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National Institute of Mental Health (NIMH)

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Learn about depression, including types, signs and symptoms, risk factors, treatments and therapies, and things you can do to help during treatment.

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National Institute of Mental Health (NIMH)

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If you or someone you know has a mental illness, there are ways to get help. Use these resources to find help for yourself, a friend, or a family member.

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Overview

Bipolar disorder, also known as manic-depressive illness, is a brain disorder that causes unusual shifts in mood, energy, activity levels, and the ability to carry out day-to-day tasks.

There are four basic types of bipolar disorder; all of them involve clear changes in mood, energy, and activity levels. These moods range from periods of extremely "up," elated, and energized behavior (known as manic episodes) to very sad, "down," or hopeless periods (known as depressive episodes). Less severe manic periods are known as hypomanic episodes.

Bipolar I Disorder- defined by manic episodes that last at least 7 days, or by manic symptoms that are so severe that the person needs immediate hospital care. Usually, depressive episodes occur as well, typically lasting at least 2 weeks. Episodes of depression with mixed features (having depression and manic symptoms at the same time) are also possible.

Bipolar II Disorder- defined by a pattern of depressive episodes and hypomanic episodes, but not the full-blown manic episodes described above.

Cyclothymic Disorder (also called cyclothymia)- defined by numerous periods of hypomanic symptoms as well numerous periods of depressive symptoms lasting for at least 2 years (1 year in children and adolescents). However, the symptoms do not meet the diagnostic requirements for a hypomanic episode and a depressive episode.

Other Specified and Unspecified Bipolar and Related Disorders- defined by bipolar disorder symptoms that do not match the three categories listed above.

Signs and Symptoms

Risk Factors

Treatments and Therapies

Join a Study

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Bipolar disorder, also known as manic-depressive illness, is a brain disorder that causes unusual shifts in mood, energy, activity levels, and the ability to carry out day-to-day tasks. There are four basic types of bipolar disorder; all of them involve clear changes in mood, energy, and activity levels.

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Community mental health services are usually provided at an office or in the home. Services support families to make positive changes that help children recover from mental illness and foster resilience.

Mental health services start with a thorough assessment and developing a plan to address goals identified by the child and family. Services to the child and family may include:

Crisis intervention

Skills training and development

Counseling

Supportive employment

Medication training and support

Case management

Peer services (family partner support services)

To learn more, read the Family Guide: Children's Mental Health Services (PDF).

What Are the Benefits of Child or Youth Mental Health Services?

National statistics show that one out of four children will have a mental illness during childhood. Children diagnosed and treated are more likely to succeed at home and in the community.

These services are based upon the child's strengths, needs and preferences. The benefits include:

Reduction of mental health symptoms

Development of new communication skills

Development of new ways to manage emotions

Development of new ways to relax and create

Improved social functioning at home and the community

Services that fit into the child's and family's schedule

Services provided where the child and family live

Who Is Eligible for Community Mental Health Services for Children?

Children's Mental Health serves children 3 to 17 with a mental health diagnosis who:

Are at risk of having to move away from their home or school

Are enrolled in special education

How Do I Get Community Mental Health Services for Children?

Contact Us

Email: Childrens_MH@hhsc.state.tx.us

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Community mental health services are usually provided at an office or in the home. Services support families to make positive changes that help children recover from mental illness and foster resilience. Mental health services start with a thorough assessment and developing a plan to address goals identified by the child and family.

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We are calling on our community to help us share brightness this season! Together we can provide empowering resources and services for mental well-being. Visit our toolkit to learn how you can spread awareness and support DBSA during our busiest giving time.

Your support is an investment in fostering hope, healing, and a brighter future for all those living with mood disorders.
Brighten Lives Toolkit!

Treatment Options

Seeking mental health treatment is not a sign of weakness or failure, but rather a show of great strength and compassion for yourself and those you love. Learn more about options to treat mood disorders and how to choose a provider.
See Treatment Options

Daily tools empower your wellness journey

Each person's wellness journey is unique. With that in mind, DBSA has developed tools to help you take the first steps and determine what support you may need along the way.

Start with Strengths

The DBSA Wellness Wheel is an easy-to-use tool that focuses on your strengths in 7 key areas of life.
Wellness Wheel

Keep Daily Logs

Our Wellness Tracker can be an essential resource to understand your moods, symptoms, medications, and lifestyle.
Wellness Tracker

If there's a young child in your life, we think you'll be excited to learn more about the DBSA Mood Crew®
Meet the DBSA Mood Crew!

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DBSA - Depression and Bipolar Support Alliance

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Living with depression or bipolar disorder? Find free support groups, resources, and wellness tools.

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Anxiety and Depression Association of America, ADAA

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Anxiety Disorders and Depression Research & Treatment | Anxiety and Depression Association of America, ADAA

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ADAA is an international nonprofit membership organization dedicated to the prevention, treatment, and cure of anxiety, depression, OCD, PTSD, and co-occurring disorders through education, practice, and research.

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CHADD - Improving the lives of people affected by ADHD

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Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD) is the nation’s leading nonprofit organization serving people affected by ADHD.

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The mission of the International OCD Foundation is to help those affected by obsessive compulsive disorder (OCD) and related disorders to live full and productive lives. Our aim is to increase access to effective treatment through research and training, foster a hopeful and supportive community for those affected by OCD and the professionals who treat them, and fight stigma surrounding mental health issues.

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NCEED is thrilled to be recognized among the list of accomplishments NC Congressman David E. Price mentioned, and we thank him for his tireless work on behalf of patients with eating disorders and other mental health conditions!

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NCEED - National Center of Excellence for Eating Disorders

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NCEED is thrilled to be recognized among the list of accomplishments NC Congressman David E. Price mentioned, and we thank him for his tireless work on behalf of patients with eating disorders and other mental health conditions!

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Anorexia, bulimia and binge-eating disorder affect physical and mental health. Learn about symptoms, causes, risk factors, diagnosis and treatment options.

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Overview

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

Signs and Symptoms

Risk Factors

Treatments and Therapies

Join a Study

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

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ADHD is a chronic condition marked by persistent inattention, hyperactivity, and sometimes impulsivity. ADHD begins in childhood and often lasts into adulthood. As many as 2 out of every 3 children with ADHD continue to have symptoms as adults.

Symptoms of ADHD can differ from person to person, but there are three basic types of ADHD. Each one is identified by the symptoms of hyperactivity, impulsivity, and inattention. When the main symptoms are inattention, distraction, and disorganization, the type is usually called primarily inattentive. The symptoms of hyperactivity and possibly impulsiveness appear to diminish with age but are seen in the primarily hyperactive/impulsive type. The third type has some symptoms from each of the other two and is called the combined type.

Children with ADHD often have trouble functioning at home and in school and can have difficulty making and keeping friends. If left untreated, ADHD may interfere with school and work, as well as with social and emotional development.

ADHD is more common in boys, whose impulsivity and hyperactivity may appear as disruptive behavior. Inattentiveness is a hallmark of ADHD in girls, but because they aren't often disruptive in the classroom, they may be harder to diagnose.

ADHD tends to run in families. When one person is diagnosed with ADHD, there is a 25%-35% chance that another family member will also have the condition, compared to 4%-6% of the general public.

No one knows for sure whether ADHD is more common today, but it is very clear that the number of children getting diagnosed and treated for ADHD has risen over time. Some of this increase in diagnosis and treatment is due to greater awareness of the symptoms and an expansion of what is considered ADHD. Some experts feel that ADHD is overdiagnosed, while others feel it is underdiagnosed or under treated.

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Get the basics on attention deficit hyperactivity disorder (ADHD) from the experts at WebMD.

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Are obsessive thoughts and compulsive behaviors interfering with your daily life? Explore the symptoms, treatment, and self-help for OCD.

What is obsessive-compulsive disorder (OCD)?

It's normal, on occasion, to go back and double-check that the iron is unplugged or worry that you might be contaminated by germs, or even have an occasional unpleasant, violent thought. But if you suffer from obsessive-compulsive disorder (OCD), obsessive thoughts and compulsive behaviors become so consuming they interfere with your daily life. OCD is an anxiety disorder characterized by uncontrollable, unwanted thoughts and ritualized, repetitive behaviors you feel compelled to perform. If you have OCD, you probably recognize that your obsessive thoughts and compulsive behaviors are irrational-but even so, you feel unable to resist them and break free.

Like a needle getting stuck on an old record, OCD causes the brain to get stuck on a particular thought or urge. For example, you may check the stove 20 times to make sure it's really turned off because you're terrified of burning down your house, or wash your hands until they're scrubbed raw for fear of germs. While you don't derive any sense of pleasure from performing these repetitive behaviors, they may offer some passing relief for the anxiety generated by the obsessive thoughts.

You may try to avoid situations that trigger or worsen your symptoms or self-medicate with alcohol or drugs. But while it can seem like there's no escaping your obsessions and compulsions, there are plenty of things you can do to break free of unwanted thoughts and irrational urges and regain control of your thoughts and actions.

OCD obsessions and compulsions

Obsessions are involuntary thoughts, images, or impulses that occur over and over again in your mind. You don't want to have these ideas, but you can't stop them. Unfortunately, these obsessive thoughts are often disturbing and distracting.

Compulsions are behaviors or rituals that you feel driven to act out again and again. Usually, compulsions are performed in an attempt to make obsessions go away. For example, if you're afraid of contamination, you might develop elaborate cleaning rituals. However, the relief never lasts. In fact, the obsessive thoughts usually come back stronger. And the compulsive rituals and behaviors often end up causing anxiety themselves as they become more demanding and time-consuming. This is the vicious cycle of OCD.

Most people with OCD fall into one of the following categories:

Washers are afraid of contamination. They usually have cleaning or hand-washing compulsions.

Checkers repeatedly check things (oven turned off, door locked, etc.) that they associate with harm or danger.

Doubters and sinners are afraid that if everything isn't perfect or done just right something terrible will happen, or they will be punished.

Counters and arrangers are obsessed with order and symmetry. They may have superstitions about certain numbers, colors, or arrangements.

OCD and hoarding

Hoarding used to be considered a category of OCD. While estimates suggest that up to 25 percent of people with OCD experience compulsive hoarding, it can also be a sign of a separate condition, hoarding disorder.

Hoarders fear that something bad will happen if they throw anything away and hoard things that they don't need or use. However, there are distinctions between OCD-related hoarding and hoarding disorder.

OCD-related hoarders tend not to accumulate so many possessions that their homes become unmanageable. Hoarding for them is usually unwelcome and distressing-a way to manage intrusive thoughts

Someone with hoarding disorder, on the other hand, experiences both positive and negative emotions. Acquiring possessions provides pleasure rather than simply satisfying a compulsion and they being surrounded by their things provides comfort. The distress in hoarding disorder stems more from the consequences of hoarding-the clutter and unsafe environment-along with the anxiety of having to discard possessions .

Read: Hoarding Disorder: Help for Hoarders

OCD signs and symptoms

Just because you have obsessive thoughts or perform compulsive behaviors does NOT mean that you have obsessive-compulsive disorder. With OCD, these thoughts and behaviors cause tremendous distress, take up a lot of time (at least one hour per day), and interfere with your daily life and relationships.

Most people with obsessive-compulsive disorder have both obsessions and compulsions, but some people experience just one or the other.
Common obsessive thoughts in OCD include:

Fear of being contaminated by germs or dirt or contaminating others.

Fear of losing control and harming yourself or others.

Intrusive sexually explicit or violent thoughts and images.

Excessive focus on religious or moral ideas.

Fear of losing or not having things you might need.

Order and symmetry: the idea that everything must line up "just right".

Superstitions; excessive attention to something considered lucky or unlucky.

Common compulsive behaviors in OCD include:

Excessive double-checking of things, such as locks, appliances, and switches.

Repeatedly checking in on loved ones to make sure they're safe.

Counting, tapping, repeating certain words, or doing other senseless things to reduce anxiety.

Spending a lot of time washing or cleaning.

Ordering or arranging things "just so".

Praying excessively or engaging in rituals triggered by religious fear.

Accumulating "junk" such as old newspapers or empty food containers.

OCD symptoms in children

While the onset of obsessive-compulsive disorder usually occurs during adolescence or young adulthood, younger children sometimes have symptoms that look like OCD. However, the symptoms of other disorders, such as ADHD, autism, and Tourette's syndrome, can also look like obsessive-compulsive disorder, so a thorough medical and psychological exam is essential before any diagnosis is made.

OCD self-help tip 1: Identify your triggers

The first step to managing your OCD symptoms is to recognize the triggers-the thoughts or situations-that bring on your obsessions and compulsions. Record a list of the triggers you experience each day and the obsessions they provoke. Rate the intensity of the fear or anxiety you experienced in each situation and then the compulsions or mental strategies you used to ease your anxiety. For example, if you have a fear of being contaminated by germs, touching a railing at the mall might generate a fear intensity of 3, whereas touching the restroom floor in the mall might generate a 10 and require 15 minutes of hand washing to ease your anxiety.

Keeping track of your triggers can help you anticipate your urges. And by anticipating your compulsive urges before they arise, you can help to ease them. For example, if your compulsive behavior involves checking that doors are locked, windows closed, or appliances turned off, try to lock the door or turn off the appliance with extra attention the first time.

Create a solid mental picture and then make a mental note. Tell yourself, "The window is now closed," or "I can see that the oven is turned off."

When the urge to check arises later, you will find it easier to re-label it as "just an obsessive thought."

Identifying and recording your triggers also provides an important tool for learning to resist your OCD compulsions.

Tip 2: Learn to resist OCD compulsions

It might seem smart to avoid the situations that trigger your obsessive thoughts, but the more you avoid them, the scarier they feel. Conversely, by repeatedly exposing yourself to your OCD triggers, you can learn to resist the urge to complete your compulsive rituals. This is known as exposure and response prevention (ERP) and is a mainstay of professional therapy for OCD.

ERP requires you to repeatedly expose yourself to the source of your obsession-and then refrain from the compulsive behavior you'd usually perform to reduce your anxiety. If you are a compulsive hand washer, for example, that could mean touching the door handle in a public restroom and then not allowing yourself to wash your hands. As you sit with the anxiety, the urge to wash your hands will gradually begin to go away on its own. In this way, you'll learn that you don't need the ritual to get rid of your anxiety and that you have some control over your obsessive thoughts and compulsive behaviors.

Tackling your biggest fears straight off might be too extreme, so ERP exercises start with you confronting lesser fears and then working your way up the "fear ladder." Confront those situations that generate a low fear intensity and once you're able to tolerate the anxiety you can move on to the next, more difficult exposure challenge.

Building your fear ladder

Think about your end goal (to be able to use a public restroom without fear of contamination, for example, or to drive to work without stopping to check if you've hit something) and then break down the steps needed to reach that goal. Using the information you recorded in identifying your triggers, make a list of situations from the least scary to the most scary. The first step should make you slightly anxious, but not so frightened that you're too intimidated to try it.

Here's a sample fear ladder:

Goal: To drive to work without stopping to check if you've hit something

Fear intensity

Situation

10

Drive all the way to work without stopping to check if you've hit something

8

Don't phone your spouse to check they got to work safely

6

Leave the house, lock the front door and walk away without checking

4

Turn off the stove and leave the room without checking

2

Put milk in the refrigerator without checking the top is secure

Using your fear ladder

Work your way up the ladder. Start with the first step and don't move on until you start to feel more comfortable doing it. If possible, stay in the situation long enough for your anxiety to decrease. The longer you expose yourself to your OCD trigger, the more you'll get used to it and the less anxious you'll feel when you face it the next time. Once you've done a step on several separate occasions without feeling too much anxiety, you can move on to the next step. If a step is too hard, break it down into smaller steps or go slower.

As you're resisting your compulsions, focus on the feelings of anxiety. Instead of trying to distract yourself, allow yourself to feel anxious as you resist the urge to engage in your compulsive behavior. You may believe that the discomfort you're feeling will continue until you engage in the compulsion. But if you stick with it, the anxiety will fade. And you'll realize that you're not going to "lose control" or have some kind of breakdown if you don't perform the ritual.

Practice. The more often you practice, the quicker your progress will be. But don't rush. Go at a pace that you can manage without feeling overwhelmed. And remember: you will feel uncomfortable and anxious as you face your fears, but the feelings are only temporary. Each time you expose yourself to your trigger, your anxiety should lessen and you'll start to realize that you have more control (and less to fear) than you thought.

Tip 3: Challenge obsessive thoughts

Everyone has troubling thoughts or worries from time to time. But obsessive-compulsive disorder causes the brain to get stuck on a particular anxiety-provoking thought, causing it to play over and over in your head. The more unpleasant or distressing the thought, the more likely you are to try to repress it. But repressing thoughts is almost impossible and trying usually has the opposite effect, causing the unpleasant thought to resurface more frequently and become more bothersome.

As with resisting compulsions, you can overcome disturbing, obsessive thoughts by learning to tolerate them through exposure and response prevention exercises. It's also important to remind yourself that just because you have an unpleasant thought, that doesn't make you a bad person. Your thoughts are just thoughts. Even unwanted, intrusive, or violent thoughts are normal-it's only the importance you attach to them that turns them into damaging obsessions.

The following strategies can help you see your thoughts for what they are and regain a sense of control over your anxious mind.

Write down your obsessive thoughts. Keep a pad and pencil on you, or type on a smartphone. When you begin to obsess, write down all your thoughts or compulsions.

Keep writing as the OCD urges continue, aiming to record exactly what you're thinking, even if you're repeating the same phrases or the same urges over and over.

Writing it all down will help you see just how repetitive your obsessions are.

Writing down the same phrase or urge hundreds of times will help it lose its power.

Writing thoughts down is much harder work than simply thinking them, so your obsessive thoughts are likely to disappear sooner.

Create an OCD worry period. Rather than trying to suppress obsessions or compulsions, develop the habit of rescheduling them.

Choose one or two 10-minute "worry periods" each day, time you can devote to obsessing.

During your worry period, focus only on negative thoughts or urges. Don't try to correct them. At the end of the worry period, take a few calming breaths, let the obsessive thoughts go, and return to your normal activities. The rest of the day, however, is to be designated free of obsessions.

When thoughts come into your head during the day, write them down and "postpone" them to your worry period.

Challenge your obsessive thoughts. Use your worry period to challenge negative or intrusive thoughts by asking yourself:

What's the evidence that the thought is true? That it's not true? Have I confused a thought with a fact?

Is there a more positive, realistic way of looking at the situation?

What's the probability that what I'm scared of will actually happen? If the probability is low, what are some more likely outcomes?

Is the thought helpful? How will obsessing about it help me and how will it hurt me?

What would I say to a friend who had this thought?

Create a tape of your OCD obsessions or intrusive thoughts. Focus on one specific thought or obsession and record it to a tape recorder or smartphone.

Recount the obsessive phrase, sentence, or story exactly as it comes into your mind.

Play the tape back to yourself, over and over for a 45-minute period each day, until listening to the obsession no longer causes you to feel highly distressed.

By continuously confronting your worry or obsession you will gradually become less anxious. You can then repeat the exercise for a different obsession.

Tip 4: Reach out for support

OCD can get worse when you feel powerless and alone, so it's important to build a strong support system. The more connected you are to other people, the less vulnerable you'll feel. And just talking to an understanding person about your worries and urges can make them seem less threatening.

Stay connected to family and friends. Obsessions and compulsions can consume your life to the point of social isolation. In turn, social isolation will aggravate your OCD symptoms. It's important to invest in relating to family and friends. Talking face-to-face about your worries and urges can make them feel less real and less threatening.

Join an OCD support group. You're not alone in your struggle with OCD, and participating in a support group can be an effective reminder of that. OCD support groups enable you to both share your own experiences and learn from others who are facing the same problems.

Tip 5: Manage stress

While stress doesn't cause OCD, it can trigger symptoms or make them worse. Physical exercise and connecting with another person face-to-face are two very effective ways to calm your nervous system. You can also:

Quickly self-soothe and relieve anxiety symptoms by making use of one or more of your physical senses -sight, smell, hearing, touch, taste-or movement. You might try listening to a favorite piece of music, looking at a treasured photo, savoring a cup of tea, or stroking a pet.

Practice relaxation techniques. Mindful meditation, yoga, deep breathing, and other relaxation techniques can help lower your overall stress and tension levels and help you manage your urges. For best results, try practicing a relaxation technique regularly.

Tip 6: Make lifestyle changes to ease OCD

A healthy, balanced lifestyle plays a big role in easing anxiety and keeping OCD compulsions, fears, and worry at bay.

Exercise regularly. Exercise is a natural and effective anti-anxiety treatment that helps to control OCD symptoms by refocusing your mind when obsessive thoughts and compulsions arise. For maximum benefit, try to get 30 minutes or more of aerobic activity on most days. Ten minutes several times a day can be as effective as one longer period especially if you pay mindful attention to the movement process.

Get enough sleep. Not only can anxiety and worry cause insomnia, but a lack of sleep can also exacerbate anxious thoughts and feelings. When you're well rested, it's much easier to keep your emotional balance, a key factor in coping with anxiety disorders such as OCD.

Avoid alcohol and nicotine. Alcohol temporarily reduces anxiety and worry, but it actually causes anxiety symptoms as it wears off. Similarly, while it may seem that cigarettes are calming, nicotine is actually a powerful stimulant. Smoking leads to higher, not lower, levels of anxiety and OCD symptoms.

Treatment for OCD

Cognitive-behavioral therapy is the most effective treatment for obsessive-compulsive disorder and generally involves two components:

1. Exposure and response prevention, which requires repeated exposure to the source of your obsession, as explained above.

2. Cognitive therapy, which focuses on the catastrophic thoughts and exaggerated sense of responsibility you feel. A big part of cognitive therapy for OCD is teaching you healthy and effective ways of responding to obsessive thoughts, without resorting to compulsive behavior.

Other OCD treatments

In addition to cognitive-behavioral therapy, the following treatments are also used for OCD:

Medication. Antidepressants are sometimes used in conjunction with therapy for the treatment of obsessive-compulsive disorder. However, medication alone is rarely effective in relieving the symptoms.

Family Therapy. Since OCD often causes problems in family life and social adjustment, family therapy can help promote understanding of the disorder and reduce family conflicts. It can also motivate family members and teach them how to help their loved one with OCD.

Group Therapy. Through interaction with fellow OCD sufferers, group therapy provides support and encouragement and decreases feelings of isolation.

Is unresolved trauma playing a role in your OCD?

In some people, OCD symptoms such as compulsive washing or hoarding are ways of coping with trauma. If you have post-traumatic OCD, cognitive approaches may not be effective until underlying traumatic issues are resolved.

How to help someone with OCD

The way you react to your loved one's OCD symptoms can have a big impact on their outlook and recovery. Negative comments or criticism can make OCD worse, while a calm, supportive environment can help improve the outcome of treatment.

Avoid making personal criticisms. Remember, your loved one's OCD behaviors are symptoms, not character flaws.

Don't scold someone with OCD or tell them to stop performing rituals. They can't comply, and the pressure to stop will only make the behaviors worse.

Be as kind and patient as possible. Each sufferer needs to overcome problems at their own pace. Praise any successful attempt to resist OCD, and focus attention on positive elements in the person's life.

Do not play along with your loved one's rituals. Going along with your loved one's OCD "rules," or helping with their compulsions or rituals will only reinforce the behavior. Support the person, not their compulsions.

Keep communication positive and clear. Communication is important so you can find a balance between supporting your loved one and standing up to the OCD symptoms and not further distressing your loved one.

Find the humor. Laughing together over the funny side and absurdity of some OCD symptoms can help your loved one become more detached from the disorder. Just make sure your loved one feels respected and in on the joke.

Don't let OCD take over family life. Sit down as a family and decide how you will work together to tackle your loved one's symptoms. Try to keep family life as normal as possible and the home a low-stress environment.

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It's normal, on occasion, to go back and double-check that the iron is unplugged or worry that you might be contaminated by germs, or even have an occasional unpleasant, violent thought. But if you suffer from obsessive-compulsive disorder (OCD), obsessive thoughts and compulsive behaviors become so consuming they interfere with your daily life.

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Asperger's syndrome defintion and facts

Asperger's syndrome was formerly characterized as a distinct autism spectrum disorder; the DSM-5 in May 2013 combined the diagnosis with autistic disorder into one condition called autism spectrum disorder or ASD.

People with Asperger's syndrome have normal to above-average intelligence but typically have difficulties with social skills and often have pervasive, absorbing interests in special topics.

Abnormalities in the subtle use of language and interpretation of language are common with Asperger's syndrome, although language development (grammar, syntax, etc.) is normal.

The degree of severity of symptoms can vary among affected individuals.

Anxiety and frustration may contribute to disruptive behaviors or depression in people with Asperger's syndrome.

Successful treatment generally involves one or multiple social, behavioral, and/or educational interventions.

The personality and cognitive traits common to those with Asperger's syndrome are seen as beneficial by many, and many people with Asperger's syndrome believe it has helped advance their professional lives.

What is Asperger's syndrome?

Asperger's syndrome, also known as Asperger disorder or Asperger syndrome, is one of a group of neurodevelopmental disorders that have effects on an individual's behavior, use of language and communication, and pattern of social interactions. Asperger disorder was formerly characterized as one distinct autism spectrum disorder (others included autistic disorder, Rett syndrome, childhood disintegrative disorder, and pervasive developmental disorder-not otherwise specified [PDD-NOS]), although Asperger's syndrome was considered to be at the milder, or higher-functioning, range of this spectrum. There is still some controversy as to whether Asperger's syndrome should be regarded as a separate clinical entity or simply represents a high-functioning form of autism. In the revised Diagnostic and Statistical Manual of Mental Disorders ( DSM-5) published in May 2013, Asperger's syndrome and autistic disorder have been combined into one condition for diagnostic purposes, known as ASD. This change was controversial, because many experts believe that people formerly diagnosed with Asperger's syndrome will not meet the diagnostic criteria for ASD. Also, many experts feel that Asperger's syndrome should be preserved as a separate diagnostic entity to represent a condition related to, but not the same as, autism. Those diagnosed with Asperger's disorder were felt to have a higher-functioning form of autism or autism-related condition. People with Asperger's syndrome typically have normal to above-average intelligence but typically have difficulties with social interactions and often have pervasive, absorbing interests in special topics.

Asperger's syndrome is named for Dr. Hans Asperger, an Austrian pediatrician, who first described the condition in 1944. Dr. Asperger described four boys who showed "a lack of empathy, little ability to form friendships, one-sided conversation, intense absorption in a special interest, and clumsy movements." Because of their obsessive interests in and knowledge of particular subjects, he termed the boys "little professors." The American Psychiatric Association (APA) recognized Asperger disorder as a specific entity and published diagnostic criteria in the Diagnostic and Statistical Manual of Mental Disorders-IV ( DSM-IV) in 1994. Most recently, after significant deliberation, the APA recommended "subsuming" Asperger's Disorder into Autism Spectrum Disorders for the next edition of the DSM-V.

Today, many experts in the field stress the particular gifts and positive aspects of Asperger syndrome and consider it to represent a different, but not necessarily defective, way of thinking. Positive characteristics of people with Asperger syndrome have been described as beneficial in many professions and include:

the increased ability to focus on details,

the capacity to persevere in specific interests without being swayed by others' opinions,

the ability to work independently,

the recognition of patterns that may be missed by others,

intensity, and

an original way of thinking.

Dr. Temple Grandin, a noted engineer, author, and professor who suffers from Asperger disorder believes that her condition has been an asset in her professional life. Her life and story was featured in a film that first aired in 2010.

Although the diagnosis of Asperger's syndrome is not possible without direct testing and observation of an individual, it has been suggested by some authors that many successful historical figures may have had Asperger's syndrome, including Mozart, Albert Einstein, Benjamin Franklin, Thomas Jefferson, and Marie Curie. Of course, definitive diagnosis of historical figures with Asperger's syndrome is not possible, and many of the traits exhibited by people with Asperger's syndrome can also occur because of intellectual giftedness or even attention deficit disorder ( ADD).

QUESTION
See Answer

What causes Asperger's syndrome?

If one accepts the conclusion that Asperger's syndrome is one of the autistic disorders, then the causes of Asperger's syndrome would be expected to be the same as the causes of autism. The precise causes of autistic disorders have not been identified, although an inherited (genetic) component is believed to be involved. Supporting this idea is the fact that Asperger's syndrome has been observed to run in families. In some cases, autistic disorders may be related to toxic exposures, teratogens, problems with pregnancy or birth, and prenatal infections. These environmental influences may act together to modify or potentially increase the severity of the underlying genetic defect.

Some authors have suggested a causal role for vaccine exposure (particularly measles vaccine and thimerosal, a mercury preservative used in some vaccines) in autism. However, the overwhelming majority of epidemiologic evidence shows no evidence for an association between immunizations and autism, and experts have discredited this theory.

How common is Asperger's syndrome?

Asperger's syndrome is five times more common in boys than in girls. In recent years, the number of autism spectrum disorders has increased dramatically in the U.S. The reason for the increase is not fully clear, but is likely due to both improvements and modifications in the diagnostic process that result in an increase in the number of children being identified, as well as some degree of true increase in the incidence of the disorders themselves. The CDC notes one out of every 59 children in the U.S. has an autism spectrum disorder.

Asperger's syndrome has been estimated to affect two and a half out of every 1,000 children, based upon the total number of children with autistic disorders.

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What are the signs and symptoms of Asperger's syndrome?

Social-behavioral symptoms can begin as early as infancy. Characteristic differences are seen in social development, but these changes are hard to identify in toddlers and may be attributed to another condition or not perceived as abnormal. Most cases of Asperger's syndrome are identified when the child is school-aged or older; studies have shown an average age at diagnosis of 11 years. Some of the symptoms that may be present are:

lack of social awareness;

lack of interest in socializing/making friends;

difficulty making and sustaining friendships;

inability to infer the thoughts, feelings, or emotions of others;

either gazing too intently or avoiding eye contact;

lack of changing facial expression, or use of exaggerated facial expressions;

lack of use or comprehension of gestures;

inability to perceive nonverbal cues or communications;

failure to respect interpersonal boundaries;

unusually sensitive to noises, touch, odors, tastes, or visual stimuli;

inflexibility and over-adherence to or dependence on routines; and

stereotypical and repetitive motor patterns such as hand flapping or arm waving.

Another defining characteristic of Asperger's syndrome is the presence of perseverative and obsessive interests in special topics (such as cars or trains, or even more narrow topics such as vacuum cleaners), which may be of little interest to others.

These interests are unusually repetitive and intense when compared to other children's interests.

Specific or narrow interests remain the focus of the child's interest and conversation in spite of efforts to redirect the child's attention.

Language development in children with Asperger's syndrome is generally normal, in contrast to other autistic conditions. Children with Asperger's syndrome have normal scores on tests for language function involving vocabulary, syntax, and grammar. In fact, some experts believe the presence of normal language development distinguishes Asperger's syndrome from high-functioning autism. However, the use or application of language skills is altered in people with Asperger's syndrome:

Their speech may be disorganized or not relevant to the discussion, or they may focus too intently on their defined area of interest (see above) in conversations. The child may switch topics for no apparent reason in conversation, often in an attempt to steer the conversation toward his or her area of interest.

Changes in voice and speaking (for example, speaking too loudly or dramatically, using an invariant tone or incorrect intonation, loud pitch, or speaking too rapidly or too slowly) can also be seen.

Language may be interpreted literally, and difficulties can arise with interpreting language in a specific context.

There are difficulties with understanding the subtle use of language, such as irony or sarcasm.

In school, children with Asperger's syndrome tend to excel with the rote learning often required in the early grades. As they get older, they may have more difficulties in school due to the nature of reading comprehension and written assignments. Special education support is sometimes, but not always, necessary.

Sometimes, people with Asperger disorder have other associated psychiatric conditions or may show behaviors that are typical for other conditions. Some common associated conditions include the following (but these are not always present):

SLIDESHOW
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How do medical professionals diagnose Asperger's syndrome?

Diagnosis is based upon interviews and observation of the individual along with interviews of his/her family members and sometimes teachers or counselors. The Diagnostic and Statistical Manual of Mental Disorders is published by the American Psychiatric Association and includes the diagnostic criteria for all recognized psychiatric conditions.

The DSM-IV had specific diagnostic criteria for Asperger's syndrome. However, revision of the DSM-IV was carried out, with a fifth edition ( DSM-V) published in May 2013. In this new version, Asperger's syndrome is included in the same diagnostic group as people with autism and pervasive developmental disorders.

What are the risks or complications of Asperger's syndrome?

As mentioned before, Asperger's syndrome may coexist with other psychiatric conditions such as attention deficit hyperactivity disorder ( ADHD) or anxiety disorder. Even when anxiety disorder is not present, people with Asperger's syndrome may suffer from anxiety or hypersensitivity to certain stimuli such as loud noises. In some cases, disruptive behaviors (tantrums, self-injury, and aggression) and/or depression may occur in response to the anxiety and frustration experienced by sufferers of Asperger's syndrome. Other behaviors that have been reported in people with Asperger's syndrome include obsessive-compulsive behaviors and difficulties with anger management.

As with any condition, the degree of severity of symptoms can vary widely among individuals, and not all persons with Asperger's syndrome will experience associated psychiatric disorders, depression, or disruptive behaviors.

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What are the treatments for Asperger's syndrome?

Treatment of Asperger's syndrome involves a multidisciplinary approach.

Medical therapy is not effective in treating Asperger syndrome, although medications may be prescribed to help control troubling symptoms or symptoms of other psychiatric conditions that may coexist with Asperger's syndrome. In some cases, selective serotonin reuptake inhibitor (SSRI) medications are used for relief of anxiety or depression. Medical treatments for ADHD may also be tried if there is significant hyperactivity and/or distraction.

A number of behavioral therapies and educational interventions can help people with Asperger's syndrome, although all of these may not be necessary in a given individual. The type of interventions chosen must be based upon the individual's age and needs. Types of interventions that have been shown to be of benefit include:

efforts to reduce overstimulation or overload of sensory input;

supporting executive function skills by provision of an environment that is predictable, structured, and organized;

organization skills training;

speech/language therapy that addresses the ambiguous use of language and the use of language in social settings;

social skills training programs, including training in the awareness of social cognition, use of gestures and facial expressions, and conversational language;

adaptive skills or life-skills training;

educational supports such as assistance with organization, note-taking, allowing oral rather than written testing, use of scripts, and assistance with reading comprehension and subtlety of language use; and

self-advocacy training.

What is the prognosis for Asperger's syndrome?

An estimation of the prognosis of Asperger's syndrome is difficult, if not impossible, since affected individuals have variable degrees of impairment, and the provision of treatment can dramatically improve the long-term outlook for people with Asperger's syndrome. In general, when social, behavioral, and educational support is provided as needed, people with Asperger's syndrome can be expected to lead happy and productive lives.

From

Medically Reviewed on 7/15/2019

Medically reviewed by Margaret Walsh, MD; American Board of Pediatrics

REFERENCES:

American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders DSM-IV Fourth Edition. Washington, D.C.: American Psychiatric Association, 1994.

American Psychiatric Association. DSM-V Proposed Revisions. < http://www.dsm5.org/ProposedRevisions/Pages/Default.aspx>.

Attwood, Tony. The Complete Guide to Asperger's Syndrome. Great Britain: Jessica Kingsley Publishers, 2006.

CDC MMWR Surveillance Summaries. "Prevalence of Autism Spectrum Disorders -- Autism and Development Disabilities Monitoring Network." MMWR Surveillance Summaries 58.10 (2009): 1-20.

Centers for Disease Control and Prevention. "Autism Spectrum Disorders (ASDs)." April 5, 2019. <http://www.cdc.gov/ncbddd/autism/index.html>.

Macintosh, K.E., and C. Dissanayake. "Annotation: The similarities and differences between autistic disorder and Asperger's disorder: a review of the empirical evidence." Journal of Child Psychology and Psychiatry, and Allied Disciplines 45.3 (2004): 421-434.

United States. National Institute of Neurological Disorders and Stroke. "Asperger Syndrome Information Page." Mar. 27, 2019. <?https://www.ninds.nih.gov/Disorders/All-Disorders/Asperger-Syndrome-Information-Page>.

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aspergers syndrome asperger syndrome asperger disorder

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Asperger's Syndrome Symptoms, Definition, Facts & Testing

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Asperger's syndrome defintion and facts Asperger's syndrome was formerly characterized as a distinct autism spectrum disorder; the DSM-5 in May 2013 combined the diagnosis with autistic disorder into one condition called autism spectrum disorder or ASD. People with Asperger's syndrome have normal to above-average intelligence but typically have difficulties with social skills and often have pervasive, absorbing interests in special topics.

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What is oppositional defiant disorder (ODD) in children?

Oppositional defiant disorder (ODD) is a type of behavior disorder. It is mostly diagnosed in childhood. Children with ODD are uncooperative, defiant, and hostile toward peers, parents, teachers, and other authority figures. They are more troubling to others than they are to themselves.

What causes ODD in a child?

Researchers don't know what causes ODD. But there are 2 main theories for why it occurs:

Developmental theory. This theory suggests that the problems start when children are toddlers. Children and teens with ODD may have had trouble learning to become independent from a parent or other main person to whom they were emotionally attached. Their behavior may be normal developmental issues that are lasting beyond the toddler years.

Learning theory. This theory suggests that the negative symptoms of ODD are learned attitudes. They mirror the effects of negative reinforcement methods used by parents and others in power. The use of negative reinforcement increases the child's ODD behaviors. That's because these behaviors allow the child to get what he or she wants: attention and reaction from parents or others.

Which children are at risk for ODD?

ODD is more common in boys than in girls. Children with the following mental health problems are also more likely to have ODD:

Mood or anxiety disorders

Conduct disorder

Attention-deficit/hyperactivity disorder (ADHD)

What are the symptoms of ODD in a child?

Most symptoms seen in children and teens with ODD also happen at times in other children without it. This is especially true for children around ages 2 or 3, or during the teen years. Many children tend to disobey, argue with parents, or defy authority. They may often behave this way when they are tired, hungry, or upset. But in children and teens with ODD, these symptoms happen more often. They also interfere with learning and school adjustment. And in some cases, they disrupt the child's relationships with others.

Symptoms of ODD may include:

Having frequent temper tantrums

Arguing a lot with adults

Refusing to do what an adult asks

Always questioning rules and refusing to follow rules

Doing things to annoy or upset others, including adults

Blaming others for the child's own misbehaviors or mistakes

Being easily annoyed by others

Often having an angry attitude

Speaking harshly or unkindly

Seeking revenge or being vindictive

These symptoms may look like other mental health problems. Make sure your child sees his or her healthcare provider for a diagnosis.

How is ODD diagnosed in a child?

If you notice symptoms of ODD in your child or teen, you can help by seeking a diagnosis right away. Early treatment can often prevent future problems.

A child psychiatrist or qualified mental health expert can diagnose ODD. He or she will talk with the parents and teachers about the child's behavior and may observe the child. In some cases, your child may need mental health testing.

How is ODD treated in a child?

Early treatment can often prevent future problems. Treatment will depend on your child's symptoms, age, and health. It will also depend on how bad the ODD is.

Children with ODD may need to try different therapists and types of therapies before they find what works for them. Treatment may include:

Cognitive-behavioral therapy. A child learns to better solve problems and communicate. He or she also learns how to control impulses and anger.

Family therapy. This therapy helps make changes in the family. It improves communication skills and family interactions. Having a child with ODD can be very hard for parents. It can also cause problems for siblings. Parents and siblings need support and understanding.

Peer group therapy. A child develops better social and interpersonal skills.

Medicines. These are not often used to treat ODD. But a child may need them for other symptoms or disorders, such as ADHD.

How can I help prevent ODD in my child?

Researchers don't know what causes ODD. But certain approaches can help prevent the disorder. Young children be helped by early intervention programs that teach them social skills and how to deal with anger. For teens, talk therapy (psychotherapy), learning social skills, and getting help with schoolwork can all help reduce problem behaviors. School-based programs can also help to stop bullying and improve relationships among teens.

Parent-management training programs are also important. These programs teach parents how to manage their child's behavior. Parents learn positive reinforcement methods, and also how to discipline their child.

How can I help my child live with ODD?

Early treatment for your child can often prevent future problems. Here are things you can do to help:

Keep all appointments with your child's healthcare provider.

Take part in family therapy as needed.

Talk with your child's healthcare provider about other providers who will be involved in your child's care. Your child may get care from a team that may include counselors, therapists, social workers, psychologists, and psychiatrists. Your child's care team will depend on his or her needs and how serious the disorder is.

Tell others about your child's conduct disorder. Work with your child's healthcare provider and school to develop a treatment plan.

Reach out for support. Being in touch with other parents who have a child with ODD may be helpful. If you feel overwhelmed or stressed out, talk with your child's healthcare provider. He or she may direct you to a support group for caregivers of children with ODD.

When should I call my child's healthcare provider?

Call your child's healthcare provider right away if your child:

Feels extreme depression, fear, anxiety, or anger toward him or herself or others

Feels out of control

Hears voices that others don't hear

Sees things that others don't see

Can't sleep or eat for 3 days in a row

Shows behavior that concerns friends, family, or teachers, and others express concern about this behavior and ask you to seek help

Call 911 if your child has suicidal thoughts, a suicide plan, and the means to carry out the plan.

Key points about ODD in children

Oppositional defiant disorder (ODD) is a type of behavior disorder. Children with ODD are uncooperative, defiant, and hostile toward peers, parents, teachers, and other authority figures.

Developmental problems may cause ODD. Or the behaviors may be learned.

A child with ODD may argue a lot with adults or refuse to do what they ask. He or she may also be unkind to others.

A mental health expert often diagnoses ODD.

Therapy that helps the child interact better with others is the main treatment. Medicines may be needed for other problems, such as ADHD.

Next steps

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

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

Before your visit, write down questions you want answered.

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

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

Ask if your child's condition can be treated in other ways.

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

Know what to expect if your child does not take the medicine or have the test or procedure.

If your child has a follow-up appointment, write down the date, time, and purpose for that visit.

Know how you can contact your child's provider after office hours. This is important if your child becomes ill and you have questions or need advice.

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Oppositional Defiant Disorder (ODD) in Children

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Oppositional defiant disorder (ODD) is a type of behavior disorder. It is mostly diagnosed in childhood. Children with ODD are uncooperative, defiant, and hostile toward peers, parents, teachers, and other authority figures.

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Overview

Even the best-behaved children can be difficult and challenging at times. But oppositional defiant disorder (ODD) includes a frequent and ongoing pattern of anger, irritability, arguing and defiance toward parents and other authority figures. ODD also includes being spiteful and seeking revenge, a behavior called vindictiveness.

These emotional and behavioral issues cause serious problems with family life, social activities, school and work. But as a parent, you don't have to try to manage a child with ODD alone. Your health care provider, a mental health professional and a child development expert can help.

Treatment of ODD involves learning skills to help build positive family interactions and to manage problem behaviors. Other therapy, and possibly medicines, may be needed to treat related mental health conditions.

Symptoms

Sometimes it's difficult to recognize the difference between a strong-willed or emotional child and one with oppositional defiant disorder. It's common for children to show oppositional behavior at certain stages of development.

Symptoms of ODD generally begin during preschool years. Sometimes ODD may develop later, but almost always before the early teen years. Oppositional and defiant behaviors are frequent and ongoing. They cause severe problems with relationships, social activities, school and work, for both the child and the family.

Emotional and behavioral symptoms of ODD generally last at least six months. They include angry and irritable mood, argumentative and defiant behavior, and hurtful and revengeful behavior.
Angry and irritable mood

Often and easily loses temper.

Is frequently touchy and easily annoyed by others.

Is often angry and resentful.

Argumentative and defiant behavior

Often argues with adults or people in authority.

Often actively defies or refuses to follow adults' requests or rules.

Often annoys or upsets people on purpose.

Often blames others for their own mistakes or misbehavior.

Hurtful and revengeful behavior

Says mean and hateful things when upset.

Tries to hurt the feelings of others and seeks revenge, also called being vindictive.

Has shown vindictive behavior at least twice in the past six months.

Severity
ODD can be mild, moderate or severe:

Mild. Symptoms occur only in one setting, such as only at home, school, work or with peers.

Moderate. Some symptoms occur in at least two settings.

Severe. Some symptoms occur in three or more settings.

For some children, symptoms may first be seen only at home. But with time, problem behavior also may happen in other settings, such as school, social activities and with friends.

When to see a doctor

Your child isn't likely to see their own behavior as a problem. Instead, your child will probably complain about unreasonable demands or blame others for problems.

If you think your child may have ODD or other problem behavior, or you're concerned about your ability to parent a challenging child, seek help from a child psychologist or a child psychiatrist with expertise in behavior problems. Ask your child's pediatrician or other health care provider for a referral to a mental health provider.

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Causes

There's no known clear cause of oppositional defiant disorder. Causes may include a combination of genetic and environmental factors:

Genetics. A child's natural personality or character - also called temperament - may contribute to developing ODD. Differences in the way nerves and the brain function also may play a role.

Environment. Problems with parenting that may involve a lack of supervision, inconsistent or harsh discipline, or abuse or neglect may contribute to developing ODD.

Risk factors

Oppositional defiant disorder is a complex problem. Possible risk factors for ODD include:

Temperament - a child who has a temperament that includes difficulty managing emotions, such as reacting with strong emotions to situations or having trouble tolerating frustration.

Parenting issues - a child who experiences abuse or neglect, harsh or inconsistent discipline, or a lack of proper supervision.

Other family issues - a child who lives with parent or family relationships that are unstable or has a parent with a mental health condition or substance use disorder.

Environment - problem behaviors that are reinforced through attention from peers and inconsistent discipline from other authority figures, such as teachers.

Complications

Children and teenagers with oppositional defiant disorder may have trouble at home with parents and siblings, in school with teachers, and at work with supervisors and other authority figures. Children and teens with ODD may struggle to make and keep friends and relationships.

ODD also may lead to other problems, such as:

Poor school and work performance.

Antisocial behavior.

Legal problems.

Impulse control problems.

Substance use disorder.

Suicide.

Many children and teens with ODD also have other mental health conditions, such as:

Attention-deficit/hyperactivity disorder (ADHD).

Conduct disorder.

Depression.

Anxiety disorders.

Learning and communication disorders.

Treating these other mental health conditions may help reduce ODD symptoms. It may be difficult to treat ODD if these other conditions are not evaluated and treated appropriately.

Prevention

There's no sure way to prevent oppositional defiant disorder. But positive parenting and early treatment can help improve behavior and prevent the situation from getting worse. The earlier that ODD can be managed, the better.

Treatment can help restore your child's self-esteem and rebuild a positive relationship between you and your child. Your child's relationships with other important adults in their life - such as teachers and care providers - also will benefit from early treatment.

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Oppositional defiant disorder (ODD) - Symptoms and causes

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This childhood mental health condition includes frequent and persistent anger, irritability, arguing, defiance or vindictiveness toward authority.

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It's not unusual for children -- especially those in their "terrible twos" and early teens -- to defy authority every now and then. They may express their defiance by arguing, disobeying, or talking back to their parents, teachers, or other adults. When this behavior lasts longer than six months and is excessive compared to what is usual for the child's age, it may mean that the child has a type of behavior disorder called oppositional defiant disorder (ODD).

ODD is a condition in which a child displays an ongoing pattern of an angry or irritable mood, defiant or argumentative behavior, and vindictiveness toward people in authority. The child's behavior often disrupts the child's normal daily activities, including activities within the family and at school.

Many children and teens with ODD also have other behavioral problems, such as attention deficit disorder, learning disabilities, mood disorders (such as depression), and anxiety disorders. Some children with ODD go on to develop a more serious behavior disorder called conduct disorder.

What Are the Symptoms of Oppositional Defiant Disorder?

Symptoms of ODD may include:

Throwing repeated temper tantrums

Excessively arguing with adults, especially those with authority

Actively refusing to comply with requests and rules

Deliberately trying to annoy or upset others, or being easily annoyed by others

Blaming others for your mistakes

Having frequent outbursts of anger and resentment

Being spiteful and seeking revenge

Swearing or using obscene language

Saying mean and hateful things when upset

In addition, many children with ODD are moody, easily frustrated, and have a low self-esteem. They also sometimes may abuse drugs and alcohol.

What Causes Oppositional Defiant Disorder?

The exact cause of ODD is not known, but it is believed that a combination of biological, genetic, and environmental factors may contribute to the condition.

Biological: Some studies suggest that defects in or injuries to certain areas of the brain can lead to serious behavioral problems in children. In addition, ODD has been linked to abnormal functioning of certain types of brain chemicals, or neurotransmitters. Neurotransmitters help nerve cells in the brain communicate with each other. If these chemicals are not working properly, messages may not make it through the brain correctly, leading to symptoms of ODD, and other mental illnesses. Further, many children and teens with ODD also have other mental illnesses, such as ADHD, learning disorders, depression, or an anxiety disorder, which may contribute to their behavior problems.

Genetics: Many children and teens with ODD have close family members with mental illnesses, including mood disorders, anxiety disorders, and personality disorders. This suggests that a vulnerability to develop ODD may be inherited.

Environmental: Factors such as a dysfunctional family life, a family history of mental illnesses and/or substance abuse, and inconsistent discipline by parents may contribute to the development of behavior disorders.

Continued

How Common Is Oppositional Defiant Disorder?

Estimates suggest that 2%-16% of children and teens have ODD. In younger children, ODD is more common in boys. In older children, it occurs about equally in boys and in girls. It typically begins by age 8.

How Is Oppositional Defiant Disorder Diagnosed?

As with adults, mental illnesses in children are diagnosed based on signs and symptoms that suggest a particular illness like ODD. If symptoms are present, the doctor will begin an evaluation by performing a complete medical history and physical exam. Although there are no lab tests to specifically diagnose ODD, the doctor may sometimes use tests such as neuroimaging studies or blood tests if they suspect that there may be a medical explanation for the behavior problems that occur. The doctor also will look for signs of other conditions that often occur along with ODD, such as ADHD and depression.

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

How Is Oppositional Defiant Disorder Treated?

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

Psychotherapy: Psychotherapy (a type of counseling) is aimed at helping the child develop more effective coping and problem-solving skills, and ways to express and control anger. A type of therapy called cognitive-behavioral therapy aims to reshape the child's thinking (cognition) to improve behavior. Family therapy may be used to help improve family interactions and communication among family members. A specialized therapy technique called parent management training (PMT) teaches parents ways to positively alter their child's behavior. Behavior management plans also often involve developing contracts between parent and child that identify rewards for positive behaviors and consequences (punishments) for negative behaviors.

Medication: While there is no medication that is scientifically established or formally approved to treat ODD, drugs may sometimes be used to treat symptoms (impulsivity, irritability, etc.) or other mental illnesses that may be present, such as ADHD or depression.

Continued

What Is the Outlook for Children With Oppositional Defiant Disorder?

If your child is showing signs of ODD, it is very important that you seek care from a qualified mental health professional immediately. Without treatment, children with ODD may experience rejection by classmates and other peers because of their poor social skills and aggressive and annoying behavior. In addition, a child with ODD has a greater chance of developing a more serious behavioral disorder called conduct disorder. When started early, treatment is usually very effective.

Can Oppositional Defiant Disorder Be Prevented?

Although it may not be possible to prevent ODD, recognizing and acting on symptoms when they first appear can minimize distress to the child and family, and prevent many of the problems associated with the illness. Family members also can learn steps to take if signs of relapse (return of symptoms) appear. In addition, providing a nurturing, supportive, and consistent home environment with a balance of love and discipline may help reduce symptoms and prevent episodes of defiant behavior.

Sources

SOURCES:

Mayo Clinic: "Oppositional defiant disorder (ODD)."

KidsHealth: "What Is ADHD?"

healthychildren.org: "Disruptive Behavior Disorders."

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It's not unusual for children -- especially those in their "terrible twos" and early teens -- to defy authority every now and then. They may express their defiance by arguing, disobeying, or talking back to their parents, teachers, or other adults.

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Oppositional Defiant Disorder

No. 72; Reviewed January 2019

All children are oppositional from time to time, particularly when tired, hungry, stressed, or upset. They may argue, talk back, disobey, and defy parents, teachers, and other adults. Oppositional behavior is a normal part of development for two to three year olds and early adolescents. However, openly uncooperative and hostile behavior becomes a serious concern when it is so frequent and consistent that it stands out when compared with other children of the same age and developmental level and when it affects the child's social, family, and academic life.

In children with Oppositional Defiant Disorder (ODD), there is an ongoing pattern of uncooperative, defiant, and hostile behavior toward authority figures that seriously interferes with the child's day to day functioning.

Symptoms of ODD may include:

Frequent temper tantrums

Excessive arguing with adults

Often questioning rules

Active defiance and refusal to comply with adult requests and rules

Deliberate attempts to annoy or upset people

Blaming others for his or her mistakes or misbehavior

Often being touchy or easily annoyed by others

Frequent anger and resentment

Mean and hateful talking when upset

Spiteful attitude and revenge seeking

The symptoms are usually seen in multiple settings but may be more noticeable at home or at school. One to sixteen percent of all school-age children and adolescents have ODD. The causes of ODD are unknown, but many parents report that their child with ODD was more rigid and demanding than the child's siblings from an early age. Biological, psychological, and social factors may have a role.

A child presenting with ODD symptoms should have a comprehensive evaluation. It is important to look for other disorders which may be present, such as attention-deficit hyperactivity disorder (ADHD), learning disabilities, mood disorders (depression, bipolar disorder), and anxiety disorders. It may be difficult to improve the symptoms of ODD without treating the coexisting disorder. Some children with ODD may go on to develop conduct disorder.

Treatment of ODD may include:

Parent Management Training to help parents and others manage the child's behavior

Individual Psychotherapy to develop more effective anger management

Family Psychotherapy to improve communication and mutual understanding

Cognitive Problem-Solving Skills Training and Therapies to decrease negativity

Social Skills Training to increase flexibility and improve social skills and frustration tolerance with peers

Medications may be helpful in controlling some of the more distressing symptoms of ODD as well as the symptoms related to coexistent conditions such as ADHD, anxiety, and mood disorders.

A child with ODD can be very difficult for parents. These parents need support and understanding. Parents can help their child with ODD in the following ways:

Always build on the positives, give the child praise and positive reinforcement when s/he shows flexibility or cooperation.

Take a time-out or break if you are about to make the conflict with your child worse, not better. This is good modeling for your child. Support your child if s/he decides to take a time-out to prevent overreacting.

Pick your battles. Since the child with ODD has trouble avoiding power struggles, prioritize the things you want your child to do. If you give your child a time-out in his room for misbehavior, don't add time for arguing. Say "your time will start when you go to your room."

Set reasonable, age appropriate limits with consequences that can be enforced consistently.

Maintain interests other than your child with ODD, so that managing your child doesn't take all your time and energy. Try to work with and obtain support from the other adults (teachers, coaches, and spouse) dealing with your child.

Manage your own stress with healthy life choices such as exercise and relaxation. Use respite care and other breaks as needed.

Many children with ODD will respond to the positive parenting techniques. Parents may ask their pediatrician or family physician to refer them to a child and adolescent psychiatrist or other qualified mental health professional who can help diagnose and treat ODD and any coexisting psychiatric condition.

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Oppositional Defiant Disorder No. 72; Reviewed January 2019 All children are oppositional from time to time, particularly when tired, hungry, stressed, or upset. They may argue, talk back, disobey, and defy parents, teachers, and other adults. Oppositional behavior is a normal part of development for two to three year olds and early adolescents.

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

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

What Are the Symptoms of Conduct Disorder?

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

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

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

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

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

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

Continued

What Causes Conduct Disorder?

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

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

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

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

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

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

How Common Is Conduct Disorder?

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

How Is Conduct Disorder Diagnosed?

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

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

Continued

How Is Conduct Disorder Treated?

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

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

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

What Is the Outlook for Children With Conduct Disorder?

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

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

Can Conduct Disorder Be Prevented?

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

Sources

SOURCES:

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

MedlinePlus: "Conduct Disorder."

HealthyChildren.org: "Disruptive Behavior Disorders."

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

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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.

What is conduct disorder?

Conduct disorder is a mental health condition that can affect children and teenagers. Kids who have conduct disorder seem to enjoy hurting people and doing bad things. They are unkind and often violent, and they don't care about other people's feelings. This behavior goes beyond normal teasing, bullying, or acting out.

Extreme bullying, hurting animals, and lying for no reason are all signs of conduct disorder. In younger kids, conduct disorder starts with pushing, hitting and biting. In older kids, conduct disorder can come with more extreme violent behavior and crimes like stealing, destroying things and setting fires.

All kids act out sometimes, so conduct disorder is only diagnosed when this extreme behavior shows up over a long period of time and isn't caused by the child's environment.

What are the symptoms of conduct disorder?

Symptoms of conduct disorder include:

Not caring about social norms of good behavior

Ignoring the rights and feelings of other people

Enjoying causing harm, lying or manipulating people

Committing physical or sexual violence

Hurting animals

In younger kids: lying for no real reason, stealing for the fun of it, and extreme bullying

In older kids: picking fights, lying, cheating, stealing, destroying property, and physically or emotionally abusing others

How is conduct disorder diagnosed?

Conduct disorder is different from just bad behavior or acting out, which most kids do at some point. Kids must show symptoms of conduct disorder for several months at a time to be diagnosed. Before diagnosing a child with conduct disorder, a professional will also try to figure out if their extreme behavior could be a reaction to problems at home. To be diagnosed, a child's enjoyment of causing pain must seem to come from something inside them.

What are the risk factors for conduct disorder?

Several things put kids at higher risk of developing conduct disorder:

Having a parent or sibling with conduct disorder

Having a biological parent who abuses alcohol or has depression, ADHD, bipolar disorder, or schizophrenia

Experiencing abuse or neglect

Being bullied or having friends who encourage negative behavior

How is conduct disorder treated?

Conduct disorder is hard to treat but treatment can work if the child's family, friends and teachers get involved. Treatment works better if it starts when the child is young.

In therapy for conduct disorder, the child learns healthier ways to interact with others. At the same time, the child's family and support system learn ways to communicate with the child. Children with conduct disorder usually stay in psychotherapy or behavioral therapy for a long time.

In younger children, therapy for conduct disorder usually involves teaching parents how to encourage good behavior. In adolescents, therapy may also focus on the child's relationships with friends, other kids, and adults at school (like teachers and principals).

There is no medication specifically for conduct disorder. But kids with conduct disorder sometimes have other disorders as well, like depression or bipolar disorder. Treating those other disorders with medication can help therapy for conduct disorder work better.

This guide was last reviewed or updated on February 23, 2023.

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Quick Guide to Conduct Disorder - Child Mind Institute

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Lo sentimos, la página que usted busca no se ha podido encontrar. Puede intentar su búsqueda de nuevo o visitar la lista de temas populares. Conduct disorder is a mental health condition that can affect children and teenagers. Kids who have conduct disorder seem to enjoy hurting people and doing bad things.

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What is conduct disorder in children?

Conduct disorder is a type of behavior disorder. It's when a child has antisocial behavior. He or she may disregard basic social standards and rules. He or she may also:

Be irresponsible

Skip school or run away (delinquent behavior)

Steal or do other things to violate the rights of others

Physically harm animals or other people, such as committing assault or rape

These behaviors sometimes happen together. But one or more may occur without the others.

What causes conduct disorder in a child?

Experts believe that many factors play a role in conduct disorder. These are:

Some children with conduct disorders seem to have a problem in the frontal lobe of the brain. This interferes with a child's ability to plan, stay away from harm, and learn from negative experiences.

Some experts believe that a series of traumatic experiences occurs for a child to develop a conduct disorder. These experiences then often lead to depressed mood, behavior problems, and involvement in a deviant peer group.

Which children are at risk for conduct disorder?

A conduct disorder is more common in boys than in girls. It is also more likely to develop in children or teens who come from homes that are:

Children with these mental health problems are also more likely to have conduct disorder:

Mood or anxiety disorders

Posttraumatic stress disorder (PTSD)

Substance abuse

Attention-deficit/hyperactivity disorder (ADHD)

Learning problems or learning disorders

Children or teens who are considered to have a difficult temperament are more likely to develop behavior problems.

What are the symptoms of conduct disorder in a child?

Most symptoms seen in children with conduct disorder also happen at times in children without this problem. But in children with the disorder, these symptoms occur more often. They also interfere with learning, school adjustment, and sometimes with the child's relationships.

Each child's symptoms may vary. But the 4 main groups of behaviors are described below.

Aggressive conduct

Destructive conduct

Deceitfulness

Violation of rules or age-appropriate norms

These symptoms may look like other mental health problems. Have your child see his or her healthcare provider for a diagnosis.

How is conduct disorder diagnosed in a child?

A child psychiatrist or qualified mental health expert can diagnose a conduct disorder. He or she will talk with parents and teachers about the child's behavior and may observe the child. In some cases, your child may need mental health testing.

If you notice symptoms of conduct disorder in your child or teen, you can help by seeking a diagnosis right away. Early treatment can often prevent future problems.

How is conduct disorder treated in a child?

Treatment will depend on your child's symptoms, age, and general health. It will also depend on how severe the condition is.

Treatment for conduct disorder may include:

Cognitive-behavioral therapy. A child learns how to better solve problems, communicate, and handle stress. He or she also learns how to control impulses and anger.

Family therapy. This therapy helps make changes in the family. It improves communication skills and family interactions.

Peer group therapy. A child develops better social and interpersonal skills.

Medicines. These are not often used to treat conduct disorder. But a child may need them for other symptoms or disorders such as ADHD. These other disorders often occurs along with symptoms of conduct disorder.

How can I help prevent conduct disorder in my child?

Experts don't know exactly why some children develop conduct disorder. Things such as a traumatic experience, social problems, and biological factors may be involved. To reduce the risk for this disorder, parents can learn positive parenting strategies. They can be good role models for their children.. This can help to create a closer parent-child relationship and give the child with examples of how to respectfully treat other people, animals, and property. It can also create a safe and stable home life for the child.

How can I help my child live with conduct disorder?

Early treatment for your child can often prevent future problems. Here are things you can do to help your child:

Keep all appointments with your child's healthcare provider.

Take part in family therapy as needed.

Talk to your child's healthcare provider about other providers who will be involved in your child's care. Your child may get care from a team that may include counselors, therapists, social workers, psychologists, and psychiatrists. Your child's care team will depend on his or her needs and how serious the disorder is.

Tell others about your child's conduct disorder. Work with your healthcare provider and schools to develop a treatment plan.

Reach out for support. Being in touch with other parents who have a child with conduct disorder may be helpful. If you feel overwhelmed or stressed out, talk with your healthcare provider about a support group for caregivers of children with conduct disorder.

When should I call my child's healthcare provider?

Call your healthcare provider right away if your child:

Feels extreme depression, fear, anxiety, or anger toward him or herself or others

Feels out of control

Hears voices that others don't hear

Sees things that others don't see

Can't sleep or eat for 3 days in a row

Shows behavior that concerns friends, family, or teachers, and others express concern about this behavior and ask you to seek help

Call 911 if your child has suicidal thoughts, a suicide plan, and the means to carry out the plan. Never leave them alone until the situation is assessed and treatment laid out. This may include a hospital stay.

Key points about conduct disorder in children

Conduct disorder is a type of behavior disorder. It's when a child has antisocial behavior.

Both genetic and environmental factors may play a role.

Children with other mental health problems are more likely to have this disorder.

Symptoms are divided into 4 main groups. They are aggression, destruction, deceitfulness, and violation of rules.

Therapy that helps the child interact better with others is the main treatment. Therapy may include both individual and family counseling. Medicines may be needed for other problems, such as ADHD.

Reach out for support. Being in touch with other parents who have a child with conduct disorder may be helpful.

Call 911 if your child has suicidal thoughts, a suicide plan, and the means to carry out the plan. Never leave the child alone.

Next steps

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

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

Before your visit, write down questions you want answered.

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

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

Ask if your child's condition can be treated in other ways.

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

Know what to expect if your child does not take the medicine or have the test or procedure.

If your child has a follow-up appointment, write down the date, time, and purpose for that visit.

Know how you can contact your child's provider after office hours. This is important if your child becomes ill and you have questions or need advice.

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Conduct disorder is a type of behavior disorder. It's when a child has antisocial behavior. He or she may disregard basic social standards and rules. He or she may also: Be irresponsible Skip school or run away (delinquent behavior) Steal or do other things to violate the rights of others Physically harm animals or other people, such as committing assault or rape These behaviors sometimes happen together.

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National Institute of Mental Health (NIMH)

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What is schizophrenia?

Schizophrenia is a serious mental illness that affects how a person thinks, feels, and behaves. People with schizophrenia may seem like they have lost touch with reality, which can be distressing for them and for their family and friends. The symptoms of schizophrenia can make it difficult to participate in usual, everyday activities, but effective treatments are available. Many people who receive treatment can engage in school or work, achieve independence, and enjoy personal relationships.

What are the signs and symptoms of schizophrenia?

What are the risk factors for schizophrenia?

How is schizophrenia treated?

How can I find help for schizophrenia?

How can I find a clinical trial for schizophrenia?

Where can I learn more about schizophrenia?

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Learn about schizophrenia, including onset & symptoms, risk factors, treatments and therapies, how to help a loved one, & resources for more information.

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

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Schizophrenia is a serious mental illness that interferes with a person's ability to think clearly, manage emotions, make decisions and relate to others. It is a complex, long-term medical illness. The exact prevalence of schizophrenia is difficult to measure, but estimates range from 0.25% to 0.64% of U.S. adults. Although schizophrenia can occur at any age, the average age of onset tends to be in the late teens to the early 20s for men, and the late 20s to early 30s for women. It is uncommon for schizophrenia to be diagnosed in a person younger than 12 or older than 40. It is possible to live well with schizophrenia.

Symptoms

It can be difficult to diagnose schizophrenia in teens. This is because the first signs can include a change of friends, a drop in grades, sleep problems, and irritability-common and nonspecific adolescent behavior. Other factors include isolating oneself and withdrawing from others, an increase in unusual thoughts and suspicions, and a family history of psychosis. In young people who develop schizophrenia, this stage of the disorder is called the "prodromal" period.

With any condition, it's essential to get a comprehensive medical evaluation in order to obtain the best diagnosis. For a diagnosis of schizophrenia, some of the following symptoms are present in the context of reduced functioning for a least 6 months:

Hallucinations. These include a person hearing voices, seeing things, or smelling things others can't perceive. The hallucination is very real to the person experiencing it, and it may be very confusing for a loved one to witness. The voices in the hallucination can be critical or threatening. Voices may involve people that are known or unknown to the person hearing them.

Delusions. These are false beliefs that don't change even when the person who holds them is presented with new ideas or facts. People who have delusions often also have problems concentrating, confused thinking, or the sense that their thoughts are blocked.

Negative symptoms are ones that diminish a person's abilities. Negative symptoms often include being emotionally flat or speaking in a dull, disconnected way. People with the negative symptoms may be unable to start or follow through with activities, show little interest in life, or sustain relationships. Negative symptoms are sometimes confused with clinical depression.

Cognitive issues/disorganized thinking. People with the cognitive symptoms of schizophrenia often struggle to remember things, organize their thoughts or complete tasks. Commonly, people with schizophrenia have anosognosia or "lack of insight." This means the person is unaware that he has the illness, which can make treating or working with him much more challenging.

Causes

Research suggests that schizophrenia may have several possible causes:

Genetics. Schizophrenia isn't caused by just one genetic variation, but a complex interplay of genetics and environmental influences. Heredity does play a strong role-your likelihood of developing schizophrenia is more than six times higher if you have a close relative, such as a parent or sibling, with the disorder

Environment. Exposure to viruses or malnutrition before birth, particularly in the first and second trimesters has been shown to increase the risk of schizophrenia. Recent research also suggests a relationship between autoimmune disorders and the development of psychosis.

Brain chemistry. Problems with certain brain chemicals, including neurotransmitters called dopamine and glutamate, may contribute to schizophrenia. Neurotransmitters allow brain cells to communicate with each other. Networks of neurons are likely involved as well.

Substance use. Some studies have suggested that taking mind-altering drugs during teen years and young adulthood can increase the risk of schizophrenia. A growing body of evidence indicates that smoking marijuana increases the risk of psychotic incidents and the risk of ongoing psychotic experiences. The younger and more frequent the use, the greater the risk.

Diagnosis

Diagnosing schizophrenia is not easy. Sometimes using drugs, such as methamphetamines or LSD, can cause a person to have schizophrenia-like symptoms. The difficulty of diagnosing this illness is compounded by the fact that many people who are diagnosed do not believe they have it. Lack of awareness is a common symptom of people diagnosed with schizophrenia and greatly complicates treatment.

While there is no single physical or lab test that can diagnosis schizophrenia, a health care provider who evaluates the symptoms and the course of a person's illness over six months can help ensure a correct diagnosis. The health care provider must rule out other factors such as brain tumors, possible medical conditions and other psychiatric diagnoses, such as bipolar disorder.

To be diagnosed with schizophrenia, a person must have two or more of the following symptoms occurring persistently in the context of reduced functioning:

Delusions

Hallucinations

Disorganized speech

Disorganized or catatonic behavior

Negative symptoms

Delusions or hallucinations alone can often be enough to lead to a diagnosis of schizophrenia. Identifying it as early as possible greatly improves a person's chances of managing the illness, reducing psychotic episodes, and recovering. People who receive good care during their first psychotic episode are admitted to the hospital less often, and may require less time to control symptoms than those who don't receive immediate help. The literature on the role of medicines early in treatment is evolving, but we do know that psychotherapy is essential.

People can describe symptoms in a variety of ways. How a person describes symptoms often depends on the cultural lens she is looking through. African Americans and Latinos are more likely to be misdiagnosed, potentially due to differing cultural perspectives or structural barriers. Any person who has been diagnosed with schizophrenia should try to work with a health care professional that understands his or her cultural background and shares the same expectations for treatment.

Treatment

There is no cure for schizophrenia, but it can be treated and managed in several ways.

Related Conditions

People with schizophrenia may have additional illnesses. These may include:

Successfully treating schizohprenia almost always improves these related illnesses. And successful treatment of substance misuse, PTSD or OCD usually improves the symptoms of schizophrenia.

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Schizophrenia is a serious mental illness that interferes with a person's ability to think clearly, manage emotions, make decisions and relate to others. It is a complex, long-term medical illness. The exact prevalence of schizophrenia is difficult to measure, but estimates range from 0.25% to 0.64% of U.S. adults.

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Psycom.net - Mental Health Treatment Resource Since 1986

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What Is Depression?

Being depressed often feels like carrying a very heavy burden, but you are not alone in this struggle. Millions of Americans suffer from some form of depression every year, making it one of the most common mental disorders in the country.

Gaining a deeper understanding of depression can help begin the journey to recovery. Taking some time to learn more about the causes and symptoms of depression will assist you greatly when it comes time to consider methods of treatment.

Depression is more than just feeling sad. Everyone feels upset or unmotivated from time to time, but depression is more serious. It is a mood disorder characterized by prolonged feelings of sadness and loss of interest in daily activities. If these symptoms persist for a period of at least two weeks, it is considered a depressive episode.

Patient Statistics

According to the National Institute of Mental Health (NIMH), major depression is one of the most common mental disorders in the United States. ¹

Data from the Substance Abuse and Mental Health Services Administration (SAMHSA) shows that in 2017, an estimated 17.3 million adults in the United States reported having at least one major depressive episode in the previous 12 months. That's 7.1% of all US adults ages 18 and older. Adult females have a higher prevalence of experiencing a major depressive episode than their male counterparts-8.7% compared to 5.3% in adult males. Depression in the adolescent population (ages 12 to 17) has also increased. An estimated 3.2 million adolescents had at least one major depressive episode-a number that represents 13.3% of the adolescent population.

Not only is depression prevalent, but it also creates the heaviest burden of disability among mental and behavior disorders. According to a 2010 World Health Organization (WHO) report, depression accounted for 3.7% of all U.S. disability-adjusted life years and 8.3% of all U.S. years lived with disability.

Causes of Depression

There is no one cause for depression, as it depends on a unique combination of an individual's genetic makeup and environmental conditions. There are many factors to take into account:

The brain's physical structure or chemistry

History of depression in the family

History of other disorders (anxiety, post-traumatic stress disorder)

Stressful, traumatic events (abuse, financial issues, death of a loved one)

Hormone changes (menstrual cycles, pregnancy)

Certain medications (sleeping aids, blood pressure medication)

Types of Depression

Just as there is no one cause for depression, there isn't only one type of depression. It can take many forms. The fifth edition of the Diagnostic and Statistical Manual of Mental Health Disorders lists nine distinct types:

1. Major depression, as we discussed, is the most common type of depression. Often, people with major depression experience recurrent episodes throughout their lives.

2. Dysthymia is a persistent low mood over a long period of time, even a year or more. It could be described as feeling like you're living on autopilot.

3. Some people are more sensitive to the lower amount of light in the wintertime. Seasonal Affective Disorder is a type of depression brought on from a lack of natural sunlight.

4. Those with Atypical Depression often report feeling a heaviness in their limbs. They may suffer from irritability and relationship problems, as well as be prone to overeating and oversleeping.

5. Bipolar Disorder is also called Manic Depressive Disorder because it involves alternating between mania and depressive episodes.

6. Sometimes depressive episodes can get so severe that hallucinations or delusions are present, the person becomes catatonic, or they feel stuck in bed. This is known as Psychotic Depression.

7. Postpartum Depression occurs after giving birth. Mothers may feel disconnected from their new baby or fear that they will hurt their child.

8. Severe depression that shows up during the second half of the menstrual cycle is called Premenstrual Dysphoric Disorder. It affects the individual's ability to function normally.

9. Situational Depression is triggered by a life-changing event. It could be anything, from losing your job to the death of an immediate family member.

Signs and Symptoms of Depression

Though there are multiple types of depression, many of them have similar recognizable symptoms. This list scratches the surface, but it provides a general idea of what comprises depression:

Persistent feelings of sadness, hopelessness, worthlessness, or emptiness

Irritability, frustration, or restlessness

Loss of interest in activities or hobbies that used to be enjoyable

Difficulty sleeping, sleep disturbances or sleeping too much

Fatigue and lack of energy

Difficulty thinking clearly, remembering, concentrating, or making decisions

Appetite or weight changes

Recurrent thoughts of death or suicide

Physical symptoms such as headaches, stomachaches, or back pain

Experiencing some combination of these symptoms for a period of at least two weeks likely signifies that you are in the midst of a depressive episode. See 7 Surprising Symptoms of Depression.

Treatment

Any treatment for depression should coincide with a healthy diet and a regular sleep schedule. It may sound simplistic, but the importance of taking care of your body cannot be overstated.

There are various methods you could use to sooth the symptoms of depression. All of us could stand to exercise more often, but exercise is especially helpful for the depressed mind. It enables you to better handle stress, and the endorphins released during exercise give you a mental boost. Aside from the mental health benefits, the Centers for Disease Control and Prevention (CDC) report that physical activity helps you sleep better at night.

Yoga is a more accessible form of exercise, because it doesn't require equipment and because many of the moves and poses do not require much effort. Meditation is a highly effective way of clearing your head and calming your body. It's also easy to do, with guided meditations available through phone apps, online in text and videos, and in books.

If you enjoy keeping a journal, you may find that it helps to express your thoughts on paper instead of bottling them inside. It's helpful to have close friends and family who you can confide in, but they're not always available or may be dealing with stress of their own. This makes keeping a journal a good idea to have an alternate way to vent.

Therapy with anyone from a guidance counselor to a certified therapist can work wonders, and many may prefer therapy over the medication route. Situational depression especially can be relieved by having a way to get everything off your chest and receive practical advice.

For a more hands-on approach, try experts like psychiatrists or psychologists. They offer many types of therapy, from light therapy for Seasonal Affective Disorder to cognitive behavioral therapy that works to change your thought processes.

Other alternatives include drinking special teas or taking supplements. The properties of green tea and chamomile tea give them a calming effect, and some have found success drinking St. John's Wort tea to treat depression. It can also be taken as a supplement. While there is no proof that St. John's Wort improves depression symptoms, fish oil, and SAM-e are supplements with a proven impact.

There is no shame in taking medication to manage your depression. People routinely take medication for physical ailments, and having a mental illness isn't any different. If you're worried about the possible side effects, call your doctor to discuss them. Any medication can be tapered down or ceased, and there are different types available to suit your individual needs and chemistry.

Remember that recovery is a journey, not a destination. Bad days will still come, but with well-targeted treatment, you should be able to overcome extreme lows. While science has yet to find a cure for mental disorders such as depression, it is entirely possible to live a happy and fulfilling life in spite of it.
If you are experiencing a mental health crisis, or someone you love is in danger, we strongly suggest that you reach out to to a qualified mental health professional. To aid in your search please consider our directory of emergency mental health resources.

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Depression Types, Causes, Symptoms, Statistics, & Treatment

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Being depressed often feels like carrying a very heavy burden, but you are not alone in this struggle. Millions of Americans suffer from some form of depression every year, making it one of the most common mental disorders in the country. Gaining a deeper understanding of depression can help begin the journey to recovery.

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Mental Health Nursing - Bipolar Disorder

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10 Facts About Bipolar Disorder That Everyone Should Know

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What is ODD? ODD meaning and Oppositional Defiant Disorder DSM 5  diagnosis

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What is ODD? Oppositional defiant disorder, also known as ODD, is a pattern of angry/irritable mood, argumentative/defiant behavior, or vindictiveness lasting at least six months. ODD is different than Conduct Disorder is that children with ODD are not aggressive towards, people, animals, or property and they do not show a proclivity towards theft or deceit.

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Attention deficit hyperactivity disorder (ADHD) - Symptoms, Causes & Treatment

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ADHD in Children (Attention-Deficit Hyperactivity Disorder)

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Are You Impulsive? How Meditation Can Help

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What is obsessive compulsive disorder (OCD)?

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What is Asperger's Syndrome (Developmental Disorder)

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Autism and Aspergers: 5 intriguing differences (YOU need to know)

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What is Schizophrenia? - It's More Than Hallucinations

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7 ASPERGERS SYMPTOMS (YOU Never KNEW Were TRAITS)