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Information about Bipolar & Related Disorders

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Information about Bipolar & Related Disorders

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Depression: Causes, Symptoms, Types & Treatment

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Depression is a mood disorder that causes a persistent feeling of sadness and loss of interest in things and activities you once enjoyed. It’s treatable.

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Diagnosis

Your doctor may determine a diagnosis of depression based on:

Physical exam. Your doctor may do a physical exam and ask questions about your health. In some cases, depression may be linked to an underlying physical health problem.

Lab tests. For example, your doctor may do a blood test called a complete blood count or test your thyroid to make sure it's functioning properly.

Psychiatric evaluation. Your mental health professional asks about your symptoms, thoughts, feelings and behavior patterns. You may be asked to fill out a questionnaire to help answer these questions.

DSM-5. Your mental health professional may use the criteria for depression listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association.

Types of depression

Symptoms caused by major depression can vary from person to person. To clarify the type of depression you have, your doctor may add one or more specifiers. A specifier means that you have depression with specific features, such as:

Anxious distress - depression with unusual restlessness or worry about possible events or loss of control

Mixed features - simultaneous depression and mania, which includes elevated self-esteem, talking too much and increased energy

Melancholic features - severe depression with lack of response to something that used to bring pleasure and associated with early morning awakening, worsened mood in the morning, major changes in appetite, and feelings of guilt, agitation or sluggishness

Atypical features - depression that includes the ability to temporarily be cheered by happy events, increased appetite, excessive need for sleep, sensitivity to rejection, and a heavy feeling in the arms or legs

Psychotic features - depression accompanied by delusions or hallucinations, which may involve personal inadequacy or other negative themes

Catatonia - depression that includes motor activity that involves either uncontrollable and purposeless movement or fixed and inflexible posture

Peripartum onset - depression that occurs during pregnancy or in the weeks or months after delivery (postpartum)

Seasonal pattern - depression related to changes in seasons and reduced exposure to sunlight

Other disorders that cause depression symptoms

Several other disorders, such as those below, include depression as a symptom. It's important to get an accurate diagnosis, so you can get appropriate treatment.

Bipolar I and II disorders. These mood disorders include mood swings that range from highs (mania) to lows (depression). It's sometimes difficult to distinguish between bipolar disorder and depression.

Cyclothymic disorder. Cyclothymic (sy-kloe-THIE-mik) disorder involves highs and lows that are milder than those of bipolar disorder.

Disruptive mood dysregulation disorder. This mood disorder in children includes chronic and severe irritability and anger with frequent extreme temper outbursts. This disorder typically develops into depressive disorder or anxiety disorder during the teen years or adulthood.

Persistent depressive disorder. Sometimes called dysthymia (dis-THIE-me-uh), this is a less severe but more chronic form of depression. While it's usually not disabling, persistent depressive disorder can prevent you from functioning normally in your daily routine and from living life to its fullest.

Premenstrual dysphoric disorder. This involves depression symptoms associated with hormone changes that begin a week before and improve within a few days after the onset of your period, and are minimal or gone after completion of your period.

Other depression disorders. This includes depression that's caused by the use of recreational drugs, some prescribed medications or another medical condition.

Treatment

Medications and psychotherapy are effective for most people with depression. Your primary care doctor or psychiatrist can prescribe medications to relieve symptoms. However, many people with depression also benefit from seeing a psychiatrist, psychologist or other mental health professional.

If you have severe depression, you may need a hospital stay, or you may need to participate in an outpatient treatment program until your symptoms improve.

Here's a closer look at depression treatment options.

Medications

Many types of antidepressants are available, including those below. Be sure to discuss possible major side effects with your doctor or pharmacist.

Selective serotonin reuptake inhibitors (SSRIs). Doctors often start by prescribing an SSRI. These drugs are considered safer and generally cause fewer bothersome side effects than other types of antidepressants. SSRIs include citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Prozac), paroxetine (Paxil, Pexeva), sertraline (Zoloft) and vilazodone (Viibryd).

Serotonin-norepinephrine reuptake inhibitors (SNRIs). Examples of SNRIs include duloxetine (Cymbalta), venlafaxine (Effexor XR), desvenlafaxine (Pristiq, Khedezla) and levomilnacipran (Fetzima).

Atypical antidepressants. These medications don't fit neatly into any of the other antidepressant categories. They include bupropion (Wellbutrin XL, Wellbutrin SR, Aplenzin, Forfivo XL), mirtazapine (Remeron), nefazodone, trazodone and vortioxetine (Trintellix).

Tricyclic antidepressants. These drugs - such as imipramine (Tofranil), nortriptyline (Pamelor), amitriptyline, doxepin, trimipramine (Surmontil), desipramine (Norpramin) and protriptyline (Vivactil) - can be very effective, but tend to cause more-severe side effects than newer antidepressants. So tricyclics generally aren't prescribed unless you've tried an SSRI first without improvement.

Monoamine oxidase inhibitors (MAOIs). MAOIs - such as tranylcypromine (Parnate), phenelzine (Nardil) and isocarboxazid (Marplan) - may be prescribed, typically when other drugs haven't worked, because they can have serious side effects. Using MAOIs requires a strict diet because of dangerous (or even deadly) interactions with foods - such as certain cheeses, pickles and wines - and some medications and herbal supplements. Selegiline (Emsam), a newer MAOI that sticks on the skin as a patch, may cause fewer side effects than other MAOIs do. These medications can't be combined with SSRIs.

Other medications. Other medications may be added to an antidepressant to enhance antidepressant effects. Your doctor may recommend combining two antidepressants or adding medications such as mood stabilizers or antipsychotics. Anti-anxiety and stimulant medications also may be added for short-term use.

Finding the right medication

If a family member has responded well to an antidepressant, it may be one that could help you. Or you may need to try several medications or a combination of medications before you find one that works. This requires patience, as some medications need several weeks or longer to take full effect and for side effects to ease as your body adjusts.

Inherited traits play a role in how antidepressants affect you. In some cases, where available, results of genetic tests (done by a blood test or cheek swab) may offer clues about how your body may respond to a particular antidepressant. However, other variables besides genetics can affect your response to medication.

Risks of abruptly stopping medication

Don't stop taking an antidepressant without talking to your doctor first. Antidepressants aren't considered addictive, but sometimes physical dependence (which is different from addiction) can occur.

Stopping treatment abruptly or missing several doses can cause withdrawal-like symptoms, and quitting suddenly may cause a sudden worsening of depression. Work with your doctor to gradually and safely decrease your dose.

Antidepressants and pregnancy

If you're pregnant or breast-feeding, some antidepressants may pose an increased health risk to your unborn child or nursing child. Talk with your doctor if you become pregnant or you're planning to become pregnant.

Antidepressants and increased suicide risk

Most antidepressants are generally safe, but the Food and Drug Administration (FDA) requires all antidepressants to carry a black box warning, the strictest warning for prescriptions. In some cases, children, teenagers and young adults under age 25 may have an increase in suicidal thoughts or behavior when taking antidepressants, especially in the first few weeks after starting or when the dose is changed.

Anyone taking an antidepressant should be watched closely for worsening depression or unusual behavior, especially when starting a new medication or with a change in dosage. If you or someone you know has suicidal thoughts when taking an antidepressant, immediately contact a doctor or get emergency help.

Keep in mind that antidepressants are more likely to reduce suicide risk in the long run by improving mood.

Psychotherapy

Psychotherapy is a general term for treating depression by talking about your condition and related issues with a mental health professional. Psychotherapy is also known as talk therapy or psychological therapy.

Different types of psychotherapy can be effective for depression, such as cognitive behavioral therapy or interpersonal therapy. Your mental health professional may also recommend other types of therapies. Psychotherapy can help you:

Adjust to a crisis or other current difficulty

Identify negative beliefs and behaviors and replace them with healthy, positive ones

Explore relationships and experiences, and develop positive interactions with others

Find better ways to cope and solve problems

Identify issues that contribute to your depression and change behaviors that make it worse

Regain a sense of satisfaction and control in your life and help ease depression symptoms, such as hopelessness and anger

Learn to set realistic goals for your life

Develop the ability to tolerate and accept distress using healthier behaviors

Alternate formats for therapy

Formats for depression therapy as an alternative to face-to-face office sessions are available and may be an effective option for some people. Therapy can be provided, for example, as a computer program, by online sessions, or using videos or workbooks. Programs can be guided by a therapist or be partially or totally independent.

Before you choose one of these options, discuss these formats with your therapist to determine if they may be helpful for you. Also, ask your therapist if he or she can recommend a trusted source or program. Some may not be covered by your insurance and not all developers and online therapists have the proper credentials or training.

Smartphones and tablets that offer mobile health apps, such as support and general education about depression, are not a substitute for seeing your doctor or therapist.

Hospital and residential treatment

In some people, depression is so severe that a hospital stay is needed. This may be necessary if you can't care for yourself properly or when you're in immediate danger of harming yourself or someone else. Psychiatric treatment at a hospital can help keep you calm and safe until your mood improves.

Partial hospitalization or day treatment programs also may help some people. These programs provide the outpatient support and counseling needed to get symptoms under control.

Other treatment options

For some people, other procedures, sometimes called brain stimulation therapies, may be suggested:

Electroconvulsive therapy (ECT). In ECT, electrical currents are passed through the brain to impact the function and effect of neurotransmitters in your brain to relieve depression. ECT is usually used for people who don't get better with medications, can't take antidepressants for health reasons or are at high risk of suicide.

Transcranial magnetic stimulation (TMS). TMS may be an option for those who haven't responded to antidepressants. During TMS, a treatment coil placed against your scalp sends brief magnetic pulses to stimulate nerve cells in your brain that are involved in mood regulation and depression.

Clinical trials

Explore Mayo Clinic studies testing new treatments, interventions and tests as a means to prevent, detect, treat or manage this condition.

Lifestyle and home remedies

Depression generally isn't a disorder that you can treat on your own. But in addition to professional treatment, these self-care steps can help:

Stick to your treatment plan. Don't skip psychotherapy sessions or appointments. Even if you're feeling well, don't skip your medications. If you stop, depression symptoms may come back, and you could also experience withdrawal-like symptoms. Recognize that it will take time to feel better.

Learn about depression. Education about your condition can empower you and motivate you to stick to your treatment plan. Encourage your family to learn about depression to help them understand and support you.

Pay attention to warning signs. Work with your doctor or therapist to learn what might trigger your depression symptoms. Make a plan so that you know what to do if your symptoms get worse. Contact your doctor or therapist if you notice any changes in symptoms or how you feel. Ask relatives or friends to help watch for warning signs.

Avoid alcohol and recreational drugs. It may seem like alcohol or drugs lessen depression symptoms, but in the long run they generally worsen symptoms and make depression harder to treat. Talk with your doctor or therapist if you need help with alcohol or substance use.

Take care of yourself. Eat healthy, be physically active and get plenty of sleep. Consider walking, jogging, swimming, gardening or another activity that you enjoy. Sleeping well is important for both your physical and mental well-being. If you're having trouble sleeping, talk to your doctor about what you can do.

Alternative medicine

Alternative medicine is the use of a nonconventional approach instead of conventional medicine. Complementary medicine is a nonconventional approach used along with conventional medicine - sometimes called integrative medicine.

Make sure you understand the risks as well as possible benefits if you pursue alternative or complementary therapy. Don't replace conventional medical treatment or psychotherapy with alternative medicine. When it comes to depression, alternative treatments aren't a substitute for medical care.

Supplements

Examples of supplements that are sometimes used for depression include:

St. John's wort. Although this herbal supplement isn't approved by the Food and Drug Administration (FDA) to treat depression in the U.S., it may be helpful for mild or moderate depression. But if you choose to use it, be careful - St. John's wort can interfere with a number of medications, such as heart drugs, blood-thinning drugs, birth control pills, chemotherapy, HIV/AIDS medications and drugs to prevent organ rejection after a transplant. Also, avoid taking St. John's wort while taking antidepressants because the combination can cause serious side effects.

SAMe. Pronounced "sam-E," this dietary supplement is a synthetic form of a chemical that occurs naturally in the body. The name is short for S-adenosylmethionine (es-uh-den-o-sul-muh-THIE-o-neen). SAMe isn't approved by the FDA to treat depression in the U.S. It may be helpful, but more research is needed. SAMe may trigger mania in people with bipolar disorder.

Omega-3 fatty acids. These healthy fats are found in cold-water fish, flaxseed, flax oil, walnuts and some other foods. Omega-3 supplements are being studied as a possible treatment for depression. While considered generally safe, in high doses, omega-3 supplements may interact with other medications. More research is needed to determine if eating foods with omega-3 fatty acids can help relieve depression.

Nutritional and dietary products aren't monitored by the FDA the same way medications are. You can't always be certain of what you're getting and whether it's safe. Also, because some herbal and dietary supplements can interfere with prescription medications or cause dangerous interactions, talk to your doctor or pharmacist before taking any supplements.

Mind-body connections

Integrative medicine practitioners believe the mind and body must be in harmony for you to stay healthy. Examples of mind-body techniques that may be helpful for depression include:

Acupuncture

Relaxation techniques such as yoga or tai chi

Meditation

Guided imagery

Massage therapy

Music or art therapy

Spirituality

Aerobic exercise

Relying solely on these therapies is generally not enough to treat depression. They may be helpful when used in addition to medication and psychotherapy.

Coping and support

Talk with your doctor or therapist about improving your coping skills, and try these tips:

Simplify your life. Cut back on obligations when possible, and set reasonable goals for yourself. Give yourself permission to do less when you feel down.

Write in a journal. Journaling, as part of your treatment, may improve mood by allowing you to express pain, anger, fear or other emotions.

Read reputable self-help books and websites. Your doctor or therapist may be able to recommend books or websites to read.

Locate helpful groups. Many organizations, such as the National Alliance on Mental Illness (NAMI) and the Depression and Bipolar Support Alliance, offer education, support groups, counseling and other resources to help with depression. Employee assistance programs and religious groups also may offer help for mental health concerns.

Don't become isolated. Try to participate in social activities, and get together with family or friends regularly. Support groups for people with depression can help you connect to others facing similar challenges and share experiences.

Learn ways to relax and manage your stress. Examples include meditation, progressive muscle relaxation, yoga and tai chi.

Structure your time. Plan your day. You may find it helps to make a list of daily tasks, use sticky notes as reminders or use a planner to stay organized.

Don't make important decisions when you're down. Avoid decision-making when you're feeling depressed, since you may not be thinking clearly.

Preparing for your appointment

You may see your primary care doctor, or your doctor may refer you to a mental health professional. Here's some information to help you get ready for your appointment.

What you can do

Before your appointment, make a list of:

Any symptoms you've had, including any that may seem unrelated to the reason for your appointment

Key personal information, including any major stresses or recent life changes

All medications, vitamins or other supplements that you're taking, including dosages

Questions to ask your doctor or mental health professional

Take a family member or friend along, if possible, to help you remember all of the information provided during the appointment.

Some basic questions to ask your doctor include:

Is depression the most likely cause of my symptoms?

What are other possible causes for my symptoms?

What kinds of tests will I need?

What treatment is likely to work best for me?

What are the alternatives to the primary approach that you're suggesting?

I have these other health conditions. How can I best manage them together?

Are there any restrictions that I need to follow?

Should I see a psychiatrist or other mental health professional?

What are the main side effects of the medications you're recommending?

Is there a generic alternative to the medicine you're prescribing?

Are there any brochures or other printed material that I can have? What websites do you recommend?

Don't hesitate to ask other questions during your appointment.

What to expect from your doctor

Your doctor will likely ask you a number of questions. Be ready to answer them to reserve time to go over any points you want to focus on. Your doctor may ask:

When did you or your loved ones first notice your symptoms of depression?

How long have you felt depressed? Do you generally always feel down, or does your mood fluctuate?

Does your mood ever swing from feeling down to feeling intensely happy (euphoric) and full of energy?

Do you ever have suicidal thoughts when you're feeling down?

Do your symptoms interfere with your daily life or relationships?

Do you have any blood relatives with depression or another mood disorder?

What other mental or physical health conditions do you have?

Do you drink alcohol or use recreational drugs?

How much do you sleep at night? Does it change over time?

What, if anything, seems to improve your symptoms?

What, if anything, appears to worsen your symptoms?

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Depression is a mood disorder that causes a persistent feeling of sadness and loss of interest and can interfere with your daily functioning.

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Substance Abuse and Mental Health Services Administration

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Frequently Asked Questions - What is SAMHSA’s National Helpline?

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How to assist a person with Dysfunctional Behaviors

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How to assist a person with Dysfunctional Behaviors

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5 WAYS TO CHANGE A PERSON'S DYSFUNCTIONAL BEHAVIOUR | Hello Sunday Morning

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If there was one core question that the Hello Sunday Morning project is an attempt to try and answer, I believe that question would be 'how do we change the behaviour of those around us?' More specifically, how do we change a normalised, very attractive behaviour like binge drinking?

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Behavioral disorders can be described as a set of behaviors that cause negative emotional symptoms when left untreated.

Many of these disorders are detectable during childhood, and, if caught early can be treated effectively with behavioral interventions. Occasionally, medication is necessary, in addition to behavioral strategies.

Are Behavioral and Emotional Disorders the Same?

There is frequently an overlap in behavioral and emotional disorders, but certain characteristics are specifically indicative of behavioral disorders.

These disorders predominately relate to social and communication dynamics and adaptive functioning that shape the symptom profile outlines in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V). (1)

Major Causes of Behavioral Disorders

The data are mixed when determining the etiology of behavioral disorders. However, there is definitive evidence that alcoholism is a common teratogen responsible for cognitive disabilities, attention-deficit/hyperactivity disorder (ADHD), and other behavioral disorders. (2)

Genetic factors can also play a role in promoting or impeding mental health development during growth. There is evidence to suggest that children with parents diagnosed with schizophrenia have a substantially higher predisposition to this disorder when compared to children who have no family history of the disorder. (3)(4)

Treating Behavioral Disorders

Behavioral disorders are treated with routine psychotherapy by a licensed mental health clinician.

Occasionally, symptoms can be severe to the point where psychotropic medications are dispensed by a medical doctor as a necessary intervention to alleviate symptoms.

Generally, there is no cure for behavioral disorders. However, symptoms are often managed with optimistic and positive outcomes that may not have been achieved without intervention. It is important to have your child assessed if you suspect they could have a behavioral disorder.

Evidence-based treatment approaches, while using protective factors such as consistent and loving parenting skills, are the key to overcoming challenges associated with these disorders.

While self-help strategies are certainly encouraged, it is advisable to involve a licensed professional to guide the progress of the patient. For children, reinforcement schedules are very effective in shaping more advantageous behaviors and promoting an overall sense of well-being.

Diagnosing Behavioral Disorders

Behavioral disorders are diagnosed by a carefully selected list of psychological tests as well as observations and reports of past behavioral patterns. The examiner must determine the appropriate testing needed by reviewing the subject's cognitive, emotional, social, and behavioral functioning.

Testing is frequently used to determine appropriate treatment interventions, clarify the diagnosis, and monitor baseline progression. Testing can be divided into three main categories:

1. Intellectual assessment

Intellectual testing typically measures cognitive abilities with a set of subtests that correlate with IQ scores. (5) Examples of these tests include:

The test results can aid in determining a subject's overall cognitive profile, intellectual deficits, or even superior intellectual performance.

2. Personality tests

Measures of personality include tests that measure emotional, social, and behavioral themes. Frequently, the tests of choice are:

The construction of the test may be seen as largely unstructured, and the results are driven by correlations of categorized characteristics.

3. Clinical assessments

Clinical assessments evaluate dysfunctional behavior and the severity of organic anomalies, such as brain damage. The following assessments are commonly used in determining if an aberrant behavioral pattern exists:

The Beck assessments are a great tool for achieving a quick and concise evaluation of mood disorders in order to formulate treatment plans.

Differences Between Personality and Behavioral Disorders

Personality and behavioral disorders have many differences. Personality disorders are generally pervasive with a consistent pattern of dysfunctional behavior that is routinely intolerant of change.

Personality disorders include:

1. Paranoid personality disorder

A paranoid personality disorder is described as a marked distrust in others and a preoccupation with the suspiciousness of other's motives. Those affected frequently tend to carry grudges against others.

2. Schizoid personality disorder

A schizoid personality disorder is characterized by a significant detachment from others in a social setting. The affected individual prefers solitary activities and may be described as emotionally cold or aloof.

3. Antisocial personality disorder

An antisocial personality disorder is characterized by engaging in criminal behavior with a blatant disregard for the rights of others. Affected individuals are also known to lack empathy and have a bolstered ego.

4. Borderline personality disorder

Borderline personality disorder involves significant difficulty in maintaining healthy interpersonal connections. People with this disorder frequently describe feeling damaged and exhibit difficulty controlling angry outbursts.

5. Histrionic personality disorder

A histrionic personality disorder is characterized by a yearning to be the center of attention and considering relationships to have a deeper quality than what actually exists.

6. Narcissistic personality disorder

A narcissistic personality disorder is a condition wherein individuals thrive on a need for admiration and lack empathy towards others. They tend to feel a sense of entitlement and manifest arrogance and a haughty demeanor.

7. Avoidant personality disorder

An avoidant personality disorder is commonly known for feelings of oversensitivity and an intense fear of rejection. Affected individuals may avoid novel activities for fear of being ridiculed.

8. Dependent personality disorder

A dependent personality disorder is characterized by a need to be validated by others. People with this disorder have a fear of separation and feel helpless when alone. They also lean on others heavily for advice and decision making.

9. Obsessive-compulsive personality disorder

An obsessive-compulsive personality disorder is characterized by a need for perfectionism in performance. Those affected are generally described as inflexible and thrive on regimens and order.

Behavioral disorders include:

1. Intellectual disability

Intellectual disability is characterized by significant cognitive deficits in intellectual functioning determined through cognitive testing. The deficits are found to impair functioning across multiple adaptive settings.

2. Communication disorder

A communication disorder is characterized by abnormalities in speech and speech patterns that are infrequent at the age of the child.

3. Autism spectrum disorder

Autism spectrum disorder is characterized by deficits in social reciprocity and restrictive patterns in behaviors and interests.

4. Attention-deficit/hyperactivity disorder

Attention-deficit/hyperactivity disorder exhibits a marked inability to pay attention and easy distractibility. Affected individuals are frequently fidgety.

5. Tics disorder

Tics disorder is characterized in the DSM as sudden, rapid, non-rhythmic motor movement or vocalization. (6)

How Common Is Attention-Deficit/Hyperactivity Disorder (ADHD)?

Studies suggest that across cultural boundaries, ADHD affects about 5% of children (7) and 2.5% of adults. (8) It is typically more prevalent in males than in females. (7)

Risk Factors for Behavioral Disorders

Risk factors for behavioral disorders include genetic predisposition and exposure during the prenatal period of development.

Adverse social factors such as poverty, abuse, child-onset trauma, and medical illness that promote maladaptive qualities can also exacerbate the risk of exposure to behavioral disorders.

Final Word

Generally, there is no cure for behavioral disorders. However, symptoms are often managed with optimistic and positive outcomes that may not have been achieved without intervention. It is important to have your child assessed if you suspect they could have a behavioral disorder.

Evidence-based treatment approaches, while using protective factors such as consistent and loving parenting skills, are the key to overcoming challenges associated with these disorders.

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Behavioral Disorders: Causes, Diagnosis, and Treatment

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Behavioral disorders can be described as a set of behaviors that cause negative emotional symptoms when left untreated. Many of these disorders are detectable during childhood, and, if caught early can be treated effectively with behavioral interventions. Occasionally, medication is necessary, in addition to behavioral strategies.

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Cognitive behavioral therapy (CBT) is a form of psychological treatment that has been demonstrated to be effective for a range of problems including depression, anxiety disorders, alcohol and drug use problems, marital problems, eating disorders, and severe mental illness. Numerous research studies suggest that CBT leads to significant improvement in functioning and quality of life. In many studies, CBT has been demonstrated to be as effective as, or more effective than, other forms of psychological therapy or psychiatric medications.

It is important to emphasize that advances in CBT have been made on the basis of both research and clinical practice. Indeed, CBT is an approach for which there is ample scientific evidence that the methods that have been developed actually produce change. In this manner, CBT differs from many other forms of psychological treatment.

CBT is based on several core principles, including:

1. Psychological problems are based, in part, on faulty or unhelpful ways of thinking.

2. Psychological problems are based, in part, on learned patterns of unhelpful behavior.

3. People suffering from psychological problems can learn better ways of coping with them, thereby relieving their symptoms and becoming more effective in their lives.

CBT treatment usually involves efforts to change thinking patterns. These strategies might include:

Learning to recognize one's distortions in thinking that are creating problems, and then to reevaluate them in light of reality.

Gaining a better understanding of the behavior and motivation of others.

Using problem-solving skills to cope with difficult situations.

Learning to develop a greater sense of confidence in one's own abilities.

CBT treatment also usually involves efforts to change behavioral patterns. These strategies might include:

Facing one's fears instead of avoiding them.

Using role playing to prepare for potentially problematic interactions with others.

Learning to calm one's mind and relax one's body.

Not all CBT will use all of these strategies. Rather, the psychologist and patient/client work together, in a collaborative fashion, to develop an understanding of the problem and to develop a treatment strategy.

CBT places an emphasis on helping individuals learn to be their own therapists. Through exercises in the session as well as "homework" exercises outside of sessions, patients/clients are helped to develop coping skills, whereby they can learn to change their own thinking, problematic emotions, and behavior.

CBT therapists emphasize what is going on in the person's current life, rather than what has led up to their difficulties. A certain amount of information about one's history is needed, but the focus is primarily on moving forward in time to develop more effective ways of coping with life.

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Numerous research studies suggest that cognitive behavioral therapy leads to significant improvement in functioning and quality of life.

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Play therapy is a form of therapy used primarily for children. That's because children may not be able to process their own emotions or articulate problems to parents or other adults.

While it may look like an ordinary playtime, play therapy can be much more than that.

A trained therapist can use playtime to observe and gain insights into a child's problems. The therapist can then help the child explore emotions and deal with unresolved trauma. Through play, children can learn new coping mechanisms and how to redirect inappropriate behaviors.

Play therapy is practiced by a variety of licensed mental health professionals, like psychologists and psychiatrists. It's also practiced by behavioral and occupational therapists, physical therapists, and social workers.

In addition, the Association for Play Therapy offers specialized training programs and advanced credentials for licensed mental health professionals, school counselors, and school psychologists.

According to the professional organization Play Therapy International, up to 71 percent of children referred to play therapy may experience positive change.

While some children might start off with some hesitation, trust in the therapist tends to grow. As they become more comfortable and their bond strengthens, the child may become more creative or more verbal in their play.

Some of the potential benefits of play therapy are:

taking more responsibility for certain behaviors

developing coping strategies and creative problem-solving skills

self-respect

empathy and respect for others

alleviation of anxiety

learning to fully experience and express feelings

stronger social skills

stronger family relationships

Play therapy can also encourage use of language or improve fine and gross motor skills.

If your child has a diagnosed mental or physical illness, play therapy doesn't replace medications or any other necessary treatments. Play therapy can be used alone or alongside other therapies.

Although people of all ages can benefit from play therapy, it's typically used with children between the ages of 3 and 12. Play therapy may be helpful in a variety of circumstances, such as:

There's a bit of a communication gap between children and adults. Depending on age and stage of development, children simply don't have the language skills of adults. They may feel something, but in many cases, they either can't express it to an adult or don't have a trusted adult to express it to.

On the other end, adults can misinterpret or completely miss the child's verbal and nonverbal cues.

Children learn to understand the world and their place in it through play. It's where they're free to act out their inner feelings and deepest emotions. Toys can act as symbols and take on greater meaning - if you know what to look for.

Since the child can't adequately express themselves in the adult world, the therapist joins the child in their world, on their level.

As they play, the child may become less guarded and more apt to share their feelings. But they aren't pressured. They're allowed to do so in their own time and with their own method of communication.

Play therapy will differ depending on the therapist and the particular needs of the child. To begin, the therapist may want to observe the child at play. They may also want to conduct separate interviews with the child, parents, or teachers.

After a thorough assessment, the therapist will set some therapeutic goals, decide on what limits may be necessary, and formulate a plan for how to proceed.

Play therapists pay close attention to how a child handles being separated from the parent, how they play alone, and how they react when the parent returns.

Much can be revealed in how a child interacts with different types of toys and how their behavior changes from session to session. They may use play to act out fears and anxieties, as a soothing mechanism, or to heal and problem-solve.

Play therapists use these observations as a guide to the next steps. Each child is different, so therapy will be tailored to their individual needs. As therapy progresses, behaviors and goals can be reassessed.

At some point, the therapist may bring parents, siblings, or other family members into play therapy. This is known as filial therapy. It can help teach conflict resolution, promote healing, and improve family dynamics.

Sessions typically last 30 minutes to an hour and are held once a week or so. How many sessions are needed depends on the child and how well they respond to this type of therapy. Therapy can take place individually or in groups.

Play therapy can be directive or nondirective. In the directive approach, the therapist will take the lead by specifying the toys or games that'll be used in the session. The therapist will guide the play with a specific goal in mind.

The nondirective approach is less structured. The child is able to choose toys and games as they see fit. They're free to play in their own way with few instructions or interruptions. The therapist will observe closely and participate as appropriate.

Sessions must take place in an environment where the child feels safe and where there are few limitations. The therapist may use techniques that involve:

creative visualization

storytelling

role-playing

toy phones

puppets, stuffed animals, and masks

dolls, action figures

arts and crafts

water and sand play

blocks and construction toys

dance and creative movement

musical play

Depending on the child and the situation, the therapist will either guide the child toward certain methods of play or let them choose for themselves. There are any number of ways the therapist can use play therapy to get to know the child and help them cope with their problems.

For example, the therapist might offer the child a dollhouse and some dolls, asking them to act out some problems they have at home. Or they might encourage the child to use hand puppets to recreate something they found stressful or frightening.

They might ask your child to tell a "once upon a time" story to see what the child might bring to light. Or they might read stories that solve a problem similar to your child's. This is referred to as bibliotherapy.

It could be as simple as asking questions while your child is drawing or painting to try to gain insights into their thought process. Or play various games with the child to encourage problem-solving, cooperation, and social skills.

Play isn't just for kids, and neither is play therapy. Teenagers and adults can also have a difficult time expressing their innermost feelings in words. Adults who may benefit from play therapy include those affected by:

When working with adults, a therapist may use dramatic role-playing or sand-tray therapy to help you get in touch with feelings that are hard to talk about. These therapies can help you work on strategies for dealing with particular scenarios.

The very act of playing, whether it's games, arts and crafts, or music and dance, can help you relax and unwind from the stresses of everyday life.

Art therapy, music therapy, and movement can help reveal hidden traumas and promote healing. Under the guidance of an experienced therapist, play can be a valuable tool in getting you where you want to be.

Play therapy for adults may be used as a complement to other types of therapy and medications. As with children, the therapist will tailor play therapy to your specific needs.

Play therapy is a method of therapy that uses play to uncover and deal with psychological issues. It can be used on its own, particularly with children, or along with other therapies and medications.

To get the most out of play therapy, look for a licensed mental health professional experienced in this type of therapy. Your pediatrician or primary care doctor can make a referral.

If you don't already have a mental health professional, the Healthline FindCare tool can help you find one in your area.

You may also choose to search for a credentialed registered play therapist (RPT) or registered play therapist-supervisor (RPT-S) through the Association for Play Therapy.

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Play Therapy: What Is It, How It Works, and Techniques

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Play therapy is a form of therapy used primarily for children. That's because children may not be able to process their own emotions or articulate problems to parents or other adults. While it may look like an ordinary playtime, play therapy can be much more than that.

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Guidance Counselor / The Referral Process

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The purpose of the referral process is to provide timely and effective support to initiate an appropriate plan of action for students at various levels of need. The School Counselor recognizes the contribution of all members of the school community including educators, parent/guardians, and student…

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Individuals with Disabilities Education Act

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The Individuals with Disabilities Education Act (IDEA) is a law that makes available a free appropriate public education to eligible children with disabilities throughout the nation and ensures special education and related services to those children.

The IDEA governs how states and public agencies provide early intervention, special education, and related services to more than 8 million (as of school year 2022-23) eligible infants, toddlers, children, and youth with disabilities.

Infants and toddlers, birth through age 2, with disabilities and their families receive early intervention services under IDEA Part C. Children and youth ages 3 through 21 receive special education and related services under IDEA Part B.

Additionally, the IDEA authorizes:

Formula grants to states to support special education and related services and early intervention services.

Discretionary grants to state educational agencies, institutions of higher education, and other nonprofit organizations to support research, demonstrations, technical assistance and dissemination, technology development, personnel preparation and development, and parent-training and -information centers.

Congress reauthorized the IDEA in 2004 and most recently amended the IDEA through Public Law 114-95, the Every Student Succeeds Act, in December 2015.

In the law, Congress states:

Disability is a natural part of the human experience and in no way diminishes the right of individuals to participate in or contribute to society. Improving educational results for children with disabilities is an essential element of our national policy of ensuring equality of opportunity, full participation, independent living, and economic self-sufficiency for individuals with disabilities.

Other Laws for Children with Disabilities

The U.S. Department of Education's Office for Civil Rights (OCR) provides additional resources of interest for individuals with disabilities and their families.

OCR does not enforce the IDEA; however, OCR does enforce the Rehabilitation Act of 1973, Section 504 and Americans with Disabilities Act of 1990, Title II rights of IDEA-eligible students with disabilities.

To learn more, visit the OCR's Frequently Asked Questions About Section 504 and the Education of Children with Disabilities.

Visit OCR's website for additional resources.

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About IDEA - Individuals with Disabilities Education Act

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The IDEA is a law that makes available a free appropriate public education to eligible children with disabilities throughout the nation and ensures special education and related services to those children.

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If a child is eligible for special education services, the admission, review, and dismissal (ARD) committee is required to develop an individualized education program (IEP). [34 CFR §300.320 - Definition of individualized education program.]

The ARD committee must consider:

The most recent evaluation

The strengths of the child

Parent input

Academic, developmental, and functional needs of the child

The IEP must contain:

A statement of present levels of academic achievement and functional performance (PLAAFP)

A statement of annual goal(s) and how progress toward meeting the annual goal will be measured. For students with disabilities who take alternate assessment, a description of benchmarks or short-term objectives must be included (see information for Question and Answer Document: Individualized Education Program (IEP) Measurable Annual Goals below)

A description of special education and related services designed to meet the student's needs

A description of the frequency for reporting progress to the parents

A statement of participation in state and districtwide assessments (see information for the STAAR Alternate 2 Eligibility module below)

A description of opportunities to participate in extracurricular and nonacademic activities or justification for nonparticipation

A description of the instructional setting and lengths of the student's school day

A written statement of the IEP must document the decisions of the ARD committee with respect to issues discussed at each ARD committee meeting. The written statement must also include: (1) the date of the meeting; (2) the name, position, and signature of each member participating in the meeting; and (3) an indication of whether the child's parents, the adult student, if applicable, and the administrator agreed or disagreed with the decisions of the ARD committee.

Completion of the requirements for transition services (beginning for a student not later than when the student reaches 14 years of age)

Documentation of information provided to the parents and student regarding transfer of rights at age of majority

Completion of supplements for additional areas that are addressed for children with certain disabilities or needs:

Student who is blind or visually impaired

Transportation

Extended school year

Autism (Autism Supplement Guidance Document)

Placement in a residential educational placement

Placement at the Texas School for the Blind and Visually Impaired (TSBI) or the Texas School for the Deaf

Behavior intervention plan

The Texas Education Agency (TEA) has developed a model individualized education program form. The form contains only the required components of an IEP set out in the IDEA and all state-imposed requirements relevant to an individualized education program not required under federal law. (see TEC 29.0051)

Senate Bill (SB) 89, passed during the 87th Regular Texas Legislative Session, was signed into law on June 7, 2021, by Governor Abbott, and took effect immediately.

No later than May 1, 2022, Admission, Review, and Dismissal (ARD) committees must complete a required supplement as a written statement included in the child's IEP.

Access more information from TEA about implementation of SB 89 at the following:

House Bill 4545 recently passed in the 87th Regular Legislative Session . The new statute is effective, as of June, 2021, with acceleration instruction practices required during the 2021-2022 school year for all students, based on results from Spring 2021.

HB 4545 establishes new requirements for accelerated instruction for students who do not pass the State of Texas Assessments of Academic Readiness (STAAR®).

Access more information from TEA about House Bill 4545 and accelerated learning resources at the following:

Click HERE to register for access the Writing PLAAFP and Developing Measurable Annual Goals recording.
This webinar consists of content related to PLAAFPs (the federal law and state guidance related to PLAAFPs that identify a student's strengths, baseline data, and critical areas of need), annual academic goals (the purpose and importance of measurable annual goals and a four-step process for developing annual academic goals), and annual functional goals (the purpose and importance of functional goals and a four-step process for developing a functional goal).

Technical Assistance: Individualized Education Program (IEP) Development
This Technical Assistance: Individualized Education Program (IEP) Development from the Texas Education Agency provides helpful, general information for local education agencies (LEAs) and parents to develop an IEP that is individualized and based on the unique needs of the child, and is designed to enable him or her to work towards grade level content standards and achieve challenging goals.

STAAR Alternate 2 Eligibility Module
As part of the Texas Education Agency's (TEA) ongoing efforts to improve the state's testing program, the Student Assessment Division has developed a web-based training, the STAAR Alternate 2: Eligibility module to provide guidance to Admission, Review and Dismissal (ARD) committees to make assessment decisions based on state guidelines. This module helps ARD committee members assure that only students with significant cognitive disabilities are assessed with an alternate assessment. It is designed to supplement, not replace, the mandatory training required of all personnel involved in testing.

Standards-Based Individualized Education Program (IEP) Process Training
A training was created by the Child Find, Evaluation, and ARD Support Statewide Technical Assistance Network in collaboration with the Texas Education Agency with state and federal grants that focuses on developing present levels of academic achievement and functional performance (PLAAFP) development based on student data, drafting annual goals (academic and/or functional) and objectives, if appropriate, and collecting data for reporting progress. Participants will understand the importance of these components and how their alignment results in an appropriate and ambitious individualized education program for students receiving special education and related services. The intended audience for this training is special education teachers, related service providers, and any other professional staff responsible for drafting a student's IEP, including present levels of academic achievement and functional performance and measurable annual goals.

Please contact your regional education service center (ESC) for information about session details.

Standards-Based Individualized Education Program (IEP) Process: Implications for Administrators
The focus of this session is to learn more about the Standards-Based IEP Process. The primary focus of the training is to review the role of the administrator (or LEA representative in an Admission, Review, or Dismissal (ARD) committee meeting in reviewing the full and individual evaluation (FIE), developing present levels of academic achievement and functional performance (PLAAFP) development, drafting measurable annual goals, and objectives if appropriate, and creating a data collection system for progress monitoring. This training was created by the Child Find, Evaluation, and ARD Support Statewide Technical Assistance Network in collaboration with the Texas Education Agency with state and federal grants.
Please contact your regional education service center (ESC) for information about session details.

Standards-Based Individualized Education Program (IEP) Process: Implications for Evaluation Personnel
The focus of this session is to learn more about the Standards-Based IEP Process. The primary focus of the training is on the full and individual evaluation (FIE), present levels of academic achievement and functional performance (PLAAFP) development and writing goals and objectives. This training was created by the Child Find, Evaluation, and ARD Support Statewide Technical Assistance Network in collaboration with the Texas Education Agency with state and federal grants.
Please contact your regional education service center (ESC) for information about session details.

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The Individualized Education Program (IEP)

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If a child is eligible for special education services, the admission, review, and dismissal (ARD) committee is required to develop an individualized education program (IEP). [34 CFR §300.320 - Definition of individualized education program.]

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Baldridge, I. C., & Piotrowski, N. A., PhD. (2022). Obsessive-compulsive disorder. Magill’s Medical Guide (Online Edition).

Gage, N. A. (2013). Characteristics of Students with Emotional Disturbance Manifesting Internalizing Behaviors: A Latent Class Analysis. Education and Treatment of Children, 36(4), 127–145.

Missouri Department of Elementary and Secondary Education. (2015). Professional School Counselor Referral Process Guide. Missouri Comprehensive School Counseling Program: Responsive Services. http://www.missouricareereducation.org/doc/referral/ReferralProcess.pdf

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Smitha Bhandari, MD on January 21, 2020

Schizophrenia is a chronic, severe mental disorder that affects the way a person thinks, acts, expresses emotions, perceives reality, and relates to others. Though schizophrenia isn't as common as other major mental illnesses, it can be the most chronic and disabling.

People with schizophrenia often have problems doing well in society, at work, at school, and in relationships. They might feel frightened and withdrawn, and could appear to have lost touch with reality. This lifelong disease can't be cured but can be controlled with proper treatment.

Contrary to popular belief, schizophrenia is not a split or multiple personality. Schizophrenia involves a psychosis, a type of mental illness in which a person can't tell what's real from what's imagined. At times, people with psychotic disorders lose touch with reality. The world may seem like a jumble of confusing thoughts, images, and sounds. Their behavior may be very strange and even shocking. A sudden change in personality and behavior, which happens when people who have it lose touch with reality, is called a psychotic episode.

How severe schizophrenia is varies from person to person. Some people have only one psychotic episode, while others have many episodes during a lifetime but lead relatively normal lives in between. Still others may have more trouble functioning over time, with little improvement between full-blown psychotic episodes. Schizophrenia symptoms seem to worsen and improve in cycles known as relapses and remissions.

What Are the Early Symptoms of Schizophrenia?

The condition usually shows its first signs in men in their late teens or early 20s. It mostly affects women in their early 20s and 30s. The period when symptoms first start and before full psychosis is called the prodromal period. It can last days, weeks, or even years. It can be hard to spot because there's usually no specific trigger. You might only notice subtle behavioral changes, especially in teens. This includes:

A change in grades

Social withdrawal

Trouble concentrating

Temper flares

Difficulty sleeping

Positive Symptoms of Schizophrenia

In this case, the word positive doesn't mean good. It refers to added thoughts or actions that aren't based in reality. They're sometimes called psychotic symptoms and can include:

Delusions: These are false, mixed, and sometimes strange beliefs that aren't based in reality and that the person refuses to give up, even when shown the facts. For example, a person with delusions may believe that people can hear their thoughts, that they are God or the devil, or that people are putting thoughts into their head or plotting against them.

Hallucinations: These involve sensations that aren't real. Hearing voices is the most common hallucination in people with schizophrenia. The voices may comment on the person's behavior, insult them, or give commands. Less common types include seeing things that aren't there, smelling strange odors, having a funny taste in your mouth, and feeling sensations on your skin even though nothing is touching your body.

Catatonia: In this condition, the person may stop speaking, and their body may be fixed in a single position for a very long time.

Disorganized Symptoms of Schizophrenia

These are positive symptoms that show that the person can't think clearly or respond as expected. Examples include:

Talking in sentences that don't make sense or using nonsense words, making it difficult for the person to communicate or hold a conversation

Shifting quickly from one thought to the next without obvious or logical connections between them

Moving slowly

Being unable to make decisions

Writing excessively but without meaning

Forgetting or losing things

Repeating movements or gestures, like pacing or walking in circles

Having problems making sense of everyday sights, sounds, and feelings

Cognitive Symptoms of Schizophrenia

The person will have trouble:

Understanding information and using it to make decisions (a doctor might call this poor executive functioning)

Focusing or paying attention

Using their information immediately after learning it (this is called working memory)

Recognizing that they have any of these problems

Negative Symptoms of Schizophrenia

The word "negative" here doesn't mean "bad." It notes the absence of normal behaviors in people with schizophrenia. Negative symptoms of schizophrenia include:

Lack of emotion or a limited range of emotions

Withdrawal from family, friends, and social activities

Less energy

Speaking less

Lack of motivation

Loss of pleasure or interest in life

Poor hygiene and grooming habits

What Causes Schizophrenia?

The exact cause of schizophrenia isn't known. But like cancer and diabetes, schizophrenia is a real illness with a biological basis. Researchers have uncovered a number of things that appear to make someone more likely to get schizophrenia, including:

Genetics (heredity): Schizophrenia can run in families, which means a greater likelihood to have schizophrenia may be passed on from parents to their children.

Brain chemistry and circuits: People with schizophrenia may not be able to regulate brain chemicals called neurotransmitters that control certain pathways, or "circuits," of nerve cells that affect thinking and behavior.

Brain abnormality: Research has found abnormal brain structure in people with schizophrenia. But this doesn't apply to all people with schizophrenia. It can affect people without the disease.

Environment: Things like viral infections, exposure to toxins like marijuana, or highly stressful situations may trigger schizophrenia in people whose genes make them more likely to get the disorder. Schizophrenia more often surfaces when the body is having hormonal and physical changes, like those that happen during the teen and young adult years.

Who Gets Schizophrenia?

Anyone can get schizophrenia. It affects people all over the world, from all races and cultures. While it can happen at any age, schizophrenia typically first appears in the teenage years or early 20s. The disorder affects men and women equally, although symptoms generally appear earlier in men. The earlier the symptoms start, the more severe the illness tends to be. Children over the age of 5 can have schizophrenia, but it's rare before adolescence.

How Is Schizophrenia Diagnosed?

If symptoms of schizophrenia are present, the doctor will perform a complete medical history and sometimes a physical exam. While there are no laboratory tests to specifically diagnose schizophrenia, the doctor may use various tests, and possibly blood tests or brain imaging studies, to rule out another physical illness or intoxication (substance-induced psychosis) as the cause of the symptoms.

If the doctor finds no other physical reason for the schizophrenia symptoms, they may refer the person to a psychiatrist or psychologist, mental health professionals trained to diagnose and treat mental illnesses. Psychiatrists and psychologists use specially designed interviews and assessment tools to evaluate a person for a psychotic disorder. The therapist bases their diagnosis on the person's and family's report of symptoms and their observation of the person's attitude and behavior.

A person is diagnosed with schizophrenia if they have at least two of these symptoms for at least 6 months:

Delusions

Hallucinations

Disorganized speech

Disorganized or catatonic behavior

Negative symptoms

One of the symptoms has to be

Delusions

Hallucinations

Disorganized speech

During the 6 months, the person must have a month of active symptoms. (It can be less with successful treatment.) Symptoms should negatively affect them socially or at work, and can't be caused by any other condition.

How Is Schizophrenia Treated?

The goal of schizophrenia treatment is to ease the symptoms and to cut the chances of a relapse, or return of symptoms. Treatment for schizophrenia may include:

Medications: The primary medications used to treat schizophrenia are called antipsychotics. These drugs don't cure schizophrenia but help relieve the most troubling symptoms, including delusions, hallucinations, and thinking problems.

Older (commonly referred to as "first-generation") antipsychotic medications used include:

Newer ("atypical" or second-generation) drugs used to treat schizophrenia include:

Note: Clozapine is the only FDA-approved medication for treating schizophrenia that is resistant to other treatments. It's also used to lessen suicidal behaviors in those with schizophrenia who are at risk.

Coordinated specialty care (CSC): This is a team approach toward treating schizophrenia when the first symptoms appear. It combines medicine and therapy with social services, employment, and educational interventions. The family is involved as much as possible. Early treatment is key to helping patients lead a normal life.

Psychosocial therapy: While medication may help relieve symptoms of schizophrenia, various psychosocial treatments can help with the behavioral, psychological, social, and occupational problems that go with the illness. Through therapy, patients also can learn to manage their symptoms, identify early warning signs of relapse, and come up with a relapse prevention plan. Psychosocial therapies include:

Rehabilitation, which focuses on social skills and job training to help people with schizophrenia function in the community and live as independently as possible

Cognitive remediation, which involves learning techniques to make up for problems with information processing. It often uses drills, coaching, and computer-based exercises to strengthen mental skills that involve attention, memory, planning, and organization.

Individual psychotherapy, which can help the person better understand their illness, and learn coping and problem-solving skills

Family therapy, which can help families deal with a loved one who has schizophrenia, enabling them to better help their loved one

Group therapy/support groups, which can provide continuing mutual support

Hospitalization: Many people with schizophrenia may be treated as outpatients. But hospitalization may be the best option for people:

With severe symptoms

Who might harm themselves or others

Who can't take care of themselves at home

Electroconvulsive therapy (ECT): In this procedure, electrodes are attached to the person's scalp. While they're asleep under general anesthesia, doctors send a small electric shock to the brain. A course of ECT therapy usually involves 2-3 treatments per week for several weeks. Each shock treatment causes a controlled seizure. A series of treatments over time leads to improvement in mood and thinking. Scientists don't fully understand exactly how ECT and the controlled seizures it causes help, but some researchers think ECT-induced seizures may affect the release of neurotransmitters in the brain. ECT is less well-proven to help with schizophrenia than depression or bipolar disorder, so it isn't used very often when mood symptoms are absent. It can help when medications no longer work, or if severe depression or catatonia makes treating the illness difficult.

Research: Researchers are looking at a procedure called deep brain stimulation (DBS) to treat schizophrenia. Doctors surgically implant electrodes that stimulate certain brain areas believed to control thinking and perception. DBS is an established treatment for severe Parkinson's disease and essential tremor, but it's still experimental for the treatment of psychiatric disorders.

Are People With Schizophrenia Dangerous?

Popular books and movies often depict people with schizophrenia and other mental illnesses as dangerous and violent. This usually isn't true. Most people with schizophrenia are not violent. More typically, they prefer to withdraw and be left alone. When people with mental illness do take part in dangerous or violent behaviors, it's generally a result of their psychosis and the fear that they're being threatened in some way by their surroundings. Drug or alcohol use can make it worse.

On the other hand, people with schizophrenia can be a danger to themselves. Suicide is the top cause of premature death among people with schizophrenia.

What Is the Outlook for People With Schizophrenia?

With proper treatment, most people with schizophrenia can lead productive and fulfilling lives. Depending on how severe the condition is and how well they get and stick with treatment, they should be able to live with their families or in community settings rather than in long-term psychiatric hospitals.

Ongoing research on the brain and how brain disorders happen will likely lead to more effective medicines with fewer side effects.

Can Schizophrenia Be Prevented?

There's no known way to prevent schizophrenia. But early diagnosis and treatment can help avoid or ease frequent relapses and hospitalizations, and help cut the disruption to the person's life, family, and relationships.

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Smitha Bhandari, MD on January 21, 2020 Schizophrenia is a chronic, severe mental disorder that affects the way a person thinks, acts, expresses emotions, perceives reality, and relates to others. Though schizophrenia isn't as common as other major mental illnesses, it can be the most chronic and disabling.

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This severe mental disorder can result in hallucinations, delusions, and extremely disordered thinking and behavior that interfere with daily living.

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A "psychotic disorder" is an umbrella term to describe multiple types of mental health conditions that involve a phenomenon called psychosis.

Psychosis itself is characterized by an impaired relationship with reality, often including confusion, hallucinations, and delusions.

It's estimated that 3 in every 100 people will experience psychosis at some point during their lives.

It's important to note that psychosis is not present in all mental health disorders, and the symptoms vary greatly by individual.

The term "psychotic disorder" tends to be used by some mental health professionals, but isn't always socially acceptable because of stigmas attached to it.

Psychosis is related to multiple types of mental health disorders. Below are the most commonly associated conditions.

Schizophrenia

Schizophrenia is one of the most common types of psychotic disorders, and often has a genetic component.

It can cause hallucinations - seeing or hearing things that don't exist. Delusions are also possible, where you might believe things that are untrue.

Schizoaffective disorder

Schizoaffective disorder is a condition where you experience both psychosis and a mood disorder.

It's most notable for its mood disorder traits, such as depression and bipolar disorder. It can also cause hallucinations, paranoia, and delusions.

Genetics and brain chemical changes are both thought to be possible causes of this mental health disorder.

Bipolar disorder

Bipolar disorder is a type of mood disorder that's often characterized by cyclic changes between extreme highs (mania) and lows (depression).

Symptoms of psychosis may occur during manic episodes, where you might experience a combination of hallucinations and delusions.

Catatonia

It's estimated that around of people with mental health disorders have a psychomotor syndrome called catatonia.

While once considered a subtype of schizophrenia, catatonia is now recognized as its own mental illness.

This condition can cause psychosis as well as impaired motor skills and speech.

Substance use disorder

Misusing drugs or alcohol is strongly related to the development of mental illness later in life.

It's thought that people in their early 20s with substance use issues may be especially vulnerable to the development of psychosis, since their brains are still developing at this stage of life.

Other conditions

Sometimes psychosis may stem from depression, neurological disorders, and traumatic events.

In other cases, certain aspects of psychosis may cause standalone symptoms, such as the case with delusional disorders.

The symptoms of psychosis can vary between mental health disorders, but below are some possible signs:

concentration difficulties

increased anxiety or agitation

loss of interest or joy in your normal activities

increased or decreased appetite

hallucinations, where you hear or see things that seem real to you

social withdrawal

neglected personal hygiene

holding strong beliefs that aren't actually true

paranoia over people and situations around you

There's no one cause of psychosis. Genetics and brain chemical changes are strong links. Traumatic events, substance use, and underlying health conditions can sometimes lead to changes in the way your brain works.

Past research has indicated that dopamine, serotonin, and glutamate disruptions in the brain may cause certain psychotic disorders. However, there's not enough evidence to associate any one neurotransmitter disruption with psychosis.

Psychotic disorders are most effectively treated with a combination of medications and therapies. A psychiatrist can help you determine what your needs are based on the severity of your condition.

Medication

Antipsychotic medications are among the first lines of treatment for psychosis. These help to block serotonin or dopamine receptors in your brain to prevent hallucinations and delusions.

However, antipsychotics may not be appropriate for substance use-related psychosis. This largely depends on the substance used.

Low-dose benzodiazepines, a class of tranquilizers, may work best for catatonia. Your doctor may also recommend electroconvulsive therapy in some cases.

If you have a mood disorder, your doctor may also recommend antidepressants. These help to improve depression-related symptoms, such as sadness and hopelessness.

Therapy

Different forms of therapy are used in the treatment of psychosis:

Cognitive behavioral therapy (CBT) may be particularly helpful by changing the thought patterns that can lead to delusions and hallucinations.

Individual talk therapy may also help you work through your feelings, which can be useful in treating instances of trauma.

Psychoanalytic therapy can have a significant impact on the functioning of people with psychosis.

Some people also find group or family therapies helpful in psychosis management.

Social rehabilitation can be especially helpful for loved ones who have isolated themselves due to their symptoms.

Can home remedies help?

While home remedies continue to be a trending topic in all aspects of health, it's important not to trade in proven medications and therapies for natural versions.

At the same time, lifestyle measures will certainly help your overall mental health, including a healthy diet and regular exercise.

It's important to discuss the use of any herbs or supplements with your doctor. This includes fish oil.

While there's some clinical evidence that shows the omega-3 fatty acids in fish oil may support brain health and subsequent mental illnesses, more research needs to be done to conclude whether taking fish oil - and how much - can effectively treat mental health disorders.

Not all studies support the use of omega-3 fatty acids for psychosis and other mental health conditions.

Psychosis tends to first develop during the adolescent years. It sometimes shows up during early adulthood, too.

If you have a family history of mental health disorders with psychosis, it's important to pay special attention to the possibility of symptoms developing in your children. Hallucinations are common in children experiencing psychosis.

Another early sign is that your child suddenly loses interest in the activities they usually enjoy. They might also withdraw from their friend groups and have difficulties with school.

Treatment for psychosis in children focuses more on therapies than medications. CBT, for example, may help correct thinking patterns early on in an effort to prevent hallucinations and delusions.

also suggests that managing stress may help this age group.

Antipsychotic medications may be used as a last resort, but at low doses only. Side effects of these drugs in children may include:

Given the complexity of psychosis, it's not advised to self-diagnose and treat it on your own. You can, however, make note of your symptoms to determine when it's time to seek help from a psychiatrist or other mental health professional.

If you suspect symptoms of psychosis, and if these are severe enough to interfere with your daily life, consider seeking professional advice. Your primary care doctor is a starting point for recommendations.

You can also search for mental health providers via your insurance company, or find a therapist in your area here.

If you or a loved one is struggling with substance misuse, you may also consider finding help through the Substance Abuse and Mental Health Services Administration (SAMHSA).

If you're supporting a friend or family member struggling with psychosis, it's important to learn coping mechanisms early on so that you can be at your best.

Taking care of yourself is paramount, and you'll also want to take time to manage stress every day.

You can also help by:

learning everything you can about your loved one's condition

making sure your loved one takes all their medications and goes to therapy, as directed

reducing triggering situations that can worsen your loved one's symptoms

listening to what your loved one is going through, without judgment

avoiding harmful situations, such as drinking and illicit drug use

You might also find it helpful to connect with other families who may be going through similar situations.

Psychosis can occur in schizophrenia and other mental health disorders.

While psychosis can leave you or your loved ones feeling uncertain, it is treatable - especially when detected early. Treatment will consist of a combination of medications, therapies, and lifestyle changes.

It's also important for loved ones to be patient and supportive of family and friends struggling with mental health disorders. If you suspect that mental illness is interfering with reality, see a mental health professional for an evaluation.

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Psychotic Disorder: Symptoms, Treatments, and More

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A "psychotic disorder" is an umbrella term to describe multiple types of mental health conditions that involve a phenomenon called psychosis. Psychosis itself is characterized by an impaired relationship with reality, often including confusion, hallucinations, and delusions. It's estimated that 3 in every 100 people will experience psychosis at some point during their lives.

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

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

Types

There are different types of psychotic disorders, including:

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

Schizoaffective disorder: People have symptoms of both schizophrenia and a mood disorder, such as depression or bipolar disorder. Learn more about the symptoms of schizoaffective disorder.

Schizophreniform disorder: This includes symptoms of schizophrenia, but the symptoms last for a shorter time: between 1 and 6 months. Find out more on schizophreniform disorder symptoms to look for.

Continued

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

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

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

Substance-induced psychotic disorder: This condition is caused by the use of or withdrawal from drugs, such as hallucinogens and crack cocaine, that cause hallucinations, delusions, or confused speech. Find out more on substance-induced psychosis and other causes of secondary psychosis.

Continued

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

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

Symptoms

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

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

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

Other possible symptoms of psychotic illnesses include:

Disorganized or incoherent speech

Confused thinking

Strange, possibly dangerous behavior

Slowed or unusual movements

Loss of interest in personal hygiene

Loss of interest in activities

Problems at school or work and with relationships

Cold, detached manner with the inability to express emotion

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

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

Causes

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

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

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

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

Diagnosis

To diagnose a psychotic disorder, doctors will take a medical and psychiatric history and possibly perform a brief physical exam. The person may get blood tests and sometimes brain imaging (such as MRI scans) to rule out physical illness or drug use like cocaine or LSD.

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

Treatment

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

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

Older antipsychotics include:

Newer "atypical antipsychotics" include:

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

Continued

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

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

Recovery

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

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

What Is the Outlook for People With Psychotic Disorders?

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

Can Psychotic Disorders Be Prevented?

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

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

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

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Credit: Julius-Maximilians-Universität Würzburg, JMU

An overactive molecular signal pathway in the brain region of the amygdala can lead to obsessive-compulsive disorder (OCD). A research team from Würzburg has established this connection.

Some people have an extreme fear of dirt or bacteria. As a result, they may develop a habit of compulsive washing and repeatedly cleaning their hands or body. They are trapped in a vicious circle, as the fear of new contamination returns quickly after washing. Sufferers see no way out. They are even incapable of changing their behaviour when the excessive washing has led to skin irritation or damage.

Around two percent of the general population suffer from some kind of obsessive-compulsive disorder (OCD) at least once in their life. The disorder is characterised by persistent intrusive thoughts which the sufferers try to compensate for by repetitive ritualized behaviour.

Like depression, eating disorders and other mental diseases, OCD is treated with antidepressants. However, the drugs are non-specific, that is they are not tailored to the respective disease. Therefore, scientists have been looking for new and better targeted therapies that have fewer side effects.
Missing protein triggers urge to wash
Professor Kai Schuh from the Institute of Physiology at the Julius-Maximilians-Universität (JMU) Würzburg (Germany) and his team explore the underlying causes of obsessive-compulsive disorder in collaboration with the JMU's Departments of Psychiatry and Neurology.

"We were able to show in mouse models that the absence of the protein SPRED2 alone can trigger an excessive grooming behaviour," Schuh says. He believes that this finding is crucial as no clear trigger for this type of disorder has been identified until now. Previous research pointed to multiple factors being responsible for developing OCD.

Occurring in all cells of the body, the protein SPRED2 is found in particularly high concentrations in regions of the brain, namely in the basal ganglia and the amygdala. Normally, the protein inhibits an important signal pathway of the cell, the so-called Ras/ERK-MAP kinase cascade. When it is missing, this signal pathway is more active than usual.
Hyperactive signal cascade in the brain
"It is primarily the brain-specific initiator of the signal pathway, the receptor tyrosine kinase TrkB, that is excessively active and causes the overshooting reaction of the downstream components", biologist Dr. Melanie Ullrich explains.

Administering an inhibitor to attenuate the overactive signal cascade in the animal model improves the obsessive-compulsive symptoms. Moreover, the JMU research team was able to treat the OCD with an antidepressant, similarly to standard therapy in humans. Their detailed results have been published in the journal Molecular Psychiatry.
New targets for therapies pinpointed
"Our study delivers a valuable new model that allows the disease mechanisms to be investigated and new therapy options for obsessive-compulsive disorders to be tested," Professor Schuh says.

The recently discovered link between OCDs and the Ras/ERK-MAP kinase cascade also opens up new targets for therapy. Drugs that inhibit this cascade are already available and some of them are approved for human treatment.

According to Melanie Ullrich, these are cancer drugs, as overactivation of the Ras/ERK-MAP kinase cascade is also a frequent trigger of cancer: "So we are wondering whether such drugs could also be effective in the treatment of obsessive-compulsive disorders and whether they are beneficial in terms of side effects."

More information: M Ullrich et al. OCD-like behavior is caused by dysfunction of thalamo-amygdala circuits and upregulated TrkB/ERK-MAPK signaling as a result of SPRED2 deficiency, Molecular Psychiatry (2017). DOI: 10.1038/mp.2016.232

Provided by Julius-Maximilians-Universität Würzburg

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An overactive molecular signal pathway in the brain region of the amygdala can lead to obsessive-compulsive disorder (OCD). A research team from Würzburg has established this connection. Some people have an extreme fear of dirt or bacteria. As a result, they may develop a habit of compulsive washing and repeatedly cleaning their hands or body.

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National Institute of Mental Health (NIMH)

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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

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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

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Children who have obsessive-compulsive disorder (OCD) are plagued with unwanted thoughts, images or impulses that are difficult to suppress, causing them great stress and worry. These are called obsessions. To alleviate the anxiety caused by their obsessive thoughts, they perform repetitive, ritualized actions called compulsions. A child with OCD might need to line things up, touch things in a certain order when leaving the room or wash his hands repeatedly.

Obsessions Common in Kids With OCD

Contamination: Kids with this obsession are sometimes called "germaphobes." In schools, this plays out with kids worrying about other kids sneezing and coughing, touching things that might be dirty or getting sick in many different ways. This is the most common obsession seen in children.

Magical thinking: This is a kind of superstition, like "step on a crack, break your mother's back," taken to extremes. For example, kids might worry that their thoughts can cause someone to get hurt, or get sick. A child might think, "Unless my things are lined up in a certain way, mom will get in a car accident."

Catastrophizing: Some kids easily jump to the conclusion that something terrible has happened. For example, if her parents are five minutes late picking her up, a girl who is catastrophizing might tell herself that they've decided to abandon her.

Scrupulosity: This is when kids have obsessive worries about offending God or being blasphemous in some way.

What ifs: Kids may be plagued by a lot of different kinds of thoughts about bad things they could do. "What if I hurt someone? What if I stab someone? What if I kill someone?"

The "just right feeling": When OCD first develops, from about 6 to 9 years of age, kids may not know why they are doing something, but just that they need to do it until they get what we call the "just right feeling." So: "I'll line these things up until it just kind of feels right, and then I'll stop." And then over time - in the 9- to 12-year-old range - it evolves into magical thinking and becomes more superstitious in nature.

Behaviors You Might See in Students With OCD

Frequent requests to go to the bathroom: This could be to wash hands, if someone near the child was coughing or sneezing, or if she touched something that she perceives as contaminated. She could be washing items-pens, pencils, backpacks, books. It could also be an excuse to get out the classroom and just be away from everyone, and have some respite.

Constant reassurance-seeking: This takes the form of repetitive questions. "Are you sure that's the answer? Could you tell me again? Did you hear what I said?" Checking doors, windows, lockers, desks. Over and over and over again.

Getting stuck on tasks: Sometimes kids with OCD will need to finish something to completion, or understand it to completion, before they're able to move on. So if a child is working out what he did wrong on a math test, and the teacher says, "Now let's open the textbook and start a new chapter," he's not going to be able to shift gears.

Retracing: If a child leaves the classroom and worries that she left a pencil behind, she'll go back into the classroom and go to her desk and check. If she had a bad thought as she went through the doorway, she might have to "fix it" by going back through the doorway again saying a good word. If she had a bad thought when she went down a flight of stairs on the way to class, she might need to go back up that same stairway at the end of the period, even if it means being late to her next class.

Obsessive erasing: A child could be erasing a lot because the letters have to look perfect. Or he could have used a word that disturbs him. For example, if he has a fear of vomiting and he's written the word vomit, he might not be able to stand seeing that word, so he erases it. Kids start having erasers worn down to the metal. Teachers start to see holes in the paper. Words will be drawn over on the back of the page. A lot of different areas of writing become problematic.

Behaviors Often Confused With Another Disorder

Some behaviors associated with OCD are easy to confuse with ADHD, learning problems or being oppositional.

Distraction: If a child is busy thinking that if she doesn't turn the pen cap and count to four the right way then her mom is going to get sick, she's not going to be paying attention in class. And if her teacher calls on her to answer a question, her distraction might look like ADHD, but it isn't.

Slowness on exams, papers and tasks: Sometimes when kids take a long time, they're struggling with the perfectionism of needing to do things the right way. This could look like learning problems, or inattention, but it isn't.

Avoidance: Teachers might see a child who doesn't want to sit on the floor, or pick things up that touched the floor, or get his hands dirty in art class. He may avoid a lot of playground activities - kids with germ fears will view the playground the way some adults view the subway: it's gross. Why touch anything there?

Tapping and touching symmetrically: If a child sits down at her desk and she accidentally kicks the chair of the kid next to her with her right foot, she's going to have to then kick it with her left foot. That might look like somebody who's being oppositional, or somebody who's got too much energy, but actually it's OCD.

Complaints of anxiety and fatigue: There's one interesting theory that kids with OCD are smarter than other kids. And if you consider how much thinking they're doing, they're really using their brain more frequently than a lot of other kids are. But when that's coupled with a lot of anxiety, you can have a lot of fatigue. So it's common for kids with OCD to want to come home and take a nap after school.

How to Help Students With OCD

For children struggling with OCD, functioning in school can be complicated and very difficult. Here are some things you can do to help them, and the class as a whole, focus on learning:

Seating arrangement: If the school has noisy hallways, you might not want to have a child with OCD sit by the door. You might have her sit in the front, where she's less able to hear the noise and can stay more focused on her work. On the other hand, a child who has very observable symptoms, and doesn't want other kids to see her fidgeting with her hands, rocking or getting up a lot, might be better off closer to the door, toward the back of the room.

Extended time for tests and papers: If writing is a problem for a child who needs to find the perfect way to say something, he's going to need more time to finish those essay questions or papers.

Laptops for writing: If writing and rewriting/erasing is really problematic for a child, consider letting her use a laptop for taking notes, and having all assignments be typed instead of handwritten.

Private testing rooms: Research is quite clear that kids with OCD do better, are less overwhelmed and are more in control of their thoughts and their reactions if they're in a quiet place away from the other kids.

Skip reading out loud: Kids who feel they need to read perfectly may have to go back and reread sentences or whole paragraphs over and over to make sure they've got them right. So reading becomes a very laborious task, and reading in front of the class can become a nightmare. So if we know doing this is a problem for children, we can spare them.

Books on tape: If kids get so hung up reading that it takes forever, listening to the books can be a solution.

Break homework into chunks: If looking at a whole page of math makes kids feel overwhelmed and anxious - think of the potential for mistakes! - the problems can be broken up over four pages. It helps kids stay focused on doing the problems instead of worrying.

How to Minimize Behavioral Problems

Plan an escape route: Try working out a communication system so that if the student feels symptoms coming on, she can signal to you and leave the classroom, or go to a protected place in the classroom, without interrupting the class. It can prevent an embarrassing and disruptive blowup of symptoms in the classroom, and the other kids picking on or bullying her about it.

Be aware of triggering events: It's very important for teachers to know what kind of things might trigger the symptoms. Fatigue is a huge piece of OCD, and it can be exacerbated by medication. So it's important to know that if a child is drowsy in class, and maybe he's putting his head down, it's not because he's being oppositional or disrespectful, but because he's overwhelmed with fatigue.

Advance notice: Irritability and frustration are two of the longer-lasting things that kids with OCD are feeling on a daily basis. Changes in schedule can be very disruptive for a child with OCD, so it can be helpful for teachers to give advance notice of things. Kids who know what to expect are less likely to be thrown by the change.

Children with OCD are often teased and bullied because of their symptoms. Kids feel very uncomfortable about their rituals, knowing that they're being watched. It can be helpful to educate the whole class about what's going on, especially if a child is going to be in the same school for a number of years, and it can inspire a surprising amount of support from other children.

Peer understanding program: A peer understanding program includes a presentation in the classroom that explains (with the child participating) what OCD is. The child might say, "Listen, I have OCD. It's an anxiety disorder. It makes me think that my hands are dirty and I have to wash my hands a lot, so if you see me getting up and going to the sink to wash my hands, that's why." Psychologists can role-play with the teacher and child ahead of time, to anticipate questions his classmates might ask, and how to answer them.

A buddy system: A buddy is like a peer coach who sits next to the child and prompts him to keep up with note taking and staying on task. It can be great for the buddy, to foster a sense of confidence and pride and to be able to help someone in need, and great for fostering friendship.

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Lo sentimos, la página que usted busca no se ha podido encontrar. Puede intentar su búsqueda de nuevo o visitar la lista de temas populares. Children who have obsessive-compulsive disorder (OCD) are plagued with unwanted thoughts, images or impulses that are difficult to suppress, causing them great stress and worry.

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Neurodevelopmental disorders are conditions that affect how your brain functions. They range from mild impairments, allowing those affected to live fairly normal lives, to severe disorders that require lifelong care. Examples of neurodevelopmental disorders include:

If you're living with a neurological disorder, the doctors at Dignity Health - St. Rose Dominican hospitals are knowledgeable about the challenges you have to face daily. They can provide the treatment you need for neurodevelopmental disorders in Las Vegas and Henderson, NV. To learn more, find a neurologist or neurosurgeon associated with St. Rose Dominican or call (702) 616-4900.

Neurodevelopmental Disorder Symptoms

With many neurodevelopmental disorders, the signs and symptoms most often begin to show when a child is young, usually around preschool years. But in some, such as schizophrenia, symptoms may begin during the older teen years or in young adulthood.

Signs and symptoms of neurodevelopmental disorders vary, depending on the specific disorder:

Schizophrenia: Withdrawing from friends and family, disorganized thoughts, delusions, and hallucinations

ADHD: Inattention, distractibility, impulsivity, and hyperactivity

Autism: Little or no eye contact, difficulty communicating, resisting touch, and self-harm

Tourette Syndrome: Tics such as eye blinking, shoulder shrugging, and grunting or coughing

If you notice signs and symptoms of a neurological disorder, seek care from a neurologist at Dignity Health - St. Rose Dominican. Our experts will perform a full evaluation and make a diagnosis.

What Causes Neurodevelopmental Disorders?

The causes of neurodevelopmental disorders are still largely unknown. In some cases, there may be a genetic factor; a neurodevelopmental disorder may run in certain families. Researchers also believe that certain things related to or that occurred during pregnancy may play a role in the development of these disorders, such as:

Low birth weight

Environmental contaminants, such as lead

Fetal exposure to smoking, alcohol, recreational drugs, or medications during pregnancy

Premature birth

Neurodevelopmental Disorder Treatment at Dignity Health - St. Rose Dominican Hospitals

There are no cures for neurodevelopmental disorders, although there are effective therapeutic strategies that may help control some of the signs and symptoms, depending on the disorder. Medications are available that may reduce anxiety, agitation, tics, and hyperactivity. Behavior therapy and psychotherapy are also available to help children and parents manage behavior patterns. Older children and adults may benefit from psychotherapy, including speaking with a counselor or therapist to help learn coping techniques to control their behavior.

There is no certain way to prevent a neurodevelopmental disorder. For conditions with links to the environment and genetics, such as autism and ADHD, good prenatal care increases the chances of having a full-term, healthy baby with a reduced risk of neurological problems.

Regular wellness checkups can help you and your doctor recognize the signs and symptoms of a neurodevelopmental disorder. Early intervention is the best way to overcome the challenges from a neurodevelopmental condition.

Dignity Health - St. Rose Dominican provides complete care for neurodevelopmental disorders in Las Vegas and Henderson, NV, as part of our neurological services.

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Neurodevelopmental Disorders | Nevada Hospitals | Dignity Health

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Neurodevelopmental disorders are conditions that affect how your brain functions. They range from mild impairments, allowing those affected to live fairly normal lives, to severe disorders that require lifelong care. Examples of neurodevelopmental disorders include: If you're living with a neurological disorder, the doctors at Dignity Health - St.

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Finding the motivation to make positive lifestyle changes can be hard for anyone. For teenagers, it can be especially difficult when parents are the ones telling them to do it. But if they've fallen into unhealthy habits like vaping or alcohol abuse, change can be beneficial. Motivational interviewing is a form of therapy that creates a safe, non-judgmental environment for teens to establish their own goals and values and see how changing unhealthy behaviors can benefit them in the long run.

This series of articles comes from the Child Mind Institute, with most available in English and Spanish. Why might teens be resistant to therapy and how can parents and others to help them get the treatment they need? The articles explain how motivational interviewing can help teens gain the self-confidence to make important behavioral changes. To read more about motivational interviewing, and to connect with the articles in both English and Spanish, please visit CPIR's abstract.

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Center for Parent Information and Resources | Your Central Hub for Parent Centers Serving Families of Children With Disabilities

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Finding the motivation to make positive lifestyle changes can be hard for anyone. For teenagers, it can be especially difficult when parents are the ones telling them to do it. But if they've fallen into unhealthy habits like vaping or alcohol abuse, change can be beneficial.

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Home - ADDA - Attention Deficit Disorder Association

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Empowering adults with adhd to live their best lives A Different Brain Requires a Different Approach Whether you're newly diagnosed, wondering if you have ADHD, or simply ready to take charge of your life - we're here to help. Have ...

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Feeding disorders are characterized by extreme food selectivity by type, texture, brand, shape or color.

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How to assist children with Feeding Disorders

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How to assist children with Feeding Disorders

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About feeding disorders

Quite simply, this term describes any disorder that causes problems with intake of food. It could mean refusal to eat or to eat certain foods, or it could involve a physical inability to suck, chew or swallow food. Feeding problems are often associated with conditions such as reflux, esophageal achalasia or swallowing disorders. No two feeding disorders are the same, and each child's case is often complex, involving a constellation of interrelated problems. The Feeding, Swallowing and Nutrition Program at Children's Wisconsin understands this complexity and provides a true interdisciplinary approach to treat each child's feeding disorder.

What causes feeding disorders?

It all depends on your child's medical history. Feeding disorders can result from an underlying physiological condition, a psychological/behavioral problem, or a combination of both. Children with developmental disorders or other medical conditions are much more likely to experience feeding issues.

Some children are born with physical defects that make eating difficult. There could be an anomaly in the brain center that controls swallowing, poor tone of oral-motor muscles, or problems with texture because of sensory disturbances. Children with autism often develop very ritualistic eating patterns, such as rejecting any food that isn't cut into a triangle or eating only one kind of food.

Sometimes parents attempt to introduce an eating milestone (such as spoon-feeding or table foods) too early, which can trigger a feeding aversion. Children who have experienced choking or other bad feeding experiences can develop a fear of eating.

How often do feeding disorders occur?

Feeding and swallowing problems affect between 25 to 45 percent of typically developing children, though the prevalence is much higher (up to 80 percent) for children with other medical and behavioral disorders. Between 25 to 30 percent of children with cardiac issues have persistent feeding problems.

How do feeding disorders develop?

Sometimes feeding problems start at birth, while other times they develop later in life. They often emerge during the toddler years, between ages 2 to 4. Older children with feeding problems tend to have trouble with anxiety or may have a developmental disorder such as autism

What are the symptoms of feeding disorders?

Symptoms can vary depending on the underlying cause of your child's eating problem, but they can include:

Choking, gagging on food or certain textures

Aspirating on food (getting food into the respiratory tract)

Food refusal Intense behavioral outbursts with meals

Vomiting

Coughing

Pocketing of food in the child's cheek

Who is at risk of developing a feeding disorder?

Children who have genetic syndromes such as DiGeorge syndrome, Down syndrome or other chromosomal disorders, autism and heart conditions are at higher risk of developing feeding disorders. In addition, premature babies or any other child with a complicated medical history who required a long-term feeding tube after birth may have trouble with feeding. But many otherwise healthy kids can also develop an aversion to eating, especially if there's a lack of structure in the child's feeding environment.

Why are feeding disorders a concern?

Children with feeding disorders tend to consume fewer calories and have a less varied and nutritious diet, which can lead to failure to thrive, poor weight gain or weight loss. These children can have poor energy levels, behavioral problems and constipation (particularly if their fluid intake is also low). They may also be more susceptible to infections or other illnesses because of the toll that malnutrition takes on the immune system.

How are feeding disorders diagnosed?

The specialists within our Feeding Program will start by analyzing your child's medical history and feeding patterns. Our Feeding team will also observe while your child eats to look for signs of choking, coughing or gagging during eating. The team may also use imaging tests to assess swallowing function. Those tests could include a barium swallow study, a videoflouroscopic swallow study, and/or an esophageal manometry test. If your child's doctor suspects another underlying condition, such as eosinophilic esophagitis, the doctor might order an endoscopy or other additional tests.

What is the treatment for feeding disorders?

Because feeding disorders vary in type and severity, treatment is based on your child's needs. Our Feeding team takes a highly interdisciplinary approach to address the complexity of feeding disorders. Pediatric specialists from gastroenterology, speech pathology, psychology and nutrition work together to assess each child and develop a customized treatment plan to address each child's needs. We believe this is key to offering our families the most comprehensive and efficient care.

Learn more about what to expect from an appointment with our feeding, swallowing and nutrition team.

What happens after treatment?

Some children may need to see our feeding team regularly for many years, while others could be discharged after only a few visits. For the Feeding Program, the average duration of treatment for feeding disorders is about one year. If problems reemerge, your child may need to restart treatment.

When should you contact a physician?

If you have any concerns about your child's eating habits, talk to your pediatrician. He or she may refer you to a feeding specialist if further evaluation is necessary.

What is the long-term outlook for feeding disorders?

Children with this condition generally have a good outcome. Outcomes are even better for cases that are more behavioral than physiological in nature. Children who have autism, seizures or severe developmental delays may continue to have difficulty eating and may need nutritional supplements to ensure adequate nutrition.

How do I live with this condition?

Parents are key to a child's success in overcoming a feeding disorder, and our team will provide education and coaching on behavioral strategies that can be used at home. It may take some time, but in most cases, feeding disorders can be successfully managed.

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Caring for children with feeding disorders

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Quite simply, this term describes any disorder that causes problems with intake of food. It could mean refusal to eat or to eat certain foods, or it could involve a physical inability to suck, chew or swallow food. Feeding problems are often associated with conditions such as reflux, esophageal achalasia or swallowing disorders.

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Feeding & Swallowing Disorder in Children

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Feeding & Swallowing Disorder in Children

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Feeding and swallowing disorders can lead to health, learning, and social problems. Feeding disorders include problems with sucking, eating from a spoon, chewing, or drinking from a cup. Swallowing disorders, also called dysphagia (dis-FAY-juh) are difficulties with moving food or liquid from the mouth, throat, or esophagus to the stomach. Feeding and swallowing disorders are often related to other medical conditions but may also occur without a known cause.

Speech-language pathologists (SLPs) help children with feeding and swallowing problems.

On this page:

About Feeding and Swallowing Disorders

Think about how you eat. First, you have to get the food or drink to your mouth. You may use a fork, spoon, straw, cup, or your hands. Then you have to open your mouth and take the food in. You close your lips to keep the food in your mouth. Then you chew the food or move the liquid to get ready to swallow.

From birth, infants eat by sucking. As they grow, they learn how to eat solid foods and drink from a cup. All children will have some trouble at first. Drinks may spill from their mouths. They may push food back out or gag on new foods. Some degree of this behavior is normal and should go away over time. However, a child with a feeding disorder will keep having trouble or may have an especially hard time eating or drinking. Some children will eat only certain foods, or they may take a long time to eat. These children may also have a feeding disorder. If your child coughs or chokes when eating, refuses food or liquid, has a wet, gurgly voice after eating, starts to lose weight, or has less energy than usual, talk to your doctor about seeing a feeding and swallowing professional.

Swallowing happens in three stages. A child can have a problem in one or more of these stages. They include:

Oral phase-sucking, chewing, and moving food or liquid into the throat. Feeding is a part of the oral phase.

Pharyngeal phase-starting the swallow and squeezing food down the throat. The body needs to close off their airway to keep food or liquid out. Food going into the airway can cause coughing and choking.

Esophageal phase-opening and closing the esophagus (the tube that goes from the mouth to the stomach). The esophagus squeezes food down to the stomach. Food can get stuck in the esophagus. Or a child may throw up a lot if there is a problem with the esophagus.

Signs of Feeding and Swallowing Disorders

Your child may have a feeding or swallowing problem if they:

arch their back or stiffen when feeding

cry or fuss when feeding

fall asleep when feeding

have problems breastfeeding

have trouble breathing while eating and drinking

refuse to eat or drink

eat only certain textures, such as soft food or crunchy food

take a long time to eat

pocket (which means to hold food in their mouth)

have problems chewing

cough or gag during meals

drool a lot or have liquid come out of their mouth or nose

get stuffy during meals

have a gurgly, hoarse, or breathy voice during or after meals

spit up or throw up a lot

are not gaining weight or growing

Not every child has every sign listed here. Your child may show a few signs or many of them. Your child may be at risk for:

dehydration or poor nutrition;

food or liquid going into the airway, called aspiration;

pneumonia or other lung infections; and

having negative feelings about eating. They may avoid eating or associate it with pain, frustration, or embarrassment.

Causes of Feeding and Swallowing Disorders

There are many possible causes for feeding and swallowing problems, including:

nervous system disorders, like cerebral palsy or meningitis;

reflux or other stomach problems;

being premature or having a low birth weight;

heart disease;

cleft lip or palate;

breathing problems, like asthma or other diseases;

autism;

head and neck problems;

muscle weakness in the face and neck;

medicines that make them sleepy or not hungry;

sensory issues; and

behavior problems.

Testing for Feeding and Swallowing Disorders

Talk to your child's doctor if you think they have a feeding or swallowing problem. Your doctor can test your child for medical problems and check their growth and weight. An SLP trained in feeding and swallowing can look at how your child eats and drinks. The SLP will take the following steps:

ask questions about your child's medical history, development, and the problems they are having

watch how your child moves their mouth and tongue

watch your child eat to see how they pick up food, chew, swallow, and drink

watch how your child behaves during meals

do special tests, if needed

The SLP can watch how your child swallows using two methods:

Modified barium swallow study-your child eats or drinks food or liquid with barium in it. Barium shows up on an x-ray so the SLP can watch where the food goes.

Endoscopic assessment-the doctor or SLP puts a tube with a light on the end of it into your child's nose. This scope has a camera on it, and the SLP can watch your child swallow on a screen.

The SLP may lead or work as part of a feeding team. Other team members may include

an occupational therapist,

a physical therapist,

a physician or nurse,

a registered dietitian,

a developmental specialist,

a social worker, and

a lactation consultant.

The team will suggest ways to improve your child's feeding and swallowing.

Treatment for Feeding and Swallowing Disorders

The SLP or feeding team may suggest some of these next steps:

referral to a doctor for medical treatment, like medicines for reflux

feeding therapy

trying different foods or adding calories to their diet

trying new ways to get your child to try new foods or textures

changing how hot or cold food is or how crunchy or soft it is

changing your child's position while eating

trying new ways to handle your child's behavior

seeing another professional, like a psychologist or dentist

In severe cases, your child may need to get nutrition in other ways. These ways may include a tube inserted through their nose or into their stomach.

Your child may need feeding or swallowing treatment with an SLP. The SLP may work on a variety of tasks:

Making the muscles of their mouth stronger.

Helping them move their tongue more.

Helping them chew foods.

Getting them to try new foods and drinks.

Improving how well they can suck from a bottle or drink from a cup.

Helping them learn how to breathe while sucking and swallowing. This will be for babies only.

Changing food textures and liquid thickness to help them swallow safely.

Getting them to participate during meals, including accepting food.

Helping with sensory issues. Your child may not like the way food feels in their mouth or on their hands. The SLP can help them get used to how food feels.

Changing the way you hold your baby or the way your child sits when eating.

You are an important part of your child's treatment. You can

ask questions to understand the problems your child has,

make sure you understand what the SLP will work on and why they will work on it,

go with your child to treatment,

follow suggestions from the SLP for eating and drinking at home and at school,

talk with your child's teachers and other family members about your child's feeding problems and what others can do to help, and

let the SLP or feeding team know what is or is not working at home.

Other Resources

This list does not include every website on this topic. ASHA does not endorse the information on these sites.

To find an SLP near you, visit ProFind.

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Feeding and Swallowing Disorders in Children

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Feeding and swallowing disorders can lead to health, learning, and social problems. Feeding disorders include problems with sucking, eating from a spoon, chewing, or drinking from a cup. Swallowing disorders, also called dysphagia (dis-FAY-juh) are difficulties with moving food or liquid from the mouth, throat, or esophagus to the stomach.

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National Institute of Mental Health (NIMH)

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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

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Learn about eating disorders, including types (e.g., anorexia nervosa, bulimia nervosa), signs and symptoms, risk factors, and treatments and therapies.

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Learn about 6 common types of eating disorders and their symptoms

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Eating disorders are characterized by unusual or disturbed eating habits. Learn more here.

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Psychiatry.org - What are Anxiety Disorders?

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Anxiety disorders are the most common of mental disorders and affect more than 25 million Americans.

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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.

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Learn the symptoms of this mental health condition, and ways to manage worry and fear that interfere with your daily activities.

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The term dysfunction is defined as "any impairment, disturbance, or deficiency in behavior" on the part of an individual person, between people in a relationship, or among family members. Dysfunction can manifest as poor communication, frequent conflict, emotional or physical abuse, and much more.

Dysfunctional relationships or situations often serve as motivation for people to seek help, often in the form of psychotherapy.

Examples of Dysfunctional Behavior

Examples of dysfunctional behavior within families can include situations such as when a family member, parent, or caregiver:

Engages in compulsive behavior such as gambling or overworking

Engages in emotionally, physically, or sexually abusive behavior

Misuses drugs or alcohol

Uses threats of violence

Allows children to drink alcohol or use drugs

Fails to provide children with emotional support

Relies on a child to provide emotional or financial support

Uses an authoritarian style of parenting in which there is no flexibility

Abuses or neglects children

Cannot provide basic needs such as food and shelter for children

Doesn't address or manage violence or inappropriate behavior

A parent or caregiver in a dysfunctional family might view their children or other family members as property or as things they can control, abuse, or use as an outlet for negative emotions.

Causes of Family Dysfunction

There are many potential causes of family dysfunction. Dysfunction is often the result of a parent or caregiver not getting the emotional support they need. As a result, they are unable or don't know how to provide their children with emotional support.

If a parent or caregiver is abusive, it's possible they themselves experienced abuse as a child-whether emotional, physical, or sexual. For instance, a child who is verbally abused may grow up confusing feelings like anger and love, so they may express themselves with yelling and aggression as an adult in their close relationships.

Mental Health Conditions

If a parent or caregiver experiences severe symptoms of a mental health disorder such as depression, bipolar disorder, post-traumatic stress disorder (PTSD), or a personality or mood disorder, and these symptoms are not appropriately treated, they may contribute to dysfunction within the family dynamic.

Someone with a mental health condition may find it difficult to perform daily tasks or support their family, especially if they aren't receiving adequate treatment or if they don't have a support system of loved ones to step in and help. A child's needs may go unmet and they may experience the added stress of seeing their parent struggle and not being able to help.

One study found that severe symptoms of mental health conditions like depression can often result in a parent treating a child harshly or disengaging from the relationship with their child.

Substance Use

Substance use disorder can also contribute to family dysfunction. If a member of the family misuses drugs or alcohol, all members of the family can experience stress as a result. Coping with addiction in the family may lead to other members of the family feeling neglected.

A parent or family member may also struggle with other types of addiction like overeating or gambling. If, for example, a family member is spending money on the object of their addiction and are unable to pay for basic needs like rent or food, it's likely that everyone in the family will feel stressed and insecure as a result.

Socioeconomic Status

Families who are at a socioeconomic disadvantage, or those who have low income, tend to experience additional stress levels, especially in single-parent households.

A parent or caregiver might struggle to provide food and shelter; they may also work long hours in harsh conditions. Some may have multiple children or family members to support financially. These burdens can contribute to family dysfunction, particularly if the parent is not receiving any support themselves.

Low-income communities generally have less access to mental health services, which can make it even more difficult for a parent or caregiver to get the support that they need. Unfortunately, they may end up taking their negative feelings out on their children or other family members.

The Effects of Dysfunction on Children

When dysfunctional patterns become the standard in a family, the detrimental effects on the children are significant and can be carried into their adult relationships. Some of the potentially damaging effects for children include:

One study found that people who endured stress during childhood as a result of a parent or caregiver's poor mental health experienced more stress into adulthood compared to people who weren't exposed to the same type of stress as children.

If a child's parents or caregivers don't provide them with adequate emotional support, they may grow up not knowing how to prioritize or express their needs or feeling that their needs are unimportant.

Children who've experienced familial dysfunction may even repeat patterns of abuse in their future relationships. They may unconsciously seek out partners who are abusive in similar ways as their parents or they themselves may abuse their partners or children.

Acknowledging dysfunction within your family, how it's affected you, and/or how you contribute to it is the first step in healing.

Getting Help for Family Dysfunction

If your family is experiencing dysfunction for any reason, there is help available. Outside of traditional therapy, there are accessible resources to help you and your family address dysfunctional patterns. Many communities have mental health centers that offer free information and counseling.

Family Therapy

Family therapy may be a good option for those experiencing the effects of dysfunction. Family therapy has been shown to be extremely effective in helping families learn new ways of communicating, solving problems, and supporting each other.

Family therapy sessions usually last 50 minutes to an hour and continue once a week for up to 12 weeks. Oftentimes, families will enter therapy looking to resolve a specific issue such as one family member's uncontrolled anger.

A therapist would work with your family as a unit to discuss how you're all communicating, how you can all respond to incidents of anger more effectively, and teach you how to set goals for productively handling future incidents.

If you have health insurance, check with your plan about coverage for mental and behavioral health services as well as providers that are in-network (which means that the provider is contracted with your insurance and your plan will likely cover more of the cost). If you don't have insurance, you can still research family therapists. Some therapists offer a sliding payment scale based on your income, so be sure to inquire about this prior to booking a session.

Individual Therapy

Whether your family seeks family therapy or not, online or in-person therapy can be a helpful option for anyone in the family. Individual therapy includes working one-on-one with a therapist who can address the underlying causes or effects of family dysfunction with the individual family member seeking help.

For example, if you have learned any negative beliefs as a result of family dysfunction, such as "I don't matter," or "My needs aren't important," a therapist who offers cognitive behavioral therapy (CBT) can work with you to reframe these beliefs into more positive ones. If you are contributing to dysfunction within your family, CBT can help you understand the roots behind your behavior and how to replace negative actions with healthy coping mechanisms.

Support Groups

There are also online or in-person support groups that may offer support for what you're going through in your family. Some support groups are tailored for people coping with specific mental health conditions as well as their friends and family members.

Self-Help Resources

There are also mental health apps, podcasts, and books that cover specific types of family dysfunction and offer practical advice for you and your family to start addressing maladaptive patterns.

Religious Counseling

If you are part of a religious group, you may seek advice from a religious leader as well. Some religious leaders may meet with your entire family and offer words of support and encouragement as you cope with dysfunctional patterns.

Get Advice From The Verywell Mind Podcast

A Word From Verywell

Whether you are coping with family dysfunction right now or you are dealing with the aftermath of a tumultuous childhood experience, remember that you are not alone. Therapy can be very effective in addressing the causes, effects, and trauma of family dysfunction, giving you or your family a roadmap for healing.

Be sure to prioritize your own physical and emotional safety. Family dysfunction may not change overnight, but you should do your best to ensure your own health and the health of your children as best you can.

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How Dysfunctional Behavior Affects Families

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The term dysfunction is defined as "any impairment, disturbance, or deficiency in behavior" on the part of an individual person, between people in a relationship, or among family members. Dysfunction can manifest as poor communication, frequent conflict, emotional or physical abuse, and much more.

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Behavioral disorders, also known as disruptive behavioral disorders, are the most common reasons that parents are told to take their kids for mental health assessments and treatment. Behavioral disorders are also common in adults. If left untreated in childhood, these disorders can negatively affect a person's ability to hold a job and maintain relationships.

What Are the Types of Behavioral Disorders?

According to BehaviorDisorder.org, behavioral disorders may be broken down into a few types, which include:

Anxiety disorders

Disruptive behavioral disorders

Dissociative disorders

Emotional disorders

Pervasive developmental disorders

Attention Deficit Hyperactivity Disorder (ADHD)

According to Centers for Disease Control and Prevention, ADHD is a condition that impairs an individual's ability to properly focus and to control impulsive behaviors, or it may make the person overactive.

ADHD is more common in boys than it is in girls. According to the Wexner Medical Center at Ohio State University, males are two to three times more likely than females to get ADHD.

Emotional Behavioral Disorder

An emotional behavioral disorder affects a person's ability to be happy, control their emotions and pay attention in school. According to Gallaudet University, symptoms of an emotional behavioral disorder include:

Inappropriate actions or emotions under normal circumstances

Learning difficulties that are not caused by another health factor

Difficulty with interpersonal relationships, including relationships with teachers and peers

A general feeling of unhappiness or depression

Feelings of fear and anxiety related to personal or school matters

Oppositional Defiant Disorder (ODD)

ODD is a behavioral disorder characterized by hostile, irritable and uncooperative attitudes in children, according to Children's Mental Health Ontario. Children with ODD may be spiteful or annoying on purpose, and they generally direct their negative actions at authority figures.

Anxiety

Anxiety is a normal emotion, and all people feel anxiety at some point in their lives. However, for some people, anxiety may get to a point where it interferes with their daily lives, causing insomnia and negatively affecting performance at work or school, according to the Mayo Clinic. Anxiety disorders involve more than regular anxiety. They are serious mental health conditions that require treatment. Examples of these types of mental conditions include:

Post-traumatic stress disorder

Obsessive-compulsive disorder

Generalized anxiety disorder

Panic disorder

Obsessive-Compulsive Disorder (OCD)

OCD is characterized by fears and irrational thoughts that lead to obsessions, which, in turn, cause compulsions, according to the Mayo Clinic. If you have OCD, you engage in compulsive, repetitive behavior despite realizing the negative consequences of - or even the unreasonable nature of - your actions. Performing these repetitive acts does nothing more than relieve stress temporarily.

If you or a loved one is experiencing any of these behavioral disorders, it is important to get help as soon as possible, because these conditions can affect quality of life to such a degree that they may lead to self-harm. Please call for assistance.

What Causes a Behavioral Disorder?

A behavioral disorder can have a variety of causes. According to the University of North Carolina at Chapel Hill, the abnormal behavior that is usually associated with these disorders can be traced back to biological, family and school-related factors.

Some biological causes may include:

Other factors related to an individual's home life may contribute to behaviors associated with a behavioral disorder:

Divorce or other emotional upset at home

Coercion from parents

Unhealthy or inconsistent discipline style

Poor attitude toward education or schooling

What Are the Signs of a Behavioral Disorder?

Someone who has a behavioral disorder may act out or display emotional upset in different ways, which will also vary from person to person.

Emotional Symptoms of Behavioral Disorders

According to Boston Children's Hospital, some of the emotional symptoms of behavioral disorders include:

Easily getting annoyed or nervous

Often appearing angry

Putting blame on others

Refusing to follow rules or questioning authority

Arguing and throwing temper tantrums

Having difficulty in handling frustration

Physical Symptoms of Behavioral Disorders

Unlike other types of health issues, a behavioral disorder will have mostly emotional symptoms, with physical symptoms such as a fever, rash, or headache being absent. However, sometimes people suffering from a behavioral disorder will develop a substance abuse problem, which could show physical symptoms such as burnt fingertips, shaking or bloodshot eyes.

Short-Term and Long-Term Effects of a Behavioral Disorder

If left untreated, a behavioral disorder may have negative short-term and long-term effects on an individual's personal and professional life. People may get into trouble for acting out, such as face suspension or expulsion for fighting, bullying or arguing with authority figures. Adults may eventually lose their jobs. Marriages can fall apart due to prolonged strained relationships, while children may have to switch schools and then eventually run out of options.

According to HealthyChildren.org, the most serious actions a person with a behavioral disorder may engage in include starting fights, abusing animals and threatening to use a weapon on others.

The earlier a behavioral disorder is diagnosed and properly treated, the more likely it is that a child or adult suffering from it will be able to control their behavior. Contact us at for assistance in finding treatment options.

Is There a Test or Self-Assessment I Can Do?

Mental health professionals and treatment centers can evaluate people to determine if they a behavioral disorder. Tests called functional behavioral assessments offer problem-solving help to address behavioral problems in students. According to Center for Effective Collaboration and Practice, these assessments are based on many techniques and strategies for identifying problem behaviors. Individualized educational program teams use these assessments to choose interventions that address specific behavioral problems. These teams are involved in the education of students, and they may include parents and teachers. Don't ignore your mental health. Take a mental health test and get the help you need.

Medication: Behavior-Modifying Drug Options

A person may receive prescription medications to help manage a behavioral disorder. Though medication will not cure the disorder, it is effective in assisting with treatment to control and modify behaviors.

Behavioral Drugs: Possible Options

Many drugs are available for behavioral problems, and the type of drug that will be prescribed depends on the specific condition being treated. The Positive Environments Network of Trainers of the California Department of Education lists Ritalin and Dexedrine as short-acting medications for the treatment of ADHD. They may help a child focus better, reduce impulsive behavior and reduce motor restlessness.

Ritalin is also included in a group of medications known as long-acting stimulants. Other types of medications in this group include Concerta, Methylin ER, Methylin CD, Focalin, and Metadate ER. These medications may also be effective against ADHD. Concerta may prevent drug abuse, as can Vyanase and Daytrana. Some professionals recommend Wellbutrin as a primary ADHD treatment.

People with an anxiety disorder, OCD or ADHD may benefit from antidepressants, including Paxil, Tofranil, Anafranil, Prozac, Luvox, Celexa, Zoloft and Norpramin. Other medications that may help include Daytrana, Biphetamine, Dexedrine, Adderall XR and Strattera. These medications are aimed at decreasing impulsivity, reducing hyperactivity, decreasing obsessive-compulsive actions and reducing feelings of depression.

Medication Side Effects

Medications for behavioral disorders may have side effects. They can increase emotional issues, increase suicidal thoughts and aggravate seizure conditions. Some of the possible side effects include:

Behavior Drug Addiction, Dependence and Withdrawal

An individual may become addicted to the medication taken to treat a behavioral disorder. As a result, the person may need professional help with weaning off that medication. You may experience withdrawal symptoms if you abuse certain medications.

If you suspect that you, your child or someone else you know has become dependent on prescription medication, contact us at for immediate assistance.

Medication Overdose

Children are more likely than adults to accidentally overdose on medication, including behavioral medications. A person who is depressed because of a behavioral disorder may attempt an overdose on purpose. People who are depressed or have suicidal thoughts have a high risk for overdose, according to the National Coalition Against Prescription Drug Abuse.

Depression and Behavioral Disorders

According to the Cleveland Clinic, a behavioral disorder may trigger depression. The opposite is also possible, with depression being a trigger for a behavioral disorder, which can also lead to substance abuse.

Dual Diagnosis: Addiction and Behavioral Disorders

It is not uncommon for people with a behavioral disorder to also have an addiction to drugs or alcohol. According to Psychology Today, an individual who has a panic disorder may also be addicted to alcohol.

Children with ADHD may be at a higher risk for developing a substance abuse or alcohol dependence issue if the condition carries over into adulthood, according to WebMD.

Getting Help for a Behavioral Disorder

Because of the severity of these mental health issues, getting help for a behavioral disorder is crucial. Cognitive behavioral therapy along with medication is an effective way to treat disorders such as ODD. The sooner you get help, the easier it will be to restore your life to normal.

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Emotional Behavioral Disorder Symptoms, Causes and Effects | PsychGuides.com

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Behavioral disorders are common in both adults and children. Learn more about causes, symptoms and treatment on PsychGuides.com.

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Inside Higher Ed | Higher Education News, Events and Jobs

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More than half of the college students who visited their campus counseling centers during the 2015-16 academic year reported symptoms of anxiety, according to a survey by the Association for University and College Counseling Center Directors.

This marks the seventh year in a row that anxiety has been the top complaint among students seeking mental health services. This year, 51 percent of students who visited a counseling center reported having anxiety, followed by depression (41 percent), relationship concerns (34 percent) and suicidal ideation (20.5 percent). Many students reported experiencing multiple conditions at once.

Since 2009, when anxiety overtook depression as the No. 1 concern among college students, the number of students experiencing anxiety has steadily increased.

This survey was conducted between September 2015 and August 2016. In total, 529 counseling center directors representing that many institutions responded to the survey, with an even split between public and private institutions. The majority of respondents came from four-year colleges, but community colleges, professional schools and art schools were also included.

In an effort to reflect the makeup of their student bodies, counseling centers have diversified their clinical staff members. Of new hires, 62.2 percent are white, 15.3 percent black, 7.5 percent Latino and 10 percent Asian. This compares to current clinical staff, who are 70.9 percent white, 10.1 percent black, 7.3 percent Latino and 7.9 percent Asian.

"Student populations have become more diverse," said Micky Sharma, president of the AUCCCD and director of counseling and consultation services at Ohio State University. "Counseling services work to create a staff that represents their student bodies."

At Ohio State, for example, the counseling center now offers clinical services in nine different languages to meet the needs of their international students, who make up about 12 percent of the student body, Sharma said.

Regardless of race, ethnicity, gender or sexual orientation, "anyone could show up with anxiety or depression or a relationship issue," Sharma said. "A university counseling center is charged with providing help for everybody."

Another key finding in the survey is that 41.6 percent of counseling centers hired additional staff members in the last academic year, compared to about 26 percent in 2011 and 36 percent in 2016.

College counseling centers continue to grow to match the demands of their students, according to David Reetz, the lead researcher and coordinator for the 2016 survey and director of counseling and psychological services at the Rochester Institute of Technology.

"More students are seeking services because we continue to be more and more aware that a student's health and well-being have a lot to do with their success in their academic programs and the quality of their student life experience," Reetz said.

In fact, of the students surveyed, about 72 percent who used counseling services said it helped their academic performance in some way.

As more students continue to seek out mental health services and campus counseling centers try to keep up with new hires, the question of student wait times becomes key.

For the first time, this year's survey asked counseling center directors about average wait times for students based on the number of business days between when the appointment was scheduled and when it occurred.

The survey team found that, on average, students waited between six and eight business days for counseling services. However, as might be expected, institutions with a lower ratio of professional staff to students saw shorter wait times.

Reetz noted that the wait-time average is a "tricky number," given that some students opt to schedule their first appointment farther out to accommodate their own schedules.

"Students don't necessarily want to be seen right away," Reetz said, adding that, generally, "the more staff a center has, the shorter that wait time is between initial contact and first appointment."

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Anxiety and depression are the primary concerns for students seeking counseling services

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Survey of campus counseling centers finds increased demand for services, as well as additional positions and more diversity in hiring.

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From Dr. Tamar Chansky Creator of Worrywisekids.org

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Texas Model for Comprehensive School Counseling Programs

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Texas Model for Comprehensive School Counseling Programs

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Not all care is created equal. In fact, care that is truly evidence-based, compassionate and personalized makes all the difference. That's why the Child Mind Institute began offering treatment for children and young adults with mental health and learning challenges over a decade ago. Our clinical centers and telehealth practice continue to offer solutions for each family's unique needs, because every child deserves to thrive.

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Brady's Story

A young man learns to manage his anxiety and intrusive thoughts through expert care supported by financial aid at the Child Mind Institute.

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Lo sentimos, la página que usted busca no se ha podido encontrar. Puede intentar su búsqueda de nuevo o visitar la lista de temas populares. Not all care is created equal. In fact, care that is truly evidence-based, compassionate and personalized makes all the difference.

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Characteristics of Students with Emotional Disturbance

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Characteristics of Students with Emotional Disturbance