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When worrying gets in the way of a child's functioning, parents need to get help rather than arranging the child's life to avoid the occasions of anxiety.

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Anxiety disorders, the most common mental health problems in children and adolescents, often go untreated while children suffer, even though there are effective treatments available, according to a new report on anxiety in children and adolescents from the Child Mind Institute in New York. Anxiety may be missed because it doesn't necessarily declare itself with attention-getting disruptive behaviors; in fact, symptoms may keep some children quiet and inhibited, though in other children, alternatively, anxiety may be misunderstood as oppositional behavior.

Adults may also assume that anxiety in a child is just a phase to be outgrown. A certain amount of anxiety is a normal aspect of development for young children - consider separation anxiety, for example - and it can even be protective, since children need to learn to keep themselves safe and anticipate certain kinds of dangers. But when worrying or avoiding possible threats gets in the way of a child's functioning or a child's enjoyment, it should be a signal to parents that help is needed, not just watching and waiting, not arranging the child's life to avoid the occasions of anxiety.

Kathleen Merikangas, the senior investigator and chief of the Genetic Epidemiology Research Branch at the National Institute of Mental Health, said, "To me, anxiety is one of the most underrecognized or under-treated conditions of childhood and adolescence." These children can get missed, she said, because they may seem to be functioning well; many don't have the kinds of developmental problems or attention issues that draw attention in school, though they may be suffering.

Consider the child whose anxiety about speaking in public gets in the way of participating in class. The child may be silent out of a fear of being laughed at or otherwise rejected, Dr. Merikangas said, but to the teacher, it may look like the child is just not interested. Environmental modifications can really help these children thrive in school, she said; for example, working in small groups with children they know.

The new report, released in September, summarizes the evidence that early temperament in children predicts their later behavior patterns around anxiety; toddlers who show what are called "behaviorally inhibited" behaviors, which parents are likely to perceive as extreme shyness, or anxiety around new people, are more likely to develop social anxiety later on. That doesn't mean that shyness is pathological (as with all varieties of temperament, there's a wide range of function), but it does suggest how important it is to help a child with this temperament who develops difficulties.

The tendency toward anxiety - and toward some specific forms of anxiety, like phobias - may persist throughout childhood and adolescence and into adulthood. And anxiety is closely tied to depression, Dr. Merikangas said. Although there have been reports that anxiety rates among American teenagers have soared, she cited evidence that the international rates of the underlying disorders had stayed consistent from 1998 to 2013; there is no global "epidemic" of clinical anxiety disorders, she said.

But with rates of suicide and suicidal ideation on the rise, it's particularly important to provide information to schools and to parents about recognizing anxiety and getting children help.

Dr. Harold Koplewicz, the president of the Child Mind Institute, said that when anxiety disorders in children are left untreated, anxiety can inhibit their lives, making standard daily activities difficult, from attending school to sleeping in their own beds, and lead to many extra visits to the school nurse or the pediatrician.

But beyond that, he said, "people underestimate that this is a gateway disorder." If children don't get help with these disorders, they may be at risk to develop other mental health problems; the child with severe separation anxiety may develop panic disorder, he said; the child with untreated general anxiety may be at greater risk for depression.

Dr. Merikangas was a co-investigator on a national study of mental disorders in adolescents, which has shown both that anxiety disorders were the most common mental health problems in adolescents in the United States, and also the problems that showed up earliest in those children's lives - the mean age of onset for anxiety disorders was 6. But many adolescents had never received treatment. That makes it essential to get the word out, Dr. Merikangas said, that anxiety is "one of the most treatable symptoms and syndromes, we can really change their lives with minimal intervention."

"All these disorders are remarkably treatable," Dr. Koplewicz said. There are highly effective behavioral and psychosocial therapies, including cognitive behavioral therapies, to help children cope with the demands of daily life. For children who don't respond to psychosocial therapies, he said, medications can be added.

But perhaps because anxiety is a normal response, parents often believe that even severe and disabling anxiety symptoms are just a phase, and on average, there is a two-year lag between the time children develop anxiety and the time they get help. "It's bad for these children's brains," he said. "Having your brain's thermostat miss-set is not good for your brain."

"Anxiety can manifest itself along a continuum," said Rachel Busman, the senior director of the anxiety disorders center at the Child Mind Institute. The report shows that there is some overlap with physical illnesses, such as chronic headaches or stomach aches, often coordinated with school. "That could be a kid's way of saying, 'I'm anxious,'" she said.

And when a child who is having a lot of difficulty with separation gets into the classroom, Dr. Busman said, that child may start throwing things, or running and hiding, and that "bad behavior" may represent the fight or flight response of anxiety. "We've also seen kids who have intense social anxiety and their way of managing it is to be class clown," she said.

Treating children with anxiety always means working with their parents. Jerry Bubrick, senior clinical psychologist at the anxiety disorders center of the Child Mind Institute, said that when children are little, it's normal for parents to operate in "fix-it mode," blocking the staircase so a toddler doesn't tumble down, averting problems before they happen.

As children get older, parents normally pull back, helping children find solutions of their own. "But anxious parents of anxious children remain in fix-it mode," he said, helping their children avoid the situations that make them anxious. Therapy involves exposing children to those situations and helping them develop strategies to manage them; with treatment, Dr. Bubrick said, parents can "let the child experience the anxiety and learn to tolerate and overcome it on their own."

"If you see things you're not sure about, talk to the preschool, talk to the pediatrician, be open to the idea that maybe there is anxiety," even in a young child, Dr. Busman said. Separation anxiety can be a problem even in children who are able to go to school, she said. Parents should pay attention if a child can't be left with a babysitter, a child can't sleep alone at home."These are the kids, they go into the bathroom, and they're like, are you still there?" she said. "We do see really young anxious children."

"If your child is suffering distress and dysfunction, reach out to your pediatrician," Dr. Koplewicz said. When you get to a mental health professional, "make sure you ask the right questions," he said, including asking whether that person has specific experience with treating anxiety and how long the treatment is expected to take.

"You want a professional who understands what they're doing and can explain to you what they're doing."

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How to Help a Child With an Anxiety Disorder

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When worrying gets in the way of a child's functioning, parents need to get help rather than arranging the child's life to avoid the occasions of anxiety. By Anxiety disorders, the most common mental health problems in children and adolescents, often go untreated while children suffer, even though there are effective treatments available, according to a new report on anxiety in children and adolescents from the Child Mind Institute in New York.

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Centers for Disease Control and Prevention

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Being mentally healthy during childhood means reaching developmental and emotional milestones and learning healthy social skills and how to cope when there are problems. Mentally healthy children have a positive quality of life and can function well at home, in school, and in their communities.

Mental disorders among children are described as serious changes in the way children typically learn, behave, or handle their emotions, which cause distress and problems getting through the day. Many children occasionally experience fears and worries or display disruptive behaviors. If symptoms are serious and persistent and interfere with school, home, or play activities, the child may be diagnosed with a mental disorder.

Mental health is not simply the absence of a mental disorder. Children who don't have a mental disorder might differ in how well they are doing, and children who have the same diagnosed mental disorder might differ in their strengths and weaknesses in how they are developing and coping, and in their quality of life. Mental health as a continuum and the identification of specific mental disorders are both ways to understand how well children are doing.

What are common childhood mental disorders?

Among the more common mental disorders that can be diagnosed in childhood are attention-deficit/hyperactivity disorder (ADHD), anxiety (fears or worries), and behavior disorders.

Learn more about childhood mental disorders, symptoms, and treatment.

Other childhood disorders and concerns that affect how children learn, behave, or handle their emotions can include learning and developmental disabilities, autism, and risk factors like substance use and self-harm.

Read more about related conditions.

What are the symptoms of childhood mental disorders?

Symptoms of mental disorders change over time as a child grows, and may include difficulties with how a child plays, learns, speaks, and acts, or how the child handles their emotions. Symptoms often start in early childhood, although some disorders may develop during the teenage years. The diagnosis is often made in the school years and sometimes earlier; however, some children with a mental disorder may not be recognized or diagnosed as having one.

Can childhood mental disorders be treated?

Childhood mental disorders can be treated and managed. There are many treatment options based on the best and most current medical evidence. Parents and doctors should work closely with everyone involved in the child's treatment-teachers, coaches, therapists, and other family members. Taking advantage of all the resources available will help parents, health professionals, and educators guide the child towards success. Early diagnosis and appropriate services for children and their families can make a difference in the lives of children with mental disorders.

Get help finding treatment

If you have concerns about a child, you can use these resources to help you find a healthcare provider familiar with treatment options.

Who is affected?

Childhood mental disorders affect many children and families. Boys and girls of all ages and ethnic/racial backgrounds and living in all regions of the United States experience mental disorders. Based on the National Research Council and Institute of Medicine report, which gathered findings from previous studies, it is estimated that in 2007, 13-20% of children living in the United States (up to 1 out of 5 children) experienced a mental disorder in a given year, costing individuals, families, and society an estimated $247 billion per year.

What is the impact of mental disorders in children?

Mental health is important to overall health. Mental disorders are chronic health conditions-conditions that last a long time and often don't go away completely-that can continue through the lifespan. Without early diagnosis and treatment, children with mental disorders can have problems at home, in school, and in forming friendships. Mental disorders can also interfere with a child's healthy development, causing problems that can continue into adulthood.

Public health includes mental health

Supporting children's mental health also includes making sure children meet developmental milestones, understanding what to do when there is a concern, supporting positive parenting strategies, and improving access to care.

CDC works with partner agencies to better understand mental health and mental disorders and the impact they have on children.
Read more about research on children's mental health.
What you can do

Parents: You know your child best. Talk to your child's healthcare professional if you have concerns about the way your child behaves at home, in school, or with friends.

Youth: It is just as important to take care of your mental health as it is to take care of your physical health. If you are angry, worried or sad, don't be afraid to talk about your feelings and reach out to a trusted friend or adult.

Healthcare professionals: Early diagnosis and appropriate treatment based on updated guidelines are very important. There are resources available to help diagnose and treat children's mental disorders.

Teachers/school administrators: Early identification is important so that children can get the help they need. Work with families and healthcare professionals if you have concerns about the mental health of a child in your school.

Resources

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Learn more about mental health, mental disorders, treatments, prevention, and public health research on children's mental health.

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Centers for Disease Control and Prevention

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Mental health is an important part of children's overall health and well-being. Mental health includes children's mental, emotional, and behavioral well-being. It affects how children think, feel, and act. It also plays a role in how children handle stress, relate to others, and make healthy choices.

Mental disorders among children are described as serious changes in the way children typically learn, behave, or handle their emotions, causing distress and problems getting through the day. Among the more common mental disorders that can be diagnosed in childhood are attention-deficit/hyperactivity disorder (ADHD), anxiety, and behavior disorders.

There are different ways to assess mental health and mental disorders in children. CDC uses surveys, like the National Survey of Children's Health, to describe the presence of positive indicators of children's mental health and to understand the number of children with diagnosed mental disorders and whether they received treatment. In this type of survey, parents report on indicators of positive mental health for their child and report any diagnoses their child has received from a healthcare provider. The information on this page provides data about indicators of positive mental health in children and mental health disorders that are most common in children.

Facts about mental health in U.S. children

National data on positive mental health indicators that describe mental, emotional, and behavioral well-being for children are limited. Based on the data we do have:

Facts about mental disorders in U.S. children

ADHD, anxiety problems, behavior problems, and depression are the most commonly diagnosed mental disorders in children. Estimates for ever having a diagnosis among children aged 3-17 years, in 2016-19, are given below.

ADHD 9.8% (approximately 6.0 million)

Anxiety 9.4% (approximately 5.8 million)

Behavior problems 8.9% (approximately 5.5 million)

Depression 4.4% (approximately 2.7 million)

Some of these conditions commonly occur together. For example, among children aged 3-17 years in 2016:

Having another mental disorder was most common in children with depression: about 3 in 4 children with depression also had anxiety (73.8%) and almost 1 in 2 had behavior problems (47.2%).

For children with anxiety, more than 1 in 3 also had behavior problems (37.9%) and about 1 in 3 also had depression (32.3%).

For children with behavior problems, more than 1 in 3 also had anxiety (36.6%) and about 1 in 5 also had depression (20.3%).

For adolescents, depression, substance use and suicide are important concerns. Among adolescents aged 12-17 years in 2018-2019 reporting on the past year:

Learn more about high-risk substance use among youth. Learn more about suicide.

Mental, behavioral, and developmental disorders begin in early childhood
1 in 6 U.S. children aged 2-8 years (17.4%) had a diagnosed mental, behavioral, or developmental disorder.

Prevalence of mental disorders change with age

Diagnoses of ADHD, anxiety, and depression become are more common with increased age.

Behavior problems are more common among children aged 6-11 years than younger or older children.

Adverse childhood events (ACEs) are associated with children's physical and mental health. In 2016-2019, among children aged 6-17 years:

Children who were discriminated against based on race or ethnicity had higher percentages of one or more physical health conditions (37.8% versus 27.1%), and one or more mental health conditions (28.9% versus 17.8%).

Racial/ethnic discrimination was almost seven times as common among children with three other ACEs compared to those with no other ACEs.

Note: The estimates reported on this page are based on parent report, using nationally representative surveys. This method has several limitations. It is not known to what extent children receive these diagnoses accurately. Estimates based on parent-reported diagnoses may match those based on medical records, but some children may also have mental disorders that have not been diagnosed, or receive diagnoses that may not be the best fit for their symptoms. Limited information on measuring children's mental health nationally is available.

Read more about children's mental health from a community study.

Access to mental health treatment

Early diagnosis and appropriate services for children and their families can make a difference in the lives of children with mental disorders. Access to providers who can offer services, including screening, referrals, and treatment, varies by location. CDC is working to learn more about access to behavioral health services and supports for children and their families.
View information by state describing the rates of different types of providers who can offer behavioral health services providers by county. Read a recent report describing shortages of services, barriers to treatment, and how integration of behavioral health care with pediatric primary care could address the issues. Read a policy brief on potential ways to increase access to mental health services for children in rural areas
Data sources for mental health and related conditions

There are many different datasets which include information on children's mental health and related conditions for children living in the United States.

Healthy People 2030
Healthy People 2030 sets data-driven national objectives to improve health and well-being over the next decade, including children's mental health and well-being.

National Survey of Family Growth (NSFG)
NSFG gathers information on family life, marriage and divorce, pregnancy, infertility, use of contraception, and general and reproductive health.

National Health and Nutrition Examination Survey (NHANES)
NHANES assesses health and nutritional status through interviews and physical examinations, and includes conditions, symptoms, and concerns associated with mental health and substance abuse, as well as the use and need for mental health services.

National Health Interview Survey (NHIS)
NHIS collects data on children's mental health, mental disorders, such as ADHD, autism spectrum disorder, depression and anxiety problems, and use and need for mental health services.

National Survey of Children's Health (NSCH)
NSCH examines the health of children, with emphasis on well-being, including medical homes, family interactions, the health of parents, school and after-school experiences, and safe neighborhoods. This survey was redesigned in 2016.

For previous versions of this survey, see also:
National Survey of Children's Health (NSCH 2003, 2007, 2011-12)
National Survey of Children with Special Healthcare Needs (NS-CSHCN 2001, 2005-6, 2009-10)

National Survey of the Diagnosis and Treatment of ADHD and Tourette Syndrome (NS-DATA)
NS-DATA collects information about children, 2-15 years old in 2011-2012, who had ever been diagnosed with ADHD and/or Tourette syndrome (TS), with the goal of better understanding diagnostic practices, level of impairment, and treatments for this group of children.

National Survey on Drug Use and Health (NSDUH)
NSDUH, administered by the Substance Abuse and Mental Health Services Administration (SAMHSA), provides national- and state-level data on the use of tobacco, alcohol, and illicit drugs (including non-medical use of prescription drugs), as well as data on mental health in the United States.

National Vital Statistics System (NVSS)
NVSS contains vital statistics from the official records of live births, deaths, causes of death, marriages, divorces, and annulment recorded by states and independent registration areas

National Youth Tobacco Survey (NYTS)
NYTS is a nationally representative school-based survey on tobacco use by public school students enrolled in grades 6-12.

School Associated Violent Death Study (SAVD)
SAVD plays an important role in monitoring trends related to school-associated violent deaths (including suicide), identifying the factors that increase the risk, and assessing the effects of prevention efforts.

School Health Policies and Programs Study (SHPPS)
SHPPS is a national survey assessing school health policies and practices at the state, district, school, and classroom levels. Collected data includes mental health and social service policies.

Web-based Injury Statistics Query and Reporting System (WISQARS)
WISQARS is an interactive database system that provides customized reports of injury-related data.

Youth Risk Behavior Surveillance System (YRBSS)
The YRBSS monitors health-risk behaviors, including tobacco use, substance abuse, unintentional injuries and violence, sexual behaviors that contribute to unintended pregnancy, and sexually transmitted diseases.

References

1. Perou R, Bitsko RH, Blumberg SJ, Pastor P, Ghandour RM, Gfroerer JC, Hedden SL, Crosby AE, Visser SN, Schieve LA, Parks SE, Hall JE, Brody D, Simile CM, Thompson WW, Baio J, Avenevoli S, Kogan MD, Huang LN. Mental health surveillance among children - United States, 2005-2011. MMWR 2013;62(Suppl; May 16, 2013):1-35. [Read summary]

2. Bitsko RH, Claussen AH, Lichtstein J, Black LJ, Everett Jones S, Danielson MD, Hoenig JM, Davis Jack SP, Brody DJ, Gyawali S, Maenner MM, Warner M, Holland KM, Perou R, Crosby AE, Blumberg SJ, Avenevoli S, Kaminski JW, Ghandour RM. Surveillance of Children's Mental Health - United States, 2013 - 2019 MMWR, , 2022 / 71(Suppl-2);1-42. [Read article]

3. Ghandour RM, Sherman LJ, Vladutiu CJ, Ali MM, Lynch SE, Bitsko RH, Blumberg SJ. Prevalence and treatment of depression, anxiety, and conduct problems in U.S. children. The Journal of Pediatrics, 2018. Published online before print October 12, 2018 [Read summary]

4. Bitsko RH, Holbrook JR, Ghandour RM, Blumberg SJ, Visser SN, Perou R, Walkup J. Epidemiology and impact of healthcare provider diagnosed anxiety and depression among US children. Journal of Developmental and Behavioral Pediatrics. Published online before print April 24, 2018 [Read summary]

5. Cree RA, Bitsko RH, Robinson LR, Holbrook JR, Danielson ML, Smith DS, Kaminski JW, Kenney MK, Peacock G. Health care, family, and community factors associated with mental, behavioral, and developmental disorders and poverty among children aged 2-8 years - United States, 2016. MMWR, 2018;67(5):1377-1383. [Read article]

6. Hutchins HJ, Barry CM, Valentine V, Bacon S, Njai R, Claussen AH, Ghandour RM, Lebrun-Harris LA, Perkins K, Robinson LR (submitted). Perceived racial/ethnic discrimination, physical and mental health conditions in childhood, and the relative role of other adverse experiences. Adversity and Resilience Science published online May 23, 2022. [Read summary]

7. US Department of Health and Human Services Health Resources and Services Administration & Maternal and Child Health Bureau. Mental health: A report of the Surgeon General. Rockville, MD: US Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Center for Mental Health Services, and National Institutes of Health, National Institute of Mental Health; 1999. [Read report]

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Data and Statistics on Children's Mental Health | CDC

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Read data highlights about children's mental health.

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Centers for Disease Control and Prevention

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Research on children's mental health in the community

Project to Learn About Youth - Mental Health

The Project to Learn About Youth - Mental Health (PLAY-MH) analyzed information collected from four communities. The focus was to study attention-deficit/hyperactivity disorder (ADHD) and other externalizing and internalizing disorders, as well as tic disorders in school-aged children. The purpose was to learn more about public health prevention and intervention strategies to support children's health and development.

Study questions included:

What percentage of children in the community had one or more externalizing, internalizing, or tic disorders?

How frequently did these disorders appear together?

What types of treatment were children receiving in their communities?

This project used the same methodology as the original Project to Learn about ADHD in Youth (PLAY) project. Read more about the original study approach here.

Other research

Read more about research on

CDC and partner agencies are working to understand the prevalence of mental disorders in children and how they impact their lives. Currently, it is not known exactly how many children have any mental disorder, or how often different disorders occur together, because no national dataset is available that looks at all mental, emotional, or behavioral disorders together.

Research on prevalence

Using different data sources

Healthcare providers, public health researchers, educators, and policy makers can get information about the prevalence of children's mental health disorders from a variety of sources. Data sources, such as national surveys, community-based studies, and administrative claims data (like healthcare insurance claims), use different study methods and provide different types of information, each with advantages and disadvantages. Advantages and disadvantages for different data sources include the following:

National surveys have large sample sizes that are needed to create estimates at the national and state levels. However, they also generally use a parent's report of the child's diagnosis, which means that the healthcare provider has to give an accurate diagnosis and the parent has to accurately remember what it was.

Community-based studies offer the opportunity to observe children's symptoms, which means that even children who have not been diagnosed or do not have the right diagnosis could be found. However, these studies are typically done in small geographic areas, so findings are not necessarily the same in other communities.

Administrative claims are typically very large datasets with information on diagnosis and treatment directly from the providers, which allows tracking changes over time. Because they are recorded for billing purposes, diagnoses or services that would not be reimbursed from the specific health insurance might not be recorded in the data.

Using different sources of data together provides more information because it is possible to describe the following:

Children with a diagnosed condition compared to children who have the same symptoms, but are not diagnosed

Differences between populations with or without health insurance

How estimates for mental health disorders change over time

Read more about using different data sources.external icon
National data on children's mental health

A comprehensive report from the Centers for Disease Control and Prevention (CDC), Mental Health Surveillance Among Children -United States, 2005-2011, described federal efforts on monitoring mental disorders, and presented estimates of the number of children with specific mental disorders. The report was developed in collaboration with the Substance Abuse and Mental Health Services Administration (SAMHSAexternal icon ), the National Institute of Mental Health (NIMHexternal icon ), and the Health Resources and Services Administration (HRSAexternal icon ). The report is an important step towards better understanding these disorders and the impact they have on children. This is the first report to describe the number of U.S. children aged 3-17 years who have specific mental disorders, compiling information from different data sources covering the period 2005-2011. You can read a summary of the findings here.

The goal is now to build on the strengths of federal agencies serving children with mental disorders to:

Develop better ways to document how many children have these disorders,

Better understand the impacts of mental disorders,

Inform needs for treatment and intervention strategies, and

Promote the mental health of children.

This report is an important step on the road to recognizing the impact of childhood mental disorders and developing a public health approach to address children's mental health.

Reference

Holbrook JR, Bitsko RB, Danielson ML, Visser SN. Interpreting the Prevalence of Mental Disorders in Children: Tribulation and Triangulation. Health Promotion Practice. Published online November 15, 2016 https://www.ncbi.nlm.nih.gov/pubmed/27852820external icon .

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Project to Learn About Youth - Mental Health The Project to Learn About Youth - Mental Health (PLAY-MH) analyzed information collected from four communities. The focus was to study attention-deficit/hyperactivity disorder (ADHD) and other externalizing and internalizing disorders, as well as tic disorders in school-aged children.

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Centers for Disease Control and Prevention

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Learn about different types of mental disorders in children, including symptoms, treatment, and what can be done to prevent them.

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From Dr. Tamar Chansky Creator of Worrywisekids.org

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Risk Factors in Children and Adolescents

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Risk Factors in Children and Adolescents

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Child Mind Institute | Transforming Children’s Lives.

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The Child Mind Institute is an independent nonprofit dedicated to transforming the lives of children struggling with mental health and learning disorders.

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Another great book. Helps understand how a diagnosis is assigned. Found on EBSCO

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Another great book. Helps understand how a diagnosis is assigned. Found on EBSCO

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By Olivia Guy-Evans, published March 08, 2022

Fact checked by Saul Mcleod, PhD

Moods are long-term emotional states, compared to emotions alone which can be fleeting and short-term. Whilst it is normal to experience periods of different moods, mood disorders are characterised by emotional extremes and difficulties in regulating mood.

Although moods can be temporary, when these moods persist to extremities and cause significant dysfunction, these can cause long-term disturbances.

Mood disorders are a broad umbrella term used to include all different types of depressive and bipolar disorders. Conditions which affect mood can range from feeling extremely low to extremely high.

Mood disorders are found to affect about 20% of the general population at any given time. Specifically, in the US for instance, 17% of the population is thought to suffer from depression over the course of their lifetime, with bipolar disorders affecting 1% of the general population.

Whilst the rate for bipolar disorders is significantly lower, many researchers agree that many instances of manic moods (describing the emotional 'highs' of bipolar disorder) often go unnoticed or are deemed unproblematic, meaning that many people may go undiagnosed.

Types of mood disorders

Major depressive disorder

Major depressive disorder is characterised by prolonged and persistent periods of extreme sadness.

Whilst it is normal to experience sadness or grief in times of traumatic life events, if this depression continues even when the events are over or if there is no apparent cause to the sadness, this may classify as clinical or major depression.

This is a very common mental disorder which is accompanied by a variety of physical, cognitive, and emotional symptoms.

Bipolar I disorder

This disorder was formerly known as 'manic depression', characterised by extreme emotional highs and extreme emotional lows.

The extreme highs are called mania and involve euphoric and/or irritable moods and increased energy or activity. The extreme lows are symptomatic of depression symptoms.

Bipolar I disorder is thought to be the most severe form of bipolar disorder as the manic episodes can cause disruption to everyday life.

Bipolar II disorder

This disorder causes cycles of depression which is similar to those who have bipolar I disorder.

Individuals with bipolar II disorder also experience hypomania, which is a less severe form of mania.

Hypomanic periods are not as intense or as disruptive as manic episodes and people are usually able to handle daily tasks despite these episodes.

Seasonal affective disorder (SAD)

SAD is a type of depression which only occurs during certain seasons. Typically, depressed symptoms start in late autumn or early winter for many people, less commonly starting in spring or summer for others.

The symptoms of SAD resemble those of major depression although SAD differs as the individual will usually start to feel better once the season is over.

Cyclothymic disorder

This is a disorder which is sometimes defined as a milder form of bipolar disorder. It causes emotional highs and lows which are believed to be less extreme than those experiencing bipolar I or II disorder.

Individuals with cyclothymic disorder experience continuous irregular mood swings for extended periods of time. The changes in mood can occur suddenly, at any time, with only short periods of baseline mood.

Disruptive mood dysregulation disorder

This is a newer type of depressive disorder which was added to the Diagnostic and Statistical Manual on Mental Disorders (DSM-5).

This is usually diagnosed in children who exhibit persistent irritability and anger with frequent episodes of extreme temper outbursts without any observable cause.

This is often diagnosed when the symptoms are inconsistent with the child's developmental age.

Persistent depressive disorder

This disorder was previously known as dysthymic disorder, a less severe form of major depression.

This type of depressive disorder is long-term, occurring for at least 2 years for individuals and the symptoms of depression occasionally lessen during this time.

Premenstrual dysphoric disorder

This is characterised by mood changes and irritability which occurs during the premenstrual stage of a female's cycle.

They will often experience extreme mood swings, hopelessness, anger, anxiety, or tension. Once the individual begins their menstruation, the symptoms usually cease.

Symptoms

Below are some of the common symptoms that may be experienced by someone who is experiencing a mood disorder:

Loss of interest in activities that were once enjoyed

An increase or decrease in appetite

Difficulty sleeping, or sleeping more than usual

Feeling fatigued

Being easily upset or crying a lot

Feeling isolated

Feeling hopeless and worthless

Feeling guilty

Feeling irritable

Physical symptoms such as headaches or stomach aches

Low self-esteem

Withdrawing from social events, friends, or family

Suicidal ideation

Difficulty in keeping up with daily tasks and demands of life

Below are some of the common symptoms of manic or hypomanic episodes:

Often with depressed feelings, this is usually preceded by a number of unhelpful self-statements and thoughts. Usually there is a pattern to these thoughts, and these are called unhelpful thinking styles.

People tend to use these thinking styles as an automatic habit that they may not be aware of.

If someone consistently uses some of the styles of thinking, they can often cause themselves a great deal of emotional distress.

Mental filter - this includes focusing on only one part of a situation, usually the negative part, ignoring the rest which may be more positive.

Catastrophizing - people may blow something that happens out of proportion. Situations are viewed as more terrible and disastrous than they actually are.

Black and white thinking - seeing only one extreme or the other. Someone with this thinking style may only view things as right or wrong, good or bad, with no grey areas in-between.

Overgeneralization - a person may take one instance in the past or present and impose it on all current or future situations. For instance, they may say 'I never...' or 'Everyone...'.

Jumping to conclusions - people who jump to conclusions tend to assume they known what someone else is thinking (mind reading) and they tend to make predictions about what is going to happen in the future (predictive thinking).

Personalisation -with this thinking style, individuals tend to blame themselves for everything that goes wrong or could go wrong. They may take 100% responsibility for the occurrence of external events which they realistically would not have control over.

Shoulding and musting - although not always unhelpful depending on the situation, saying 'I should...' or 'I must...' sentences can put unreasonable pressure on the individual.

Labelling - this is where the individual makes global statements about themselves, and others based on their behaviour in specific situations. They may use this label even though there are many more examples that aren't consistent with that label.

Emotional reasoning - this is where people base their view of situations or themselves on the way they are feeling. For example, the only evidence that something bad is going to happen if they feel like something bad will happen.

Magnification and minimisation - individuals may often magnify the positive attributes of others and minimise their own positive attributes. They may explain away their own positive characteristics or success as though they are not important.

Causes and risk factors

Whilst there is not a known direct cause for someone to develop a mood disorder, there are some possible contributing factors which may play a part.

Often, the cause of mood disorders is thought to be a combination of biological, genetic, psychological, and environmental factors.

Mood disorders have been found to run in families and so may have a genetic component. If someone has a close family member such as a parent with a mood disorder, this can make it more likely that they will also develop a mood disorder.

However, this could in part be an environmental factor because if someone grows up in a household with someone that has a mood disorder, it may make it more likely that these traits are picked up.

Likewise, environmental factors such as significant life stress could contribute to someone developing a mood disorder, specifically a depressive disorder.

Whilst a stressful life event is not likely to give someone a bipolar disorder, it could trigger a manic or depressive episode in someone with a pre-existing condition.

Also, if an individual has a history of a previous diagnosis of a mood disorder, it is likely that they are at risk of developing another mood disorder.

Brain chemistry could also play a significant role in someone developing mood disorders. The neurotransmitter norepinephrine, which usually increases arousal and focus appears to be a key chemical.

Norepinephrine is thought to be severely lacking in depressed individuals but significantly high during manic episodes. Also, serotonin, a neurotransmitter responsible for feelings of well-being and happiness is believed to be significantly low in those with depression.

Medications which affect norepinephrine and serotonin levels in the brain are known to have a positive effect on improving the symptoms of mood disorders, providing evidence that brain chemistry plays a big role in theses disorders.

Another possible factor involved in the development of mood disorder is differences in brain structure in those with mood disorders. There is considerable evidence that the amygdala and medial prefrontal cortical areas are involved in response to emotions and mood disorders (Price & Drevets, 2010).

Closely related to these areas is a network of areas in the central orbital cortex which has connections with several sensory-related cortical areas and appears to be critical for assessing objecting and anticipating reward.

Depressed individuals show abnormalities in this network during functional MRI studies involving reward and emotional processing tasks (Murray et al., 2010).

Also, amygdala volume appears abnormally smaller in individuals with bipolar disorder who are not taking medication, but larger in those with bipolar disorder who are receiving mood stabilising treatments.

Moreover, depressed individuals tend to show exaggerated response of the amygdala when presented with sad words, sad faces, and fearful faces, but a blunted response to happy faces (Victor et al., 2010). This suggests the amygdala may play a big role in mood disorders.

Other possible risk factors can include substance abuse and some medications in increasing the likelihood of developing a mood disorder.

Depression is often more diagnosed in women than men, which may imply it is more common in women. However, many believe it may be more diagnosed in women because they tend to seek help more than men.

In a 2020 study, it was found that depression was becoming increasingly common among U.S. adolescents between 2011 and 2018. It was suggested that an increased in social media and technology use could be a risk factor to explain this significant rise in depression.

It was found that heavy users of technology were twice as likely to be depressed or have low well-being compared to light users of technology.

Although technology Is not the cause of most depression, an increased time spent on technology may be a contributing factor to the sudden increase in depression (Twenge, 2020).

The vicious cycle of depression

For those with depressive disorders, the symptoms can change a person's life, daily routines, and their behaviours. Often, it is these changes that make the depression worse and prevents the individual from getting better.

For instance, having a lack of motivation or energy as a result of depression can result in the person disengaging in their usual activities, neglect their daily tasks and leave decision-making to others.

They may find that if they engage less in their usually activities, they may be seeing their friends and family less often. Because of a reduction in activities and not seeing loved ones, they may be locked in a vicious cycle of depression.

Decreased activity and neglecting responsibilities and daily tasks can induce feelings of guilt, hopelessness and ineffectiveness which ultimately can lead to stronger depressed feelings, which will then mean lower energy, lower engagement in activities, and so on.

Therefore, depression will only get worse if people are stuck in this cycle.

When to seek help

It is important to seek help for a possible mood disorder because it is unlikely to go away on its own. The disorder is likely to get worse over time so seeking help before the disorder becomes more severe can make it easier to treat.

Often, people with bipolar disorder are more likely to seek help when they are experiencing a depressed episode than when they are experiencing mania or hypomania.

Many people may find that they enjoy the extreme elated moods that come with bipolar disorder and thus may be less likely to seek help for this, or even recognise that their feelings are a part of a disorder.

If someone suspects that they may have bipolar disorder, it may be useful to keep a mood diary so they can keep track of how they are feeling and see if they notice any unusual patterns in their mood, emotions, and behaviour.

If any of the symptoms being experienced seem out of proportion or they have been interfering with life, particularly if having suicidal thought, help should be sought as soon as possible.

It is important to talk to a health professional if an individual is feeling like their emotions are interfering with their work, relationships, social activities, or any other areas of their life.

It is also important to seek help if the individual is having trouble with alcohol or drugs, as it is common for many people to rely on substances to cope with their symptoms.

Diagnosis

When going for a diagnosis of a mood disorder, doctors will usually perform physical examinations and lab tests to rule out any physical reasons for the symptoms being experienced.

Doctors will often ask about the medical history of the individual and any medications they may be taking, and whether any family members have been diagnosed with a mood disorder in the past.

A mental health professional such as a psychologist or a psychiatrist will usually conduct an interview, asking questions about the person's symptoms, sleeping, eating habits, and other behaviours.

They will usually use the diagnostic criteria laid out in the DSM-5 to see if the individual meets the characteristics of one of the mood disorders.

The DSM-4 section on mood disorders was replaced in the DSM-5 with separate sections for bipolar disorders and depressive disorders. Three new depressive disorders were included in the DSM-5: disruptive mood dysregulation disorder, persistent depressive disorder, and premenstrual dysphoric disorder.

The number of bipolar disorders remains unchanged in the DSM-5 - they consist of bipolar I, II, and cyclothymic disorders.

There are specific criteria for each depressive and bipolar disorder. Below will establish the diagnostic criteria for major depressive disorder and bipolar disorder.

Diagnostic criteria for depression

For a diagnosis of depression, the individual must be experiencing five or more of the following symptoms during the same two-week period and at least one of the symptoms should be either a depressed mood or a loss of interest or pleasure.

1. Depressed mood most of the day, nearly every day.

2. Markedly diminished interest or pleasure in all, or almost all, activities most of the day, every day.

3. Significant weight loss when not dieting, or weight gain, or a decrease or increase in appetite nearly every day.

4. A slowing down of thought and a reduction of physical movement (observable by others, not merely subjective feelings of restlessness or being slowed down).

5. Fatigue or loss of energy nearly every day.

6. Feelings of worthlessness or excessive or inappropriate guilt nearly every day.

7. Diminished ability to think or concentrate, or indecisiveness, nearly every day.

8. Recurrent thoughts of death, recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide.

To receive a diagnosis of depression, these symptoms must cause the individual clinically significant distress or impairment in social, occupation, or other important areas of functioning.

The symptoms must also not be the result of substance abuse, or another medical condition.

Diagnostic criteria for bipolar disorder

To be diagnosed with bipolar disorder, a person must have experienced at least one episode of mania or hypomania.

To be considered mania, the elevated, expansive, or irritable mood must have lasted for at least one week and be present for most of the day, nearly every day.

To be considered hypomania, the mood must last at least four consecutive days and be present most of the day, almost every day.

During these periods, three or more of the following symptoms must be present and represent a significant change from usual behaviour:

1. Inflated self-esteem or grandiosity

2. Decreased need for sleep

3. Increased talkativeness

4. Racing thoughts

5. Distracted easily

6. Increase in goal-directed activity or psychomotor agitation

7. Engaging in activities that hold the potential for painful consequences, e.g., unrestrained spending sprees and gambling.

The depressive episode of bipolar disorder is characterised by a major depressive episode resulting in depressed mood or loss of intertest or pleasure.

The DSM-5 states that a person must experience five or more of the symptoms of depressive disorder in two weeks to be diagnosed with major depressive episodes.

Treatment

Medications

Most medications for mood disorders work on raising serotonin or norepinephrine levels. For depressive disorders, antidepressants are commonly prescribed to increase these neurotransmitter levels.

Often, antidepressants can help change energy levels, improve sleep, and have proved to be effective in improving mood. Although different types of antidepressants are found to work equally well, some may be more effective depending on the individual.

If prescribed antidepressants, it is important to take them as prescribed and continue taking them even when starting to feel better. People usually report a significant improvement after taking the medication for 4-6 weeks.

Those who experience mania in bipolar disorder are often prescribed lithium, a type of mood stabiliser, in the first instance. Mood stabilisers are medications used to help regulate the mood swings that occur with bipolar disorder, through reducing abnormal brain activity.

They usually help to protect someone from the extreme highs of a manic episode and the severe lows of a depressive episode. Antipsychotics, previously known as tranquilisers, are generally known to treat psychosis but can also be used to treat bipolar disorder and depression.

They can be especially useful for people with bipolar disorder who experience mania or mixed episodes. They can also sometimes be used to treat depression if symptoms are not controlled with an antidepressant alone.

Whilst medications on their own can help alleviate some of the symptoms of mood disorders, health providers often recommend a combination of medication and psychotherapy for more effective treatment.

A popular type of psychotherapy which has proved effective for many is cognitive behavioural therapy (CBT). CBT involves working with a therapist to identify negative thoughts and behaviours, then working to challenge these thoughts and behaviours into more helpful, healthy ones.

This can involve challenging some of the unhelpful thinking patterns and recognising when these patterns come up in everyday situations. This therapy has shown to be especially effective for those with depression.

Brain stimulation therapies

A brain stimulation therapy called electroconvulsive therapy has been used to treat severe depression or bipolar disorder in cases when medication or psychotherapy have been unsuccessful.

During this treatment, an electric current is passed through the brain via electrodes attached to the scalp or forehead. The treatment is usually given over 2 or 3 sessions per week, with generally 6 to 12 sessions required for most effectiveness.

Repetitive transcranial magnetic stimulation (rTMS) is another type of treatment which uses non-invasive magnetic coils to apply short electromagnetic pulses to specific nerve cells in the brain.

The procedure is used to treat major depression for those who do not respond to at least one antidepressant drug and has proven to be useful in improving symptoms.

Light therapy

For seasonal affective disorder, light therapy is common and has proved to be useful for reducing some of the depressive feelings being experienced.

Light therapy involves using a light, such as a light box, which supplements natural sunlight with a bright artificial light. It is usually recommended to use the light in the mornings for about 20-60 minutes consistently, for most effectiveness.

Lifestyle

Aside from medications and therapeutic treatments for mood disorders, there are some lifestyle changes individuals can make to help reduce their symptoms or as a preventative for mood disorders to begin. Some of these lifestyle changes include:

Maintaining a consistent sleep schedule and ensuring getting enough sleep.

Where possible, reducing stress at home or work.

Keeping a mood diary to note when one is heading towards a manic or depressive episode.

Avoiding alcohol and illicit drugs.

Eating a healthy and balanced diet.

Engaging in regular exercise, especially aerobic exercise.

Engaging in yoga, mindfulness, meditation, or other relaxation methods.

Maintaining a support network with trusted friends, family, or support groups.

Do you need mental health help?
USA
Contact the National Suicide Prevention Lifeline for support and assistance from a trained counselor. If you or a loved one are in immediate danger: https://suicidepreventionlifeline.org/

1-800-273-8255
UK
Contact the Samaritans for support and assistance from a trained counselor: https://www.samaritans.org/; email [email protected] .

Availiale 24 hours day, 365 days a year (this number is FREE to call):

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Rethink Mental Illness: rethink.org

0300 5000 927

About the Author

Olivia Guy-Evans obtained her undergraduate degree in Educational Psychology at Edge Hill University in 2015. She then received her master's degree in Psychology of Education from the University of Bristol in 2019. Olivia has been working as a support worker for adults with learning disabilities in Bristol for the last four years.

Sources

Mayo Clinic (2017, November 17). Dissociative disorders. https://www.mayoclinic.org/diseases-conditions/dissociative-disorders/diagnosis-treatment/drc-20355221

Dissociative Disorders. (Jul 05, 2021). 2021 Traumadissociation.com. Retrieved Jul 5, from http://traumadissociation.com/dissociative.

Dissociative Identity Disorder. (Jul 05, 2021). Traumadissociation.com, Retrieved Jul 5, 2021, from h

Cleveland Clinic. (2018, July 16). Mood Disorders. Retrieved November 25, 2021, from: https://my.clevelandclinic.org/health/diseases/17843-mood-disorders

DiMaria, L. (2020, July 7). The Various Types of Mood Disorders. Very Well Mind. https://www.verywellmind.com/mood-disorder-1067175

Gregory, C. (2020, September 3). Mood Disorders. PSYCOM. https://www.psycom.net/mood-disorders

Mayo Clinic Staff. (2021, October 29). Mood Disorders. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/mood-disorders/symptoms-causes/syc-20365057

Murray, E. A., Wise, S. P., & Drevets, W. C. (2011). Localization of dysfunction in major depressive disorder: prefrontal cortex and amygdala. Biological psychiatry, 69(12), e43-e54.

Nathan, P., Rees, C., Lim, L., & Correia, H. (2003). Back from the Bluez. Perth, Western Australia: Centre for Clinical Interventions

Price, J. L., & Drevets, W. C. (2010). Neurocircuitry of mood disorders. Neuropsychopharmacology, 35(1), 192-216.

Price, J. L., & Drevets, W. C. (2012). Neural circuits underlying the pathophysiology of mood disorders. Trends in cognitive sciences, 16(1), 61-71.

Truschel J. (2020, September 29). Bipolar Definition and DSM-5 Diagnostic Criteria. PSYCOM. https://www.psycom.net/bipolar-definition-dsm-5/

Twenge, J. M. (2020). Why increases in adolescent depression may be linked to the technological environment. Current opinion in psychology, 32, 89-94.

Victor, T. A., Furey, M. L., Fromm, S. J., Öhman, A., & Drevets, W. C. (2010). Relationship of emotional processing to masked faces in the amygdala to mood state and treatment in major depressive disorder. Archives of General Psychiatry, 67(11), 1128.

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By Olivia Guy-Evans, published March 08, 2022 Fact checked by Saul Mcleod, PhD Moods are long-term emotional states, compared to emotions alone which can be fleeting and short-term. Whilst it is normal to experience periods of different moods, mood disorders are characterised by emotional extremes and difficulties in regulating mood.

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Quick Guide to Bipolar Disorder - Child Mind Institute

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Download our free guide bipolar disorder in kids. Kids with bipolar disorder have periods of time where they are extremely happy and energetic, called mania, and other periods where they are very depressed.

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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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Individuals with Disabilities Education Act

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Individuals with Disabilities Education Act (IDEA)

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The U.S. Department of Education’s Individuals with Disabilities Education Act website brings together department and grantee IDEA information and resources. The IDEA makes available a free appropriate public education to and ensures special education and related services to eligible children with disabilities.

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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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The difference between IEPs and 504 plans

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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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Working to deliver a better special education service

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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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"We initially chose IRIS because of the past experiences and their credible research-based, high-quality modules that align with specific areas of growth and need to support a state-directed corrective action plan in our region."

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"We initially chose IRIS because of the past experiences and their credible research-based, high-quality modules that align with specific areas of growth and need to support a state-directed corrective action plan in our region."

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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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Child Mind Institute | Transforming Children’s Lives.

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The Child Mind Institute is an independent nonprofit dedicated to transforming the lives of children struggling with mental health and learning disorders.

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Suffering in Silence- Examining OCD in School Setting

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Definition

Students with emotional disorders are a very heterogeneous group with a wide range of issues that are unique to each individual. However, there are some key characteristics that are used to define this disability category, mostly relating to issues of personal identity and emotional well-being. An emotional disorder may be present if a student responds to a situation with an inappropriate behavior or emotion, and particularly, if this emotion is depression or long term unhappiness. Students with emotional disorders typically have a very difficult time maintaining personal relationships with others, and these personal problems lead to physical symptoms in time. If the student has difficulty learning, but there is no intellectual or sensory cause of this difficulty, then an emotional disorder may be to blame. This disability category does include some mental illnesses such as schizophrenia.

It should be noted that one or more of the previously mentioned characteristics has to be present for an extended period of time, and must have a negative impact on the student's academic performance before being considered an emotional disorder. Signs of an emotional disorder need to be taken seriously, as they can lead to physical aggression and self-injurious behavior. However, care must also be taken to recognize the difference between emotional disturbance and general teenage angst. There are as many causes of emotional disturbance in children as there are children in this category, but they can generally be divided into either biological causes, environmental causes, or a combination of the two.

Prevalence

The U.S. Department of Education reports 5,971,495 students receiving special education services in the 2003-2004 school year. Of that number, roughly 7.7%, or 461,055 students, received special education services based on a classification of emotional disturbance. However, within this group of 461,055 students, there was a definite disproportionally between gender, race and socioeconomic background. African-American students were far more likely to be diagnosed as emotionally disturbed than white students, reflecting possible race bias in this category. Research has pointed to a direct correlation between low income status and emotional disorders, but the exact reasons for this correlation are unknown.

Characteristics

Each student with an emotional disturbance will have characteristics that are unique to that individual. However, these students will all share deficits in three specific areas, namely emotional development, behavioral development, and cognitive development.

These students may have specific emotional characteristics/conditions such as anxiety disorder, mood disorder, oppositional defiant disorder, conduct disorder, and schizophrenia. Not addressing any one of these disorders with the appropriate support system could have potentially tragic results. Behavioral characteristics of an emotional disorder include externalizing behavior and conversely internalizing behavior. The former can result in problem behavior and physical aggression while the latter results in depression and anxiety. Finally, students with emotional disorders have a number of academic issues as well, and each year half of the students in this category drop out of school entirely.

One intriguing possible contributing factor to emotional disturbance can be found in deficits in communication. An estimated 71% of students with emotional disorders also have expressive and receptive language disorders that impact their ability to understand and communicate with peers and adults.

Impact on Learning

Students with emotional disorders can be found at every level of cognitive functioning, but the majority of these students tend to have low average intelligence. Most achieve below grade level in academic achievement, with the greatest deficits in both math and spelling. Many have a coexisting learning disability of some type. Students that exhibit externalizing behaviors are at the greatest risk for continued deficits in academic functioning. Students with emotional disorders are less likely to attend post-secondary school than students in many other disability categories. An effective educational program for students with emotional disorders will provide emotional and behavioral supports that foster the replacement of problem behaviors with more appropriate behaviors. Positive behavior support systems are one especially effective strategy to achieve this goal, as are the implementation of wraparound services.

Teaching Strategies

Wraparound planning is a collaborative process that has shown great promise in supporting students with emotional disorders, both in research and in more practical application. This planning process brings all of the involved service providers (i.e., adult rehabilitation services, mental health services, guidance counselor) and individuals together to create a natural support system that is founded on the strengths of the individual student and the community in which that student lives. The family is an integral part of this process, and the overall goal is to devise a program that will capitalize on the strengths and interests of the student while utilizing community resources for placement and intervention.

Generally, academic achievement and problem behaviors often go hand-in-hand for students with emotional disorders. To put this another way, the more difficulty they have with a classroom task, the more likely that maladaptive behavior will result. Supporting the academic performance of these students will thus have the added benefit of decreasing externalizing and internalizing behaviors. Best practices for students with emotional disorders are often best practices for all students. A strategy such as allowing students to choose between classroom tasks, for example, is an effective way to decrease problem behaviors in general. Consistent and specific praise is also a great technique to utilize with all students in the classroom, but can be particularly effective with students with emotional disorders.

It is very important to not make assumptions about any family of a child with an emotional disorder. Many emotional disorders have an organic cause, and the parents of the child may well be loving and supportive in every way. However, some of these students have indeed been abused in some fashion in their young lives, and this too can be a cause of emotional or behavioral issues. Trust can be a very large issue for these children. Forming a relationship with these students that is built on empathy, trust, and mutual respect can often be the solution to many problem behaviors, and can have a lasting impact of the emotional development of the child.

Assistive Technology

Some modification in instruction will be necessary to allow a student with an emotional disorder to demonstrate mastery in a number of academic areas, and most especially in the area of writing. Word processing software can be an excellent supplementary aid for these students, allowing them to edit and revise their work as they produce it. These programs can strengthen spelling skills and writing cohesion simply by making the writing process easier overall. Of particular benefit are word processing programs that read the text as it is typed, providing an additional audio cue for the student.

Organizations

There are a number of excellent organizations that can help support classroom instruction for students with emotional and behavioral disabilities. The information presented in this module is intended as just a very brief description of emotional disorder and its impact on learning. Much more in-depth information and instructional strategies can be accessed through the following organizations:

American Academy of Child and Adolescent Psychiatry

The AACAP (American Academy of Child and Adolescent Psychiatry) is the leading national professional medical association dedicated to treating and improving the quality of life for children, adolescents, and families affected by these disorders. Composed of over 7,500 child and adolescent psychiatrists and other interested physicians, its members actively research, evaluate, diagnose, and treat psychiatric disorders and pride themselves on giving direction to and responding quickly to new developments in addressing the health care needs of children and their families.

Public Information Office
3615 Wisconsin Ave., NW
Washington, DC 20016-3007

Web: www.aacap.org

Center on Positive Behavioral Interventions and Supports

The OSEP-funded National Technical Assistance Center on Positive Behavior and Intervention Supports was established to address the behavioral and discipline systems needed for successful learning and social development of students. The Center provides capacity-building information and technical support about behavioral systems to assist states and districts in the design of effective schools.

5262 University of Oregon
Eugene, OR 97403-5262

Email: pbis@oregon.uregon.edu
Web: www.pbis.org

Center for Disability and Development

Dept. of Educational Psychology
4225 Texas A&M University
College Station, TX 77843-4225

Council for Exceptional Children

The Council for Exceptional Children (CEC) is the largest international professional organization dedicated to improving educational outcomes for individuals with exceptionalities, students with disabilities, and/or the gifted. CEC advocates for appropriate governmental policies, sets professional standards, provides continual professional development, advocates for newly and historically underserved individuals with exceptionalities, and helps professionals obtain conditions and resources necessary for effective professional practice.

1110 North Glebe Road, Suite 300
Arlington, VA 22201-5704

Federation of Families for Children's Mental Health

This organization is dedicated exclusively to helping children with mental health needs and their families achieve a better quality of life. They provide leadership to develop and sustain a nationwide network of family-run organizations; focus the passion and cultural diversity of our membership to be a potent force for changing how systems respond to children with mental health needs and their families; help policy-makers, agencies, and providers become more effective in delivering services and supports that foster healthy emotional development for all children.

1101 King Street, Suite 420
Alexandria, VA 22314

Email: ffcmh@ffcmh.org
Web: www.ffcmh.org

National Alliance for the Mentally Ill (NAMI)

NAMI is the National Alliance on Mental Illness, the nation's largest grassroots organization for people with mental illness and their families. NAMI is dedicated to the eradication of mental illnesses and to the improvement of the quality of life for persons of all ages who are affected by mental illnesses. NAMI members and friends work to fulfill our mission by providing support, education, and advocacy.

Colonial Place Three
2107 Wilson Boulevard, Suite 300
Arlington, VA 22203-3754

Web: www.nami.org

Mental Health America

Mental Health America is dedicated to helping ALL people live mentally healthier lives. They work to fulfill this mission by education the public about ways to preserve and strengthen mental health; advocating for access to effective care; fostering innovation in research, practice, services and policy; and providing support to individuals and families.

2001 N. Beauregard Street, 12th Floor
Alexandria, VA 22311

Web: www.nmha.org

National Mental Health Information Center

The National Mental Health Information Center was developed for users of mental health services and their families, the general public, policy makers, providers, and the media. They provide free information about mental health via a toll-free number, their website, and more than 600 publications.

P.O. Box 42557
Washington, DC 20015

Web: www.mentalhealth.org

References

Hunt, N., and Marshall, K. (2006). Exceptional children and youth. Boston, MA: Houghton Mifflin Company.

National Dissemination Center for Children with Disabilities (2004). Fact Sheet 5. Retrieved February 1, 2008 from www.nichcy.org/pubs/factshe/fs5txt.htm.

Turnbull, A., Turnbull, R. & Wehmeyer, M. L. (2007). Exceptional lives. Special education in today's schools. Upper Saddle River, NJ: Pearson Merrill Prentice Hall.

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Students with emotional disorders typically have a hard time maintaining relationships, and these personal problems may lead to physical symptoms in time.

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Early Onset Schizophrenia Community of Practice - National Council for Mental Wellbeing

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In 2015, the National Council launched the eight-month Early Onset Schizophrenia Community of Practice (CoP) which focused on making information about the clinical, workforce, training and financing elements necessary for successful adoption […]

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Child Mind Institute | Transforming Children’s Lives.

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The Child Mind Institute is an independent nonprofit dedicated to transforming the lives of children struggling with mental health and learning disorders.

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Affiliations

¹ Center for Subjectivity Research, University of Copenhagen, 2300, Copenhagen, Denmark.

² Mental Health Centre Glostrup, University Hospital of Copenhagen, 2605, Brøndby, Denmark.

³ Faculty of Health and Medical Sciences, University of Copenhagen, 2200, Copenhagen, Denmark.

⁴ Mental Health Centre Amager, University Hospital of Copenhagen, 1610, Copenhagen, Denmark.

⁵ Center for Subjectivity Research, University of Copenhagen, 2300, Copenhagen, Denmark. hst@hum.ku.dk.

⁶ Mental Health Centre Glostrup, University Hospital of Copenhagen, 2605, Brøndby, Denmark. hst@hum.ku.dk.

Free PMC article

Free PMC article

Affiliations

¹ Center for Subjectivity Research, University of Copenhagen, 2300, Copenhagen, Denmark.

² Mental Health Centre Glostrup, University Hospital of Copenhagen, 2605, Brøndby, Denmark.

³ Faculty of Health and Medical Sciences, University of Copenhagen, 2200, Copenhagen, Denmark.

⁴ Mental Health Centre Amager, University Hospital of Copenhagen, 1610, Copenhagen, Denmark.

⁵ Center for Subjectivity Research, University of Copenhagen, 2300, Copenhagen, Denmark. hst@hum.ku.dk.

⁶ Mental Health Centre Glostrup, University Hospital of Copenhagen, 2605, Brøndby, Denmark. hst@hum.ku.dk.

Abstract

Eugen Bleuler, the founder of the concept of schizophrenia, pointed out that psychotic patients were able to live in two disjoint worlds (namely, the social, intersubjective world and the delusional world). He termed this phenomenon "double bookkeeping," but did not provide any conceptual elaboration of this phenomenon or its possible mechanisms. Double bookkeeping has been neglected in mainstream psychiatry, but it has been addressed in recent theoretical work, however mainly concerned with the issue of delusion. In this article, we present clinical material that supports the view that double bookkeeping manifests itself across various psychotic phenomena and its antecedent may be observed in premorbid (pre-onset) phases as well as in the schizotypal disorder. We try to conceptualize double bookkeeping to concretize an often atmospheric perception of paradoxicality in the encounter with the patient. A phenomenological analysis of double bookkeeping suggests an instability in the affective ("auto-affection") articulation of selfhood. We point to four main implications of our presentation: (1) diagnostic, (2) epistemological, (3) therapeutic and (4) pathogenetic research.

Keywords: Auto-affection; Consciousness; Double bookkeeping; Schizophrenia spectrum; Self-disorders.

Conflict of interest statement

The authors declare that they have no conflicts of interest.

Disordered Selfhood in Schizophrenia and the Examination of Anomalous Self-Experience: Accumulated Evidence and Experience.

Nordgaard J, Henriksen MG, Jansson L, Handest P, Møller P, Rasmussen AR, Sandsten KE, Nilsson LS, Zandersen M, Zahavi D, Parnas J. Nordgaard J, et al. Psychopathology. 2021;54(6):275-281. doi: 10.1159/000517672. Epub 2021 Aug 12. Psychopathology. 2021. PMID: 34384082 Free PMC article. Review.

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Bleuler E (1950). Dementia praecox or the group of schizophrenias (trans. J. Zinkin & N. D. C. Lewis). International University Press, New York (Original work published 1911)

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Sass L. Delusion and Double Book-Keeping. In: Fuchs T, Breyer T, Mundt C, editors. Karl Jaspers' philosophy and psychopathology. New York: Springer; 2014. pp. 125-147.

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national center for biotechnology information

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Double bookkeeping and schizophrenia spectrum: divided unified phenomenal consciousness - PubMed

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Eugen Bleuler, the founder of the concept of schizophrenia, pointed out that psychotic patients were able to live in two disjoint worlds (namely, the social, intersubjective world and the delusional world). He termed this phenomenon "double bookkeeping," but did not provide any conceptual elaboratio ...

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Parenting the Love and Logic Way ® is a six-week program designed to help parents nurture responsible, respectful, fun-to-be around children who will learn how to make their own choices, own their problems, think critically and logically for themselves, while parents let empathy and consequences do the teaching.

Visit the Love and Logic site or attend a free introductory session for more information about their philosophy.

Parenting the Love and Logic Way® Class Information:

Cost: $35/individual; $55/couple (if sharing materials). Scholarships are available.

Fall classes will be offered online. Class link will be sent upon registration.

Spring 2022 Classes

Classes will be held on Thursdays from 6-8 p.m. in the Mason Elementary School library ( 1501 N. Lakeline Blvd., Cedar Park).

Note: After the first week, a make-up class will be offered weekly for the previous week's session from 5-6 p.m.

For questions about this course offering, email Mary Ann Kluga or call 512-570-0315.

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Parenting the Love and Logic Way ® is a six-week program designed to help parents nurture responsible, respectful, fun-to-be around children who will learn how to make their own choices, own their problems, think critically and logically for themselves, while parents let empathy and consequences do the teaching.

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(Canva Stock Photo, 2022)

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Block, R. W., Macdonald, N. E., & Piotrowski, N. A. (2022). Attention deficit hyperactivity disorder (ADHD). Magill’s Medical Guide (Online Edition).

Guy-Evans, O. (2022). The Various Types of Mood Disorders. Simply Psychology. https://www.simplypsychology.org/mood-disorder.html

Leander Independent School District. (2022). 10 ethical principles.  https://www.leanderisd.org/guidingdocuments/

Minnesota Department of Human Services. (2015). Disruptive behavior disorders: Oppositional Defiant Disorder (ODD) and Conduct Disorder (CD) fact sheet. https://edocs.dhs.state.mn.us/lfserver/Public/DHS-6984-ENG

Missouri School Counselors and Counselor Educators. (2015). School counselor referral process guide. https://dese.mo.gov/college-career-readiness/school-counseling/responsive-services

National Center on Birth Defects and Developmental Disabilities Division of Human Development and Disability. ADHD facts sheet. Center for Disease Control. http://www.cdc.gov/info

National Eating Disorder Association. (2022). Rumination disorder. https://www.nationaleatingdisorders.org/learn/by-eating-disorder/other/rumination-disorder

Oehrtman, J. P. (2022). Brief counseling techniques for school counselors. American Counseling Association. https://www.counseling.org/

PACER Center, Inc. (2012). Students with disabilities & section 504 of the Rehabilitation Act of 1973. Pacer Center. https://www.pacer.org/parent/php/php-c33.pdf

Pertuit, T. L., Trusty, J. & Ballard, M. (2014). Suffering in silence: Examining obsessive compulsive behaviors in the school setting. VISTAS Online. https://www.counseling.org/docs/default-source/vistas/article_17.pdf?sfvrsn=fc3e0e4_12

Prerost, F. J. (2021). Conduct disorder. Salem Press Encyclopedia of Health

Tobin, R. M. & Alvin E. House, A. E. (2016). DSM-5® Diagnosis in the Schools. The Guilford Press.

Substance Abuse and Mental Health Services Administration. (2015). School mental health referral pathways toolkit. https://www.escneo.org/Downloads/NITT%20SMHRP%20Toolkit_11%2019%2015%20FINAL.PDF

West Virginia Board of Education. (2015). Addressing mental health in school crisis prevention & response. https://wvde.us/wp-content/uploads/2018/01/Addressing-Mental-Health-in-School-Crisis-Prevention-Response.pdf

Ybañez-Llorente, K. (2014). Addressing anxiety in school settings: Information for counselors. VISTAS. http://www.counseling.org/knowledge-center/vistas.