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Emotional Disturbances Fact Sheet

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How common is major depression? At least 10% of people in the U.S. will experience major depressive disorder at some point in their lives. Two times as many women as men experience major depression.

How do we know that genes play a role in causing depression? Scientists look at patterns of illness in families to estimate their "heritability," or roughly what percentage of their cause is due to genes. To do this we find people with the disease who have a twin, and then find out whether the twin is also ill. Identical (monozygotic) twins share 100% of their genes, while non-identical ("fraternal" or dizygotic) twins share 50% of their genes. If genes are part of the cause, we expect a patient's identical twin to have a much higher risk of disease than a patient's non-identical twin. That is the case for major depression. Heritability is probably 40-50%, and might be higher for severe depression.

This could mean that in most cases of depression, around 50% of the cause is genetic, and around 50% is unrelated to genes (psychological or physical factors). Or it could mean that in some cases, the tendency to become depressed is almost completely genetic, and in other cases it is not really genetic at all. We don't know the answer yet.

We can also look at adoption studies, to see whether an adopted person's risk of depression is greater if a biological parent had depression. This also seems to be the case.

What about non-genetic factors? There are probably many non-genetic factors that increase risk of depression, many of which are probably not yet known. Severe childhood physical or sexual abuse, childhood emotional and physical neglect, and severe life stress are probably all risk factors. Losing a parent early in life probably also increases risk to some extent.

If someone has a family history of depression, are they at very high risk? If someone has a parent or sibling with major depression, that person probably has a 2 or 3 times greater risk of developing depression compared with the average person (or around 20-30% instead of 10%).

The situation is a little different if the parent or sibling has had depression more than once ("recurrent depression"), and if the depression started relatively early in life (childhood, teens or twenties). This form of depression is less common - the exact percentage of the population is not known, but is probably around 3-5%. But the siblings and children of people with this form of depression probably develop it at a rate that is 4 or 5 times greater than the average person.

Is there a "depression gene"? Some diseases are caused by a single defective gene. Cystic fibrosis, several kinds of muscular dystrophy, and Huntington's disease are examples. These are usually rare diseases. But many common disorders like depression, diabetes and high blood pressure are also influenced by genes. In these disorders, there seem to be combinations of genetic changes that predispose some people to become ill. We don't yet know how many genes are involved in depression, but it is very doubtful that any one gene causes depression in any large number of people.

So no one simply "inherits" depression from their mother or father. Each person inherits a unique combination of genes from their mother and father, and certain combinations can predispose to a particular illness.

How are major depression and bipolar disorder related? Most people who suffer from depression do not have episodes of mania. We use the term major depression for depression without mania. Most people who experience mania also have major depression. We use the term bipolar disorder (or manic-depression) for this pattern. Major depressive disorder and bipolar disorder are the two "major mood disorders." For more information on the symptoms of mania abd bipolar disorder, see the links at the bottom of this page. Most people with major depression do not have close relatives with bipolar disorder, but the relatives of people with bipolar disorder are at increased risk of both major depression and bipolar disorder.

What about major depression and anxiety disorders? There are probably genetic changes that can increase the predisposition to both major depression and to certain anxiety disorders including generalized anxiety disorder, panic disorder and social phobia. Also, some people have a more general lifelong tendency to experience unpleasant emotions and anxiety in response to stress. Psychologists use terms like "neuroticism" and "negative affectivity" to refer to this tendency, and people who have it are also more likely to experience major depression.

However, many people who develop major depression did not have this type of personality before their depression started.

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A research project at Stanford University's School of Medicine to find genes that contribute to depression.

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Can Children Really Suffer From Depression?

Yes. Childhood depression is different from the normal "blues" and everyday emotions that occur as a child develops. Just because a child seems sad doesn't necessarily mean he or she has significant depression. If the sadness becomes persistent, or interferes with normal social activities, interests, schoolwork, or family life, it may indicate that he or she has a depressive illness. Keep in mind that while depression is a serious illness, it is also a treatable one.

How Can I Tell if My Child Is Depressed?

The symptoms of depression in children vary. It is often undiagnosed and untreated because they are passed off as normal emotional and psychological changes that occur during growth. Early medical studies focused on "masked" depression, where a child's depressed mood was evidenced by acting out or angry behavior. While this does occur, particularly in younger children, many children display sadness or low mood similar to adults who are depressed. The primary symptoms of depression revolve around sadness, a feeling of hopelessness, and mood changes.

Signs and symptoms of depression in children include:

Irritability or anger

Continuous feelings of sadness and hopelessness

Social withdrawal

Increased sensitivity to rejection

Changes in appetite -- either increased or decreased

Changes in sleep -- sleeplessness or excessive sleep

Vocal outbursts or crying

Difficulty concentrating

Fatigue and low energy

Physical complaints (such as stomachaches, headaches) that don't respond to treatment

Reduced ability to function during events and activities at home or with friends, in school, extracurricular activities, and in other hobbies or interests

Feelings of worthlessness or guilt

Impaired thinking or concentration

Thoughts of death or suicide

Not all children have all of these symptoms. In fact, most will display different symptoms at different times and in different settings. Although some children may continue to function reasonably well in structured environments, most kids with significant depression will suffer a noticeable change in social activities, loss of interest in school and poor academic performance, or a change in appearance. Children may also begin using drugs or alcohol, especially if they are over age 12.

Although relatively rare in youths under 12, young children do attempt suicide -- and may do so impulsively when they are upset or angry. Girls are more likely to attempt suicide, but boys are more likely to actually kill themselves when they make an attempt. Children with a family history of violence, alcohol abuse, or physical or sexual abuse are at greater risk for suicide, as are those with depressive symptoms.

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Which Children Get Depressed?

Up to 3% of children and 8% of adolescents in the U.S. suffer from depression. Depression is significantly more common in boys under age 10. But by age 16, girls have a greater incidence of depression.

Bipolar disorder is more common in adolescents than in younger children. Bipolar disorder in children can, however, be more severe than in adolescents. It may also occur with, or be hidden by, attention deficit hyperactivity disorder ( ADHD), obsessive-compulsive disorder ( OCD), or conduct disorder (CD).

What Causes Depression in Children?

As in adults, depression in children can be caused by any combination of factors that relate to physical health, life events, family history, environment, genetic vulnerability and biochemical disturbance. Depression is not a passing mood, nor is it a condition that will go away without proper treatment.

Can Depression in Children Be Prevented?

Children with a family history of depression are at greater risk of experiencing depression themselves. Children who have parents that suffer from depression tend to develop their first episode of depression earlier than children whose parents do not. Children from chaotic or conflicted families, or children and teens who abuse substances like alcohol and drugs, are also at greater risk of depression.

How Is Depression Diagnosed in Children?

If the symptoms of depression in your child have lasted for at least two weeks, you should schedule a visit with his or her doctor to make sure there are no physical reasons for the symptoms and to make sure that your child receives proper treatment. A consultation with a mental health care professional who specializes in children is also recommended. Keep in mind that the pediatrician may ask to speak with your child alone.

A mental health evaluation should include interviews with you (the parent or primary caregiver) and your child, and any additional psychological testing that is necessary. Information from teachers, friends and classmates can be useful for showing that these symptoms are consistent during your child's various activities and are a marked change from previous behavior.

There are no specific tests -- medical or psychological -- that can clearly show depression, but tools such as questionnaires (for both the child and parents) combined with personal information, can be very useful in helping diagnose depression in children. Sometimes those therapy sessions and questionnaires can uncover other concerns that contribute to the depression such as ADHD, conduct disorder, and OCD.

Some pediatricians start using mental health screens at a child's 11th year well visit and each year after.

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What Are the Treatment Options?

Treatment options for children with depression are similar to those for adults, including psychotherapy (counseling) and medication. The role that family and the child's environment play in the treatment process is different from that of adults. Your child's doctor may suggest psychotherapy first, and consider antidepressant medicine as an additional option if there is no significant improvement. The best studies to date indicate that a combination of psychotherapy and medication is most effective at treating depression.

Studies show that the antidepressant Prozac is effective in treating depression in children and teens. The drug is officially recognized by the FDA for treatment of children ages 8 to 18 with depression. Other medications may be chosen if there are other coexisting illnesses contributing to the depression.

Treating Children With Bipolar Disorder

Children with bipolar disorder are usually treated with psychotherapy and a combination of medicines, usually an antidepressant and a mood stabilizer.

Antidepressants need to be used with caution, as they can trigger bouts of manic or hyperactive behavior in children with bipolar disorder. Managing a child's medication must be part of an overall care plan that includes therapy and routine primary care appointments.

The FDA warns that antidepressant medications may increase the risk of suicidal thinking and behavior in children and adolescents with depression and other psychiatric disorders. If you have questions or concerns, discuss them with your health care provider. Additionally, if your child is placed on these medications, it is still very important to continue to follow closely with the physician and therapist.

Long-Term Outlook

Studies have found that first-time depression in children is occurring at younger ages than previously. As in adults, depression may occur again later in life. Depression often occurs at the same time as other physical illnesses. And because studies have shown that depression may precede more serious mental illness later in life, diagnosis, early treatment and close monitoring are crucial.

As a parent, it is sometimes easier to deny that your child has depression. You may put off seeking the help of a mental health care professional because of the social stigmas associated with mental illness. It is very important for you -- as the parent -- to understand depression and realize the importance of treatment so that your child may continue to grow physically and emotionally in a healthy way. It is also important to seek education about the future effects depression may have on your child throughout adolescence and adulthood.

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Depression in Children: Warning Signs

Parents should be particularly vigilant for signs that may indicate that their child is at risk for suicide.

Warning signs of suicidal behavior in children include:

Many depressive symptoms (changes in eating, sleeping, activities)

Social isolation, including isolation from the family

Talk of suicide, hopelessness, or helplessness

Increased acting-out of undesirable behaviors (sexual/behavioral)

Increased risk-taking behaviors

Frequent accidents

Substance abuse

Focus on morbid and negative themes

Talk about death and dying

Increased crying or reduced emotional expression

Giving away possessions

Sources

SOURCE:

National Institute of Mental Health: "Depression in Children and Adolescents."

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Depression in Children: Symptoms and Common Types of Child Depression

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Yes. Childhood depression is different from the normal "blues" and everyday emotions that occur as a child develops. Just because a child seems sad doesn't necessarily mean he or she has significant depression. If the sadness becomes persistent, or interferes with normal social activities, interests, schoolwork, or family life, it may indicate that he or she has a depressive illness.

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Many people with obsessive compulsive disorder (OCD) know their behavior is unreasonable, but they're still unable to resist recurrent unwanted thoughts or stop engaging in repetitive actions.
Obsessive-compulsive disorder is a disorder in which a person has recurring obsessions (unwanted thoughts, ideas, images, or sensations) that lead to compulsions (repetitive behaviors or rituals). It is not officially classified as an anxiety disorder by the American Psychiatric Association, but it has similarities to anxiety disorders.

Although many people have thoughts that linger, or have a tendency to repeat certain routines or habits, these behaviors don't necessarily interfere with daily function and may even provide structure.

But in people with OCD, frequent, upsetting thoughts are persistent enough to cause severe anxiety, and not engaging in their routines or habits can cause them great distress.

Jonathan Abramowitz, PhD, a professor of psychology at the University of North Carolina at Chapel Hill and the editor in chief of the Journal of Obsessive-Compulsive and Related Disorders, says having OCD does not mean your brain is damaged or beyond help.

"You need to have a brain to have OCD, but there is no evidence that people with OCD have diseased brains, bad genes, or broken neurotransmitter systems," he says. "Actually, everyone has unwanted thoughts, and everyone has anxiety sometimes. The whole idea of really overcoming OCD is learning that you can tolerate these experiences, and they don't have to stop you from doing what's important in your life. When you stop fighting anxiety and obsessions, that's ironically when the anxiety and obsessions stop bullying you."

How Common Is OCD?

According to the National Institutes of Mental Health, 1.2 percent of the U.S. adult population experiences OCD within a given year. Almost 51 percent of these people experience severe OCD symptoms.

On average, OCD begins around age 19, with boys generally having an earlier age of onset than girls.

What Causes OCD?

Scientists still don't know the exact causes of OCD. But researchers believe the following might contribute to the condition:

Genetics OCD sometimes runs in families. You have a higher risk of developing OCD if you have a parent, sibling, or child with the disorder.

Brain structure OCD symptoms may be connected to differences in certain areas of the brain, but research is still ongoing.

Early childhood trauma Experiencing physical or sexual abuse at a young age increases your risk of developing OCD or an anxiety disorder.

Childhood streptococcal infections This can sometimes cause OCD symptoms known as pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections, or PANDAS.

What Are the Symptoms of OCD?

Most people with OCD experience both obsessions and compulsions, although some people may only develop one or the other. Others may also have vocal or motor (movement) tics.

Common obsessions include:

Excessive fear of germs, dirt, or contamination

Forbidden sexual or religious thoughts

Concern with order, symmetry, or exactness

Aggressive thoughts about doing harm to yourself or others

Repeatedly thinking about certain words, sounds, or numbers

Common compulsions include:

Excessively washing yourself or cleaning your surroundings

Repeatedly uttering the same phrase or counting to the same number

Repeating actions, such as going in and out of a doorway or sitting down and getting up from a chair

Ordering or arranging items in a specific way (keeping things in perfect order or symmetry)

Repeatedly checking on certain things, such as whether a door is locked or the oven is off

Saving things that are no longer needed (hoarding)

Constantly praying silently or engaging in other religious rituals.

How Is OCD Diagnosed?

Diagnosis of OCD typically involves a physical exam and lab tests to rule out other causes of the symptoms, as well as a psychological examination. Because the symptoms can be so diverse, and it can be hard to admit to them, it can sometimes take a long time - an estimated 11 years, on average - for a person to receive a diagnosis.

In order to be diagnosed with the disorder, you have to meet several specific criteria set forth by the American Psychiatric Association. (3) One criterion is that you spend at least an hour a day engaging in obsessions and compulsions, and experience significant problems in social, professional, or other contexts because of them.

What Is the Treatment for OCD?

Treatment for OCD may involve therapy and medication, but, says Dr. Abramowitz, research suggests that medications for OCD are only partially effective. "Cognitive behavioral therapy, using the techniques of exposure and response prevention, have the best and most consistent research support for OCD," he says.

Cognitive behavioral therapy (CBT) aims to teach people with OCD skills to better manage and reduce obsessive thoughts, compulsive behaviors, and anxiety.

Exposure and response prevention, or ERP, is a form of CBT used to treat certain phobias. It involves gradual and repeated exposure to a feared situation or object, and encourages you to refrain from engaging in the compulsions brought on by the situation or object, causing you to become less fearful over time.

For example, if you can't leave the house without checking that you've locked the front door, your therapist would work with you to try leaving the house without double-checking, until the distress at not checking decreases significantly.

Noah Clyman, a licensed clinical social worker and the director of NYC Cognitive Therapy, a private psychotherapy practice in Manhattan, says that exposure therapy can help those with OCD find a way to understand and then relinquish the habits that disrupt their daily lives.

"I tell patients that when they confront situations that cause them distress, and they stay in the situation for long enough without escaping or doing rituals, they'll learn several things," he says. "They'll learn that the anxiety does not last forever. In fact, it decreases even without escaping, avoiding, or ritualizing. Also, they'll find out that as their anxiety decreases, their urge to ritualize and to escape from the situation also decreases."

These are the antidepressants that are frequently prescribed to those with OCD:

Luvox (fluvoxamine)

Prozac (fluoxetine)

Zoloft (sertraline)

Anafranil (clomipramine)

In addition, meditation, yoga, and massage therapy may help ease the stress and anxiety caused by OCD.

Deep brain stimulation may also help the 10 percent of people with treatment-resistant OCD. ( 4)

What Is the Difference Between OCD and Obsessive-Compulsive Personality Disorder?

There are two main differences between OCD and obsessive-compulsive personality disorder (OCPD).

The first difference has to do with insight. People with obsessive-compulsive personality disorder often think that their thoughts are correct. They may even feel entitled to their responses or reactions,and may not think they should get treatment.

In addition, OCPD affects someone's way of relating to others, whereas OCD causes certain thoughts and behaviors, such as hand-washing or counting.

In order to be diagnosed with OCPD, a person must have at least four of the following symptoms:

Overly devoted to work at the expense of personal relationships

Unable to throw things away, even when the objects have no value

Rigid moral or ethical beliefs

Lack of financial generosity

Not wanting to allow other people to do things

Fixation on lists, details, and regulations

Perfectionism that interferes with an ability to complete tasks

It's of course possible to possess these qualities without having the disorder. To be diagnosed with OCPD, these qualities have to seriously disrupt your personal and professional relationships. And, as mentioned above, those with OCPD may not think they need to be treated.

Similar to OCD, the best treatment for obsessive-compulsive personality disorder is talk therapy, and medications may also help reduce the anxiety and depression that can be associated with OCPD.

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What Is Obsessive-Compulsive Disorder (OCD)?

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Many people with obsessive compulsive disorder (OCD) know their behavior is unreasonable, but they're still unable to resist recurrent unwanted thoughts or stop engaging in repetitive actions. Obsessive-compulsive disorder is a disorder in which a person has recurring obsessions (unwanted thoughts, ideas, images, or sensations) that lead to compulsions (repetitive behaviors or rituals).

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

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

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https://paradigmtreatment.com/obsessive-compulsive-disorder-teen-young-adult/

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www.litthousestudio.net/anxiety-awareness

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Generalized anxiety disorder (GAD) is characterized by excessive and uncontrollable worry about a variety of events. It is often accompanied by physical symptoms such as headaches, muscular tension, restlessness, heart palpitations, and stomach upset. Children and adolescents with GAD may worry excessively about their performance and competence at school or in sporting events, about personal safety and the safety of family members, or about natural disasters and future events.

The difference between normal feelings of anxiety and the presence of generalized anxiety disorder is that children with GAD worry more often and more intensely than other children in the same circumstances. Children with GAD tend to worry about the same things as their non-anxious peers but they do so in excess. These worries and associated symptoms cause significant distress and impair daily functioning. Children with GAD are often overly self-critical and avoid activities in which they feel that may not be able to perform perfectly. They also tend to seek frequent reassurance from caregivers, teachers, and others about their performance, although this reassurance only provides only fleeting relief from their worries.

GAD is relatively common disorder among children and adolescents. It begins gradually, often in childhood or adolescence, with symptoms that may worsen during times of stress. Worries may switch from one concern to another and may change with time and age. GAD may result in significant academic, social, and familial impairment. If left untreated, the disorder may be chronic and predicative of adulthood anxiety and depression. However, early identification and effective management can help reduce the severity of symptoms. Psychotherapeutic approaches, including cognitive-behavioral therapy, are among the most researched and promising treatments for childhood anxiety. In certain instances, medication in combination with psychotherapy, may also recommended for treatment of generalized anxiety disorder.

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Generalized anxiety disorder (GAD) is characterized by excessive and uncontrollable worry about a variety of events. It is often accompanied by physical symptoms such as headaches, muscular tension, restlessness, heart palpitations, and stomach upset.

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Overview

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

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

Signs and Symptoms

Risk Factors

Treatments and Therapies

Join a Study

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

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What Is ADHD?

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

What Are the Signs of ADHD?

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

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

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

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

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

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

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

How Is ADHD Diagnosed?

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

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

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

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

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

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

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

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

How Is ADHD Treated?

Treatment for ADHD usually includes:

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

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

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

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

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

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

What Can Parents Do?

If your child is diagnosed with ADHD:

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

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

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

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

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

What Causes ADHD?

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

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

ADHD can improve when kids get treatment, eat healthy food, get enough sleep and exercise, and have supportive parents who know how to respond to ADHD.
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What Is ADHD? ADHD stands for attention deficit hyperactivity disorder. It is a medical condition. A person with ADHD has differences in brain development and brain activity that affect attention, the ability to sit still, and self-control. ADHD can affect a child at school, at home, and in friendships.

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Karla Mosley wants you to know that people with eating disorders look like her too.

"I'm a woman of color and I certainly didn't know that people like me had eating disorders," she says. "I thought it was a white, rich, female, adolescent disorder."

Only one of those identifiers fits Mosley who's black and binged and purged for years. But Mosley, an actor and a regular on the day time soap, The Bold and the Beautiful, is sharing her story of battling bulimia and getting her health back.

She's part of a growing movement of people of color working to raise awareness in their own communities, and among researchers in the field, about how these disorders affect people of all backgrounds - and body types.

Mosley says she struggled for years with obsessive thoughts about food.

"I've experienced so many holidays and social events where I wasn't present with people because I was focusing on what was on the table, what was going in my mouth, then once I ate it, 'Is it going to make me fat the next day?' " she says.

Food haunted her at times. And it comforted her, at others. When she threw up, she says it was a way to purge pent up sadness and anxiety.

She says there was a time in her life when she was throwing up every single night. That was during a period in the early 2000s when she was working on a kids show, and hit rock bottom.

"At night, I was doing this very violent thing by myself, up all night, and during the day, I was smiling and laughing and entertaining children," she recalls. "It was this very strange Dr. Jekyll, Mr. Hyde moment and I was barely keeping it together."

Then her aunt, who was like a second mom, passed away. And, when she got that news, the first thing she did was run to the bathroom to throw up.

Her colleagues were aware this was going on...and begged her to get help.

She did. She sought treatment 16 years ago and she says she has been free from her eating disorder behaviors for the past decade.

She says she was lucky to have colleagues who supported her, and she knows not everyone has that luxury. Sharing the story of her eating disorder and her recovery is Mosley's way of giving back and she uses her platform as a black actor with 60,000 Instagram followers.

"My picture shows up in their feed every day, that's a wide range of people ... It's possible that by my telling my story, people can be helped," she says.

Mosley is an ambassador for the largest non-profit in the U.S. helping people affected by eating disorders: The National Eating Disorder Association or NEDA. Over the past week, NEDA has been running its annual Eating Disorder Awareness campaign, focused on the theme of inclusivity, with the tagline: Come As You Are. The organization encourages people to share their stories using the hashtag #ComeAsYouAre.

NEDA's CEO Claire Mysko says she hopes people of all genders and racial and ethnic backgrounds participate.

"It's really about, again, celebrating community and busting these myths that prevent and have prevented so many people from coming forward," she says.

Mysko says 30 million Americans have struggled with an eating disorder at some point in their lives. And, that number's probably higher, because the stereotype of who has an eating disorder affects how we talk about them, who seeks treatment, who gets treatment and how they're treated.

Another myth that groups like NEDA want to dispel is the idea that people with eating disorders are all thin.

Chevese Turner, who founded the Binge Eating Disorder Association, or BEDA, in 2008, says that's just not true.

She's struggled with both binge eating disorder and atypical anorexia - that's when you restrict your food intake and your calories, but you don't look especially thin.

"I have always lived in a higher weight body," she says. "Part of what the greater eating disorders community back in 2008 was not doing was really representing people in higher weight bodies with eating disorders."

Binge eating disorder wasn't recognized in the American Psychiatric Association's diagnostic manual until 2013. Turner helped push for that change.

And, now that there's more research on binge eating, she says demographic data is emerging.

"The Latino community actually has the highest rates of binge-eating disorder and they're followed by the black community," she says.

Mae Lynn Reyes-Rodriguez, a psychology researcher specializing in eating disorders, works primarily with unacculturated Latinas. She found that binge eating was common among her patients who crossed the border from Central America and Mexico and who had gone without food for much of the journey.

So, food insecurity may be a trigger. Trauma may also be a trigger, as well as anxiety and depression. But Reyes-Rodriguez says there's so much we don't know about how disordered eating affects the Latinx community. She's not even sure the tools she's using to diagnose her clients are working as well as they could be because they were developed and adapted for white women.

Turner, who's white, wanted to address the lack of representation in the eating disorder advocacy world.

She invited an equity and inclusion expert, Desiree Adaway - who's black - to speak at the Binge Eating Disorder Association's annual conference a few years ago.

She says, Adaway got up on stage and said: "I just want to let you all know that this is a room full of white supremacy."

"Until that point I had not really realized just how white our organizations were and just how much we were not listening," says Turner.

Turner's organization recently merged with NEDA to, "unify the eating disorder community."

NEDA's Mysko says they have a lot of work ahead when it comes to being more inclusive.

"As a white woman. I'm sort of putting forward that typical picture of who struggles," she says.

NEDA doesn't have a Latinx ambassador yet. But, they reached out to Gloria Lucas to help get the word out about Come As You Are.

Lucas says she felt the eating disorder community wasn't serving her needs as a Latina with an eating disorder who identifies as "chubby."

Her project, Nalgona Positivity Pride, provides information and support to people of color struggling with disordered eating.

"Nalgona means a woman with a big butt. and it's also slang, so I think that people relate to that," she says. "Common people, that speak Spanish are like, 'Oh, this is familiar.' "

Lucas shares body-positive images and inspirational quotes to her 80,000 Instagram followers. She also gives talks at schools, universities and in bilingual book stores, wherever she can gather an audience of people of color to share her recovery story.

She talks about how she came to the realization that trying to prove her worth in a society that doesn't value her was making her sick. Lucas says she believes that racism and historical trauma from colonialism play a significant role in why the Latinx community has eating problems.

She says she couldn't afford treatment for her eating disorder. So she sought help on her own, looking up information online, reading books and attending Overeaters Anonymous meetings.

"It was the only free resource for me at that time and I was always the youngest or the only person of color," she says. "I don't recommend that to anybody because it's extremely hard."

She credits something she read in the book, A Hunger So Wide and So Deep, by Becky Thompson for helping her to stop blaming herself for binge eating.

"She states how eating disorders are sane reactions to insane circumstances," Lucas says.

She hopes that idea resonates with other people of color who haven't acknowledged their eating problems because of shame or embarrassment.

"I think that 'Come as you are' is like everybody from all different types of backgrounds," she says. "Come as you are and talk about our struggles with food, right? Because eating disorders thrive in isolation."

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When It Comes To Race, Eating Disorders Don't Discriminate

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Karla Mosley wants you to know that people with eating disorders look like her too. "I'm a woman of color and I certainly didn't know that people like me had eating disorders," she says. "I thought it was a white, rich, female, adolescent disorder."

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National Institute of Mental Health (NIMH)

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

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Center for Parent Information and Resources

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Center for Parent Information and Resources

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Center for Parent Information & Resources

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Child Mind Institute Homepage

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https://www.jenkeyte.com/emotional-disturbance.html

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Home - ADDA - Attention Deficit Disorder Association

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

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Can Children Really Suffer From Depression?

Yes. Childhood depression is different from the normal "blues" and everyday emotions that occur as a child develops. Just because a child seems sad doesn't necessarily mean he or she has significant depression. If the sadness becomes persistent, or interferes with normal social activities, interests, schoolwork, or family life, it may indicate that he or she has a depressive illness. Keep in mind that while depression is a serious illness, it is also a treatable one.

How Can I Tell if My Child Is Depressed?

The symptoms of depression in children vary. It is often undiagnosed and untreated because they are passed off as normal emotional and psychological changes that occur during growth. Early medical studies focused on "masked" depression, where a child's depressed mood was evidenced by acting out or angry behavior. While this does occur, particularly in younger children, many children display sadness or low mood similar to adults who are depressed. The primary symptoms of depression revolve around sadness, a feeling of hopelessness, and mood changes.

Signs and symptoms of depression in children include:

Irritability or anger

Continuous feelings of sadness and hopelessness

Social withdrawal

Increased sensitivity to rejection

Changes in appetite -- either increased or decreased

Changes in sleep -- sleeplessness or excessive sleep

Vocal outbursts or crying

Difficulty concentrating

Fatigue and low energy

Physical complaints (such as stomachaches, headaches) that don't respond to treatment

Reduced ability to function during events and activities at home or with friends, in school, extracurricular activities, and in other hobbies or interests

Feelings of worthlessness or guilt

Impaired thinking or concentration

Thoughts of death or suicide

Not all children have all of these symptoms. In fact, most will display different symptoms at different times and in different settings. Although some children may continue to function reasonably well in structured environments, most kids with significant depression will suffer a noticeable change in social activities, loss of interest in school and poor academic performance, or a change in appearance. Children may also begin using drugs or alcohol, especially if they are over age 12.

Although relatively rare in youths under 12, young children do attempt suicide -- and may do so impulsively when they are upset or angry. Girls are more likely to attempt suicide, but boys are more likely to actually kill themselves when they make an attempt. Children with a family history of violence, alcohol abuse, or physical or sexual abuse are at greater risk for suicide, as are those with depressive symptoms.

Continued

Which Children Get Depressed?

Up to 3% of children and 8% of adolescents in the U.S. suffer from depression. Depression is significantly more common in boys under age 10. But by age 16, girls have a greater incidence of depression.

Bipolar disorder is more common in adolescents than in younger children. Bipolar disorder in children can, however, be more severe than in adolescents. It may also occur with, or be hidden by, attention deficit hyperactivity disorder ( ADHD), obsessive-compulsive disorder ( OCD), or conduct disorder (CD).

What Causes Depression in Children?

As in adults, depression in children can be caused by any combination of factors that relate to physical health, life events, family history, environment, genetic vulnerability and biochemical disturbance. Depression is not a passing mood, nor is it a condition that will go away without proper treatment.

Can Depression in Children Be Prevented?

Children with a family history of depression are at greater risk of experiencing depression themselves. Children who have parents that suffer from depression tend to develop their first episode of depression earlier than children whose parents do not. Children from chaotic or conflicted families, or children and teens who abuse substances like alcohol and drugs, are also at greater risk of depression.

How Is Depression Diagnosed in Children?

If the symptoms of depression in your child have lasted for at least two weeks, you should schedule a visit with his or her doctor to make sure there are no physical reasons for the symptoms and to make sure that your child receives proper treatment. A consultation with a mental health care professional who specializes in children is also recommended. Keep in mind that the pediatrician may ask to speak with your child alone.

A mental health evaluation should include interviews with you (the parent or primary caregiver) and your child, and any additional psychological testing that is necessary. Information from teachers, friends and classmates can be useful for showing that these symptoms are consistent during your child's various activities and are a marked change from previous behavior.

There are no specific tests -- medical or psychological -- that can clearly show depression, but tools such as questionnaires (for both the child and parents) combined with personal information, can be very useful in helping diagnose depression in children. Sometimes those therapy sessions and questionnaires can uncover other concerns that contribute to the depression such as ADHD, conduct disorder, and OCD.

Some pediatricians start using mental health screens at a child's 11th year well visit and each year after.

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What Are the Treatment Options?

Treatment options for children with depression are similar to those for adults, including psychotherapy (counseling) and medication. The role that family and the child's environment play in the treatment process is different from that of adults. Your child's doctor may suggest psychotherapy first, and consider antidepressant medicine as an additional option if there is no significant improvement. The best studies to date indicate that a combination of psychotherapy and medication is most effective at treating depression.

Studies show that the antidepressant Prozac is effective in treating depression in children and teens. The drug is officially recognized by the FDA for treatment of children ages 8 to 18 with depression. Other medications may be chosen if there are other coexisting illnesses contributing to the depression.

Treating Children With Bipolar Disorder

Children with bipolar disorder are usually treated with psychotherapy and a combination of medicines, usually an antidepressant and a mood stabilizer.

Antidepressants need to be used with caution, as they can trigger bouts of manic or hyperactive behavior in children with bipolar disorder. Managing a child's medication must be part of an overall care plan that includes therapy and routine primary care appointments.

The FDA warns that antidepressant medications may increase the risk of suicidal thinking and behavior in children and adolescents with depression and other psychiatric disorders. If you have questions or concerns, discuss them with your health care provider. Additionally, if your child is placed on these medications, it is still very important to continue to follow closely with the physician and therapist.

Long-Term Outlook

Studies have found that first-time depression in children is occurring at younger ages than previously. As in adults, depression may occur again later in life. Depression often occurs at the same time as other physical illnesses. And because studies have shown that depression may precede more serious mental illness later in life, diagnosis, early treatment and close monitoring are crucial.

As a parent, it is sometimes easier to deny that your child has depression. You may put off seeking the help of a mental health care professional because of the social stigmas associated with mental illness. It is very important for you -- as the parent -- to understand depression and realize the importance of treatment so that your child may continue to grow physically and emotionally in a healthy way. It is also important to seek education about the future effects depression may have on your child throughout adolescence and adulthood.

Continued

Depression in Children: Warning Signs

Parents should be particularly vigilant for signs that may indicate that their child is at risk for suicide.

Warning signs of suicidal behavior in children include:

Many depressive symptoms (changes in eating, sleeping, activities)

Social isolation, including isolation from the family

Talk of suicide, hopelessness, or helplessness

Increased acting-out of undesirable behaviors (sexual/behavioral)

Increased risk-taking behaviors

Frequent accidents

Substance abuse

Focus on morbid and negative themes

Talk about death and dying

Increased crying or reduced emotional expression

Giving away possessions

Sources

SOURCE:

National Institute of Mental Health: "Depression in Children and Adolescents."

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Depression in Children: Symptoms and Common Types of Child Depression

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Yes. Childhood depression is different from the normal "blues" and everyday emotions that occur as a child develops. Just because a child seems sad doesn't necessarily mean he or she has significant depression. If the sadness becomes persistent, or interferes with normal social activities, interests, schoolwork, or family life, it may indicate that he or she has a depressive illness.

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A Closer Examination of BiPolar Disorder in Schoolage Children

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Teaching Strategies (ADHD & Conduct Disorders)

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Teaching Strategies (ADHD & Conduct Disorders)

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

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

1. Emotional and Behavior Disorders (EBD)

2. Emotional Conflict (EC)

3. Serious Emotional Disturbance (SED)

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

General Strategies

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

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

Teacher Presentation

Laboratory

Group Interaction and Discussion

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

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

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

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

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

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

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

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

Reading

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

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

2. Reading in group or with others.

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

4. Demonstrating appropriate reading

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

Research

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

2. Use appropriate laboratory and field strategies.

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

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

Field Experiences

1. Use appropriate general strategies.

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

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

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

5. Use a buddy system.

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

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

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

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

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

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

Testing

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

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

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

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

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

Organizations

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

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

Resources

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

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

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Behavioral disorders also known as conduct disorders are one of the most common forms of disability among children and young adults and is the most frequently cited reason for referral to mental health services. The appearance of behavioral disorders is increasing dramatically in our K-12 classrooms. As a result, their presence severely constrains the ability of the school systems to educate students effectively.

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

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Working to deliver a better special education service

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National Eating Disorders Educator Toolkit

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National Eating Disorders Educator Toolkit

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National Institute of Mental Health (NIMH)

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Learn about obsessive-compulsive disorder, including signs and symptoms, risk factors, treatments and therapies, and links to other resources to learn more.

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Credit: Julius-Maximilians-Universität Würzburg, JMU

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

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

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

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

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

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

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

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

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

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

Provided by Julius-Maximilians-Universität Würzburg

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