campaign=evrgrn-may20-fm&gclid=Cj0KCQjw1N2TBhCOARIsAGVHQc5DZ8PONbdJdFXR2uhQQuC9pydt0UcptFixmAsb2AI-jiDxc32gtvkaAoYMEALw_wcB

# data[].attributes.attachment_link.readable_text
By Andrew M.I. Lee, JD

At a glance

IDEA is the nation's special education law.

Schools must find and evaluate students thought to have disabilities - at no cost to families.

To qualify for IDEA services, a child must have a disability and need special education to make progress in school.

To get special education services for a child, you have to follow a legal process. The most important law for this process is the Individuals with Disabilities Education Act (IDEA).

IDEA is the nation's special education law. It gives rights and protections to kids with disabilities. It covers them from birth through high school graduation or age 21 (whichever comes first). Parents and legal guardians also have rights under the law.

IDEA places two big responsibilities on states and their public schools.

Schools must find and evaluate students who may have disabilities, at no cost to families. This is known as Child Find. If a child has a qualifying disability, schools must offer special education and related services (like speech therapy and counseling) to meet the child's unique needs. These are provided through an Individualized Education Program (IEP). The goal is to help students make progress in school.

Second, schools have to give parents a voice in their child's education. At every point in the process, IDEA gives parents specific rights and protections. These are called procedural safeguards. For example, one safeguard is that a school must get consent from parents before providing services to kids.

The reach of IDEA goes beyond traditional public schools. It includes public magnet and charter schools. The law also provides early intervention services to infants and toddlers up to age 3. Finally, IDEA may impact some students in private schools.

Dive deeper

The history and purpose of IDEA

Who is eligible for services under IDEA

How to get services under IDEA

Tell us what interests you

About the author

About the author

Andrew M.I. Lee, JD is an editor and attorney who strives to help people understand complex legal, education, and parenting issues.

Reviewed by

Reviewed by

Myrna Mandlawitz, MEd, JD has worked for over 20 years as a consultant/lobbyist on special and general education.

# data[].attributes.attachment_link.title
Individual with Disabilities Education Act (IDEA)

# data[].attributes.attachment_link.description
IDEA is the nation's special education law. Schools must find and evaluate students thought to have disabilities - at no cost to families. To qualify for IDEA services, a child must have a disability and need special education to make progress in school.

# data[].attributes.body
https://schoolcounselor.org/getmedia/4ef327d0-2cb6-4abc-b1fd-0eeec61019f3/mindsets-behaviors-draft-2021.pdf