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Resources

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Behavioral disorders also known as conduct disorders are one of the most common forms of disability among children and young adults and is the most frequently cited reason for referral to mental health services. The appearance of behavioral disorders is increasing dramatically in our K-12 classrooms. As a result, their presence severely constrains the ability of the school systems to educate students effectively. The prevalence of behavioral problems among children and young adults is substantial. Many surveys indicate that behavioral disorders vary among young adults, ranging from 2 and 6 percent among K-12 students. This percentage translates into 1.3 to 3.8 million cases of behavioral disorders among the school and pre-college population.

Behavior disorders have also been referred to in a variety of different terminologies, including but not limited to:

1. Emotional and Behavior Disorders (EBD)

2. Emotional Conflict (EC)

3. Serious Emotional Disturbance (SED)

Behavioral disorders become apparent when the student displays a repetitive and impact persistent pattern of behavior that results in the significant disruption of other students. Such disturbances may cause significant impairments in academic, social, and or occupational functioning. Among the characteristics of a behavioral disorder among children and adolescents are:

General Strategies

Multidisciplinary educational teams, including parents, must design programs to meet the individual behavioral and academic needs of identified SED students. Most students can benefit from supportive treatments provided in general education programs. For others, at least temporary placements in special education classrooms, schools, or institutional programs may be appropriate.

Special education programs usually attempt to provide a structured environment where students experience a high degree of success; rules and routines are predictable; and students are consistently rewarded for appropriate behavior. Behavior management techniques, such as positive reinforcement, token economies, contracting, and time-out, which rely on direct measurement and monitoring of behavioral change, are commonly used in SED programs. The assessment and systematic teaching of social skills through modeling, discussion, and rehearsal are frequently used to help students increase control over their behavior and improve their relations with others. In addition, supportive therapies involving music, art, exercise, and relaxation techniques, as well as affective education, individual, and group counseling are sometimes employed to improve self-understanding, self-esteem, and self-control. The following are strategies that may be effective with students with EBD:

Teacher Presentation

Laboratory

Group Interaction and Discussion

1. Acknowledge the contributions of the student with an emotional disorder.

2. Call for responses and participation commensurate with the student's socialization skills.

3. As the student's comfort level rises and when a safe topic is available, encourage the student to be a group spokesperson.

4. Along with the student, devise a contingency plan in which inappropriate forms of response are replaced by appropriate ones.

5. Gradually increase the challenges in the student's participation in group exercises while providing increased positive reinforcement.

6. Help the student to feel as though he or she has something worthwhile to contribute to the discussion.

7. Some students may experience considerable strain in social adjustment in a group context. It may be necessary to work gradually toward group activities. One can devise a strategy of progressing from spectatorship to one-to-one instruction and eventually to small group discussion.

8. Should monitor carefully to ensure that the nondisabled students do not dominate the discussion or detract in any way from the successful performance of the student with the behavioral disorder.

Reading

1. It is necessary to target specific pro-social behaviors for appropriate instruction and assessment to occur such as:

1. Taking turns, working with partner, following directions.

2. Reading in group or with others.

3. Increasing positive relationships by means of awards when they read appropriately.

4. Demonstrating appropriate reading

2. Instructional strategies involving self-control, self-reinforcement, self-monitoring, self-management, problem solving, cognitive behavior modification, and metacognitive skills should be focused on teaching students reading skills

Research

1. Review and discuss with the student the steps involved in a research activity. Think about which step(s) may be difficult for the specific functional limitations of the student and jointly devise accommodations for that student.

2. Use appropriate laboratory and field strategies.

3. Depending on the site of the research check the previous two sections.

4. Show clear examples of what the students should expect as an outcome of their research.

Field Experiences

1. Use appropriate general strategies.

2. Consider alternate activities/exercises that can be utilized with less difficulty for the student, but has the same or similar learning objectives.

3. In field activities acknowledge the contributions and assistance of the student with an emotional disorder.

4. Help the student to feel as though he or she has something worthwhile to contribute to the field trip.

5. Use a buddy system.

6. Gradually increase the challenges in the student's participation in field exercises while providing increased positive reinforcement.

7. Group participation in field activities is highly desirable because it enhances social contacts.

8. Make the student with the behavioral disorder become one of the field trip leader of an activity which can often reduce their disorder.

9. Special efforts should be made to get students with behavioral disorders to interact with other students.

10. You should encourage students to practice field skills during their free hours.

11. Every effort should be made to arouse the interest of such students in activities, so they will learn to perform the activities with success and pleasure with appropriate behaviors.

Testing

1. Be sensitive to the student's reactions to the various aspects of assessment.

2. For each student, accumulate in his or her portfolio several examples of work (quizzes, assignments, projects) that demonstrate knowledge of the subject matter or the unit of study.

3. Make special arrangements for the student with an emotional disorder according to what their special needs are and that they do not compromise the integrity of the testing situation.

4. Stay on top of student progress through informal assessment, don't wait until it's too late to discover that there is a problem.

5. Provide private room/smaller group setting/alternative test site (with proctor present); alternatively screens to block out distractions.

Organizations

Council for Exceptional Children-Council for Children with Behavior Disorders (CCBD)
The Council for Children with Behavioral Disorders (CCBD) is dedicated to supporting the professional development and enhancing the expertise of those who work on behalf of children with challenging behavior and their families. It is a division of the Council for Exceptional Children (CEC).

CCBD Foundation
The CCBD Foundation was founded in 1997 by the Council for Children with Behavioral Disorders (CCBD), to support its mission of improving the education of children and youth with emotional or behavioral disorders (EBD).

Resources

Council for Exceptional Children (Behavior Disorders/Emotional Disturbance)
The Council for Exceptional Children (CEC) page on EBD. The Council for Exceptional Children (CEC) is the largest international professional organization dedicated to improving the educational success of individuals with disabilities and/or gifts and talents.

BehaviorDisorder.org
The site offers information on behavior disorders, conduct disorders, and other behavior problems.

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Behavioral disorders also known as conduct disorders are one of the most common forms of disability among children and young adults and is the most frequently cited reason for referral to mental health services. The appearance of behavioral disorders is increasing dramatically in our K–12 classrooms…

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Both Individualized Education Programs (IEPs) and 504 plans can offer formal help for K-12 students who are struggling in school. They're similar in some ways but very different in others. This chart compares them side by side to help you understand the differences.

A blueprint or plan for a child's special education experience at school.

A blueprint or plan for how the school will provide support and remove barriers for a student with a disability.

To get an IEP, there are two requirements: A child has one or more of the 13 disabilities listed in IDEA. The law lists specific challenges, like learning disabilities, ADHD, autism, and others. And the disability must affect the child's educational performance and/or ability to learn and benefit from the general education curriculum. The child must need specialized instruction to make progress in school.

To get a 504 plan, there are two requirements: A child has any disability. Section 504 covers a wide range of different struggles in school. And the disability must interfere with the child's ability to learn in a general education classroom. Section 504 has a broader definition of a disability than IDEA. (It says a disability must substantially limit one or more basic life activities. This can include learning, reading, communicating, and thinking.) That's why a child who doesn't qualify for an IEP might still be able to get a 504 plan.

There are strict legal requirements about who participates. With a few exceptions, the entire IEP team must be present for IEP meetings. The team must include:

The rules about who's on the 504 team are less specific than they are for an IEP. A 504 plan is created by a team of people who are familiar with the child and who understand the evaluation data and special services options. This might include:

* The child's parent or caregiver

* General and special education teachers

* The school principal

* The child's parent or caregiver

* At least one of the child's general education teachers

* At least one special education teacher

* A school psychologist or other specialist who can interpret evaluation results

* A district representative with authority over special education services

The IEP sets learning goals and describes the services the school will provide. It's a written document. Here are some of the most important things the IEP must include:

There is no standard 504 plan. Unlike an IEP, a 504 plan doesn't have to be a written document. A 504 plan generally includes the following:

* Specific accommodations, supports, or services for the child

* Names of who will provide each service

* Name of the person responsible for ensuring the plan is implemented

* The child's present levels of academic and functional performance - how the child is currently doing in school

* Annual education goals for the child and how the school will track progress

* The services the child will get - this may include special education, related, supplementary, and extended school year services

* The timing of services - when they start, how often they occur, and how long they last

* Any accommodations - changes to the child's learning environment

* Any modifications - changes to what the child is expected to learn or know

* How the child will participate in standardized tests

* How the child will be included in general education classes and school activities

When the school wants to change a child's services or placement, it has to tell families in writing before the change. This is called prior written notice. Notice is also required for any IEP meetings and evaluations. Families also have "stay put" rights to keep services in place while there's a disagreement about the IEP.

The school must notify families about an evaluation or a "significant change" in placement. Notice doesn't have to be in writing, but most schools do so anyway.

How to resolve disputes

IDEA gives families several ways to resolve disputes (usually in this order):

Section 504 gives families several options for resolving disagreements with the school:

* Mediation

* Alternative dispute resolution

* Impartial hearing

* Complaint to the Office for Civil Rights (OCR)

* Lawsuit

* Mediation

* Due process complaint

* Resolution session

* Civil lawsuit

* State complaint

* Lawsuit

And if you need help navigating special education law in your state, consider reaching out to your local Parent Training and Information Center. The people there can answer questions and give practical advice on issues specific to your area.

Do you want to learn more about how IEPs and 504 plans compare? Watch as an expert explains the differences between them.

About the author

About the author

The Understood Team is made up of passionate writers and editors. Many of them have kids who learn and think differently.

Reviewed by

Reviewed by

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

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IEP vs. 504 Plan: What's the Difference?

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Individualized Education Programs (IEPs) and 504 plans are similar but different. See how they compare in what they provide and the processes and laws involved.

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School Violence

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School Violence Prevention. Time and time again we find that much of what we initially believe to be true... is false. Random acts of violence in schools turn out to be hardly random at all. Learn about school violence prevention programs and how they are lifting the veil of obscurity from acts of school violence.

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Teacher Support

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Editor's note: We met middle school counselor Ian Brodie at a recent RESPECT roundtable discussion at the U.S. Department of Education. He writes to offer tips for teachers on how to form partnerships with counselors.
Collaboration is the word of the 21 st century in education. As educators, we are always looking for new ways to work with other professionals in our schools to improve the achievement of our students.

School counselors are an essential resource and great partners for teachers. Gone are the days of "guidance counselors" who existed in the background of the school, sifting through paperwork and deciding for students whether or not they were fit for college. Today's professional counselors proactively search for innovative ways to meet the needs of all students and to maximize their academic achievement. There are many ways teachers can utilize counselors to solve problems that may interfere with students' success at school. Here are 10 tips for teachers to help them maximize their partnerships with counselors.

1. Call on counselors to help you understand the whole student. When teachers notice red flags, such as behavioral issues or grades, school counselors are prepared to help teachers gain a more complete understanding of the issues behind the actions.

2. Consult with counselors for professional advice. When teachers find themselves stuck with strategies that aren't working with a particular student, a counselor who is trained to problem-solve can help them gain fresh ideas to age old problems.

3. Tackle problems before they become insurmountable. When teachers sense trouble brewing in class, language or behavior that causes them anxiety, they should talk with a school counselor who can help trouble-shoot and prevent a situation from escalating.

4. Offer students an empathetic listener. When students are having problems that seem personal or sensitive or that have the potential to get them into trouble, send them to a school counselor who can provide a sounding board and help them find solutions.

5. Guide students' decision-making. When students act out repeatedly in class, teachers should inform a counselor who can work with them on decision making. School counselors can also help the child reframe the situation and illustrate how different behaviors might be in their best interest.

6. Collaborate with a counselor to integrate counseling and class lessons. Work together to teach lessons in class about academics, careers, and personal/social issues. These lessons are preventive by design and developmental in nature to help students with their decision-making in school. For example, a lesson about bullying and harassment in a civics class could be paired with a project on laws about harassment.

7. Work with counselors and teachers to design professional development that meets your needs. In-service days provide great opportunities for counselors and teachers to explain their work and develop solutions to school-wide problems.

8. Allow a counselor to make peace. When students can't get along in class despite the teacher's attempts to separate them or diffuse tension, allow a counselor to mediate and work out a plan for how the two parties can peaceably coexist.

9. Explore career options. Educators may want to engage a school counselor in helping students understand how their academic work connects to specific careers.

10. Ask a counselor to clarify the severity of a problem. As students develop physically, rapid changes in their mood or behavior can leave teachers wondering whether certain behavior is a normal or a cause for deeper concern. School counselors have been trained to ask the questions that get at the heart of what's really going on.

Ian Brodie
Ian Brodie is a Middle School Counselor at Lake Braddock Secondary School in Burke, Va.

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The Top 10 Ways School Counselors Can Support Teachers - ED.gov Blog

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Editor's note: We met middle school counselor Ian Brodie at a recent RESPECT roundtable discussion at the U.S. Department of Education. He writes to offer tips for teachers on how to form partnerships with counselors. Collaboration is the word of the 21st century in education.

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Autism

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Everyone's story is different.

The experience of Autism is not one thing. It is many things. It's dreams, talents, relationships, victories, hurdles, and everything in between. The connection between those experiences is you.
You break the mold. No matter who you are, the person you are is infinite-and you are the only you there is.

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Autism Society Creating connections for the Autism community to live fully.

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We create connections, empowering everyone in the Autism community with the resources needed to live fully.

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Schizophrenia

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Schizophrenia is a serious disorder which affects how a person thinks, feels and acts. Someone with schizophrenia may have difficulty distinguishing between what is real and what is imaginary; may be unresponsive or withdrawn; and may have difficulty expressing normal emotions in social situations. Contrary to public perception, schizophrenia is not split personality or multiple personality.

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Overview

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People with psychotic disorders lose contact with reality and experience a range of extreme symptoms that usually includes: Hallucinations-hearing or seeing things that are not real, such as voices Delusions-believing things that are not true However, these symptoms can occur in people with other health problems, including bipolar disorder, dementia, substance abuse disorders, or brain tumors.

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Kidshealth

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What Is OCD?

Obsessive-compulsive disorder (OCD) causes upsetting thoughts called obsessions. It also causes the urge to do behaviors called compulsions (also called rituals). Kids and teens with OCD get stuck in a stressful cycle of these thoughts, anxiety, and rituals.

If you think your child has OCD, start with a visit to your child's doctor or mental health provider. They can check for OCD or for other problems that could be the cause of your child's symptoms.

How Is OCD Treated?

Treatment for OCD is a type of cognitive behavioral therapy (CBT). In therapy, kids learn coping and calming skills for anxiety. They learn how to safely face fears without doing rituals.

Along with therapy, doctors may give medicines for OCD to some kids. For kids who need medicines, doctors give SSRIs (selective serotonin reuptake inhibitors). These include Zoloft®, Prozac®, and Luvox®.

Treatment works best when a parent or caregiver goes to therapy with their child. That way, they can learn how to coach their child through OCD symptoms, help their child practice skills they learn in therapy, and offer daily support.

What Signs Might Parents Notice?

Obsessions

These are stressful thoughts that come to mind over and over. A child with OCD doesn't want to think about these things. But they feel they can't stop.

Parents may notice obsessions as intense fears or worries. Kids with OCD may feel unusually upset about:

germs, dirt, illness, injury, or harm

whether someone could get sick, hurt, or die

things that seem wrong, or out of place

whether bad thoughts might come true

things that are not straight, even, or arranged "just right"

Compulsions (Rituals)

These are behaviors a child will do, trying to feel better. To the child, rituals seem like the way to stop thoughts and relieve fears. They seem like a way to keep bad things from happening.

Parents may notice that kids:

touch, tap, or step in unusual ways

arrange things over and over

repeat words, phrases, or questions

have many doubts, and trouble making choices

wash or clean more than needed

take a long time to do things - like get dressed, shower, eat, do homework

Kids may involve parents in rituals. And at first, parents may not realize that something is a ritual. For example, a child with OCD might ask for reassurance over and over. Or a child may insist a parent say or do something a set number of times, or in a set way.

Kids and teens with OCD can have obsessions, compulsions, or both.

Feelings

OCD symptoms are hard on kids. Rituals may seem to give them some relief at first. But rituals multiply. They start to take more time and energy. Kids have little left for things they enjoy. OCD thoughts, feelings, and rituals become a stressful cycle. This can make it hard to focus in school, have fun with friends, get to sleep, or relax.

Kids may seem:

anxious, worried

frustrated, irritable

sad, tired

upset when they can't do a ritual

to need constant reassurance from a parent that things are OK

Some kids may not let parents know about the thoughts, fears, and behaviors OCD causes. They may feel confused or ashamed about their fear and keep it to themselves. They may try to hide rituals they do. Some kids may have OCD symptoms for a while before their parents realize it.

How Can I Help My Child?

If you think your child may have OCD:

Talk with your child about what you've noticed. Talk in a supportive way, listen, and show love. Say something that works for your child's situation like, "I notice you fixing your socks a lot, trying to get them even. Getting them to feel right causes you a lot of stress."

Say that something called OCD might be causing the worry and the fixing. Tell your child that a checkup with a doctor can find out if this is what's going on. Let your child know that this can get better, and that you want to help.

Make an appointment with a child psychiatrist or psychologist. Your child's doctor can help you find the right person. To diagnose OCD, they will spend time talking with you and your child. They will ask questions about your child's symptoms that help point them to signs of OCD. If they diagnose OCD, they can explain the treatment.

Take part in your child's therapy. Part of treatment is coaching parents on how to respond to their child's OCD symptoms. Learn all you can about ways you can help. Learn how to support your child's progress without giving in to rituals.

Be patient. Overcoming OCD is a process. There will be many therapy visits. Be sure to go to them all. Help your child practice the things the therapist shows you. Praise your child's effort. Show how proud you feel. Remind them that OCD is not their fault.

Get support, and give it. There are lots of resources and support for families dealing with OCD. The International OCD Foundation is a good place to start. Knowing that you're not alone can help you cope. Sharing success stories with other parents can give you hope and confidence.

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OCD causes upsetting thoughts (obsessions) and the urge to do "ritual" behaviors (compulsions). Kids and teens get stuck in a stressful cycle of these thoughts, anxiety, and rituals. OCD can get better with the right attention and care.

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Overview

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Psychiatry.org - What Is Obsessive-Compulsive Disorder?

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Obsessive-compulsive disorder (OCD) is a disorder in which people have recurring, unwanted thoughts, ideas or sensations (obsessions) that make them feel driven to do something repetitively (compulsions). The repetitive behaviors, such as hand washing, checking on things or cleaning, can significant…

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ADHD

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What Is ADHD?

ADHD stands for attention deficit hyperactivity disorder. It is a medical condition. A person with ADHD has differences in brain development and brain activity that affect attention, the ability to sit still, and self-control. ADHD can affect a child at school, at home, and in friendships.

What Are the Signs of ADHD?

All kids struggle at times to pay attention, listen and follow directions, sit still, or wait their turn. But for kids with ADHD, the struggles are harder and happen more often.

Kids with ADHD may have signs from one, two, or all three of these categories:

Inattentive. Kids who are inattentive (easily distracted) have trouble focusing their attention, concentrating, and staying on task. They may not listen well to directions, may miss important details, and may not finish what they start. They may daydream or dawdle too much. They may seem absent-minded or forgetful, and lose track of their things.

Hyperactive. Kids who are hyperactive are fidgety, restless, and easily bored. They may have trouble sitting still, or staying quiet when needed. They may rush through things and make careless mistakes. They may climb, jump, or roughhouse when they shouldn't. Without meaning to, they may act in ways that disrupt others.

Impulsive. Kids who are impulsive act too quickly before thinking. They often interrupt, might push or grab, and find it hard to wait. They may do things without asking for permission, take things that aren't theirs, or act in ways that are risky. They may have emotional reactions that seem too intense for the situation.

Sometimes parents and teachers notice signs of ADHD when a child is very young. But it's normal for little kids to be distractible, restless, impatient, or impulsive - these things don't always mean that a child has ADHD.

Attention, activity, and self-control develop little by little, as children grow. Kids learn these skills with help from parents and teachers. But some kids don't get much better at paying attention, settling down, listening, or waiting. When these things continue and begin to cause problems at school, home, and with friends, it may be ADHD.

How Is ADHD Diagnosed?

If you think your child has ADHD, make an appointment with your child's doctor. He or she will give your child a check-up, including vision and hearing, to be sure something else isn't causing the symptoms. The doctor can refer you to a child psychologist or psychiatrist if needed.

To diagnose ADHD, doctors start by asking about a child's health, behavior, and activity. They talk with parents and kids about the things they have noticed. Your doctor might ask you to complete checklists about your child's behavior, and might ask you to give your child's teacher a checklist too.

After gathering this information, doctors diagnose ADHD if it's clear that:

A child's distractibility, hyperactivity, or impulsivity go beyond what's usual for their age.

The behaviors have been going on since the child was young.

Distractibility, hyperactivity, and impulsivity affect the child at school and at home.

A health check shows that another health or learning issue isn't causing the problems.

Many kids with ADHD also have learning problems, oppositional and defiant behaviors, or mood and anxiety problems. Doctors usually treat these along with the ADHD.

How Is ADHD Treated?

Treatment for ADHD usually includes:

Medicine. This activates the brain's ability to pay attention, slow down, and use more self-control.

Behavior therapy. Therapists can help kids develop the social, emotional, and planning skills that are lagging with ADHD.

Parent coaching. Through coaching, parents learn the best ways to respond to behavior difficulties that are part of ADHD.

School support. Teachers can help kids with ADHD do well and enjoy school more.

The right treatment helps ADHD improve. Parents and teachers can teach younger kids to get better at managing their attention, behavior, and emotions. As they grow older, kids should learn to improve their own attention and self-control.

When ADHD is not treated, it can be hard for kids to succeed. This may lead to low self-esteem, depression, oppositional behavior, school failure, risk-taking behavior, or family conflict.

What Can Parents Do?

If your child is diagnosed with ADHD:

Be involved. Learn all you can about ADHD. Follow the treatment your child's health care provider recommends. Keep all recommended appointments for therapy.

Give medicines safely. If your child is taking ADHD medicine, always give it at the recommended time and dose. Keep medicines in a safe place.

Work with your child's school. Ask teachers if your child should have an IEP. Meet often with teachers to find out how your child is doing. Work together to help your child do well.

Parent with purpose and warmth. Learn what parenting approaches are best for a child with ADHD - and which can make ADHD worse. Talk openly and supportively about ADHD with your child. Focus on your child's strengths and positive qualities.

Connect with others for support and awareness. Join a support organization for ADHD to get updates on treatment and other information.

What Causes ADHD?

It's not clear what causes the brain differences of ADHD. There's strong evidence that ADHD is mostly inherited. Many kids who have ADHD have a parent or relative with it.

ADHD is not caused by too much screen time, poor parenting, or eating too much sugar.

ADHD can improve when kids get treatment, eat healthy food, get enough sleep and exercise, and have supportive parents who know how to respond to ADHD.

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ADHD is a common medical condition that can affect kids at school, at home, and in friendships. This article is for parents who want to learn more about ADHD and how to help kids get the best diagnosis and care.

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Oppositional Defiant Disorder

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Depression

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Depressive disorder, frequently referred to simply as depression, is more than just feeling sad or going through a rough patch. It's a serious mental health condition that requires understanding and medical care. Left untreated, depression can be devastating for those who have it and their families. Fortunately, with early detection, diagnosis and a treatment plan consisting of medication, psychotherapy and healthy lifestyle choices, many people can and do get better.

Some will only experience one depressive episode in a lifetime, but for most, depressive disorder recurs. Without treatment, episodes may last a few months to several years.

An estimated 16 million American adults-almost 7% of the population-had at least one major depressive episode in the past year. People of all ages and all racial, ethnic and socioeconomic backgrounds experience depression, but it does affect some groups more than others.

Symptoms

Depression can present different symptoms, depending on the person. But for most people, depressive disorder changes how they function day-to-day, and typically for more than two weeks. Common symptoms include:

Changes in sleep

Changes in appetite

Lack of concentration

Loss of energy

Lack of interest in activities

Hopelessness or guilty thoughts

Changes in movement (less activity or agitation)

Physical aches and pains

Suicidal thoughts

Causes

Depression does not have a single cause. It can be triggered by a life crisis, physical illness or something else-but it can also occur spontaneously. Scientists believe several factors can contribute to depression:

Trauma. When people experience trauma at an early age, it can cause long-term changes in how their brains respond to fear and stress. These changes may lead to depression.

Genetics. Mood disorders, such as depression, tend to run in families.

Life circumstances. Marital status, relationship changes, financial standing and where a person lives influence whether a person develops depression.

Brain changes. Imaging studies have shown that the frontal lobe of the brain becomes less active when a person is depressed. Depression is also associated with changes in how the pituitary gland and hypothalamus respond to hormone stimulation.

Other medical conditions. People who have a history of sleep disturbances, medical illness, chronic pain, anxiety and attention-deficit hyperactivity disorder (ADHD) are more likely to develop depression. Some medical syndromes (like hypothyroidism) can mimic depressive disorder. Some medications can also cause symptoms of depression.

Drug and alcohol abuse. Approximately 30% of people with substance abuse problems also have depression. This requires coordinated treatment for both conditions, as alcohol can worsen symptoms.

Diagnosis

To be diagnosed with depressive disorder, a person must have experienced a depressive episode lasting longer than two weeks. The symptoms of a depressive episode include:

Loss of interest or loss of pleasure in all activities

Change in appetite or weight

Sleep disturbances

Feeling agitated or feeling slowed down

Fatigue

Feelings of low self-worth, guilt or shortcomings

Difficulty concentrating or making decisions

Suicidal thoughts or intentions

Treatments

Although depressive disorder can be a devastating illness, it often responds to treatment. The key is to get a specific evaluation and treatment plan. Safety planning is important for individuals who have suicidal thoughts. After an assessment rules out medical and other possible causes, a patient-centered treatment plans can include any or a combination of the following:

Psychotherapy including cognitive behavioral therapy, family-focused therapy and interpersonal therapy.

Medications including antidepressants, mood stabilizers and antipsychotic medications.

Exercise can help with prevention and mild-to-moderate symptoms.

Brain stimulation therapies can be tried if psychotherapy and/or medication are not effective. These include electroconvulsive therapy (ECT) for depressive disorder with psychosis or repetitive transcranial magnetic stimulation (rTMS) for severe depression.

Light therapy, which uses a light box to expose a person to full spectrum light in an effort to regulate the hormone melatonin.

Alternative approaches including acupuncture, meditation, faith and nutrition can be part of a comprehensive treatment plan, but do not have strong scientific backing. Read more on our treatment page.

Reviewed August 2017

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Depressive disorder, frequently referred to simply as depression, is more than just feeling sad or going through a rough patch. It's a serious mental health condition that requires understanding and medical care. Left untreated, depression can be devastating for those who have it and their families.

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Journals on anxiety

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Anxiety Disorders and universal Health Care

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Home - Anxiety Disorders and universal Health Care - Anxiety Disorders and universal Health Care

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How Many Calories Should I Eat To Lose Weight? - Calorie Counting For Better Health

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Anorexia Nervosa

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Anorexia Nervosa: Signs, Symptoms, Causes, And Treatment

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Are you or a loved one struggling with anorexia? Explore the warning signs and how to get help.

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Overview

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Eating disorders are characterized by a persistent disturbance of eating patterns that lead to poor physical or psychological health. The major eating disorders are pica, rumination disorder, avoidant/restrictive food intake disorder, anorexia nervosa, bulimia nervosa, and binge-eating disorder.

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Overview of symptoms

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Overview

Occasional anxiety is an expected part of life. You might feel anxious when faced with a problem at work, before taking a test, or before making an important decision. But anxiety disorders involve more than temporary worry or fear. For a person with an anxiety disorder, the anxiety does not go away and can get worse over time. The symptoms can interfere with daily activities such as job performance, school work, and relationships.

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

Signs and Symptoms

Risk Factors

Treatments and Therapies

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Occasional anxiety is an expected part of life. You might feel anxious when faced with a problem at work, before taking a test, or before making an important decision. But anxiety disorders involve more than temporary worry or fear. For a person with an anxiety disorder, the anxiety does not go away and can get worse over time.

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Bi Polar Disorder

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What is Bipolar Disorder?

Bipolar disorder, also known in some parts of the world by its older name, "manic depression," is a mental disorder that is characterized by serious and significant mood swings. A person with this condition experiences alternating "highs" (what clinicians call " mania") and "lows" (also known as depression).

Both the manic and depressive periods can be brief, from just a few hours to a few days. Or the cycles can be much longer, lasting up to several weeks or even months. The periods of mania and depression vary from person to person - many people may only experience very brief periods of these intense moods, and may not even be aware that they have the disorder.

According to the American Psychiatric Association, there four major categories of bipolar disorder: bipolar I disorder, bipolar II disorder, cyclothymic disorder, and bipolar disorder due to another medical or substance abuse disorder (APA, 2013). Anyone can be diagnosed with bipolar disorder, but bipolar disorder in children is called disruptive mood dysregulation disorder and carries a different set of symptoms.

All types of bipolar disorder generally respond well to treatment, which usually includes medication management for many years and for some, psychotherapy. Like many mental disorders, professionals generally don't talk about a person being "cured" of this condition, so much as learning to manage it well. Medication and psychotherapy help a person do that.
Learn more: Frequently Asked Questions & Fact Sheet
Take the bipolar quiz now.

Symptoms of Bipolar

For bipolar disorder to be diagnosed, a person needs to have experienced at least one manic (or in bipolar II, hypomanic) episode, and one depressive episode during their lifetime.

A manic episode (bipolar I disorder) is characterized by extreme happiness, extreme irritability, hyperactivity, little need for sleep and/or racing thoughts, which may lead to rapid speech. People in a manic episode feel like they can do anything, make plans to try and do all those things, and believe that nothing can stop them. For bipolar I to be diagnosed, this episode must have last at least a week and represents a noticeable change from a person's usual behavior.

A hypomanic episode (bipolar II disorder) is characterized by the same symptoms as a manic episode, except the symptoms need to only have been present for at least four (4) days.

A depressive episode is characterized by extreme sadness, a lack of energy or interest in things, an inability to enjoy normally pleasurable activities and feelings of helplessness and hopelessness. On average, someone with this condition may have up to three years of normal mood between episodes of mania or depression.

When left untreated, the severity of episodes can vary. People with this condition can often predict when a new cycle is starting, as the severity of their symptoms increase.
Learn more: Review the complete symptoms of bipolar disorder.
Causes & Diagnosis

As with most mental disorders, researchers are still not certain what causes this condition. There is no single risk factor, gene, or other predisposition that puts a person at increased risk for bipolar disorder. It is likely a combination of factors increase a person's risk. According to research, these factors may include a different brain structure and way of functioning, a set of genetic factors, and family history (as this disorder tends to run in families).
Learn more: What are the Causes of Bipolar Disorder?
Bipolar disorder, like most mental disorders, is best diagnosed by a trained mental health professional - such as a psychologist, psychiatrist, or clinical social worker. While a family physician or general practitioner may offer a preliminary diagnosis, only a mental health specialist offers the experience and skills necessary to diagnose this condition reliably.
Learn more: How is Bipolar Diagnosed?
Bipolar Disorder Treatment

According to researchers at the National Institute of Mental Health (NIMH), the exact cause of bipolar disorder is not yet known - but it can still be effectively treated. Research is ongoing about finding the most effective treatments.

Like most mental disorders, today this condition is treated with psychotherapy combined with psychiatric medications (most people benefit more quickly from combined treatment of the two). Treatment for this disorder is generally effective and helps most people keep a balanced mood throughout their day, most days of the month. It may take anywhere from one to two months before a person starts feeling the full, beneficial impact of their treatment.

Self-help strategies for this condition vary in their effectiveness, depending upon the person and the severity of the disorder. Some people find it beneficial to join a support group, read books explaining effective self-help strategies, or keeping a journal (either paper or through a mood or journaling app).

One of the biggest challenges of treatment of bipolar disorder is finding and maintaining a treatment routine that works best for a person over the long-term. Most people with this condition benefit from medications for much of their life, but it can be a challenge to stick with the medications when all seems well years down the road. Commonly prescribed medications for this disorder include a mood stabilizer (like lithium), while some treatments may also involve the use of additional medications (like an atypical antipsychotic or, in some cases, an antidepressant).
Learn more: Treatment of bipolar disorder
Living With & Managing Bipolar

There are many challenges to living with this condition on a daily basis. What are some of the long-term, successful strategies to staying well, sticking with treatment, and maintaining a balanced mood?

One important component of living with this condition is learning to build routines and sticking with them, no matter what. What can often drive a person into a manic or depressive episode is going off of their routine, or deciding one day that the mood stabilizer that helps them regulation their moods is no longer needed.

These articles were written to help a person learn to live more successfully with this condition:

Getting Help

There are many ways to get started in your journey of recovery from bipolar. Many people start by seeing their physician or family doctor to see if they really might suffer from this disorder. While that's a good start, you're encouraged to also consult a mental health specialist right away too. Specialists - like psychologists and psychiatrists - can more reliably diagnose a mental disorder than a family doctor can.

Some people may feel more comfortable reading more about the condition first. While we have a great library of resources here, we also have a set of recommended bipolar books and a peer-led, online support group just for this condition.
Take action: Find a local treatment provider More Resources & Stories: Bipolar Disorder on OC87 Recovery Diaries and Bipolar Disorder on The Mighty
Watch a short video about bipolar disorder
References
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders, Fifth edition. Arlington, VA.

Caponigro, J.M. & Lee, E.H. (2012). Bipolar Disorder: A Guide for the Newly Diagnosed. New Harbinger.

Fink, C. & Kraynak, J. (2015). Bipolar Disorder For Dummies. For Dummies, New York.

Miklowitz, D.J. & Gitlin, M.J. (2015). Clinician's Guide to Bipolar Disorder. Guilford Press.

National Institute of Mental Health. (2018). Bipolar disorder. Retrieved from https://www.nimh.nih.gov/health/publications/bipolar-disorder/index.shtml on February 27, 2018.

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Bipolar Disorder - What is it? Can it be treated?

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Bipolar disorder is a mental disorder characterized by episodes of extreme highs (mania) and lows (depression) in mood and energy. Bipolar disorder symptoms include mania, hypomania, and depression. It is typically treated with a combination of medication & psychotherapy.