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School Counselors’ Recognition of the Ultra-High Risk for Psychosis

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School Counselors’ Recognition of the Ultra-High Risk for Psychosis

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INTRODUCTION

The most common time of onset for psychotic disorders is adolescence and early adulthood []. The onset of psychotic disorders is usually preceded by a prodromal period characterized by non-specific psychiatric and attenuated psychotic symptoms accompanied by functional decline []. "Ultra-high risk" (UHR) for psychosis is defined by the presence of attenuated positive psychotic symptoms without full impairment of reality testing. Recently, the UHR concept was included in "attenuated psychosis syndrome" (APS), a new diagnosis contained in Section 3 of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), the section reserved for conditions requiring further research []. Among adolescents who reported psychotic-like experiences, those of 80% remitted, and the symptoms of 20% persisted []. The early detection and treatment of people at risk for psychosis is currently regarded as a promising strategy for preventing the devastating consequences of full-blown psychosis [].

As children and adolescents spend a large portion of their time at school, mental health problems are commonly identified in this setting. School-based detection of those at UHR for psychosis has the benefit of improving access to mental health treatment for students who have psychotic-like experiences. In Korea, mandatory school based mental health screening test for mental health problems of students has been conducted every year. Due to limited school mental health resources, school counselors perform non-counseling related activities beyond their training such as clinical expertise regarding to assessment and referral of clinical high risk students.

Given increasing recognition of the need to identify individuals with UHR risk status, school counselors are facing the challenge of how to understand and deal with these symptoms. Indeed, in view of the essential contribution of the identification of symptoms to the provision of effective mental health services, it is essential to recognize the potential role played by school counselors.

Thus, the current study examined how school counselors diagnose and define the appropriate treatment for those at UHR for psychosis. We assessed respondents' recognition of UHR for psychosis based their responses to a brief vignette depicting a hypothetical student reporting relevant symptoms.

METHODS

Participants

The sample for this anonymous cross-sectional survey, which was conducted in October 2015, consisted of school counselors. In total, 132 school counselors from 125 (81.7%) of the 153 schools and all of three Wee centers in Gwangju metropolitan city participated in the survey and completed the questionnaire. Data on sociodemographic characteristics were collected. The survey was approved by the the Chonnam National University Hospital Institutional Review Board (CNUH-2015-171).

Vignette

The vignette used in this study was developed by the corresponding author (KSW) () based on the vignette developed by Jacobs et al. [] and the manual of Personal Assessment and Crisis Evaluation (PACE) clinic of Orygen Youth Health in Melbourne, Australia []. The vignette described a fictional individual at UHR for psychosis according to the Comprehensive Assessment of At-Risk Mental States (CAARMS) criteria [,]. The protagonist in the vignette met criteria for subthreshold non-bizarre ideation and perceptual abnormality with functional decline. She also met criteria of the DSM-5 criteria for APS. Two authors (LJY and CYC) with extensive experience in this area discussed and further revised the vignette.

First, we asked participants whether the vignette depicted a psychiatric disorder (yes/no/don't know). Participants were asked to identify the most appropriate diagnosis for the hypothetical student from a list of 10 diagnoses. We also asked participants to recommend an appropriate referral and treatment approach for the student by asking them to rate 11 treatment options on the following scale: first choice, second-or-later choice, would not recommend, and no opinion. Participants who diagnosed the protagonist with schizophrenia, delusional disorder, or at UHR for psychosis were considered the "schizophrenia spectrum disorders group," and others were considered the "non-psychotic disorders group."

Statistical analyses

Basic demographic differences among respondents according to the diagnosis chosen were analyzed using the chi-square test. The percentage of respondents choosing each answer was calculated and is presented. SPSS for Windows software (ver. 21.0; IBM Corp., Armonk, NY, USA) was used to perform the statistical tests. All statistical tests were two-tailed, and p-values <0.05 were deemed to indicate statistical significance.

RESULTS

Demographic characteristics of participants

The sample consisted primarily of females (94.7%), and there were no significant differences in the demographic characteristics of respondents according to the diagnosis they selected ().

Diagnosis

In total, 123 (94.6%) respondents recognized that the vignette depicted someone with a mental disorder. The data regarding diagnoses are summarized in , which shows the percentage of respondents choosing each diagnosis. The most common diagnosis was schizophrenia (n=34, 28.1%), followed by delusional disorder (n=32, 26.4%), and depressive disorder (n=23, 19.0%). The diagnosis of UHR for psychosis was selected by 15 (12.4%) subjects.

Referral and treatment

shows the referral recommendations according to the diagnosis chosen by the school counselors. Most participants who diagnosed the protagonist with schizophrenia spectrum disorder selected psychiatric clinics as the optimal referral. Additionally, an average of 58.1% of respondents would refer to Wee center, which is school counseling services, and an average of 37.2% would refer to a private counseling center.

shows treatment preferences according to the diagnosis chosen by school counselors. School counselors who diagnosed the student depicted in the vignette with schizophrenia were likely to recommend antipsychotics (35.3%) and family therapy (35.3%) as the first-line treatment. School counselors who diagnosed the protagonist as being at UHR for psychosis were also likely to prefer family therapy (46.7%). In terms of the medication options for those at UHR for psychosis, antipsychotics were the most frequently chosen.

DISCUSSION

This is the first study to explore the recognition of Korean school counselors regarding students at UHR for psychosis. Participants were presented with a vignette depicting the case of a student who initially presents with recent-onset subsyndromal psychotic symptoms with functional decline. We found that most participants believed that the student was suffering from a psychiatric disorder. However, only 12.4% of the respondents correctly diagnosed her as at UHR for psychosis, whereas over half of respondents described her as suffering from a full-blown psychotic disorder. This reflects the fact that school counselors may be unfamiliar with the concept of high risk for psychosis, and lack confidence in treating this concept as a potential precursor of psychotic symptoms.

About 40% of school counselors did not consider the protagonist in the vignette to be suffering from schizophrenia spectrum disorder but, instead, believed she was dealing with a less severe condition, including depressive disorder (19.0%). Although the vignette did not portray severe depression, many school counselors nonetheless identified the problem in question as depressive disorder, which is a common psychiatric disorder among students. While most school counselors recommended psychiatric treatment for the protagonist in the vignette, a majority also considered a counseling center, which might not offer psychiatric services and might not operate according to the medical model, as would be appropriate for the treatment of a psychotic disorder. Early detection and intervention have an important role in reducing the duration of untreated psychosis (DUP) and ameliorating the presenting symptoms of UHR subjects [,]. However, appropriate psychiatric intervention is commonly delayed within mental health services, including school counseling systems [,]. Therefore, early referral and the timely delivery of transfer information by school counselors may play an important role in improving the diagnostic and treatment approach of subsequent practitioners.

Our findings reflected great variability in the treatment recommendations offered for the protagonist of the vignette. In particular, school counselors who diagnosed her with schizophrenia or at UHR for psychosis recommended both antipsychotics and family therapy. These results may be attributable to recognition on the part of school counselors that antipsychotics have been established as a standard treatment for persons with psychotic symptoms. Additionally, as school counselors are more frequently exposed to information related to familial and environmental problems, they may consider family therapy to be an important resource for treatment. Although low doses of antipsychotics appear to be effective for reducing the severity of the presenting symptoms of UHR subjects, premature recommendations for medication by school counselors may exacerbate a student's experience of being odd and stigmatized, especially if they are adolescents []. Furthermore, there is growing evidence that psychological interventions, such as cognitive-behavioral therapy, and newly emerging treatments, such as omega-3 fatty acids, may be effective in reducing the severity of the symptoms experienced by individuals at UHR for psychosis [⁻]. These results suggest that Korean school counselors were not familiar with preventive approaches to the development of psychotic disorders or with the importance of early intervention. Thus, we should develop educational materials to raise the awareness of school-based gatekeepers of access to mental health treatment regarding psychosis prevention and help school counselors expand their knowledge about treatment options for those at UHR.

This study has several limitations. First, the use of only one vignette to assess school counselors' recognition of UHR for psychosis may have led to difficulties in distinguishing this condition from other psychotic disorders. Second, we asked only two categorical questions regarding the diagnosis of, and treatment for, individuals at UHR for psychosis; that is, we did not assess such additional factors as respondents' experiences with, goals for, and opinions regarding treatment. Future research may benefit from adding vignettes that depict different levels of psychotic symptoms and elicit more information from respondents. Moreover, as there is no "golden standard" treatment for UHR, the range of recommended treatments in our study should be tested for relevance in futures.

In conclusion, this study suggests that Korean school counselors are not sufficiently familiar with the condition known as UHR for psychosis, although they generally recognize the vignette has mental health problems and needs help. To prevent delays in the implementation of appropriate school-based interventions for attenuated psychotic symptoms, school counselors should be provided with proper education and training.

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School Counselors' Recognition of the Ultra-High Risk for Psychosis

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The most common time of onset for psychotic disorders is adolescence and early adulthood []. The onset of psychotic disorders is usually preceded by a prodromal period characterized by non-specific psychiatric and attenuated psychotic symptoms accompanied by functional decline [].

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Schizophrenia Spectrum and Other Psychotic Disorders

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Schizophrenia Spectrum and Other Psychotic Disorders

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What Is Schizophrenia Spectrum and Other Psychotic Disorders? | Hopeway

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Schizophrenia is a complicated illness that is often misunderstood. There are 5 types of schizophrenia based on predominant symptoms, 3 schizophrenia spectrum disorders, and 5 other psychotic disorders.

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Understanding Schizophrenia

Frequently Asked Questions

What causes schizophrenia?

The exact causes of schizophrenia are not entirely understood, but a complex variety of influences likely play a role. Some potential causes include genetic, environmental, social, and psychological factors.

Is schizophrenia genetic?

Research suggests that genetics play a significant role in causing schizophrenia. Having a family member with the condition greatly increases your risk of developing schizophrenia. However, while the condition sometimes runs in families, having a family member with the condition does not necessarily mean that you will develop the disorder.﻿﻿

Is there a cure for schizophrenia?

There is no cure for schizophrenia, but there are treatments that can help people manage the symptoms of the condition and improve functioning. Treatments vary depending on each individual's needs but may include medications, psychotherapy, and family-based services. People may require different levels of care and support depending on the severity of their condition.

At what age does schizophrenia typically develop?

Research suggests that early symptoms of schizophrenia begin to appear sometime between late adolescence and early twenties, although they may begin later or earlier.﻿﻿ The age of onset is also typically later in women than in men. Symptoms appear gradually and become progressively more severe.

Key Terms

Psychosocial Intervention

Psychosocial interventions include activities that focus on the cognitive, behavioral, social, and biological factors that play a role in an individual's well-being. Common psychosocial interventions for schizophrenia include cognitive therapy, psychoeducation, family intervention, assertive community treatment, and social skills training.﻿﻿

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

1. Holder SD, Wayhs A. Schizophrenia. Am Fam Physician. 2014;90(11):775-82.

2. National Institute of Mental Health. Schizophrenia. Updated May 2020.

3. Gogtay N, Vyas NS, Testa R, Wood SJ, Pantelis C. Age of onset of schizophrenia: perspectives from structural neuroimaging studies. Schizophr Bull. 2011;37(3):504-513. doi:10.1093/schbul/sbr030

4. Chien WT, Leung SF, Yeung FK, Wong WK. Current approaches to treatments for schizophrenia spectrum disorders, part II: psychosocial interventions and patient-focused perspectives in psychiatric care. Neuropsychiatr Dis Treat. 2013;9:1463-1481. doi:10.2147/NDT.S49263

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Understanding Schizophrenia What causes schizophrenia? The exact causes of schizophrenia are not entirely understood, but a complex variety of influences likely play a role. Some potential causes include genetic, environmental, social, and psychological factors. Is schizophrenia genetic? Research suggests that genetics play a significant role in causing schizophrenia.

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Overview

Schizophrenia is a serious mental disorder in which people interpret reality abnormally. Schizophrenia may result in some combination of hallucinations, delusions, and extremely disordered thinking and behavior that impairs daily functioning, and can be disabling.

People with schizophrenia require lifelong treatment. Early treatment may help get symptoms under control before serious complications develop and may help improve the long-term outlook.

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Symptoms

Schizophrenia involves a range of problems with thinking (cognition), behavior and emotions. Signs and symptoms may vary, but usually involve delusions, hallucinations or disorganized speech, and reflect an impaired ability to function. Symptoms may include:

Delusions. These are false beliefs that are not based in reality. For example, you think that you're being harmed or harassed; certain gestures or comments are directed at you; you have exceptional ability or fame; another person is in love with you; or a major catastrophe is about to occur. Delusions occur in most people with schizophrenia.

Hallucinations. These usually involve seeing or hearing things that don't exist. Yet for the person with schizophrenia, they have the full force and impact of a normal experience. Hallucinations can be in any of the senses, but hearing voices is the most common hallucination.

Disorganized thinking (speech). Disorganized thinking is inferred from disorganized speech. Effective communication can be impaired, and answers to questions may be partially or completely unrelated. Rarely, speech may include putting together meaningless words that can't be understood, sometimes known as word salad.

Extremely disorganized or abnormal motor behavior. This may show in a number of ways, from childlike silliness to unpredictable agitation. Behavior isn't focused on a goal, so it's hard to do tasks. Behavior can include resistance to instructions, inappropriate or bizarre posture, a complete lack of response, or useless and excessive movement.

Negative symptoms. This refers to reduced or lack of ability to function normally. For example, the person may neglect personal hygiene or appear to lack emotion (doesn't make eye contact, doesn't change facial expressions or speaks in a monotone). Also, the person may lose interest in everyday activities, socially withdraw or lack the ability to experience pleasure.

Symptoms can vary in type and severity over time, with periods of worsening and remission of symptoms. Some symptoms may always be present.

In men, schizophrenia symptoms typically start in the early to mid-20s. In women, symptoms typically begin in the late 20s. It's uncommon for children to be diagnosed with schizophrenia and rare for those older than age 45.

Symptoms in teenagers

Schizophrenia symptoms in teenagers are similar to those in adults, but the condition may be more difficult to recognize. This may be in part because some of the early symptoms of schizophrenia in teenagers are common for typical development during teen years, such as:

Withdrawal from friends and family

A drop in performance at school

Trouble sleeping

Irritability or depressed mood

Lack of motivation

Also, recreational substance use, such as marijuana, methamphetamines or LSD, can sometimes cause similar signs and symptoms.

Compared with schizophrenia symptoms in adults, teens may be:

Less likely to have delusions

More likely to have visual hallucinations

When to see a doctor

People with schizophrenia often lack awareness that their difficulties stem from a mental disorder that requires medical attention. So it often falls to family or friends to get them help.

Helping someone who may have schizophrenia

If you think someone you know may have symptoms of schizophrenia, talk to him or her about your concerns. Although you can't force someone to seek professional help, you can offer encouragement and support and help your loved one find a qualified doctor or mental health professional.

If your loved one poses a danger to self or others or can't provide his or her own food, clothing, or shelter, you may need to call 911 or other emergency responders for help so that your loved one can be evaluated by a mental health professional.

In some cases, emergency hospitalization may be needed. Laws on involuntary commitment for mental health treatment vary by state. You can contact community mental health agencies or police departments in your area for details.

Suicidal thoughts and behavior

Suicidal thoughts and behavior are common among people with schizophrenia. If you have a loved one who is in danger of attempting suicide or has made a suicide attempt, make sure someone stays with that person. Call 911 or your local emergency number immediately. Or, if you think you can do so safely, take the person to the nearest hospital emergency room.

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Causes

It's not known what causes schizophrenia, but researchers believe that a combination of genetics, brain chemistry and environment contributes to development of the disorder.

Problems with certain naturally occurring brain chemicals, including neurotransmitters called dopamine and glutamate, may contribute to schizophrenia. Neuroimaging studies show differences in the brain structure and central nervous system of people with schizophrenia. While researchers aren't certain about the significance of these changes, they indicate that schizophrenia is a brain disease.

Risk factors

Although the precise cause of schizophrenia isn't known, certain factors seem to increase the risk of developing or triggering schizophrenia, including:

Having a family history of schizophrenia

Some pregnancy and birth complications, such as malnutrition or exposure to toxins or viruses that may impact brain development

Taking mind-altering (psychoactive or psychotropic) drugs during teen years and young adulthood

Complications

Left untreated, schizophrenia can result in severe problems that affect every area of life. Complications that schizophrenia may cause or be associated with include:

Suicide, suicide attempts and thoughts of suicide

Anxiety disorders and obsessive-compulsive disorder (OCD)

Depression

Abuse of alcohol or other drugs, including nicotine

Inability to work or attend school

Financial problems and homelessness

Social isolation

Health and medical problems

Being victimized

Aggressive behavior, although it's uncommon

Prevention

There's no sure way to prevent schizophrenia, but sticking with the treatment plan can help prevent relapses or worsening of symptoms. In addition, researchers hope that learning more about risk factors for schizophrenia may lead to earlier diagnosis and treatment.

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Schizophrenia is a serious mental disorder in which people interpret reality abnormally. Schizophrenia may result in some combination of hallucinations, delusions, and extremely disordered thinking and behavior that impairs daily functioning, and can be disabling. People with schizophrenia require lifelong treatment.

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How Do Students Talk to the School Counselor? - Resource for Students 

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How Do Students Talk to the School Counselor? - Resource for Students 

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How Do Students Talk to the School Counselor?

Meetings with the School Counselor, can show appear in a variety of ways. Most commonly, School Counselors get to work with students in the following ways:

When do people request a meeting with a counselor?

When a student is very sad, confused, shy, angry, or worried

When severe changes in a student's behavior occur

When a student is having difficulty dealing with family changes or situations

When something seems to be bothering a student to the point of distraction or intense anxiety

When a student is dealing with a loss of a family member, friend, or pet

When stressors at home are affecting school performance or self-concept

When a student is consistently absent from school

How Do Students See the Counselor?

Parents are welcome to contact me directly! If you have concerns of any kind regarding your child I am available. I can help with an issue at home or pay attention to certain habits and behaviors you are hoping to address. I can also be of assistance with community resources and helping your family with any pressing needs!

Appointment made by the counselor to meet with a student

Self-Referral to meet with the counselor

Parent/Guardian Referral for a student to meet with the counselor

Administration, Teacher, Staff Referral request for a student to meet with the counselor

Request by a friend for a student to meet with the counselor

To make an appointment with the School Counselor, please complete one of the following forms:
Student Referral

A counselor-student relationship must be built on trust and confidentiality. This means that I am bound by ethical codes of the American School Counselor Association (ASCA) to keep conversations between myself and students private. I try my best to keep parents and teachers updated on the progress and relevant information for the betterment of your student. there are times when I may need to break confidentiality and tell appropriate persons. This is when student may be susceptible to:

Harm Themselves

Harm Others

Abuse and/or Neglect

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School Counselor / School Counseling Referral Process

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How Do Students Talk to the School Counselor? Meetings with the School Counselor, can show appear in a variety of ways. Most commonly, School Counselors get to work with students in the following ways: When do people request a meeting with a counselor?

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District Procedures for School-Based Counseling Referrals

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District Procedures for School-Based Counseling Referrals

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The School Counselor and Students with Disabilities

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The School Counselor and Students with Disabilities

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The School Counselor and Students with Disabilities

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The school counselor takes an active role in student achievement and postsecondary planning by providing a school counseling program for all students. As a part of this program, school counselors advocate for students with special needs, encourage family involvement in their child's education and collaborate with other educational professionals to promote academic achievement, social/emotional wellness and college/career readiness for all.

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What Are Neurodevelopmental Disorders?

Neurodevelopmental disorders (NDs) are types of disorder that influence how the brain functions and alters neurological development, causing difficulties in social, cognitive, and emotional functioning. The most common NDs are autism spectrum disorder (ASD) and attention-deficit/hyperactive disorder (ADHD). Many NDs are not as well known or widely studied.

NDs usually onset during stages of development which makes them most present in toddlers, children, and adolescents, but continue to persist into adulthood, or may go undiagnosed until one is an adult. There are instances in which a child outgrows the symptoms associated with an ND.

There are many different types of NDs, below are a few of the most prevalent ones;

Attention-deficit/hyperactive disorder (ADHD)

Autism spectrum disorder (ASD)

Cerebral palsy

Communication disorders

Conduct disorders

Intellectual disabilities

Learning disorders

Neurodevelopmental motor disorders

Prevalence

NDs are more prevalent in males than females. This gender difference may be due to genetics, biology, and risk factors. Although NDs, like ASD, are more present in males, researchers determined not much of a gender difference in symptoms.

Comorbidity of other conditions is highly likely in individuals with NDs and it is also common for an individual to be diagnosed with multiple NDs. A study that explored the comorbidity of NDs with mental disorders in children ages 7 through 12, determined that of those with NDs, some had coexisting psychiatric disorders or were diagnosed with multiple NDs. The study included 407 boys and girls. After parent interviews, it was determined that 55% of the children were diagnosed with at least one ND.

Of the 181 participants with ADHD, almost 40% did not have a comorbid condition, 26% did however have an anxiety disorder, while others had a variety of other conditions. There appeared to be only 18 children with ASD, and of these boys and girls, 36% also had ADHD, 44% had a tic disorder (TD), 36% had an anxiety disorder, and the others had a variety of other conditions or no comorbidity.

Although more boy participants were diagnosed with an ND, a greater number of girls with an ND had additional comorbid disorders. This study does have its limitations: a large one being that the only measure of the evaluation was parental interviews, which only consisted of just one interview at that.

Symptoms of NDs are dependent on the ND, but general descriptions usually consist of impairments with the following;

The concrete cause of NDs is not yet clear. There are various possible reasons for the onset of NDs. From the research that does exist on the cause of NDs, it is prevalent that both biology and environment play a role. Predispositions like genetics and hormones can be triggered by risk factors such as stress, illness, or trauma.

Epigenetics is an important factor in the development of conditions like NDs. Epigenetics is when an individual's environment and behavior can alter DNA and how genes operate within the body. Early childhood experiences, like trauma, neglect, or toxic environments, have recently been acknowledged as a prime risk factor in developing certain disorders, including NDs.

Research also determined an association between prenatal events and the development of medical conditions. Maternal diet can influence whether an individual grows up to develop metabolic diseases, like obesity and diabetes. Researchers believe that prenatal events, such as diet, could have similar influences on the development of NDs.

There aren't many treatment options for those with NDs, but research has determined some effective interventions. Although there is no cure for NDs there are methods that help with managing and coping with symptoms.

Behavioral Therapy

Therapies like applied behavioral analysis (ABA), cognitive-behavioral therapy (CBT), speech therapy, and developmental therapy have all been shown to be beneficial for ND symptoms. CBT, Psychotherapy, and other behavioral therapies are utilized for adults with NDs like ADHD. ABA has a significant impact on behavior in children with NDs, especially ASD and ADHD.

Transcranial Magnetic Stimulation

Repetitive transcranial magnetic stimulation (rTMS) is a stimulation therapy that is commonly used for depression, but research trials have found prospects for rTMS to offer benefits for those with NDs. In a review of multiple studies, rTMS didn't appear to have any severe adverse effects for children and adolescents with NDs.

rTMS treatment improved social functioning and behaviors for some participants with ASD. There were also benefits in those with tic disorders, in which treatment helped lessen tics. Unfortunately, rTMS did not show prospects for those with ADHD; it caused some irritation, hyperactivity, and inattentiveness in some individuals. Overall, rTMS has the potential to be an acknowledged treatment method for a few NDs.

Medication

Medication is sometimes prescribed to both children and adults with NDs. For ADHD, specifically, physicians may prescribe medication to help in managing symptoms like hyperactivity, agitation, inattentiveness, etc. Medication may consist of stimulants, antidepressants, or other pharmaceuticals suited to enhance cognition.

Medication, however, should not be the first choice when treating NDs like ADHD and AS. Experts express trying therapies and other strategies before medication. For pediatric patients, researchers suggest neurodevelopmental therapies and parenting training before incorporating medication into treatment routines.

Conventional and Alternative Medicine (CAM)

Nutrition, physical exercise, and recreational activities can also play a role in managing symptoms of NDs. It is important to develop healthy lifestyle habits for children and adults with NDs.

Complementary and alternative (CAM) medicines like supplements and mind/body practices, such as acupuncture, yoga, etc., are other options that are explored before seeking medication or are used along with medication.

Adults with NDs most seek out these types of interventions. The national percentage of adults who engage in CAM treatment is 36-38%, but the number of children who participate in CAM treatment is unclear. A population review reported 11.8% of children throughout the population experienced CAM therapy at least once, but this number may not be accurate. It was stated in another report that the amount of children that engage in CAM treatment is between 2%-55%, but this is not a population report.

Family Impact

A child being diagnosed with an ND is a huge adjustment for parents and loved ones. In attempts to make life easier for the child, a significant load is placed on the family. A large number of studies found that parents of children with NDs report feeling a greater amount of stress than those with children without an ND.

Researchers found that this form of stress can have negative influences on the mental health of parents, most commonly in mothers. There also appears to be a negative impact on marriages when overly stressed. These factors are why parents need to engage in positive interventions to manage and cope with the stress of caring for a child with an ND, such as mindfulness stress-reducing practices, marriage counseling, meditation, etc. Studies have found that these interventions have been effective in reducing stress and strengthening the parent's marriage.

A Word From Verywell

NDs are often conditions that persist throughout an individual's life-and symptoms can be challenging to relationships, productivity, social skills, and communication. They can create limitations for a person and impact their abilities to function within society.

Although NDs have their share of challenges, a person can still live a fulfilling life with effective coping and treatment methods. Support of loved ones and caretakers is also an additional attribute to the quality of life for those with NDs.

If you suspect that your child may present symptoms of an ND, speak to your healthcare provider who can refer you to a specialist and provide answers that you and your child need. If you think you may have an undiagnosed ND, consult your physician and consider reaching out to a specialist.

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What To Know About Neurodevelopmental Disorders

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Neurodevelopmental disorders (NDs) influence how the brain functions and alter neurological development, causing difficulties in social, cognitive, and emotional functioning.

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Whether it’s long hours of studying or succeeding in extracurriculars, the pressures of school can already be immensely stressful. And from elementary

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Obsessive Compulsive Disorder and the School Counselor 

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Obsessive Compulsive Disorder and the School Counselor 

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Obessive Compulsive Disorder and the School Counselor

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Supporting and Protecting the Rights of Students at Risk of Self-Harm

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Supporting and Protecting the Rights of Students at Risk of Self-Harm

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OCD, IDEA, and IEPs: How to Access Special Education Services for Children with OCD

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OCD, IDEA, and IEPs: How to Access Special Education Services for Children with OCD

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Obsessive compulsive disorder (OCD) can significantly affect a child's academic, social, and emotional functioning, which is collectively defined as his or her "educational performance" by the Individuals with Disabilities Education Act (IDEA). Fortunately, parents and educators can work together to address the educational needs of youth with OCD. In fact, schools are required by law to assist students with disabilities such as OCD. However, they may do so in different ways depending on the nature of the child's symptoms, his or her academic functioning, and the availability of resources.

The Individuals with Disabilities Education Act (IDEA)

The Individuals with Disabilities Education Act (IDEA) is a federal law in the United States that governs how states and federally funded public agencies provide early intervention, special education, and related services to children with disabilities. Although the law does not include OCD as a specific disability, children may be eligible to receive special education services through an "Other Health Impairment (OHI)" or "Emotional Disturbance (ED)" exception. Due to the way that state boards of education interpret IDEA, schools in some states may need a physician or psychologist to provide a recent medical report establishing a child's disability. Further information may need to be collected suggesting that commonly used treatment interventions were ineffective before a student is diagnosed with an OHI. To qualify to receive services for an ED exception, a student must display one or more of the following characteristics over a long period of time and to a significant degree that negatively affects his or her educational performance:

An inability to learn that cannot be explained by intellectual, sensory, motivational, lack of academic engagement, or health factors

An inability to build or maintain satisfactory interpersonal relationships with peers and teachers

Inappropriate types of behavior or feelings under normal circumstances

A general pervasive mood of unhappiness or depression

A tendency to develop physical symptoms or fears associated with personal or school problems.

Additionally, a student's problematic behavior or emotional responses must be significantly different from age appropriate, cultural, or ethnic norms and data may be needed suggesting that commonly used research-based interventions were ineffective for consideration for an ED exception.

Any legal guardian can request an evaluation to determine if his or her child may benefit from special education services. However, a request does not guarantee that a comprehensive psychological and educational evaluation will be conducted. Under the 2004 reauthorization of IDEA, state departments of education now have several options to govern how school personnel should evaluate and address student needs. Because of problems with quickly and efficiently delivering special education services, the 2004 reauthorization of IDEA blurs the lines between assessment and intervention, which allows schools to simultaneously provide research-based intervention services and collect data on a student's response to these services.

Regarding the former, many schools now use a response-to-intervention (RtI) approach to determine students' disability status and provide supportive resources. This approach involves providing students with intervention services as soon as a problem is identified to fix the problem and avoid over-identifying students with disabilities. Therefore, under IDEA, students with OCD may receive services through RtI even though this is not yet a common practice or due to being diagnosed with having an OHI or ED exception. Additionally, following a gradual service delivery approach, students with OCD may initially receive services under a RtI framework but then receive additional special education supports if they fail to respond to research-based interventions.

It is important to note that "research-based interventions" provided during the RtI process or prior to evaluating a student for an exception differ from "well-established" and "probably effective" interventions as defined by the American Psychological Association's Task Force on Promotion and Dissemination of Psychological Procedures (1995), which includes cognitive behavioral therapy (CBT) with exposure and response prevention (ERP) as a well-established treatment because of its excellent performance in properly designed research trials. In other words, the "research-based interventions" that the schools provide may not align with what OCD and psychology experts have found to be particularly effective for treating OCD in children. Research-based interventions that are commonly implemented in schools for students with OHI and ED exceptions may be behavioral in nature and have research-based support; however, they generally are not as rigorously evaluated as they should be. Therefore, it is unlikely that a student will receive CBT with ERP to treat his or her OCD symptoms at school.

Individualized Education Plan (IEP)

Once a student is diagnosed with an OHI or ED exception and becomes eligible to receive special education services, these services are then outlined in an Individualized Education Plan (IEP). An IEP describes how a student's disability influences his or her educational performance. Furthermore, it lists academic and behavioral goals and the academic/behavioral supports needed to help the child achieve these goals.

Legal guardians must be invited to participate on the IEP team, which generally includes the student's teacher, a special education teacher, a school administrator, a school psychologist, and other school personnel. A legal guardian also may invite others to attend IEP meetings such as a trusted associate, child advocate, or attorney. If a legal guardian does not agree with the IEP or the IEP team's decision regarding special education eligibility, he or she must be informed how he or she can challenge the decision.

Section 504 of the Rehabilitation Act

Section 504 of the Rehabilitation Act guarantees rights to people with disabilities. It aims to decrease discrimination and promote equal opportunities by requiring schools to provide reasonable accommodations (e.g., extra time on tests, use of computer-aided instruction) for children with disabilities. These accommodations can address temporary or chronic problems, and no diagnosis is needed for students to receive them. Thus, 504 accommodations can be implemented quickly and flexibly. However, in contrast to services provided under IDEA, school systems do not receive federal funding to provide 504 accommodations.

Children with OCD may be eligible to receive 504 accommodations if their symptoms significantly limit at least one major life activity (e.g., walking, speaking, learning, reading, writing, performing math calculations, working, self-care) as determined by a school-based team that usually includes the same individuals who sit on IEP teams. Section 504 requires the review of multiple sources of information provided by different individuals (e.g., school psychologist, parent, teacher) prior to providing accommodations.

Similar to IEPs associated with IDEA, eligible 504 students receive accommodations through an Individual Accommodation Plan (IAP). This plan simply lists specific accommodations and interventions that may help a student overcome his or her disability. These plans often list specific instructional materials that a student may need, modifications to tests or assignments, grading and assessment changes, and behavioral interventions.

Supporting and Accommodating Students with OCD

Some caregivers may believe that students with IEPs are automatically placed in a special education class, while children with IAP or 504 plans are allowed to remain in a general education classroom. However, this is not accurate. Although students with IAPs generally receive instruction in regular educational settings, students with IEPs may receive instruction in general and special education settings under the assumption that they will be served in the least restrictive setting possible.

Students who receive special education services under IDEA are automatically protected under Section 504 so there is no reason for them to have an IEP and an IAP. Generally, students who qualify for special education services under IDEA have more severe and intractable disabilities than students with 504 plans do. However, this is not always true, and students can transition back and forth between service delivery plans depending on their response to interventions and progress toward achieving IEP goals.

Similarities exist between the types of interventions and accommodations that can be provided for children with IEPs and IAPs. Common interventions and accommodations for children with OCD include but are not limited to the following:

Counseling (individual or group) (it will be important to determine if this type of therapy is specific to OCD or more supportive in nature)

Changes in the amount of time available to take tests

Changes in where tests will be taken

Provision of frequent breaks during instruction

Shortened assignments

A behavior improvement plan

Preferential seating

Transition plans

A special pass to use the restroom/office

However, members of IEP and IAP teams should carefully select accommodations and interventions that will help a student and not reinforce his or her OCD symptoms, especially if the child is in treatment with a mental health OCD specialist. For example, extra time on a test can cause a child with perfectionistic concerns to spend even more time fruitlessly erasing and rewriting his or her answers. Moreover, providing a seat cushion to a child with contamination obsessions could undermine effective treatment for the child's OCD. Therefore, in addition to including caregivers, it is important for school personnel to collaborate with a student's treatment providers when determining potential accommodations and interventions.

Discipline and Manifestation Determination

Students who have IAPs or 504 plans can be expelled from school if a behavior problem is not related to their disability. However, students with IEPs have the right to fair and appropriate educational programing under IDEA, even if they are expelled from school. In other words, schools are required to provide special education students with behavior problems with educational services in some capacity, whereas students who manifest similar problems and have an IAP - yet not an IEP - may not be eligible for these services. Therefore, students who have OCD, and a co-occuring exception as recognized by IDEA (e.g., autism, developmental delay, OHI, ED), as well as display significant behavior problems, may be better protected from being expelled if school personnel evaluate and diagnose them with the co-morbid disorder.

Summary

The Individuals with Disabilities Education Act (IDEA) and Section 504 of the Rehabilitation Act and the Americans with Disabilities Act allow children with OCD to receive intervention services and accommodations in school settings. Depending on a school-based team decision, students with OCD may be classified as having an Other Health Impairment (OHI) or and Emotional Disturbance (ED) exception and be provided with an Individualized Education Plan (IEP). Alternatively, they can receive services through Section 504 and provided with an Individual Accommodation Plan (IAP). Furthermore, schools also may decide to provide students with research-based interventions to see if they adequately respond to these interventions and do not need intensive supports or a special education diagnosis. However, schools are required to do something to help children with OCD if their symptoms negatively impact their educational performance.

In conclusion, schools are legally required to assist children with disabilities and include caregivers in the process. However, school personnel may be unfamiliar with OCD and unaware of steps they can take to better support affected children. Therefore, caregivers and mental health professionals should collaborate with members of school communities to ensure that children with OCD are adequately supported in school settings.
By Michael L. Sulkowski, PhD, & Eric A. Storch, PhD, University of South Florida

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OCD, IDEA, and IEPs: How to Access Special Education Services for Children with OCD - OCD in Kids

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Obsessive compulsive disorder (OCD) can significantly affect a child's academic, social, and emotional functioning, which is collectively defined as his or her "educational performance" by the Individuals with Disabilities Education Act (IDEA). Fortunately, parents and educators can work together to address the educational needs of youth with OCD.

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Lo sentimos, la página que usted busca no se ha podido encontrar. Puede intentar su búsqueda de nuevo o visitar la lista de temas populares.

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

Obsessions Common in Kids With OCD

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

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

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

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

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

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

Behaviors You Might See in Students With OCD

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

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

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

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

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

Behaviors Often Confused With Another Disorder

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

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

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

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

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

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

How to Help Students With OCD

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

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

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

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

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

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

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

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

How to Minimize Behavioral Problems

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

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

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

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

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

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

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

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Causes & Effects of Obsessive-Compulsive Disorder

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Causes & Effects of Obsessive-Compulsive Disorder

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How OCD Affects Social Interaction at School

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How OCD Affects Social Interaction at School

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How OCD Affects Social Interaction at School | Anxiety and Depression Association of America, ADAA

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Attending school presents students with opportunities to develop academic skills along with social skills that will follow a student throughout life. For a student who has OCD, symptoms can present barriers to social development.

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What Is Conduct Disorder?

Conduct disorder is an ongoing pattern of behavior marked by emotional and behavioral problems. Children with conduct disorder behave in angry, aggressive, argumentative, and disruptive ways.

Conduct disorder in children goes beyond bad behavior. It is a diagnosable mental health condition that is characterized by patterns of violating societal norms and the rights of others. It's estimated that around 3% of school-aged children have conduct disorder. It is more common in boys than in girls.﻿﻿

Conduct disorder extends beyond normal teenage rebellion. It involves serious behavior problems that are likely to raise alarm among teachers, parents, peers, and other adults. In order to qualify for a diagnosis of conduct disorder, children must exhibit at least three of these symptoms in the past year and at least one in the past six months:﻿﻿

Aggression Toward People and Animals

Bullying, threatening, or intimidating others

Initiating physical fights

Using a weapon that could cause serious harm

Physical cruelty to people

Physical cruelty to animals

Stealing while confronting a victim

Forced sexual activity

Property Destruction

Deliberate fire setting

Other destruction of property

Deceptiveness or Theft

Breaking or entering a house, car, or building

Lying for personal gain

Stealing without confronting the victim (such as shoplifting)

Serious Rule Violation

Staying out at night before the age of 13 years

Running away from home overnight at least twice

Truancy beginning before the age of 13

Conduct disorder isn't just a challenge for caregivers-it actually impairs a child's ability to function. Some areas where the condition may affect a child's life include:

Education: Children with conduct disorder misbehave so much that their education is affected. They usually receive frequent disciplinary action from teachers and may skip school. Children with conduct disorder may be at a higher risk of failure or dropping out of school.

Legal issues: Adolescents with conduct disorder are also more likely to have legal problems. Substance abuse, violent behavior, and a disregard for the law may lead to incarceration.

Relationships: Children with conduct disorder also have poor relationships. They struggle to develop and maintain friendships. Their relationships with family members usually suffer due to the severity of their behavior.

Sex: They may also engage in risky sexual behavior. Studies show that teens with conduct disorder are more likely to have multiple sexual partners and are less likely to use protection.﻿﻿

Conduct disorder in children can be diagnosed by a mental health professional or a physician. Often, a diagnosis is made after attempts to remedy behavior problems at school and at home aren't effective.

A professional may interview the child, review records, and ask that parents and teachers complete questionnaires about the child's behavior. Psychological testing and other assessment tools may also be used to evaluate the child.

Researchers aren't exactly sure why some children develop conduct disorder. A variety of biological, psychological, and social factors are likely involved. Quite often, those factors overlap. Some that may play a role include:

Brain abnormalities:Imaging studies suggest children with conduct disorder may have some abnormalities in certain areas of the brain. The pre-frontal cortex (which affects judgment) and the limbic system (which affects emotional responses) may be impaired.

Cognitive deficits:Low IQ, poor verbal skills, and impairment in executive functioning may make children more vulnerable to conduct disorder.

Genetics:Studies suggest that inherited genes may be responsible for about half of anti-social behavior.﻿﻿ Researchers aren't sure which specific genetic components contribute to conduct disorder.

Social issues: Poverty, disorganized neighborhoods, poor schools, family breakdown, parental mental illness, harsh parenting, and inadequate supervision are all strongly linked with conduct disorder.

Oppositional Defiant Disorder as a Precursor

Common Comorbid Conditions

Many children with conduct disorder have other mental health issues or cognitive impairments. These can include:

Self-harm

Substance misuse

Depression and anxiety

Posttraumatic stress disorder

Learning disability

Children with conduct disorder may be more likely to develop antisocial personality disorder later in life.

There are three subtypes types of conduct disorder. These subtypes are distinguished by the age at which symptoms first appear.

Childhood-onset indicates that the symptoms started before the age of 10.

Adolescent-onset indicates that the signs of the condition began during a child's teens.

Unspecified-onset indicates the age exact age that the symptoms first began is not clear.

The Diagnostic and Statistical Manual ( DSM-5), which is used to diagnose mental illnesses, also distinguishes between conduct disorder with or without "limited prosocial emotions."

Individuals with limited prosocial emotions are characterized by callousness and a lack of remorse and empathy. They are unconcerned about their performance at school or work and have shallow emotions. When present, their emotional expressions may be used to manipulate others.

Treatment for conduct disorder depends on several factors, such as a child's age and the severity of behavior problems. The most common treatment methods include:

Family therapy: Parents, siblings, and other family members may be invited to attend therapy with the child. Sometimes, improving the relationship between parents and a child may improve family interactions.

Medication: There isn't a medication that specifically treats conduct disorder. But sometimes doctors may prescribe medication to treat the disorder's symptoms or to address other underlying mental illness.﻿﻿

Parent training: Treatment often involves caregivers and parents. Parents may be taught behavior management strategies and techniques to increase safety in the home if a child is aggressive or violent.

Psychotherapy:Individual therapy may be helpful when a child could benefit from learning new skills, such as anger management and impulse control.

Residential placement:In cases where a child or adolescent's behavior has become out of control, treatment in a residential program may be necessary to keep everyone safe. A therapeutic environment may address substance abuse issues, sexualized behavior, or violence.

Early intervention is key to getting the most effective treatment, so it's important for parents, educators, and physicians to be aware of the signs of conduct disorder in children so that appropriate referrals and interventions can be put into place.

Research suggests that taking part in psychosocial treatments can help both children and families cope with the effects of conduct disorder. Such approaches often involve working with parents and caregivers to help them find effective ways of managing their child's behavior. This may include such things as:

Creating structure

Enforcing limits

Providing clear instructions

Rewarding positive behaviors

Using time-outs after inappropriate behaviors or outbursts

The ultimate goal of such training is to help parents and children interact more effectively. This can lead to less conflict and help children better regulate their behavior.

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Conduct Disorder in Children Can Cause Serious Behavior Problems

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Conduct disorder is an ongoing pattern of behavior marked by emotional and behavioral problems. Children with conduct disorder behave in angry, aggressive, argumentative, and disruptive ways. Conduct disorder in children goes beyond bad behavior. It is a diagnosable mental health condition that is characterized by patterns of violating societal norms and the rights of others.

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Impulse Control Disorder and Impulsive Behavior

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Impulse Control Disorder and Impulsive Behavior

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A person with an impulse control disorder is often unable to resist the sudden, forceful urge to do something that may violate the rights of others or conflict with societal norms. These impulsive behaviors may occur repeatedly, quickly, and without consideration of the consequences of the actions.

Pyromania (intentionally starting fires) and kleptomania (the urge to steal) are well-known types of impulsive disorders. Intermittent explosive disorder, trichotillomania (urge to pull your hair out), conduct disorder, oppositional defiant disorder, and unspecified impulse control disorder are a few others.

Signs and Symptoms of Impulse Control Disorder

There are signs and symptoms that may point to an impulse control disorder in some individuals. It is not always easy to identify this type of disorder, but the following may be cause for attention.

Behavioral symptoms: Stealing, lying, starting fires, risky or promiscuous behavior, and aggressive or volatile behaviors

Cognitive symptoms: Obsessive behavior, trouble with organization, executive dysfunction, and poor concentration abilities

Social and emotional symptoms: Low self-esteem, social withdrawal or isolation, detachment and/or anxiety, drastic shifts in thoughts and moods, and feelings of guilt or regret

When an Impulsive Behavior Becomes an Impulsive Disorder

Typically, an impulsive action results from tension that has built to the point where the person can no longer resist it. The immediate sense of relief from acting on an impulsive behavior is short-lived, however.

Feelings such as guilt or shame may follow. Repeated impulsive acts may also lead to a number of negative consequences, such as greater emotional distress or regret, in the long term.

Risk Factors for Impulse Control Disorder

Both internal and external stressors are known triggers for impaired impulse control. Many types of impulse control disorders are thought to stem from underlying neurological vulnerabilities coupled with environmental stresses.

Some risk factors of an impulsive disorder include:

Being male (males are more prone to impulse control disorders than females)

Genetic predisposition

Chronic drug or alcohol use

Being subjected to trauma, abuse, or neglect

Exposure to violence or aggression

Taking a dopamine agonist medication, such as those prescribed for Parkinson's disease

Certain types of chemical imbalances may contribute to an impulse control disorder in some individuals. Additional mental health issues, such as bipolar or personality disorders, often coexist in people with an impulse control disorder.

Common Types of Impulse Control Disorder and Treatments

The term impulse control disorder is a category of mental health problems that include:

People with this type of impulse control disorder deliberately start fires without regard to the destruction or injury their actions may cause. It is common for many convicted arsonists with evident pyromania to also have personality disorders such as antisocial and borderline personality disorders.

Research on treatments is somewhat limited because this condition is rare. That said, several case studies have found that various medications appear to help resolve this urge while cognitive behavioral therapy techniques also offers some promise of effectiveness.

Kleptomania

This is the constant and irresistible urge to steal. Kleptomania is unusual in that people with this impulse control disorder often steal things that have little personal or monetary value.​

Kleptomania can have subtypes that are more like obsessive-compulsive disorder (OCD), and others more similar to addictive and mood disorders. It is common for people with kleptomania (and their first-degree relatives) to have comorbid psychiatric or addiction issues.

Effective treatment options for kleptomania may vary depending on the subtype. Cognitive behavior therapy and medication have been shown to be effective while mood stabilizers, antidepressants, and opioid antagonist medications have also shown promise in certain circumstances.

Intermittent Explosive Disorder

Intermittent explosive disorder is diagnosed when a person has, on multiple occasions, acted on aggressive impulses and committed seriously aggressive acts, such as assault or destruction of property. One way it is identified is by the severity of the person's aggressive behavior (it's well out of proportion to the trigger that preceded it).

Individuals with intermittent explosive disorder may benefit from cognitive behavioral therapy to learn relaxation and coping skills. Additionally, depending on symptoms and age, the person may also be prescribed medications such as antidepressants, antipsychotics, or mood regulators.

Trichotillomania

Tricho is Greek for "hair," tillo means "pull," and mania is an excessive behavior or activity. Thus, trichotillomania involves a compulsive urge to pull out your own hair. This impulsive behavior is more common in children and teens; although, when appearing in adults, women have it nine times as often as men.

Behavioral therapy with habit-reversal training components appears to be the most effective treatment for trichotillomania, but some medications have provided positive results as well.

Conduct Disorder

Conduct disorder involves patterns of behavior that can include being aggressive to people and animals, destroying property, theft or other deceitful actions, and serious rule violations. This disorder can appear in young children (even those in pre-school) and isn't diagnosed beyond 18 years of age.

Conduct disorder treatment typically involves engaging in therapy with the child's parents or the entire family, while medications such as stimulants and antipsychotics may also be prescribed-especially if this disorder co-occurs with ADHD.

Oppositional Defiant Disorder

Like with conduct disorder, oppositional defiant disorder is diagnosed in childhood and adolescence. Its symptoms include irritable mood, being argumentative or defiant, and engaging in vindictive behaviors.

Effective treatment of this impulse control disorder often involves some type of psychotherapy. If another disorder exists, or if severe aggression is exhibited, medications may be used as well.

Unspecified Impulse Control Disorder

If someone has impulses that don't fit neatly into one of the other types, they may be diagnosed with unspecified impulse control disorder. Problematic internet use, for instance, may be classified as an unspecified impulse control disorder. Treatment varies based on the impulse symptoms and severity.

A Word From Verywell

If an impulse control disorder exists, a trained professional can provide a full evaluation and a comprehensive treatment program that builds and strengthens social skills. For example, a therapist may focus on problem-solving, ways to overcome a fixation with instant gratification, and strategies to curb impulses through techniques that help develop better self-control.

In some cases, medications can also enhance the treatment process, especially if there are other co-existing conditions. The type of medication prescribed can vary depending on which disorder exists.

Frequently Asked Questions

Is excessive gambling considered an impulse control disorder?

Not anymore. Pathological gambling disorder used to be classified as an unspecified impulse control disorder but the DSM-5 now categorizes it as an addiction.

What causes impulse control disorder?

Genetics, substance use, and trauma can all increase your risk of an impulsive disorder. Certain medications can also lead to the development of an impulse control disorder, such as dopamine agonists often prescribed for Parkinson's disease.

How many people are affected by impulse disorder in the United States?

In a study involving 293 adults, just under one-third (32.8%) were found to have an impulse control disorder. Impulse control disorder prevalence is slightly higher in individuals with Parkinson's disease, affecting up to 40% of those with this condition. This is largely due to medication side effects.

The number of children with impulse control issues varies depending on the type. For instance, oppositional defiance disorder affects roughly 3.3% of children while the prevalence of conduct disorder is somewhere between 1.5% and 3.4%.

How can you help a child with impulse control issues?

Creating routines, setting limits, and praising appropriate behavior are all ways to help a child with impulse control issues develop healthy behaviors. So too can modeling the behaviors you want to see and only picking battles with them that are the most important.

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Do you have trouble controlling your impulsive behavior? Here's the facts on impulse control disorder.

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A person with an impulse control disorder is often unable to resist the sudden, forceful urge to do something that may violate the rights of others or conflict with societal norms. These impulsive behaviors may occur repeatedly, quickly, and without consideration of the consequences of the actions.

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What are Disruptive, Impulse Control and Conduct Disorders?

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What are Disruptive, Impulse Control and Conduct Disorders?

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6 Ways Teachers Can Help Fight Depression and Mental Health Disorders

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6 Ways Teachers Can Help Fight Depression and Mental Health Disorders

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Educators Can Take Action To Help Fight Depression

So what can educators do to support students who are struggling with depression? Although serious depression may require external professional help, support can be provided in the school setting.

Depression is Not a Choice; Depressed Students Want to Succeed Too

First, remember that depressed children are not choosing to underperform or withdraw. They want to be successful and often are seeking guidance and support from teachers and others, but lack the ability to articulate their needs.

Learning How to Address Depression as a Teacher

Understandably, educators without significant mental health backgrounds may feel uncertain and uncomfortable approaching and interacting with students with depression; though all educators should remember that providing support and compassion does not necessitate training in therapy or counseling.

6 Actionable Steps To Help Students with Depression

1. Develop a Working and Collaborative Relationship with the Student

Do not be afraid to talk with students with depression about how they feel. In fact, saying nothing says a lot, and asking about how they feel will almost never cause harm.

Many times, they are seeking someone who cares about them and can recognize their pain without them having to seek help on their own, although it might not seem that way. Above all, don't give up on them!

2. Avoid Negative Techniques

Strategies such as punishment, sarcasm, disparagement, passive-aggression, or other negative techniques are ineffective and likely will only reinforce feelings of incompetence and low self-esteem, which may worsen the symptoms of depression.

Remember that these students are not choosing to be depressed.

They want to feel better and do well, just as you want them to do well. When depressed, students lack the personal resources to do their best work and overcome their challenges.

3. Make Adjustments or Accommodations in Assignments or Tasks

Do not lower expectations or give unearned grades. However, educatiors can give more time, break assignments into smaller pieces, offer extra help in setting up schedules or study habits, provide flexibility in assignment schedules, or pair the student with others who express an interest in helping as part of a range of classroom adjustments.

4. Plan for Success

To the extent possible, arrange experiences so that the student can be successful and receive recognition for successes. Scheduling pleasant activities and providing opportunities for successful leadership are examples. It is very important that depressed students feel accepted as a part of the school and that teachers believe in their competence.

5. Consult With Your School Psychologist, School Counselor, or School Social Worker

School-employed mental health personnel can provide suggestions of ways to support specific students, either through consultation, direct services, or collaborating with the family or other community agencies.

The world is changing quickly, and so is the research on depression and other neuro-cognitive disorders. A mental health certification through IBCCES will show you how to apply the latest research in the classroom with evidence based research and treatment. This helps educators to feel more comfortable addressing mental health disorders in students (which about 1 in 5 struggle with) and helps students to get the care they need to succeed.

Depression can impact many aspects of a student's performance at school, including both academic achievement and social relationships.

While students with depression can benefit significantly from mental health services, they can also greatly benefit from support by caring adults in their school settings that they interact with on a daily basis.

Understanding, patience, compassion, knowledge of the nature and course of depression, a desire to help, and a commitment to improving outcomes can be major factors in helping students with depression to succeed in school and life.

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6 Ways Teachers Can Help Fight Depression and Mental Health Disorders

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Depression has affected more than 10 percent of teenagers in the last year, yet most educators are not prepared to help students deal with depression.

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Although the cause of bipolar disorder isn't known, there are effective treatments. Learn more about the disorder, how to manage its symptoms, and more.

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Types of Depression Commonly Found in Teenagers

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Types of Depression Commonly Found in Teenagers

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Depression is common during adolescence and it may look different in teens than adults. Teens often seem more irritable than sad when they're depressed.

But, not all depression is created equal. The word depression is used to describe a variety of conditions. There are four main types of depression that commonly affect teenagers. Recognizing the signs and symptoms can be key to getting a teen treatment. And early intervention can often be key to successful treatment.

1. Adjustment Disorder With Depressed Mood

An adjustment disorder occurs in response to a life event. Moving to a new school, the death of a loved one, or dealing with a parents' divorce are examples of changes that can spur an adjustment disorder in teens.

Adjustment disorders begin within a few months of the event and may last up to six months.﻿﻿ If symptoms persist beyond six months, another diagnosis would be more appropriate.

Your teen may benefit from talk therapy to teach him new skills or help him cope with the stressful situation.

2. Persistent Depressive Disorder (Dysthymia)

Persistent depressive disorder (dysthymia) is a low grade, chronic depression that lasts for more than a year. Teens with dysthymia are often irritable and they may have low energy, low self-esteem, and feelings of hopelessness.

Their eating habits and sleeping patterns may also be disturbed. Frequently, dysthymia interferes with concentration and decision making. It's estimated that roughly 11 percent of teens, ages 13 to 18, experience dysthymia.﻿﻿

Although dysthymia isn't as severe as major depression, the long duration can take a serious toll on a teen's life. It can interfere with learning, socialization, and overall functioning. Dysthymia also makes a teen more susceptible to other mood disorders later in life. Cognitive-behavioral therapy and medication are often very effective in treating dysthymia.

3. Bipolar Disorder

Bipolar disorder is characterized by episodes of depression followed by periods of mania or hypomania (a less severe form of mania). Both the depressive and manic states will last anywhere from a couple of weeks to many months. Symptoms of mania include a reduced need for sleep, difficulty focusing, and a short-temper.

During a manic episode, a teen is likely to talk fast, feel very happy or silly, and be willing to engage in risky behavior. Many teens engage in high-risk sexual behavior during a manic episode.﻿﻿

Their severe mood changes interfere with their education and friendships. Bipolar is treatable but not curable. Bipolar is usually best treated with a combination of medication and therapy.

4. Major Depression

Major depression is the most serious form of depression. It is estimated that 13 percent of teens, ages 12 to 17, experienced at least one episode of major depression in 2017, according to the National Institute of Mental Health.﻿﻿

Younger children have about equal rates of depression based on gender. After puberty, however, girls are twice as likely to be diagnosed with depression.﻿﻿

Symptoms of major depression include persistent sadness and irritability, talk about suicide, a lack of interest in enjoyable activities, and frequent reports of physical aches and pains. Major depression can cause severe impairments at home and at school. Treatment usually involves therapy and may include medication.

Treatment for Depression

Unfortunately, many teens go undiagnosed and untreated. Often, adults don't recognize the signs of depression in young people.

Express your concerns and describe the symptoms that you're seeing. Make it clear to your teen that you don't think she's weak or crazy. Instead, talk about a mental health issue the same way you would discuss a physical health problem.

Explain that emotional problems need healing the same way physical health problems do. And sometimes, depression requires an exam and treatment beyond what you're able to do at home.

Your child's physician may refer you to a psychotherapist or a psychiatrist for further assessment and treatment. Talk therapy, family therapy, group therapy, and medication may be treatment options. Treatment will be based on the type of depression your teen has and the severity of her symptoms.

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Parents Should Look for the Signs of Depression in Their Teens

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Depression is common during adolescence and it may look different in teens than adults. Teens often seem more irritable than sad when they're depressed. But, not all depression is created equal. The word depression is used to describe a variety of conditions. There are four main types of depression that commonly affect teenagers.

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Overview

What is depression? A Mayo Clinic expert explains.

Learn more about depression from Craig Sawchuk, Ph.D., L.P., clinical psychologist at Mayo Clinic.

Hi, I'm Dr. Craig Sawchuk, a clinical psychologist at Mayo Clinic. And I'm here to talk with you about depression. Whether you're looking for answers for yourself, a friend, or loved one, understanding the basics of depression can help you take the next step.

What is depression?

Depression is a mood disorder that causes feelings of sadness that won't go away. Unfortunately, there's a lot of stigma around depression. Depression isn't a weakness or a character flaw. It's not about being in a bad mood, and people who experience depression can't just snap out of it. Depression is a common, serious, and treatable condition. If you're experiencing depression, you're not alone. It honestly affects people of all ages and races and biological sexes, income levels and educational backgrounds. Approximately one in six people will experience a major depressive episode at some point in their lifetime, while up to 16 million adults each year suffer from clinical depression. There are many types of symptoms that make up depression. Emotionally, you may feel sad or down or irritable or even apathetic. Physically, the body really slows down. You feel tired. Your sleep is often disrupted. It's really hard to get yourself motivated. Your thinking also changes. It can just be hard to concentrate. Your thoughts tend to be much more negative. You can be really hard on yourself, feel hopeless and helpless about things. And even in some cases, have thoughts of not wanting to live. Behaviorally, you just want to pull back and withdraw from others, activities, and day-to-day responsibilities. These symptoms all work together to keep you trapped in a cycle of depression. Symptoms of depression are different for everyone. Some symptoms may be a sign of another disorder or medical condition. That's why it's important to get an accurate diagnosis.

What causes depression?

While there's no single cause of depression, most experts believe there's a combination of biological, social, and psychological factors that contribute to depression risk. Biologically, we think about genetics or a family history of depression, health conditions such as diabetes, heart disease or thyroid disorders, and even hormonal changes that happen over the lifespan, such as pregnancy and menopause. Changes in brain chemistry, especially disruptions in neurotransmitters like serotonin, that play an important role in regulating many bodily functions, including mood, sleep, and appetite, are thought to play a particularly important role in depression. Socially stressful and traumatic life events, limited access to resources such as food, housing, and health care, and a lack of social support all contribute to depression risk. Psychologically, we think of how negative thoughts and problematic coping behaviors, such as avoidance and substance use, increase our vulnerability to depression.

The good news is that treatment helps. Effective treatments for depression exist and you do have options to see what works best for you. Lifestyle changes that improve sleep habits, exercise, and address underlying health conditions can be an important first step. Medications such as antidepressants can be helpful in alleviating depressive symptoms. Therapy, especially cognitive behavioral therapy, teaches skills to better manage negative thoughts and improve coping behaviors to help break you out of cycles of depression. Whatever the cause, remember that depression is not your fault and it can be treated.

To help diagnose depression, your health care provider may use a physical exam, lab tests, or a mental health evaluation. These results will help identify various treatment options that best fit your situation.

Help is available. You don't have to deal with depression by yourself. Take the next step and reach out. If you're hesitant to talk to a health care provider, talk to a friend or loved one about how to get help. Living with depression isn't easy and you're not alone in your struggles. Always remember that effective treatments and supports are available to help you start feeling better. Want to learn more about depression? Visit mayoclinic.org. Do take care.

Depression is a mood disorder that causes a persistent feeling of sadness and loss of interest. Also called major depressive disorder or clinical depression, it affects how you feel, think and behave and can lead to a variety of emotional and physical problems. You may have trouble doing normal day-to-day activities, and sometimes you may feel as if life isn't worth living.

More than just a bout of the blues, depression isn't a weakness and you can't simply "snap out" of it. Depression may require long-term treatment. But don't get discouraged. Most people with depression feel better with medication, psychotherapy or both.
Depression care at Mayo Clinic
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Symptoms

Although depression may occur only once during your life, people typically have multiple episodes. During these episodes, symptoms occur most of the day, nearly every day and may include:

Feelings of sadness, tearfulness, emptiness or hopelessness

Angry outbursts, irritability or frustration, even over small matters

Loss of interest or pleasure in most or all normal activities, such as sex, hobbies or sports

Sleep disturbances, including insomnia or sleeping too much

Tiredness and lack of energy, so even small tasks take extra effort

Reduced appetite and weight loss or increased cravings for food and weight gain

Anxiety, agitation or restlessness

Slowed thinking, speaking or body movements

Feelings of worthlessness or guilt, fixating on past failures or self-blame

Trouble thinking, concentrating, making decisions and remembering things

Frequent or recurrent thoughts of death, suicidal thoughts, suicide attempts or suicide

Unexplained physical problems, such as back pain or headaches

For many people with depression, symptoms usually are severe enough to cause noticeable problems in day-to-day activities, such as work, school, social activities or relationships with others. Some people may feel generally miserable or unhappy without really knowing why.

Depression symptoms in children and teens

Common signs and symptoms of depression in children and teenagers are similar to those of adults, but there can be some differences.

In younger children, symptoms of depression may include sadness, irritability, clinginess, worry, aches and pains, refusing to go to school, or being underweight.

In teens, symptoms may include sadness, irritability, feeling negative and worthless, anger, poor performance or poor attendance at school, feeling misunderstood and extremely sensitive, using recreational drugs or alcohol, eating or sleeping too much, self-harm, loss of interest in normal activities, and avoidance of social interaction.

Depression symptoms in older adults

Depression is not a normal part of growing older, and it should never be taken lightly. Unfortunately, depression often goes undiagnosed and untreated in older adults, and they may feel reluctant to seek help. Symptoms of depression may be different or less obvious in older adults, such as:

Memory difficulties or personality changes

Physical aches or pain

Fatigue, loss of appetite, sleep problems or loss of interest in sex - not caused by a medical condition or medication

Often wanting to stay at home, rather than going out to socialize or doing new things

Suicidal thinking or feelings, especially in older men

When to see a doctor

If you feel depressed, make an appointment to see your doctor or mental health professional as soon as you can. If you're reluctant to seek treatment, talk to a friend or loved one, any health care professional, a faith leader, or someone else you trust.

When to get emergency help

If you think you may hurt yourself or attempt suicide, call 911 in the U.S. or your local emergency number immediately.

Also consider these options if you're having suicidal thoughts:

Call your doctor or mental health professional.

Contact a suicide hotline.

In the U.S., call or text 988 to reach the 988 Suicide & Crisis Lifeline, available 24 hours a day, seven days a week. Or use the Lifeline Chat. Services are free and confidential.

U.S. veterans or service members who are in crisis can call 988 and then press "1" for the Veterans Crisis Line. Or text 838255. Or chat online.

The Suicide & Crisis Lifeline in the U.S. has a Spanish language phone line at 1-888-628-9454 (toll-free).

Reach out to a close friend or loved one.

Contact a minister, spiritual leader or someone else in your faith community.

If you have a loved one who is in danger of suicide or has made a suicide attempt, make sure someone stays with that person. Call 911 or your local emergency number immediately. Or, if you think you can do so safely, take the person to the nearest hospital emergency room.

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Causes

It's not known exactly what causes depression. As with many mental disorders, a variety of factors may be involved, such as:

Biological differences. People with depression appear to have physical changes in their brains. The significance of these changes is still uncertain, but may eventually help pinpoint causes.

Brain chemistry. Neurotransmitters are naturally occurring brain chemicals that likely play a role in depression. Recent research indicates that changes in the function and effect of these neurotransmitters and how they interact with neurocircuits involved in maintaining mood stability may play a significant role in depression and its treatment.

Hormones. Changes in the body's balance of hormones may be involved in causing or triggering depression. Hormone changes can result with pregnancy and during the weeks or months after delivery (postpartum) and from thyroid problems, menopause or a number of other conditions.

Inherited traits. Depression is more common in people whose blood relatives also have this condition. Researchers are trying to find genes that may be involved in causing depression.

Risk factors

Depression often begins in the teens, 20s or 30s, but it can happen at any age. More women than men are diagnosed with depression, but this may be due in part because women are more likely to seek treatment.

Factors that seem to increase the risk of developing or triggering depression include:

Certain personality traits, such as low self-esteem and being too dependent, self-critical or pessimistic

Traumatic or stressful events, such as physical or sexual abuse, the death or loss of a loved one, a difficult relationship, or financial problems

Blood relatives with a history of depression, bipolar disorder, alcoholism or suicide

Being lesbian, gay, bisexual or transgender, or having variations in the development of genital organs that aren't clearly male or female (intersex) in an unsupportive situation

History of other mental health disorders, such as anxiety disorder, eating disorders or post-traumatic stress disorder

Abuse of alcohol or recreational drugs

Serious or chronic illness, including cancer, stroke, chronic pain or heart disease

Certain medications, such as some high blood pressure medications or sleeping pills (talk to your doctor before stopping any medication)

Complications

Depression is a serious disorder that can take a terrible toll on you and your family. Depression often gets worse if it isn't treated, resulting in emotional, behavioral and health problems that affect every area of your life.

Examples of complications associated with depression include:

Excess weight or obesity, which can lead to heart disease and diabetes

Pain or physical illness

Alcohol or drug misuse

Anxiety, panic disorder or social phobia

Family conflicts, relationship difficulties, and work or school problems

Social isolation

Suicidal feelings, suicide attempts or suicide

Self-mutilation, such as cutting

Premature death from medical conditions

Prevention

There's no sure way to prevent depression. However, these strategies may help.

Take steps to control stress, to increase your resilience and boost your self-esteem.

Reach out to family and friends, especially in times of crisis, to help you weather rough spells.

Get treatment at the earliest sign of a problem to help prevent depression from worsening.

Consider getting long-term maintenance treatment to help prevent a relapse of symptoms.

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Depression (major depressive disorder) - Symptoms and causes

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

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Overview

Bipolar disorder, formerly called manic depression, is a mental health condition that causes extreme mood swings that include emotional highs (mania or hypomania) and lows (depression).

When you become depressed, you may feel sad or hopeless and lose interest or pleasure in most activities. When your mood shifts to mania or hypomania (less extreme than mania), you may feel euphoric, full of energy or unusually irritable. These mood swings can affect sleep, energy, activity, judgment, behavior and the ability to think clearly.

Episodes of mood swings may occur rarely or multiple times a year. While most people will experience some emotional symptoms between episodes, some may not experience any.

Although bipolar disorder is a lifelong condition, you can manage your mood swings and other symptoms by following a treatment plan. In most cases, bipolar disorder is treated with medications and psychological counseling (psychotherapy).
Bipolar disorder care at Mayo Clinic
Symptoms

There are several types of bipolar and related disorders. They may include mania or hypomania and depression. Symptoms can cause unpredictable changes in mood and behavior, resulting in significant distress and difficulty in life.

Bipolar I disorder. You've had at least one manic episode that may be preceded or followed by hypomanic or major depressive episodes. In some cases, mania may trigger a break from reality (psychosis).

Bipolar II disorder. You've had at least one major depressive episode and at least one hypomanic episode, but you've never had a manic episode.

Cyclothymic disorder. You've had at least two years - or one year in children and teenagers - of many periods of hypomania symptoms and periods of depressive symptoms (though less severe than major depression).

Other types. These include, for example, bipolar and related disorders induced by certain drugs or alcohol or due to a medical condition, such as Cushing's disease, multiple sclerosis or stroke.

Bipolar II disorder is not a milder form of bipolar I disorder, but a separate diagnosis. While the manic episodes of bipolar I disorder can be severe and dangerous, individuals with bipolar II disorder can be depressed for longer periods, which can cause significant impairment.

Although bipolar disorder can occur at any age, typically it's diagnosed in the teenage years or early 20s. Symptoms can vary from person to person, and symptoms may vary over time.

Mania and hypomania

Mania and hypomania are two distinct types of episodes, but they have the same symptoms. Mania is more severe than hypomania and causes more noticeable problems at work, school and social activities, as well as relationship difficulties. Mania may also trigger a break from reality (psychosis) and require hospitalization.

Both a manic and a hypomanic episode include three or more of these symptoms:

Abnormally upbeat, jumpy or wired

Increased activity, energy or agitation

Exaggerated sense of well-being and self-confidence (euphoria)

Decreased need for sleep

Unusual talkativeness

Racing thoughts

Distractibility

Poor decision-making - for example, going on buying sprees, taking sexual risks or making foolish investments

Major depressive episode

A major depressive episode includes symptoms that are severe enough to cause noticeable difficulty in day-to-day activities, such as work, school, social activities or relationships. An episode includes five or more of these symptoms:

Depressed mood, such as feeling sad, empty, hopeless or tearful (in children and teens, depressed mood can appear as irritability)

Marked loss of interest or feeling no pleasure in all - or almost all - activities

Significant weight loss when not dieting, weight gain, or decrease or increase in appetite (in children, failure to gain weight as expected can be a sign of depression)

Either insomnia or sleeping too much

Either restlessness or slowed behavior

Fatigue or loss of energy

Feelings of worthlessness or excessive or inappropriate guilt

Decreased ability to think or concentrate, or indecisiveness

Thinking about, planning or attempting suicide

Other features of bipolar disorder

Signs and symptoms of bipolar I and bipolar II disorders may include other features, such as anxious distress, melancholy, psychosis or others. The timing of symptoms may include diagnostic labels such as mixed or rapid cycling. In addition, bipolar symptoms may occur during pregnancy or change with the seasons.

Symptoms in children and teens

Symptoms of bipolar disorder can be difficult to identify in children and teens. It's often hard to tell whether these are normal ups and downs, the results of stress or trauma, or signs of a mental health problem other than bipolar disorder.

Children and teens may have distinct major depressive or manic or hypomanic episodes, but the pattern can vary from that of adults with bipolar disorder. And moods can rapidly shift during episodes. Some children may have periods without mood symptoms between episodes.

The most prominent signs of bipolar disorder in children and teenagers may include severe mood swings that are different from their usual mood swings.

When to see a doctor

Despite the mood extremes, people with bipolar disorder often don't recognize how much their emotional instability disrupts their lives and the lives of their loved ones and don't get the treatment they need.

And if you're like some people with bipolar disorder, you may enjoy the feelings of euphoria and cycles of being more productive. However, this euphoria is always followed by an emotional crash that can leave you depressed, worn out - and perhaps in financial, legal or relationship trouble.

If you have any symptoms of depression or mania, see your doctor or mental health professional. Bipolar disorder doesn't get better on its own. Getting treatment from a mental health professional with experience in bipolar disorder can help you get your symptoms under control.

When to get emergency help

Suicidal thoughts and behavior are common among people with bipolar disorder. If you have thoughts of hurting yourself, call 911 or your local emergency number immediately, go to an emergency room, or confide in a trusted relative or friend. Or contact a suicide hotline. In the U.S., call or text 988 to reach the 988 Suicide & Crisis Lifeline, available 24 hours a day, seven days a week. Or use the Lifeline Chat. Services are free and confidential.

If you have a loved one who is in danger of suicide or has made a suicide attempt, make sure someone stays with that person. Call 911 or your local emergency number immediately. Or, if you think you can do so safely, take the person to the nearest hospital emergency room.

Causes

The exact cause of bipolar disorder is unknown, but several factors may be involved, such as:

Biological differences. People with bipolar disorder appear to have physical changes in their brains. The significance of these changes is still uncertain but may eventually help pinpoint causes.

Genetics. Bipolar disorder is more common in people who have a first-degree relative, such as a sibling or parent, with the condition. Researchers are trying to find genes that may be involved in causing bipolar disorder.

Risk factors

Factors that may increase the risk of developing bipolar disorder or act as a trigger for the first episode include:

Having a first-degree relative, such as a parent or sibling, with bipolar disorder

Periods of high stress, such as the death of a loved one or other traumatic event

Drug or alcohol abuse

Complications

Left untreated, bipolar disorder can result in serious problems that affect every area of your life, such as:

Problems related to drug and alcohol use

Suicide or suicide attempts

Legal or financial problems

Damaged relationships

Poor work or school performance

Co-occurring conditions

If you have bipolar disorder, you may also have another health condition that needs to be treated along with bipolar disorder. Some conditions can worsen bipolar disorder symptoms or make treatment less successful. Examples include:

Anxiety disorders

Eating disorders

Attention-deficit/hyperactivity disorder (ADHD)

Alcohol or drug problems

Physical health problems, such as heart disease, thyroid problems, headaches or obesity

Prevention

There's no sure way to prevent bipolar disorder. However, getting treatment at the earliest sign of a mental health disorder can help prevent bipolar disorder or other mental health conditions from worsening.

If you've been diagnosed with bipolar disorder, some strategies can help prevent minor symptoms from becoming full-blown episodes of mania or depression:

Pay attention to warning signs. Addressing symptoms early on can prevent episodes from getting worse. You may have identified a pattern to your bipolar episodes and what triggers them. Call your doctor if you feel you're falling into an episode of depression or mania. Involve family members or friends in watching for warning signs.

Avoid drugs and alcohol. Using alcohol or recreational drugs can worsen your symptoms and make them more likely to come back.

Take your medications exactly as directed. You may be tempted to stop treatment - but don't. Stopping your medication or reducing your dose on your own may cause withdrawal effects or your symptoms may worsen or return.

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Bipolar disorder causes extreme mood swings that include emotional highs (mania or hypomania) and lows (depression).

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Teaching Students with Emotional Disturbances: 8 Tips for Teachers

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Teaching Students with Emotional Disturbances: 8 Tips for Teachers

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What Are Eating Disorders? - Embry Women’s Health

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Eeating disorder is an umbrella term for diseases characterized by serious disturbances in people’s eating behaviors and associated thoughts and feelings.

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Tips For Teachers: Promoting healthy eating & physical activity in the classroom

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Tips For Teachers: Promoting healthy eating & physical activity in the classroom

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The School Counselor’s Role in Addressing Eating Disorder Symptomatology Among Adolescents 

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The School Counselor’s Role in Addressing Eating Disorder Symptomatology Among Adolescents 

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A Lesson for Teachers in Addressing the Eating Disorder Bully

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A Lesson for Teachers in Addressing the Eating Disorder Bully

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Today, I would recognize the signs: the 11 year old girl in the sixth grade class spending her entire recess and lunch-break running in the schoolyard and doing circuits in the gym; every day, exercising more; the same girl continuing to get top marks with her school work, always punctual, eager to please, but becoming withdrawn; her bubbly personality disappearing; she is not eating her lunch - she offers it to her playmates. She keeps only the apple and eats this very, very slowly, one nibble at a time. Today I would recognize these signs as symptoms of anorexia nervosa, for this child was me.

Teachers are in a prime position to be among the first people to notice a child is developing an eating disorder. I certainly wish my teacher had recognized the symptoms and intervened. But that was 50 years ago. Today, I like to think that all teachers are aware of the signs of anorexia nervosa, and that they know how to respond. Sometimes, friends of the child will notice the symptoms, and confide in the teacher. Or perhaps the coach or dance instructor may notice behavioral changes.

Teachers often want to help when they suspect a child is suffering symptoms of anorexia nervosa, but don't know when to say something, what to say or how to say it. They might even decide that it is better to say nothing than say the wrong thing. This just goes to show how important it is for school staff to be educated and informed about eating disorders - so that they feel confident and more able to help. A teacher's attitude and response can greatly influence whether the illness is 'nipped in the bud' and stopped in its tracks or gathers pace and becomes entrenched.

School staff are well placed to spot the early signs of anorexia nervosa, enabling early diagnosis, early intervention and a far better prognosis. A child may feel more comfortable talking about food difficulties with a teacher rather than someone in their immediate family. The school can provide a bridge between the child, their family and other care providers to ensure the best possible outcome.

How the teacher responds - how they offer support - can greatly influence what happens next. The clues below on what to say, and when to say it, are drawn from my latest book with Professor Janet Treasure: Anorexia Nervosa: A Recovery Guide for Sufferers, Families and Friends. This updated version includes information for teachers and others whose daily work involves the care of children.

School-specific warning signs
Some anorexia nervosa warning signs are more easily noticed at school. Observing me at age 11, the teacher would have ticked a box in each of the following:

Weight loss (not because I did not want to eat, but was afraid to eat)

Avoidance of PE or swimming (because it involved undressing)

Excessive exercise (I felt driven to do more each day)

Busy during lunch breaks (to avoid questions like 'why aren't you eating?')

Wearing extra clothing (to keep warm and hide the body)

Perfectionism (important to get everything right to avoid anxiety)

Inability to focus in class (when the brain is starved, concentration is more difficult)

Loss of friends (because food thoughts increasingly dominate thinking time)

When a child is causing concern
When a teacher suspects a child may be suffering from anorexia nervosa, they should tell the person responsible for pastoral care within the school. They may already be aware of the problem, or they may enlist your help.

Creating opportunities for confiding
A child feels more comfortable when they 'make the first move' with regards to talking about their eating disorder as this helps them to feel in control of the situation. To facilitate this, a teacher can create situations for one on one time such as suggesting they stay after class to discuss their homework. Often, a child with an eating disorder feels scared and alone, and during the early stages may welcome the chance to offload to someone.

Remain calm and don't judge. Encourage the child to share their fears with questions such as: 'You don't seem quite yourself lately, how can I help you?' Avoid talking about food or weight directly as this is likely to frighten the child. Take this first meeting gently and accept that you are unlikely to get to the crux of the issue immediately. Focus on listening to the child. Work on building a trusting relationship and ensure that they know when and where they can talk to you further about what's on their mind.

* For more information, see Anorexia Nervosa: A Recovery Guide for Sufferers, Families and Friends. Pooky Knightsmith writes the chapter 'Guidelines for School Staff'.

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A Lesson for Teachers in Addressing the Eating Disorder Bully

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Today, I would recognize the signs: the 11 year old girl in the sixth grade class spending her entire recess and lunch-break running in the schoolyard and doing circuits in the gym; every day, exercising more; the same girl continuing to get top marks with her school work, always punctual, eager to please, but becoming withdrawn; her bubbly personality disappearing; she is not eating her lunch - she offers it to her playmates.

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Anxiety disorders are serious mental illnesses that cause significant worry or fear that doesn't go away and may even get worse over time. We all feel anxious at times, but with an anxiety disorder, the anxiety tends to be fairly constant and has a very negative and intrusive impact on quality of life.

According to the National Institute of Mental Health (NIMH), approximately 19.1% of adults in the United States have some type of anxiety disorder. Women are also more likely to be affected by anxiety, which is why experts now recommend that women and girls over the age of 13 should be screened for anxiety disorders as part of routine medical care.

Types of Anxiety Disorders

There are several types of anxiety disorders. While all are characterized by symptoms of anxiety, each has its own unique set of characteristics, symptoms, and criteria for diagnosis.

Agoraphobia

Agoraphobia is an irrational and extreme fear of being in a situation where escape is impossible. People often fear that they will experience symptoms of panic or other symptoms in public, which leads them to avoid any situation where they may feel panicked, helpless, or trapped.

These avoidance behaviors are often life-limiting, often causing people to avoid driving, shopping in public, air travel, or other situations. In some cases, this fear can become so severe that people are unable to leave their homes.

Generalized Anxiety Disorder

Generalized anxiety disorder (GAD) involves excessive worry and anxiety related to various activities and events. This worry is difficult to control and often shifts from one concern to another.

While there is no specific threat, people with GAD find themselves feeling anxious about everyday daily events, current events in the news, relationships, or potential events that might occur.

Panic Disorder

Panic disorder involves experiencing intense and persistent panic attacks that occur unexpectedly with little or no warning. A panic attack has physical and emotional symptoms such as rapid heartbeat, increased respiration, and feelings of extreme terror.

Selective Mutism

Selective mutism is an anxiety disorder that occurs during childhood. It involves experiencing anxiety, embarrassment, or fear that prevents children from speaking in specific settings, such as while at school or around strangers.

Selective mutism usually occurs between the ages of two and four and is often accompanied by fidgeting, lack of eye contact, and lack of expressions when faced with a situation the child fears.

Social Anxiety Disorder

Social anxiety disorder (SAD), previously known as social phobia, involves a fear of social situations. This fear may center on specific events, such as public speaking, or may involve a more generalized fear of many different social situations.

People who have this condition have an exaggerated sense that other people scrutinize everything they do. They may be very critical of themselves and experience both physical and emotional symptoms of fear in social situations.

Such symptoms include shaking, racing heartbeat, stomach upset, and dread. These symptoms often lead people to avoid social situations whenever possible.

Specific Phobias

Specific phobias involve intense fear of a specific object or situation that is overwhelming, irrational, and out of proportion to the actual threat. When they encounter the source of their fear, people with a specific phobia experience immediate symptoms such as sweating, crying, shaking, rapid heartbeat, and increased respiration.

As often happens with other anxiety disorders, people with a phobia may go to great lengths to avoid the source of their fear. Such avoidance behaviors can cause additional stress and limit daily activities.

Are OCD and PTSD Anxiety Disorders?

The fifth edition of the " Diagnostic and Statistical Manual of Mental Disorders" (DSM-5), which healthcare providers use to diagnose mental health conditions,breaks what have generally been considered anxiety disorders into three categories:

Anxiety disorders

Obsessive-compulsive and related disorders

Trauma- and stressor-related disorders

This differentiation shows that while the disorders have a commonality and are related, they are distinctly different. These classifications have remained in place in the most recent edition of the diagnostic manual, the DSM-5-TR.

While OCD and PTSD are no longer officially categorized as anxiety disorders, they share many characteristics, and anxiety symptoms are common in both conditions.

Obsessive-Compulsive Disorder

Obsessive-compulsive disorder (OCD) involves experiencing intrusive thoughts, known as obsessions, and behaviors, known as compulsions. Before the publication of the DSM-5, OCD was considered a type of anxiety disorder, because these obsessions create significant anxiety for many people.

Obsessions may focus on things such as a fear of germs, a need to have things in a certain order, or disturbing thoughts about taboo topics. Compulsions are behaviors that people often engage in as a way to relieve the anxiety caused by obsessive thoughts. They might involve actions such as counting, ordering, checking, or washing.

Conditions related to OCD and also listed in the category "OCD and related disorders" include body-dysmorphic disorder, hoarding disorder, and trichotillomania.

Post Traumatic Stress Disorder (PTSD)

Post-traumatic stress disorder (PTSD) is a condition that can occur following a traumatic event. It includes symptoms such as changes in mood, arousal, and reactivity. People may have intrusive thoughts, memories, and nightmares related to the trauma. Flashbacks, hypervigilance, anxiety, and avoidance of reminders are other common symptoms.

Other trauma- and stressor-related disorders in this DSM group include adjustment disorders, and reactive attachment disorder

Recap

Anxiety Disorder Symptoms

Anxiety disorders come with a host of symptoms and no one person has the same experience. Each disorder tends to have different symptoms as well. The symptoms common to anxiety disorders in general include:

Difficulty sleeping

Dizziness

Dry mouth

Feelings of nervousness, worry, panic, fear, and unease

Muscle tightness

Nausea

Rapid or irregular heartbeat

Sweaty or cold hands and/or feet

Tingling or numbness in the hands or feet

Unable to be calm or hold still

When you experience the physical and psychological signs of fear and anxiety such as sweating, racing heart, shortness of breath, trembling, worry, or stress, these are cues that something is happening that could be a threat and that you need to deal with it.

This "flight or fight" reaction activates the physical and psychological resources necessary to deal with the potential danger. Although this system works well most of the time, sometimes it can go into overdrive and do more harm than good. When this happens, it might indicate you have an anxiety disorder.

Millions of American adults (as well as children and teens) will experience an anxiety disorder at some point in their lives. No one knows exactly what causes anxiety disorders, although genetics, environment, stress level, brain changes, and trauma may all play a role.

Researchers are discovering more about these links all the time. A combination of factors likely plays a role in causing anxiety conditions. Some factors that have been implicated include:

Brain chemistry: Severe or prolonged stress can contribute to changes in the chemical balance in the brain. Such changes can play a part in the onset of anxiety disorders.

Experiences: Stressful or traumatic events can also contribute to feelings of anxiety.

Family history: Having close family members with symptoms of anxiety disorders increases the risk that a person will also develop an anxiety condition.

Genetic factors: Certain genes may predispose a person to a higher likelihood of developing an anxiety disorder.

Medical conditions: Some underlying health conditions can contribute to feelings of anxiety. Some of these include chronic pain, heart disease, diabetes, thyroid problems, respiratory conditions, drug use, and drug withdrawal.

Personality: People with certain personality traits, such as introversion and neuroticism, may be more prone to experiencing higher levels of anxiety.

There are no lab tests that can be done to diagnose an anxiety disorder, though a doctor may perform some tests to rule out physical problems. Your doctor may refer you to a mental health professional, such as a psychiatrist, a psychologist, or a counselor, who will use specific diagnostic tools and questions to help determine what sort of disorder you may have.

A doctor or mental health professional will ask questions and use assessment tools to help determine if you have a disorder. They will want to know the nature of your symptoms, how long they last, and how severe they are. They will also want to understand how they interfere with your ability to function in your everyday daily life.

Healthcare practitioners use the "Diagnostic and Statistical Manual of Mental Disorders" (DSM) to diagnose these conditions. Each disorder in the DSM lists specific symptom criteria that a person must meet to be diagnosed with a particular condition.

Generalized Anxiety Disorder Discussion Guide

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

Treatments

There are a variety of options available to treat anxiety disorders. A mental health professional can help determine what works best for you.

Psychotherapy

Psychotherapy can help people learn to manage the emotional, cognitive, and behavioral aspects of anxiety. One particularly effective form of psychotherapy for anxiety disorders is cognitive behavioral therapy (CBT). This approach focuses on helping people identify the automatic negative thoughts and cognitive distortions that contribute to feelings of anxiety.

Exposure therapy is another type of CBT that can be helpful for some types of anxiety. In this approach, people are gradually exposed to the things that they fear, often while simultaneously using relaxation techniques to help calm the body's stress response.

Medications

Some medications can also be prescribed to help relieve symptoms of anxiety. Some of the medications that are most often used for anxiety include:

Antidepressants can help alter the levels of certain neurotransmitters in the brain to help relieve symptoms of anxiety.

Benzodiazepines work quickly and are often used as a short-term treatment.

Beta-blockers are usually used to treat high blood pressure, but can also help relieve some of the physical symptoms of anxiety.

Coping Strategies

Coping strategies often focus on ways to manage anxiety more effectively. Lifestyle changes such as limiting caffeine intake, getting enough rest, and engaging in regular exercise may be helpful.

Stress management techniques including deep breathing, yoga, and progressive muscle relaxation can also be beneficial when managing feelings of anxiety.

If you have an anxiety disorder, there are plenty of treatment options available to help you live your life to the fullest. Remember, treatment can take time before you and your physician discover the best options for you. Be patient and keep communication open with your mental health professional in order to figure out the plan best tailored to your individual needs.

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Do You Know the Difference Between Stress and an Anxiety Disorder?

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Anxiety disorders are serious mental illnesses that cause significant worry or fear that doesn't go away and may even get worse over time. We all feel anxious at times, but with an anxiety disorder, the anxiety tends to be fairly constant and has a very negative and intrusive impact on quality of life.

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Anxiety is a natural emotion. However, it can also cause physical symptoms, such as shaking and sweating. Anxiety disorders can affect daily life and can improve with treatment.

Anxiety disorders form a category of mental health diagnoses that lead to excessive nervousness, fear, apprehension, and worry.

This article discusses the symptoms, causes, and treatments for anxiety.

According to the Anxiety and Depression Association of America (ADAA), around 40 million people in the United States have an anxiety disorder. It is the most common group of mental illnesses in the country. However, only 36.9% of people with an anxiety disorder receive treatment.

The American Psychological Association (APA) defines anxiety as "an emotion characterized by feelings of tension, worried thoughts, and physical changes like increased blood pressure."

Knowing the difference between typical feelings of anxiety and an anxiety disorder requiring medical attention can help a person identify and treat the condition.

Learn more about anxiety in our dedicated hub.

Anxiety and anxiety disorders

Anxiety is a complex response to real or perceived threats. It can involve cognitive, physical, and behavioral changes.

Real or perceived danger causes a rush of adrenaline, a hormone and chemical messenger in the brain, which in turn triggers these anxiety reactions in a process called the fight-or-flight response. Some people may experience this response in difficult social situations or around important events or decisions.

The duration or severity of feelings of anxiety can sometimes be out of proportion to the original trigger or stressor. Physical symptoms, such as increased blood pressure and nausea, may also develop. These responses move beyond anxiety into an anxiety disorder.

Once anxiety reaches the stage of a disorder, it can interfere with daily function.

Learn more about anxiety disorders here.

The Diagnostic and Statistical Manual of Mental Health Disorders: 5th Edition, text revision (DSM-5-TR) classifies anxiety disorders into several main types.

In previous editions of the DSM-5-TR, anxiety disorders included obsessive-compulsive disorder (OCD) and post-traumatic stress disorder (PTSD), as well as acute stress disorder. However, the manual no longer groups these mental health difficulties under anxiety.

Anxiety disorders now include the following:

GAD

This chronic disorder involves excessive, long lasting anxiety and worries about nonspecific life events, objects, and situations. GAD is the most common anxiety disorder, and people with it are not always able to identify the cause of their anxiety.
Learn more about GAD here.
Panic disorder

Brief or sudden attacks of intense terror and apprehension characterize panic disorder. These attacks can lead to shaking, confusion, dizziness, nausea, and breathing difficulties. Panic attacks tend to occur and escalate rapidly.

Panic disorders usually occur after frightening experiences or prolonged stress but may also occur without a trigger.
Learn about panic disorder and panic attacks here.
Specific phobia

This is a fear and avoidance of a particular object or situation. Phobias are not like other anxiety disorders, as they relate to a specific cause.

A person with a phobia might acknowledge fear as illogical or extreme but remain unable to control feelings of anxiety around the trigger. Triggers for a phobia range from situations and animals to everyday objects.
Learn more about phobias and how they develop here.
Agoraphobia

This is a fear and avoidance of places, events, or situations from which it may be difficult to escape or where help would not be available in emergencies.

People often misunderstand this condition as a phobia of open spaces and the outdoors. A person with agoraphobia may fear leaving home or using elevators and public transport.
Learn more about agoraphobia here.
Selective mutism

Some children experience this form of anxiety, in which they cannot speak in certain places or contexts, even though they may have excellent verbal communication skills around familiar people.
Learn more about selective mutism in adults and children here.
Social anxiety disorder

This is a fear of adverse judgment from others in social situations or of public embarrassment. Social anxiety disorder includes a range of feelings, such as stage fright, a fear of intimacy, and anxiety around humiliation and rejection.
Learn more about social anxiety disorder.
Separation anxiety disorder

High anxiety levels after separation from a person or place that provides feelings of security or safety characterize separation anxiety disorder. Separation anxiety is most common in young children but can affect people of all ages.

Learn all about separation anxiety in adults here.

The causes of anxiety disorders are complicated. Many might occur at once, some may lead to others, and some might not lead to an anxiety disorder unless another is present.

Possible causes include:

environmental stressors, such as relationship problems or family issues

genetics

medical factors, such as disease symptoms or the effects of a medication

substance withdrawal

Learn more about anxiety and how it affects the body here.

Treatment often consists of psychotherapy, behavioral therapy, and medication.

Sometimes, alcohol dependence, depression, or other underlying conditions require treatment before treating an anxiety disorder can take place.

Self-treatment

Sometimes, a person can treat an anxiety disorder at home without clinical supervision. However, this may not be effective for severe or long-term anxiety disorders.

There are several exercises and actions to help a person cope with milder, more focused, or shorter-term anxiety disorders, including:
Learn about some other ways to treat anxiety naturally.
Counseling

A standard way of treating anxiety is psychological counseling. This can include cognitive behavioral therapy (CBT), psychotherapy, or a combination of therapies.

CBT is a type of psychotherapy that aims to recognize and change harmful thought patterns that form the foundation of anxious and troublesome feelings.
Learn more about different types of therapy here.
Medications

A person can support anxiety management with several types of medication.

Medicines that might control some physical and mental symptoms include antidepressants, benzodiazepines, and tricyclic antidepressants.

Benzodiazepines: A doctor may prescribe these for certain people with anxiety, but they can cause addiction. Diazepam, or Valium, is a common benzodiazepine.

Antidepressants: These commonly help with anxiety, even though they also target depression. Serotonin reuptake inhibitors (SSRIs), fluoxetine, and citalopram are examples.

Tricyclic antidepressants: These are an older class of drugs that benefit most anxiety disorders other than obsessive-compulsive disorder (OCD). Imipramine and clomipramine are two examples of tricyclics.

Additional drugs a person might use to treat anxiety include:

Seek medical advice if the adverse effects of any prescribed medications become severe.
Learn more about anxiety medications here.
There are ways to reduce the risk of anxiety disorders. Remember that anxious feelings are a natural factor of daily life, and experiencing them does not always indicate the presence of a mental health disorder.

People may benefit from the following:
Learn about some foods that can help prevent anxiety.
Anxiety is not a medical condition but a natural emotion that is vital for survival when an individual faces danger.

An anxiety disorder develops when this reaction becomes exaggerated or out-of-proportion to the trigger that causes it. There are several types of anxiety disorders, including panic disorder, phobias, and social anxiety.

Treatment involves a combination of therapy, medication, and counseling alongside self-help measures.

An active lifestyle with a balanced diet can help keep anxious emotions within healthy limits.

Read the article in Spanish.

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Anxiety: Symptoms, types, causes, prevention, and treatment

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Anxiety is a normal emotion that causes increased alertness, fear, and physical signs, such as a rapid heart rate. Read on to learn more.

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Teen Stress and Anxiety: Facts and Statistics

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Teen Stress and Anxiety: Facts and Statistics

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April is Stress Awareness Month. We will publish a series of helpful articles on the topic over the next few weeks, so keep checking back or follow us on Facebook to get notified.
Stress is part of life for everyone. From children to adolescents to adults, we all deal with some amount of stress every day of our lives. It's normal. Complications begin when stress becomes chronic, which means that, over a six-month period, the stressful days outnumber the non-stressful days. Chronic stress has significant negative physical and emotional effects - for everyone, not only adults.

Chronic stress can either cause or contribute to the following physical problems:

High blood pressure

Decreased immune function

Heart Disease

Obesity

Fatigue

Chronic stress can either cause or contribute to the following emotional issues:

Depression

Irritability

Feeling overwhelmed

Negative/pessimistic thoughts

Anxiety

We'll focus on that last bullet point: anxiety.

Like stress, anxiety is part of life for everyone. We all deal with a little bit of anxiety every day. It only becomes a problem when it persists, and we lack the coping skills to process the associated symptoms in healthy and productive ways. If your teen complains about being stressed or anxious, you should take it seriously. For adults, it's both tempting and easy to minimize teen stress and anxiety because - well, from our perspective, they don't have to deal with half of what we do.

But minimizing teen stress and teen anxiety is a mistake. Here's a fact: their stress is every bit as real for them as it is for us. So are the negative physical and emotional consequences of their stress. And if your teen's stress becomes chronic, they're at increased risk of developing an anxiety disorder.

Anxiety Disorders in Adolescents

For the sake of simplicity, we'll use a clinical definition of Generalized Anxiety Disorder (GAD) to help you gauge the severity of your teen's stress. When the symptoms of stress cross the threshold from typical to the level of a psychological disorder, that's when you need to pay special attention. And that's when the professionals say it's time to seek help.

The Diagnostic and Statistical Manual of Mental Disorders (DSM-V) defines GAD as "...excessive anxiety and worry about a number of activities or events occurring more days than not for at least six months." The DSM-V identifies the following symptoms of anxiety:

1. Restlessness, feeling on edge.

2. Getting tired easily.

3. Difficulty concentrating, or feeling their mind is blank.

4. Irritability

5. Muscular tension.

6. Sleep disturbances.

If your teen displays any of these symptoms on more days than not for six months or more, the most prudent course of action is to consult a mental health professional for a full psychiatric assessment. This list is not an at-home diagnostic tool - it's meant to help you decide if your child needs professional help or not.

Now, for the statistics on adolescent anxiety and stress.

The Child Mind Institute reports that:

19.3% of teens have a specific phobia

9.1% of teens have social anxiety disorder

7.6% of teens have separation anxiety

2.3% of teens have a panic disorder

2.2% of teens have Generalized Anxiety Disorder

In addition, he National Institute of Mental Health reports that:

31.9% of teens have some type of anxiety disorder

8.3 % of those with an anxiety disorder have severe impairment as a result.

38% of female teens have an anxiety disorder.

26.1% of male teens have an anxiety disorder.

The American Psychological Association reports that:

10% say stress causes them to get lower grades than they think they can get

59% say balancing all their activities causes stress

40% say they neglect home responsibilities due to stress.

40% say they're irritable due to stess

37% said stress causes them to feel overwhelmed

36% say they feel tired because of stress.

30% say they feel sad or depressed because of stress.

Remember: stress is normal. Stress is part of life for every organism on the planet, humans included. Stress itself is not inherently bad. However, when stress is chronic and/or affects daily functioning, that's when it has the potential to cause problems, and possibly develop into an anxiety disorder. As mentioned above, if you think your child or teen may have an anxiety disorder, seek professional help. If, on the other hand, you think your child or teen simply needs help coping with their stress, there are some very simple steps to take.

Help Your Teen Deal With Stress

None of this advice will seem new or groundbreaking to you. It's mostly common sense - but when things get stressful, common sense can go out the window. If your teen's stress is causing you so much stress you forget you already know what to do about it, consult the following list. It will help both you and your teenager get back on track.

How to Decrease Teen Stress

1. Make sure your teen eats healthy food regularly.

2. Make sure your teen gets plenty of exercise.

3. Make sure your teen gets plenty of outdoor time.

4. Make sure your teen gets plenty of sleep.

5. Avoid caffeine.

6. Avoid sodas and sugary snacks when possible.

7. Teach your teen basic mindfulness techniques, such as deep breathing, yoga, tai chi, or self-relaxation.

8. Encourage your teen to reframe self-talk from negative to positive. Instead of "I'm the worst at math," they can say "Math is challenging but I'm working on it every day."

9. Encourage your teen to spend time more time with positive friends. Sure, teenagers can be a moody bunch at times, but some glorify the doom and gloom. Help your teen know when enough is enough.

10. Take a break. If life is too scheduled, rigid, and filled with one activity after another, all day every day, consider a week off, spent doing simple things like listening to music, drawing, riding bikes, walking the dog, and talking to old friends.

Early Intervention Works

Left unaddressed, stress can lead to long-term health problems. Left untreated, anxiety can become a crippling psychological and emotional disorder. The good news is that there are proven-effective ways to address and treat both stress and anxiety. A stressed teenager can benefit from any and all activities on the list above, while a teen with a clinical anxiety disorder can benefit from professional treatment, which typically includes a combination of therapy, medication, and basic lifestyle adjustments. In both cases, the sooner you begin taking proactive steps to help a stressed out or anxious teen, the better. The most important thing for you to do, as a parent, is listen. That's the beginning: what you do next and how you help depends on what they say. The fix may be simple, or it may be complex, but it all starts with open, honest, and direct communication.

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Teen Stress and Anxiety: Facts and Statistics

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April is Stress Awareness Month. We will publish a series of helpful articles on the topic over the next few weeks, so keep checking back or follow us on Facebook to get notified. Stress is part of life for everyone. From children to adolescents to adults, we all deal with some amount of stress every day of our lives.

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Addressing Anxiety in School Settings: Information for Counselors 

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Addressing Anxiety in School Settings: Information for Counselors 

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WorryWiseKids.org | Red Flags for Anxiety: What's Normal, What's Not?

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© 2017 Worrywisekids.org/The Children's and Adult Center for OCD and Anxiety. Copying by permission only. Worrywisekids.org is brought to you by The Children's and Adult Center for OCD and Anxiety with support from

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How School Counselors Can Help with Anxiety

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How School Counselors Can Help with Anxiety

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Many professionals have seen a rise in the number of students who are exhibiting symptoms of anxiety in schools. As school counselors, we know that anxiety disorders can significantly impair children's social skills and academic success. Therefore, it is important that we educate teachers and staff about the signs to look for in students who may be experiencing anxiety related disorders.

Family relationships, grades, friends, health concerns and extracurricular performance are all things students may obsess over. Other signs may be a student needing constant reassurance, frequent nurse visits, physical complaints of stomachaches, headache and other physical symptoms without a known cause. Students may also do other avoiding behaviors and may appear inattentive, restless or irritable. Anxiety can also cause perfectionism. Kids need to know that a small amount of worry is normal, but that knowing how to be in control of your worries is essential to succeed at school.

Most school counselors focus on teaching coping skills instead of trying to be anxiety free. Students with anxiety may benefit greatly from small groups or short-term individual counseling to best learn helpful coping skills. School counselors can also implement school-wide anxiety reduction programs to teach all students coping skills and to reach the students with anxiety who have not been identified.

To help students with anxiety succeed in the classroom, 504 accommodations may be provided. Students may also need an Individualized Education Plan (IEP) to address another diagnosed disability that may affect their learning, and can then receive support for their anxiety as well. Some beneficial accommodations on 504s could be preferred seating, being allowed breaks, small group or separate location for testing, support for classroom presentations or participation, and pre-warning about fire drills or other drills.

Helping students change their mindset about their anxiety is crucial to their success. Helping students see their anxiety as a positive instead of a negative can empower them to learn about their anxiety, their triggers, and the best coping skills for them.

We experienced this with one student who was experiencing high anxiety in class and could never pinpoint a trigger. Over time, we were able to identify when she was experiencing an anxiety attack and the best methods for her to be able to return to class. She brought her own small "coping toolkit" to leave in the school counseling office for when she needed it. We developed a hand signal with her classroom teacher so the student could let her teacher know if she felt an anxiety attack coming on and needed to leave the room. Eventually, she was able to stay in the classroom and work through her anxiety without needing to leave and come to my office. It may take time for students to experience this type of success; however, the lifelong benefit is well worth it!

Kelli Conraads is WySCA president-elect and April Petty is WySCA treasurer and past president.

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How School Counselors Can Help with Anxiety

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Many professionals have seen a rise in the number of students who are exhibiting symptoms of anxiety in schools. As school counselors, we know that anxiety disorders can significantly impair children's social skills and academic success. Therefore, it is important that we educate teachers and staff about the signs to look for in students who may be experiencing anxiety related disorders.

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Data and Statistics on Children's Mental Health 

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Data and Statistics on Children's Mental Health 

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Centers for Disease Control and Prevention

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

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

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

Facts about mental health in U.S. children

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

Facts about mental disorders in U.S. children

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

ADHD 9.8% (approximately 6.0 million)

Anxiety 9.4% (approximately 5.8 million)

Behavior problems 8.9% (approximately 5.5 million)

Depression 4.4% (approximately 2.7 million)

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

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

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

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

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

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

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

Prevalence of mental disorders change with age

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

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

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

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

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

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

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

Access to mental health treatment

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

References

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

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

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

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

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

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

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

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Data and Statistics on Children's Mental Health | CDC

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Read data highlights about children's mental health.

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Verywell Mind - A List of Psychological Disorders

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Verywell Mind - A List of Psychological Disorders

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The term psychological disorders is sometimes used to refer to what are more frequently known as mental disorders or psychiatric disorders.

Mental disorders are patterns of behavioral or psychological symptoms that impact multiple areas of life. These disorders create distress for the person experiencing the symptoms.

The DSM-5-TR lists hundreds of distinct conditions. Anxiety and depression are among the most common types of mental health conditions that people experience. While the DSM provides diagnostic information about such conditions, including the age at which they typically appear, it does not provide guidelines for treatment or predictions related to the course of illness.

While not a comprehensive list of every mental disorder, the following list includes some of the major categories of disorders described in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) and the fifth edition, text revision (DSM-5-TR). The DSM is one of the most widely used systems for classifying mental disorders and provides standardized diagnostic criteria.

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Neurodevelopmental Disorders

Neurodevelopmental disorders are those that are typically diagnosed during infancy, childhood, or adolescence. These psychological disorders include:

Intellectual Development Disorder

Sometimes called intellectual disability, this type of developmental disorder originates prior to the age of 18 and is characterized by limitations in both intellectual functioning and adaptive behaviors.

Limitations to intellectual functioning are often identified through the use of IQ tests, with an IQ score under 70 often indicating the presence of a limitation. Adaptive behaviors are those that involve practical, everyday skills such as self-care, social interaction, and living skills.

Global Developmental Delay

This diagnosis is for developmental disabilities in children who are under the age of five. Such delays relate to cognition, social functioning, speech, language, and motor skills.

It is generally seen as a temporary diagnosis applying to kids who are still too young to take standardized IQ tests. Once children reach the age where they are able to take a standardized intelligence test, they may be diagnosed with an intellectual development disorder.

Communication Disorders

These disorders are those that impact the ability to use, understand, or detect language and speech. The DSM-5 identifies four different subtypes of communication disorders: language disorder, speech sound disorder, childhood-onset fluency disorder (stuttering), and social (pragmatic) communication disorder.

Autism Spectrum Disorder

Autism is characterized by persistent deficits in social interaction and communication in multiple life areas as well as restricted and repetitive patterns of behaviors.

The DSM specifies that symptoms of autism spectrum disorder must be present during the early developmental period and that these symptoms must cause significant impairment in important areas of life including social and occupational functioning.

Attention-Deficit Hyperactivity Disorder (ADHD)

ADHD is characterized by a persistent pattern of hyperactivity and impulsivity and/or inattention that interferes with functioning and presents itself in two or more settings such as at home, work, school, and social situations.

The DSM-5 specifies that several of the symptoms must have been present prior to the age of 12 and that these symptoms must have a negative impact on social, occupational, or academic functioning.

Bipolar and Related Disorders

Bipolar disorder is characterized by shifts in mood as well as changes in activity and energy levels. The disorder often involves experiencing shifts between elevated moods and periods of depression. Such elevated moods can be pronounced and are referred to either as mania or hypomania.

Mania is characterized by a distinct period of elevated, expansive, or irritable mood accompanied by increased activity and energy. Periods of mania are sometimes marked by feelings of distraction, irritability, and excessive confidence.

When mania progresses, there is also the possibility of psychotic symptoms such as grandiose delusions and hallucinations. While mania occurs with bipolar I disorder, hypomania is a marker of bipolar II.

Hypomanic episodes are characterized by elevated, expansive, or irritable moods like manic episodes. However, hypomania is less severe and generally shorter in duration than mania.

Depressive Episodes

These episodes are characterized by feelings of a depressed or sad mood along with a lack of interest in activities. They may also involve feelings of guilt, fatigue, and irritability. During a depressive period, people with bipolar disorder may lose interest in activities that they previously enjoyed, experience sleeping difficulties, and even have thoughts of suicide.

Both manic and depressive episodes can be frightening for both the person experiencing these symptoms as well as family, friends, and other loved ones who observe these behaviors and mood shifts. Fortunately, appropriate and effective treatments, which often include both medications and psychotherapy, can help people with bipolar disorder successfully manage their symptoms.

Anxiety Disorders

Anxiety disorders are characterized by excessive and persistent fear, worry, anxiety and related behavioral disturbances. Fear involves an emotional response to a threat, whether that threat is real or perceived. Anxiety involves the anticipation that a future threat may arise. Types of anxiety disorders include:

Generalized Anxiety Disorder (GAD)

This disorderis marked by excessive worry about everyday events. While some stress and worry are a common part of life, GAD involves worry that is so excessive that it interferes with a person's well-being and functioning.

Social Anxiety Disorder

Social anxiety disorder is a fairly common psychological disorder that involves an irrational fear of being watched, judged, humiliated, and/or embarrassed. The anxiety caused by this disorder can have a major impact on an individual's life and make it difficult to function at school, work, and other social settings.

Specific Phobias

These phobias involve an extreme fear of a specific object or situation in the environment. Some examples of common specific phobias include fear of spiders, fear of heights, or fear of snakes.

The four main types of specific phobias involve natural events (thunder, lightning, tornadoes), medical (medical procedures, dental procedures, medical equipment), animals (dogs, snakes, bugs), and situational (small spaces, leaving home, driving).

Panic Disorder

This psychiatric disorder is characterized by panic attacks that may seem to strike out of the blue and for no reason at all. Because of this, people with panic disorder often experience anxiety and preoccupation over the possibility of having another panic attack.

People may begin to avoid situations and settings where attacks have occurred in the past or where they might occur in the future. This can create significant impairments in many areas of everyday life and make it difficult to carry out everyday routines.

Separation Anxiety Disorder

This condition is a type of anxiety disorder involving an excessive amount of fear or anxiety related to being separated from attachment figures. People are often familiar with the idea of separation anxiety as it relates to young children's fear of being apart from their parents, but older children and adults can experience it as well.

The person experiencing these symptoms may avoid moving away from home, going to school, or getting married in order to remain in close proximity to the attachment figure.

Trauma- and Stressor-Related Disorders

Trauma- and stressor-related disorders involve exposure to a stressful or traumatic event. These were previously grouped with anxiety disorders but are now considered a distinct category of disorders. Disorders included in this category include:

Acute Stress Disorder

Acute stress disorder is characterized by the emergence of severe anxiety for up to one month after exposure to a traumatic event. Some examples of traumatic events include natural disasters, war, accidents, and witnessing a death.

As a result, the individual may experience dissociative symptoms such as a sense of altered reality, an inability to remember important aspects of the event, and vivid flashbacks as if the event were reoccurring. Other symptoms can include reduced emotional responsiveness, distressing memories of the trauma, and difficulty experiencing positive emotions.

Adjustment Disorders

Adjustment disorders can occur as a response to a sudden change such as divorce, job loss, end of a close relationship, a move, or some other loss or disappointment. This type of psychological disorder can affect both children and adults and is characterized by symptoms such as anxiety, irritability, depressed mood, worry, anger, hopelessness, and feelings of isolation.

Post-Traumatic Stress Disorder (PTSD)

PTSD can develop after an individual has experienced exposure to actual or threatened death, serious injury, or sexual violence. Symptoms of PTSD include episodes of reliving or re-experiencing the event, avoiding things that remind the individual about the event, feeling on edge, and having negative thoughts.

Reactive Attachment Disorder

Reactive attachment disorder can result when children do not form healthy relationships and attachments with adult caregivers during the first few years of childhood. Symptoms of the disorder include being withdrawn from adult caregivers and social and emotional disturbances that result from patterns of insufficient care and neglect.

Dissociative Disorders

Dissociative disorders are psychological disorders that involve a dissociation or interruption in aspects of consciousness, including identity and memory. Dissociative disorders include:

Dissociative Amnesia

This disorder involves a temporary loss of memory as a result of dissociation. In many cases, this memory loss, which may last for just a brief period or for many years, is a result of some type of psychological trauma.

Dissociative amnesia is much more than simple forgetfulness. Those who experience this disorder may remember some details about events but may have no recall of other details around a circumscribed period of time.

Dissociative Identity Disorder

Formerly known as multiple personality disorder, dissociative identity disorder involves the presence of two or more different identities or personalities in one person. Each of these personalities has its own way of perceiving and interacting with the environment.

People with this disorder experience changes in behavior, memory, perception, emotional response, and consciousness.

Depersonalization/Derealization Disorder

Depersonalization/derealization disorder is characterized by experiencing a sense of being outside of one's own body (depersonalization) and being disconnected from reality (derealization). People who have this disorder often feel a sense of unreality and an involuntary disconnect from their own memories, feelings, and consciousness.

Somatic Symptom Disorders

Formerly referred to as somatoform disorders, this category is now known as somatic symptom disorders. Somatic symptom disorders are a class of psychological disorders that involve prominent physical symptoms that may not have a diagnosable physical cause.

In contrast to previous ways of conceptualizing these disorders based on the absence of a medical explanation for the physical symptoms, the current diagnosis emphasizes the unusual thoughts, feelings, and behaviors that occur in response to these symptoms. Disorders included in this category are:

Somatic Symptom Disorder

Somatic symptom disorder involves a preoccupation with physical symptoms that make it difficult to function. This preoccupation with symptoms results in emotional distress and difficulty coping with daily life.

It is important to note that somatic symptoms do not indicate that individuals are faking their physical pain, fatigue, or other symptoms. In this situation, it is not so much the actual physical symptoms that are disrupting the individual's life as it is the extreme reaction and resulting behaviors.

Illness Anxiety Disorder

Illness anxiety disorder is characterized by excessive concern about having an undiagnosed medical condition. Those who experience this psychological disorder worry excessively about body functions and sensations are convinced that they have or will get a serious disease, and are not reassured, even when medical tests don't detect any illnesses.

Conversion Disorder

Conversion disorder involves experiencing motor or sensory symptoms that lack a compatible neurological or medical explanation. In many cases, a person develops the disorder after experiencing a real physical injury or stressful event, which then results in a psychological and emotional response.

Factitious Disorder

Factitious disorder used to have its own category, but it is now included under the somatic symptom and related disorders category of the DSM-5. A factitious disorder is when an individual intentionally creates, fakes, or exaggerates symptoms of illness. Munchausen syndrome, in which people feign an illness to attract attention, is one severe form of factitious disorder.

Feeding and Eating Disorders

Eating disorders are characterized by obsessive concerns with weight and disruptive eating patterns that negatively impact physical and mental health. Types of eating disorders include:

Anorexia Nervosa

Anorexia nervosais characterized by restricted food consumption that can lead to weight loss. Some people with anorexia are underweight, while others may be of average or above-average weight. Those who experience this disorder also have a preoccupation and fear of gaining weight as well as a distorted view of their own appearance and behavior.

Bulimia Nervosa

Bulimia nervosainvolves binge eating and then taking extreme steps to compensate for these binges. These compensatory behaviors might include self-induced vomiting, the abuse of laxatives or diuretics, or excessive exercise.

Rumination Disorder

Rumination disorder is marked by regurgitating previously chewed or swallowed food in order to either spit it out or re-swallow it. Rumination disorder can occur in infants, children, teens, and adults. It's also more common in people who have anxiety, depression, or another psychiatric disorder.

Pica involves craving and consuming non-food substances such as dirt, paint, or soap. Pica is more common among young children than adults, but it is also known to occur during pregnancy. A lack of nutrients may also trigger non-food cravings in some instances.

Binge Eating Disorder

Binge eating disorder involves episodes of binge eating where the individual consumes an unusually large amount of food during a short time period, such as a couple of hours.

People with binge-eating disorder often feel they have no control over their eating. Binge eating episodes are sometimes triggered by certain emotions such as feeling happy, anxious, or bored, or following stressful events.

Sleep-Wake Disorders

Sleep disorders involve an interruption in sleep patterns that leads to distress and affects daytime functioning. Examples of sleep disorders include:

Narcolepsy

Narcolepsy is a condition in which people experience an irrepressible need to sleep. People with narcolepsy may experience a sudden loss of muscle tone, also known as cataplexy.

They are also prone to hypnagogic hallucinations, which happen as someone falls asleep, and hypnopompic hallucinations, which happen as someone wakes up.

Insomnia Disorder

Insomnia disorder involves being unable to get enough sleep to feel rested. While all people experience sleeping difficulties and interruptions at some point, insomnia is considered a disorder when it is accompanied by significant distress or impairment over time.

Hypersomnolence

Hypersomnolence disorder is characterized by excessive sleepiness despite an adequate main sleep period. People with this condition may fall asleep during the day at inappropriate times such as at work and school.

Breathing-Related Sleep Disorders

Breathing-related sleep disorders are those that involve breathing anomalies-such as sleep apnea-that can occur during sleep. These breathing problems can result in brief interruptions in sleep that can lead to other problems including insomnia and daytime sleepiness.

Parasomnias

Parasomnia is a term that describes sleep disorders that feature unusual behaviors. Such disorders include sleepwalking, sleep terrors, sleep talking, and sleep eating.

Restless Legs Syndrome

Restless legs syndrome is a neurological condition that involves having uncomfortable sensations in the legs and an irresistible urge to move the legs in order to relieve the sensations. People with this condition may feel tugging, creeping, burning, and crawling sensations in their legs resulting in an excessive movement which then interferes with sleep.

Disruptive, Impulse Control and Conduct Disorders

Disruptive, impulse control and conduct disorders are those that involve an inability to control emotions and behaviors, resulting in harm to oneself or others.

These challenges with emotional and behavioral regulation are characterized by actions that violate the rights of others such as destroying property or physical aggression and/or those that conflict with societal norms, authority figures, and laws. These disorders include:

Kleptomania

Kleptomania involves an inability to control the impulse to steal. People who have kleptomania will often steal things that they do not really need or that have no real monetary value. Those with this condition experience escalating tension prior to committing a theft and feel relief and gratification afterwards.

Pyromania involves a fascination with fire that results in acts of fire-starting that endanger the self and others. People who struggle with pyromania purposefully and deliberately have set fires more than one time. They also experience tension and emotional arousal before setting a fire.

Intermittent Explosive Disorder

Intermittent explosive disorder is characterized by brief outbursts of anger and violence that are out of proportion to the situation. People with this disorder may erupt into angry outbursts or violent actions in response to everyday annoyances or disappointments.

Conduct Disorder

Conduct disorder is a condition diagnosed in children and adolescents under the age of 18 who regularly violate social norms and the rights of others. Children with this disorder display aggression toward people and animals, destroy property, steal and deceive, and violate other rules and laws. These behaviors result in significant problems in a child's academic or social functioning.

Oppositional Defiant Disorder

Oppositional defiant disorder begins prior to the age of 18 and is characterized by defiance, irritability, anger, aggression, and vindictiveness.

Depressive Disorders

The category of depressive disorders includes a number of conditions. They are all characterized by the presence of sad, empty, or irritable moods accompanied by physical and cognitive symptoms. They differ in terms of duration, timing, and causes. Some include:

Disruptive mood dysregulation disorder: A childhood condition characterized by extreme anger and irritability. Children display frequent and intense outbursts of temper.

Major depressive disorder: A condition characterized by loss of interest in activities and depressed mood which leads to significant impairments in how a person is able to function.

Persistent depressive disorder:This is a type of ongoing, chronic depression that is characterized by other symptoms of depression. While the symptoms are often less severe, they are longer lasting. Diagnosis requires experiencing a depressed mood on most days for a period of at least two years.

Other specified depressive disorder: This diagnosis is for cases when symptoms do not meet the criteria for the diagnosis of another depressive disorder, but they still create problems with an individual's life and functioning.

Premenstrual dysphoric disorder: This condition is a form of premenstrual syndrome (PMS) characterized by significant depression, irritability, and anxiety that begins a week or two before menstruation begins. Symptoms usually go away within a few days following bleeding.

Substance/medication-induced depressive disorder: This condition occurs when an individual experiences symptoms of a depressive disorder either while using alcohol or other substances or while going through withdrawal from a substance.

Depressive disorder due to another medical condition: This condition is diagnosed when a person's medical history suggests that their depressive symptoms may be the result of a medical condition. Medical conditions that may contribute to or cause depression include diabetes, stroke, Parkinson's disease, autoimmune conditions, chronic pain conditions, cancer, infections and HIV/AIDS.

Depressive disorders are all characterized by feelings of sadness and low mood that are persistent and severe enough to affect how a person functions.

The diagnostic criteria vary for each specific condition. For major depressive disorder, diagnosis requires an individual to experience five or more of the following symptoms over the same two-week period.

One of these symptoms must include either depressed mood or loss of interest or pleasure in previously enjoyed activities. Other symptoms can include:

Significant weight loss or gain

Decreased or increased appetite

Sleep disturbances (insomnia or hypersomnia)

Feelings of slowed physical activity or restlessness

Lack of energy or fatigue that lasts most or all of the day

Feelings of guilt or worthlessness

Difficulty thinking or concentrating

Preoccupation with death or thoughts of suicide

Treatments for depressive disorders often involve a combination of psychotherapy and medications.

Substance Use and Addictive Disorders

Substance-related disorders are those that involve the misuse of different substances such as cocaine, methamphetamine, opiates, and alcohol.

These disorders may include substance-induced conditions that can result in many associated diagnoses including intoxication, withdrawal, or the emergence of psychosis, anxiety, and delirium. Examples of substance-related disorders include:

Alcohol-related disorders: Theseinvolve the consumption of alcohol, one of the most widely used drugs in the United States.

Cannabis-related disorders: These disordersinclude symptoms such as using more marijuana than originally intended, feeling unable to stop it, and continuing to use it despite adverse effects in one's life.

Inhalant-use disorders: Theseinvolve inhaling fumes from things such as paints or solvents. As with other substance-related disorders, people with this condition experience cravings for the substance and find it difficult to control or stop engaging in the behavior.

Stimulant use disorder: Thisinvolves the use of stimulants such as meth, amphetamines, and cocaine.

Tobacco use disorder: This is characterized by symptoms such as consuming more tobacco than intended, difficulty cutting back or quitting, cravings, and experiencing adverse social consequences as a result of tobacco use.

Gambling Disorder

Neurocognitive Disorders

Neurocognitive disorders are characterized by acquired deficits in cognitive function. These disorders do not include those in which impaired cognition was present at birth or early in life. Types of cognitive disorders include:

Delirium is also known as acute confusional state. This disorder develops over a short period of time-usually a few hours or a few days-and is characterized by disturbances in attention and awareness.

Other Neurocognitive Disorders

Major and mild neurocognitive disorders have the primary feature of acquired cognitive decline in one or more areas including memory, attention, language, learning, and perception.

These cognitive disorders can be due to medical conditions including Alzheimer's disease, HIV infection, Parkinson's disease, substance/medication use, vascular disease, and others.

Schizophrenia Spectrum and Other Psychotic Disorders

Schizophrenia is a chronic psychiatric condition that affects a person's thinking, feeling, and behavior. It is a complex, long-term condition that affects less than 1% of people in the United States.

The DSM-5 diagnostic criteria specify that two or more symptoms of schizophrenia must be present for a period of at least one month.

One symptom must be one of the following:

Delusions: Beliefs that conflict with reality

Hallucinations: Seeing or hearing things that aren't really there

Disorganized speech: Words that do not follow the rules of language and may be difficult or impossible to understand

The second symptom may be one of the following:

Grossly disorganized or catatonic behavior: Confused thinking or bizarre behavior or movements

Negative symptoms: The inability to initiate plans, speak, express emotions, or feel pleasure

Diagnosis also requires significant impairments in social or occupational functioning for a period of at least six months. The onset of schizophrenia is usually in the late teens or early 20s, with men usually showing symptoms earlier than women. Earlier signs of the condition that may occur before diagnosis include poor motivation, difficult relationships, and poor school performance.

The National Institute of Mental Health suggests that multiple factors may play a role in the development of schizophrenia including genetics, brain chemistry, environmental factors, and substance use.

Obsessive-Compulsive and Related Disorders

Obsessive-compulsive and related disorders is a category of psychiatric conditions that include:

Each condition in this classification has its own set of diagnostic criteria.

Obsessive-Compulsive Disorder

The diagnostic criteria in the DSM-5 specify that in order to be diagnosed with obsessive-compulsive disorder, a person must experience obsessions, compulsions, or both.

Obsessions: Defined as recurrent, persistent thoughts, impulses, and urges that lead to distress or anxiety

Compulsions: Repetitive and excessive behaviors that the individual feels that they must perform to reduce anxiety or to prevent some dreaded outcome from occurring

Treatments for OCD usually focus on a combination of therapy and medications. Cognitive-behavioral therapy (CBT) or a form of CBT known as exposure and response prevention (ERP) are commonly used. Antidepressants such as Anafranil (clomipramine) or Prozac (fluoxetine) may also be prescribed to manage symptoms.

Personality Disorders

Personality disorders are characterized by an enduring pattern of maladaptive thoughts, feelings, and behaviors that can cause serious detriments to relationships and other life areas. Types of personality disorders include:

Antisocial Personality Disorder

Antisocial personality disorder is characterized by a long-standing disregard for rules, social norms, and the rights of others. People with this disorder typically begin displaying symptoms during childhood, have difficulty feeling empathy for others, and lack remorse for their destructive behaviors.

Avoidant Personality Disorder

Avoidant personality disorder involves severe social inhibition and sensitivity to rejection. Such feelings of insecurity lead to significant problems with the individual's daily life and functioning.

Borderline Personality Disorder

Borderline personality disorder is associated with symptoms including emotional instability, unstable and intense interpersonal relationships, unstable self-image, and impulsive behaviors.

Dependent Personality Disorder

Dependent personality disorder involves a chronic pattern of fearing separation and an excessive need to be taken care of. People with this disorder will often engage in behaviors that are designed to produce care-giving actions in others.

Histrionic Personality Disorder

Histrionic personality disorder is associated with patterns of extreme emotionality and attention-seeking behaviors. People with this condition feel uncomfortable in settings where they are not the center of attention, have rapidly changing emotions, and may engage in socially inappropriate behaviors designed to attract attention from others.

Narcissistic Personality Disorder

Narcissistic personality disorder is associated with a lasting pattern of exaggerated self-image, self-centeredness, and low empathy. People with this condition tend to be more interested in themselves than in others.

Obsessive-Compulsive Personality Disorder

Obsessive-compulsive personality disorder is a pervasive pattern of preoccupation with orderliness, perfectionism, inflexibility, and mental and interpersonal control. This is a different condition than obsessive compulsive disorder (OCD).

Paranoid Personality Disorder

Paranoid personality disorder is characterized by a distrust of others, even family, friends, and romantic partners. People with this disorder perceive others' intentions as malevolent, even without any evidence or justification.

Schizoid Personality Disorder

Schizoid personality disorder involves symptoms that include being detached from social relationships. People with this disorder are directed toward their inner lives and are often indifferent to relationships. They generally display a lack of emotional expression and can appear cold and aloof.

Schizotypal Personality Disorder

Schizotypal personality disorder features eccentricities in speech, behaviors, appearance, and thought. People with this condition may experience odd beliefs or magical thinking as well as difficulty forming relationships.

A Word From Verywell

Various factors influence a person's risk of developing a psychological disorder, including biological, social, environmental, cultural, and economic factors. Factors such as social support and coping skills can have protective effects.

Some conditions are short-term, while others may be lifelong. Conditions can also change over time.

Psychological disorders can cause disruptions in daily functioning, relationships, work, school, and other important domains. However, with appropriate diagnosis and treatment, people can find relief from their symptoms and discover ways to cope effectively.

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Explore a List of Psychological Disorders From the DSM-5

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Psychological disorders are grouped into different categories in the DSM-5. Explore this list of different types of mental disorders and how they are categorized.

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How Mental Health Disorders Affect Youth

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How Mental Health Disorders Affect Youth