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Dysfunctional Disorders

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All young children can be naughty, defiant and impulsive from time to time, which is perfectly normal. However, some children have extremely difficult and challenging behaviours that are outside the norm for their age.

The most common disruptive behaviour disorders include oppositional defiant disorder (ODD), conduct disorder (CD) and attention deficit hyperactivity disorder (ADHD) . These three behavioural disorders share some common symptoms, so diagnosis can be difficult and time consuming. A child or adolescent may have two disorders at the same time. Other exacerbating factors can include emotional problems, mood disorders, family difficulties and substance abuse.

Oppositional defiant disorder

Around one in 10 children under the age of 12 years are thought to have oppositional defiant disorder (ODD), with boys outnumbering girls by two to one. Some of the typical behaviours of a child with ODD include:

easily angered, annoyed or irritated

frequent temper tantrums

argues frequently with adults, particularly the most familiar adults in their lives, such as parents

refuses to obey rules

seems to deliberately try to annoy or aggravate others

low self-esteem

low frustration threshold

seeks to blame others for any misfortunes or misdeeds.

Conduct disorder

Children with conduct disorder (CD) are often judged as 'bad kids' because of their delinquent behaviour and refusal to accept rules. Around 5 per cent of 10 year olds are thought to have CD, with boys outnumbering girls by 4 to one. Around one-third of children with CD also have attention deficit hyperactivity disorder (ADHD).

Some of the typical behaviours of a child with CD may include:

frequent refusal to obey parents or other authority figures

repeated truancy

tendency to use drugs, including cigarettes and alcohol, at a very early age

lack of empathy for others

being aggressive to animals and other people or showing sadistic behaviours including bullying and physical or sexual abuse

keenness to start physical fights

using weapons in physical fights

frequent lying

criminal behaviour such as stealing, deliberately lighting fires, breaking into houses and vandalism

a tendency to run away from home

suicidal tendencies - although these are more rare.

Attention deficit hyperactivity disorder

Around 2 to 5 per cent of children are thought to have attention deficit hyperactivity disorder (ADHD), with boys outnumbering girls by three to one. The characteristics of ADHD can include:

Inattention - difficulty concentrating, forgetting instructions, moving from one task to another without completing anything.

Impulsivity - talking over the top of others, having a 'short fuse', being accident-prone.

Overactivity - constant restlessness and fidgeting.

Risk factors in children's behavioural disorders

The causes of ODD, CD and ADHD are unknown but some of the risk factors include:

Gender - boys are much more likely than girls to suffer from behavioural disorders. It is unclear if the cause is genetic or linked to socialisation experiences.

Gestation and birth - difficult pregnancies, premature birth and low birth weight may contribute in some cases to the child's problem behaviour later in life.

Temperament - children who are difficult to manage, temperamental or aggressive from an early age are more likely to develop behavioural disorders later in life.

Family life - behavioural disorders are more likely in dysfunctional families. For example, a child is at increased risk in families where domestic violence, poverty, poor parenting skills or substance abuse are a problem.

Learning difficulties - problems with reading and writing are often associated with behaviour problems.

Intellectual disabilities - children with intellectual disabilities are twice as likely to have behavioural disorders.

Brain development - studies have shown that areas of the brain that control attention appear to be less active in children with ADHD.

Diagnosis of children's behavioural disorders

Disruptive behavioural disorders are complicated and may include many different factors working in combination. For example, a child who exhibits the delinquent behaviours of CD may also have ADHD, , , and a difficult home life.

Diagnosis methods may include:

Diagnosis by a specialist service, which may include a paediatrician, psychologist or child psychiatrist

In-depth interviews with the parents, child and teachers

Behaviour checklists or standardised questionnaires.

A diagnosis is made if the child's behaviour meets the criteria for disruptive behaviour disorders in the Diagnostic and Statistical Manual of Mental Disorders from the American Psychiatric Association.

It is important to rule out acute stressors that might be disrupting the child's behaviour. For example, a sick parent or victimising by other children might be responsible for sudden changes in a child's typical behaviour and these factors have to be considered initially.

Treatment of behavioural disorders in children

Untreated children with behavioural disorders may grow up to be dysfunctional adults. Generally, the earlier the intervention, the better the outcome is likely to be.

A large study in the United States, conducted for the National Institute of Mental Health and the Office of School Education Programs, showed that carefully designed medication management and behavioural treatment for ADHD improved all measures of behaviour in school and at home.

Treatment is usually multifaceted and depends on the particular disorder and factors contributing to it, but may include:

Parental education - for example, teaching parents how to communicate with and manage their children.

Family therapy - the entire family is helped to improve communication and problem-solving skills.

Cognitive behavioural therapy - to help the child to control their thoughts and behaviour.

Social training - the child is taught important social skills, such as how to have a conversation or play cooperatively with others.

Anger management - the child is taught how to recognise the signs of their growing frustration and given a range of coping skills designed to defuse their anger and aggressive behaviour. Relaxation techniques and stress management skills are also taught.

Support for associated problems - for example, a child with a learning difficulty will benefit from professional support.

Encouragement - many children with behavioural disorders experience repeated failures at school and in their interactions with others. Encouraging the child to excel in their particular talents (such as sport) can help to build self-esteem.

Medication - to help control impulsive behaviours.

Where to get help

Your - for a referral to a specialist service below

Child psychologist

Child psychiatrist

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Untreated behavioural disorders in children may mean they grow up to be dysfunctional adults.

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Anxiety is a mental health disorder characterized by feeling of wrong, anxiety or fears that are strong enough to interfere with one's daily activities

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By: Claire McCarthy, MD, FAAP

According to the National Institutes of Health, nearly 1 in 3 of all adolescents ages 13 to 18 will experience an anxiety disorder. These numbers have been rising steadily; between 2007 and 2012, anxiety disorders in children and teens went up 20%.

These stats combined with the rate of hospital admissions for suicidal teenagers also doubling over the past decade leaves us with many concerning questions.

What's causing the rise in teenagers with severe anxiety? How did we get here?

What's going on? While we don't know for sure, there are a number of factors that could be contributing. In addition to genetics, brain chemistry, personality, and life events, take the following into consideration:

High expectations and pressure to succeed. Between standardized testing and aculture of achievement, today's youth can feel pressure to succeed in ways previous generations did not. A survey done every year byHigher Education Research asks incoming college freshmen if they feel overwhelmed by all they have to do. In 2016, 41% of students said "yes" compared with 28% in 2000 and 18% in 1985.

A world that feels scary and threatening. We've seen an increase in school shootings, with resultant drills and lockdowns in schools. We've seen shootings in public places. There have been terrorist attacks here in the US and around the world taking many lives. From just watching or reading the news, it is reasonable for anyone to feel afraid in public spaces that previously would have felt safe.

Social media. Today's children and teens are constantly connected to social media. It's not surprising that their self-esteem―and worldview ―becomes connected to responses to social media posts. It's hard for them not to compare their life and social connections to what they see others posting on social media.

There are also some children who have unexpected and disproportionate reactions to normal developmental experiences like going to school, going to a party, doing a sleepover or going to camp; children who worry excessively about everyday life activities. This often starts in the years right before puberty.

Whatever the cause, this rise in anxiety is a real problem for our youth.

Chronic anxiety can lead to serious mental health problems― depression, substance use, and even suicide. It can interfere with the ability to focus and learn causing school problems that can have lifelong impact. It can also lead to physical problems, such as headaches, chronic pain, digestive problems, and later heart disease.

Anxiety disorders cut across all demographics―suburban, urban, and rural. They affect those who are college-bound and those who are not.

Be aware of the signs of anxiety. Sometimes children may say that they are anxious, but other times it is less clear―especially as they may not even realize it themselves. Signs can include:

Recurring fears and worries abo ut routine parts of every day life

Changes in behavior, such as irritability

Avoiding activities, school, or social interactions

Dropping grades or school avoidance

Trouble sleeping or concentrating

Substance use or other risky behaviors

Chronic physical complaints, such as fatigue, headaches, or stomachaches.

Talk with kids about potential stressors. Try to see the world the way they do-and help them to keep perspective and find ways to cope.

Be mindful of the expectations you set for children and teens. High expectations can help children reach their potential, but they need to be realistic ones. Not only that, remember that kids need time to relax, play, and be with friends-all of which are crucial for their mental and physical health. And it's important for all of us to remember that there is more to life than achievement.

Talk with kids about their social media use. Help them take breaks-and help them think critically and rationally about the effect of social media on their lives. See How to Connect with Your Teen about Smart & Safe Media Use.

So, what can parents, teachers, and anyone else who interacts with children and teens do?

How pediatricians screen kids for anxiety:

At visits―whether they are well child visits or appointments made because of a concern―pediatricians ask questions about a child's physical complaints, mood, behavior and activities, as well as what is going on at school, at home, and in other areas of life.

Pediatricians also use screening tools such as the Pediatric Symptom Checklist (PSC) that look for signs of various different mental health problems, including anxiety. Pediatricians often refer to mental health professionals, as well, in order to more fully evaluate children when there is a concern.

Know anxiety is treatable!

According to the Anxiety and Depression Association of America, 80% of kids with a diagnosable anxiety disorder are not getting treatment―and anxiety disorders are highly treatable! As with most problems, the earlier it is diagnosed the easier it is to treat.

CBT focuses on changing how the child thinks about his fear, increasing exposure to feared situations, and relaxation strategies such as deep breathing, muscle relaxation, and positive self‐talk (repeating positive or reassuring statements to oneself). Exposure therapy, a type of CBT, focuses on increasing exposure to feared objects or activities.

SSRIs (selective serotonin reuptake inhibitors) ―commonly prescribed antidepressants―are the medications most frequently used for treating anxiety disorders in children.

The most effective treatments with for anxiety disorders are cognitive‐behavioral therapy (CBT) and SSRI medications.

Studies have found a combination of CBT and medication for 12 weeks yields a positive response in 80% of children with anxiety disorders. In fact, 65% of those children had no or minimal anxiety symptoms after the 12 weeks of treatment. With CBT alone, 60% had a positive response―about 35% of those children having no or minimal anxiety symptoms. However, it is important to note that SSRI medications can be administered safely and be an important part of child's anxiety disorder treatment.

As with any mental health disorder, anything that supports general wellbeing is an important part of anxiety disorder treatment―regular sleep, exercise, meditation, relaxation apps or yoga can be helpful. However, these are not a substitute for CBT or medication.

The most important thing is to be aware of your children's mental health, ask questions, and ask for help!

Additional Information:

About Dr. McCarthy:

Claire McCarthy, MD, FAAP is a primary care pediatrician at Boston Children's Hospital, an Assistant Professor of Pediatrics at Harvard Medical School, a senior editor for Harvard Health Publications, and an official spokesperson for the American Academy of Pediatrics. She writes about health and parenting for the Harvard Health Blog, Huffington Post and many other online and print publications.

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anxiety~ anxiety disorders~ anxious teen~ anxiety in teen~ ocd~ ptsd~ trauma~ mental health disorder~ suicide~ teen mental health~ teen social media~ mental illness~ teen nervous~ adolescent mental health~ screening for anxiety~ anxiety treatment

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Anxiety in Teens is Rising: What's Going On?

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The number of teens with anxiety disorders has been rising steadily―along with hospital admissions for teens who are suicidal. This leaves parents, teachers, and anyone who interacts with these kids with many concerning questions. Read on.

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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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A certain amount of school-related anxiety is common for adolescents. It's natural for teens to feel some degree of back-to-school stress, even if they're excited to return. But when that nervousness doesn't go away, or crosses over into full-fledged anxiety in school, teens need extra support.

Anxiety disorders in teenagers are increasingly common. In fact, studies show that 40 percent of American teens suffer from an anxiety disorder at some point. Therefore, parents need to know how to recognize the difference between an anxiety disorder and common levels of anxiety in school.

Increasing Anxiety in High School Students

School and stress seem to go hand in hand for many students. And anxiety at school has increased since the pandemic began, as more kids are struggling with behavioral and mental health issues. In particular, high school anxiety is on the rise.

In general, anxiety disorders are the most common mental health disorders of childhood and adolescence. Research shows that high school students today have more anxiety symptoms and are twice as likely to see a mental health professional as teens in the 1980s.

Anxiety Disorder vs. School Anxiety: Teenager Symptoms

Can school give you anxiety? Yes, but there is a significant difference between temporary anxiety over school and an anxiety disorder that requires professional treatment. Teens with an anxiety disorder experience very high levels of anxiety and typically experience both physical and emotional symptoms. Moreover, these feelings get worse over time, rather than improving on their own.

If a child's anxiety is connected with school, they may go through what's known as school refusal: refusing to get out of bed and get ready in the morning. That's when therapists hear from parents concerned about the fact that "my child won't go to school because of anxiety."

Teens with anxiety disorders struggle with feelings of tension and fear. These symptoms are ongoing and interfere with daily activities. Furthermore, the disorder affects relationships with peers and family members.

While there are different types of teen anxiety disorders, many of these disorders manifest in a set of common symptoms. Here are some of the signs that a child is experiencing a level of anxiety that warrants an assessment by a mental health professional.

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Loss of interest in activities they used to enjoy

Withdrawing from social interactions

Trouble sleeping at night, but often seems fatigued during the day

Loss of appetite and other changes in eating habits

Difficulty concentrating

Extreme mood swings

Performance dip in school, poor report cards, poor testing results

Frequent unexplained physical complaints, such as stomachaches and headaches

Expressing feelings of hopelessness, despair, and worthlessness

Using drugs and drinking as forms of self-medication for anxiety

Avoiding people, places, and things that trigger anxious feelings

Parents who recognize these symptoms in a teen should reach out for support and an expert assessment.

"Every child is different, especially as they mature into adolescence, so parents need to judge behavior and happiness levels based on their intimate knowledge of their unique child, rather than on any checklist that describes the so-called average child."
Barbara Nosal, PhD, LMFT, LDAC, Newport Academy's Chief Clinical Officer

Anxiety in College

It's not just high school students who deal with anxiety in school. In addition, college students experience high anxiety levels.

Anxiety disorders are one of the most common mental health problems on college campuses, according to the Anxiety and Depression Association of America (ADAA). Here are some recent statistics from the ADAA:

30 percent of college students report that stress negatively impacts their academic performance

85 percent of college students report feeling overwhelmed by everything they have to do

6 percent list anxiety as their top concern

5 percent of college students reported taking psychotropic medication for anxiety or depression.

Generalized Anxiety Disorder in Teens

Generalized Anxiety Disorder (GAD) is the most common teen anxiety disorder. Onset can be as early as age 6, but symptoms usually appear around age 11.

This type of anxiety in teenagers involves excessive anxiety or worry over everyday events, which lasts for a prolonged period of time. Teens with generalized anxiety experience intense emotional stress. In addition, they have a range of anxiety-related symptoms, including those listed above. Moreover, teens with GAD typically experience excessive worrying and low self-esteem.

Researchers theorize that the causes of general anxiety disorder include a disruption in how the brain reacts to the signals it uses to identify and confront danger. Fortunately, however, GAD is very treatable.

Effective therapeutic modalities for teen anxiety include Cognitive Behavioral Therapy (CBT), Dialectical Behavioral Therapy (DBT), and a wide range of experiential therapies. In fact, more than 40 randomized clinical trials support the efficacy of CBT for the treatment of anxiety disorders in children and adolescents.

Social Anxiety in School

Teens with social anxiety find school extremely challenging. Sometimes referred to as social phobia, social anxiety disorder is when a person is overcome with fear and worry in social settings. Therefore, this type of anxiety in teenagers negatively impacts a teen's everyday activities, including time in school.

Typically, a person with a social phobia experiences intense anxiety that leads to deep feelings of embarrassment and fear of being judged by others. Consequently, a teen with social phobia often withdraws and avoids contact with peers and teachers. Thus, social anxiety can be paralyzing for teenagers in school.

Subsequent difficulties caused by social anxiety symptoms arise in school, at work, and in personal relationships. Therefore, teens who experience these symptoms for more than six months are often diagnosed with social anxiety.

Additional social anxiety symptoms include

Feeling nauseous

Sweating

Nervous shaking

Unexpected blushing

Fear of having to talk or perform in front of a group.

Teen Panic Attacks at School

Anxiety attacks often begin in the late teens or early adulthood. Unlike panic attacks, anxiety attacks are reactions to external stressors, such as anxiety in school. An anxiety attack is typically a symptom of an anxiety disorder. However, not everyone with an anxiety disorder will experience anxiety attacks.

A teenager undergoing a panic attack in school might experience any or all of the following symptoms:

Feeling fearful or full of dread

Shortness of breath

Racing heart

Cold sweats

Dizziness and wooziness.

However, anxiety attacks tend to be short-lived. As a result, a panic attack in school will typically pass once the child is able to leave the stressful situation. Therefore, teens with anxiety in school may experience such attacks during the school day, but not at home.

How to Help a Child with Anxiety About School

In response to school anxiety, teenagers can use a variety of stress-relief tools to deal with feelings of anxiety in school. Here are some powerful tips for parents to share with teens. These approaches can help teenagers counteract school fears and build stress resilience.

Parent role modeling

Parents can help their teens learn how to deal with anxiety in school by serving as role models for stress management. "The biggest gift parents can give their kids is the ability to cope with stressful situations," says Barbara Nosal, PhD, LMFT, LDAC, Newport's Chief Clinical Officer. "Children learn by example; therefore, parents need to be mindful of how they manage their own stress." Moreover, when parents are anxious, children not only sense it, but the stress also trickles down, Dr. Nosal says. "Children today are under enough stress of their own without taking on parental anxiety," she notes.

Breathing exercises

Breathing exercises are proven to have a calming effect on the nervous system; simply taking three slow, deep breaths triggers the body's relaxation response and quiets the "fight or flight" response. This is an exercise that a child or teen can do at a particularly stressful moment without anyone noticing.

Journaling

Writing in a journal is another evidence-based tool for stress relief. Encourage your child to write a little bit every day about what they're experiencing, as a way of interpreting and making sense of their emotions.

Self-care strategies

Sleep and good nutrition go a long way toward alleviating teen anxiety. Without these basics, it's difficult to restore and maintain inner calm. Parents can help teens learn to practice self-care.

Highlighting the positive

Help your anxious child recall good times from the past, including fun times at school. In addition, highlight positive moments that are happening right now and will happen in the future.

Yoga and meditation

A large body of research shows that meditation and yoga practices reduce stress. A review study at Johns Hopkins found that meditation is equally effective in treating symptoms of anxiety and depression as antidepressants.

Spending time with good friends

Close friends can help teens deal with anxiety. Acceptance and support from friends are essential to a teen's well-being. Therefore, an authentic connection with a caring friend can alleviate anxiety in school. Building a few strong, trusting friendships is a powerful approach for how to deal with social anxiety at school.

Connecting with family

The busy school-year schedule can keep the family apart. Everyone has someplace to be or something to do. So make a point of eating together at least one or two nights during the week. Moreover, turn off all devices while you're eating, so you can focus on the food and each other. As a result, meals become a time for each family member to share what's been going on in their day and their week.

Getting out in nature

Research has repeatedly proven that time outdoors reduces levels of stress, depression, and anxiety. When teens aren't in school, spending time hiking or at the beach can help relieve anxiety.

Positive visualization

Mental imagery and visualization are powerful tools for enhancing teen mental health. When teenagers practice positive visualization, they learn how to regulate their emotions and relieve stress.

Personalized stress busters

Finally, parents can ask their child or teen what would support them in transitioning back to school more easily. They might have very specific ideas about what would be helpful. Maybe it's a new outfit they would feel especially confident in. Or having an after-school plan in place for the first day or two can help. That might be a relaxing family activity, or a get-together with a close friend.

Treatment for Anxiety in School

When anxiety at school is manifesting as constant fear, dread, social anxiety, and/or panic attacks at school, teens need treatment to gain coping schools and heal underlying trauma. At Newport Academy, we support teens with school anxiety by helping them understand their triggers and use healthy approaches to regulate their emotions and reactions. In addition, our academic component gives teens a new, positive experience of learning that helps them let go of their negative associations with school.

Moreover, teens address their social anxiety in school through forming authentic connections with caring peers they trust. When they return to their home schools, our clients are equipped to handle high school anxiety and empowered to be their true selves. Contact us today to find out more about our clinical model and our outpatient and residential locations nationwide.

Sources
PNAS July 14, 2015. 112 (28) 8567-8572. Social Indicators Research. 2015 April; 121(2): 437-454. JAMA Intern Med. 2014;174(3):357-368. Child Adolesc Psychiatr Clin N Am. 2011 Apr; 20(2): 217-238. J Am Acad Child Adolesc Psychiatry. 2010 Oct;49(10):980-9. J Youth Adolesc. 2010 Feb; 39(2): 177-188.

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Anxiety in School: How Parents Can Help | Newport Academy

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Learn the symptoms of anxiety in school, the difference between school anxiety in teens vs. an anxiety disorder, and tips to help.

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Disorders Facts

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For Parents: Eating Disorders in Teens - familydoctor.org

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An eating disorder is a focus on food and bodyweight that causes a person to go to extremes when eating. There are three main types of these disorders.

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Pica is an eating disorder that involves eating items that are not typically thought of as food.

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The word "pica" is Latin for magpie-a bird known for eating almost anything. Therefore, the pica eating disorder causes individuals to consume non-food items.

Featured on TV shows such as My Strange Addiction and The Woman Who Ate a House, pica is an alarming and dangerous disorder. Moreover, pica disorder can result in serious medical conditions, such as anemia, intestinal blockages, and other life-threatening issues.

Most often, pica often manifests in individuals with other mental health conditions. In fact, 10 to 15 percent of people with mental disabilities and developmental issues also have pica.

Furthermore, pregnancy sometimes causes pica cravings.

What Is The Pica Eating Disorder?

Pica is an eating disorder that involves eating items that are not considered edible. Moreover, these items do not contain significant nutritional value. (However, eating foods or drinks that have little or no nutritional value is not a symptom of pica.)

A person with pica may experience cravings for any of the following non-food items:

Hair

Dirt and sand

Paint chips

Paper

Plastic

Pencil erasers

Soap and laundry starch

Cloth

String

Chalk

Metal and wire

Pebbles and stones

Burnt matches

Cigarette butts

Coffee grounds

Feces, including animal droppings

and more...

Pica can affect children, teens, and adults. In children, it affects boys and girls equally. Worldwide, 20 percent of cases involve pregnant women.

Moreover, small children represent 25 to 33 percent of all pica cases. But doctors don't diagnose pica in children younger than two years old. That's because attempting to eat non-food items is a normal part of childhood development among infants and babies.

Diagnosing Pica

Once an expert detects pica symptoms, the next step is diagnosis. However, no laboratory tests for pica currently exist. Therefore, healthcare professionals apply the following criteria listed in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition.

Behavior lasts for one month: The individual persistently consumes substances that are not food and do not provide nutritional value for a time period of at least one month.

Ingestion of non-food objects is not part of the person's culture: Some cultures promote the consumption of non-food substances. For example, among Australian aborigines, young women were traditionally encouraged to eat clay to enhance their fertility. Therefore, this practice is considered normal within that society. In fact, geophagia (deliberate consumption of earth, soil or clay) is common pica among many tribe-oriented societies. However, such behaviors have diminished with increased health education and access to medical care.

Pica is developmentally inappropriate: As stated above, young children tend to put non-food items in their mouth as a normal part of development. Such behavior is a way for children to explore their world and their senses. As a result, they may ingest inedible material. However, this does not mean that they have pica.

Why Pica Can Be Deadly

Pica symptoms can have dangerous and even deadly effects. A study from the Healthcare Cost and Utilization Project (HCUP) Statistical Briefs found that hospitalizations for pica increased by 93 percent between 1999 and 2009. Hence, this was the highest increase during that time of hospitalizations due to an eating disorder.

Therefore, after making a pica diagnosis, physicians should administer a medical examination and a series of tests. Such tests may include abdominal x-rays, barium exams to view the upper and lower gastrointestinal tracts, blood tests for anemia, and an upper endoscopy to determine whether there is any esophageal or intestinal damage.

Subsequently, doctors may repeat these exams at regular intervals. Hence, physicians can track any changes in the location or effects of ingested materials.

Medical Complications as a Result of Pica

Once an individual receives a pica diagnosis, medical professionals will check for the following conditions:

Pica anemia-an iron deficiency that can cause pica cravings

Intestinal blockages or constipation as a result of objects that are difficult to digest, such as pebbles or metal

Tears in the lining of the esophagus or intestines caused by hard or sharp objects, including paper clips or metal scraps

Lead poisoning, which can lead to kidney damage and cognitive delays, as a result of eating paint or other lead-containing substances

Bacteria and parasites from ingested dirt, which can cause infections, subsequently damaging the kidneys or liver

Gastric pain and bleeding as a result of sand and soil in the digestive system

Abnormal wear on teeth from chewing ice

Nutritional deficiencies that may occur when pica interferes with eating healthy food.

What Causes Pica?

Iron-deficiency anemia and malnutrition are two of the most common pica causes. Thus, pica cravings are signs that the body is seeking additional nutrients. In these cases, vitamins, supplements, and a healthy diet can therefore correct pica.

However, when no nutritional deficiency exists, it's harder to pin down the causes of pica. Often, people with pica also have other mental health disorders, including schizophrenia and obsessive-compulsive disorder. In addition, pica symptoms sometimes increase when an individual is experiencing extreme stress and anxiety.

Many pica eating disorders begin in childhood and relate to childhood experiences. As the person ages, they choose to eat non-food items that are connected to their childhood and their childhood home. Experts theorize that this type of pica may be caused by childhood trauma. Thus, the person strives to find a way back to the childhood that they lost due to their traumatic experiences.

Moreover, experts have found a link between pica and decreased activity of the dopamine system in the brain. Hence, some researchers believe that abnormally low levels of dopamine in the brain can cause pica.

Dopamine is a neurotransmitter-a chemical that helps to relay nerve impulses from one cell to another.

Pica in Pregnancy

Pica is also more common in pregnancy. Worldwide, about 28 percent of pregnant women experience pica during and just after pregnancy. Often, pica cravings begin during the first trimester.

According to the Journal of the American Dietetic Association, pica in pregnancy may be the result of an iron deficiency. Therefore, pica cravings are the body's attempt to obtain missing vitamins and minerals.

The most common non-food substances that women crave during pregnancy are dirt, clay, and laundry starch. However, pregnant women who experience non-food cravings should only be diagnosed with pica if their cravings cause them to actually ingest non-food items.

As a result of pica, pregnant women may be vulnerable to medical risks. Eating non-food substances can be harmful to both expecting women and their fetuses. For example, pica can interfere with the absorption of nutrients in healthy food. Hence, it can cause a nutritional deficiency.

Moreover, pica during pregnancy is dangerous because non-food items may contain toxic or parasitic ingredients that negatively affect both mother and baby.

Pica and Mental Health Disorders

Individuals with pica often have mental health disorders that result in impaired functioning. These disorders include developmental disabilities, brain damage, autism spectrum disorder, obsessive-compulsive disorder, and schizophrenia. Hence, these co-occurring conditions can make treatment for pica more difficult.

In addition, pica is associated with trichotillomania (hair-pulling disorder) and excoriation (skin-picking) disorder. Furthermore, people with epilepsy may be more likely to have pica.

As a result, up to 26 percent of institutionalized individuals may have pica, according to the National Eating Disorders Association. In addition, as many as one in five children who are admitted to mental health clinics in the United States have pica disorder.

Treatment for Pica

First, people diagnosed with pica need medical care to correct any nutritional deficits or other physical issues caused by the condition. Moreover, surgery may be necessary to remove metal objects from a patient's digestive tract or to repair other injuries.

In the best-case scenario, pica symptoms will disappear after the individual receives nutritional treatment. However, sometimes the pica behaviors are not caused by malnutrition and don't stop after nutritional treatment. Therefore, behavioral interventions are the next step.

This treatment is especially effective with children. Hence, children with pica are taught which foods are edible and which foods cannot be eaten through the use of positive reinforcement.

Moreover, this approach can work well for those with autism spectrum disorder. For example, treatment would include directing the person's attention away from the desired object. In addition, they would receive a reward for discarding the non-food item.

Fortunately, pica improves by itself in most young children and pregnant women. However, untreated pica can persist for many years, particularly for individuals with developmental disabilities.

In conclusion, greater awareness is needed around pica eating disorder and its symptoms, causes, and treatment. Hence, more people can be protected from the harmful side effects of this condition, and set off on the path to healing.
Images courtesy of unsplash
Sources
Am J Hum Biol. 2015 Jan; 27(1): 84-93. S Afr Med J. 1996 Dec;86(12 Suppl):1586-8, 1591-2. J Canadien Chirurgie. 1993 Dec, 36(6):551-554. Focus Autism and Other Dev Dis. 2005 February: 20(1):27-38. J Med Case Reports. 2010; 4: 86 Int J Gynaecol Obstet. 2016 Jun;133(3):277-83.

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Pica Eating Disorder and How to Treat It | Newport Academy

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The word "pica" is Latin for magpie-a bird known for eating almost anything. Therefore, the pica eating disorder causes individuals to consume non-food items. Featured on TV shows such as My Strange Addiction and The Woman Who Ate a House, pica is an alarming and dangerous disorder.

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Module ~ 4: Bipolar and Related Disorders

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Module ~ 4: Bipolar and Related Disorders

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default - Stanford Medicine Children’s Health

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Stanford Medicine Children’s Health Anyone can feel sad or depressed at times. But mood disorders are more intense. They are harder to handle than normal feelings of sadness. Read on to learn more about these types of disorders in teens.

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Bipolar Disorder (for Teens) — Print Version - Nemours KidsHealth

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Affective disorders are a set of psychiatric disorders, also called mood disorders.

The main types of affective disorders are depression and bipolar disorder. Symptoms vary by individual and can range from mild to severe.

A psychiatrist or other trained mental health professional can diagnose an affective disorder. This is done with a psychiatric evaluation.

Affective disorders can be disruptive to your life. However, there are effective treatments available, including both medication and psychotherapy.

The two main types of affective disorders are depression and bipolar disorder. Each includes subtypes and variations in severity.

Depression

Depression is a medical term that describes ongoing feelings of extreme sadness and hopelessness. It's more than simply feeling down for a day or two.

If you have depression, you may experience episodes that last for several days or even weeks.

It's estimated that more than 264 million people worldwide live with depression, which can take on multiple forms.

The most common types of depression include:

There are also certain types of depression experienced by females, due to hormonal changes at various life stages.

Examples include perinatal depression during pregnancy and postpartum depression after birth. Some women also experience depression alongside other symptoms of premenstrual dysphoric disorder (PMDD).

It is possible for men to experience postpartum depression as well, though this isn't associated with hormonal changes like in women.

Sometimes depression can also develop as a secondary condition to an underlying medical issue. Some issues include:

Bipolar disorder

Bipolar disorder is a mental health condition where a person experiences extreme shifts in mood.

These mood changes may include episodes of depression along with periods of mania or hypomania.

There are different types of bipolar disorder. They include:

Bipolar I. Bipolar I is defined by episodes of mania that last for at least . You may also experience depressive episodes that last for 2 weeks or more, though depression may not occur in bipolar I.

Bipolar II. This type includes episodes of depression lasting at least 2 weeks along with milder mania, called hypomania.

Cyclothymia. This mild form of bipolar disorder still includes periods of depression and hypomania, but with no clear timeline for each episode. Also called cyclothymic disorder, you may be diagnosed if you've experienced cycling hypomania and depression for 2 years or more.

The symptoms of affective disorders can vary greatly. There are some common signs, however, for each of the main types.

Depression

prolonged sadness

irritability or anxiety

lethargy and lack of energy

lack of interest in normal activities

major changes in eating and sleeping habits

difficulty concentrating

feelings of guilt

aches and pains that have no physical explanation

suicidal thoughts

unusual and chronic mood changes

Bipolar disorder

During a depressive episode, the symptoms may be similar to those for major depressive disorder.

During mania, you might experience:

The causes of affective disorders aren't fully understood.

Neurotransmitters, or brain chemicals, play a major role in affecting mood. When they're imbalanced in some way, or don't signal properly to your brain, an affective disorder can be the result. What exactly causes the imbalance isn't fully known.

Life events can trigger affective disorders. A traumatic event or personal loss can cause depression or another affective disorder. Use of alcohol and drugs is also a risk factor.

There also seems to be a genetic factor. If someone in your family has one of these disorders, you're at a greater risk of developing one as well. This means that they're hereditary.

However, this doesn't guarantee you'll develop an affective disorder just because a family member has one.

There are no medical tests to diagnose affective disorders.

To make a diagnosis, a mental health professional can give you a psychiatric evaluation. They will follow set guidelines.

You should expect to be asked about your symptoms. Some tests may be done to look for underlying medical conditions.

There are two main treatments for affective disorders: medication and therapy. Treatment usually involves a combination of both.

There are many antidepressant medications available. You may need to try several before you find one that helps relieve your symptoms without too many side effects.

Psychotherapy in addition to medication is also an important part of treatment. It can help you learn to cope with your disorder and possibly change behaviors that contribute to it.

In addition to therapy and medications, supplemental approaches may be used to help treat some types of depression. These include vitamin D supplements and light therapy, which is supplied by specialized lamps.

Talk to your doctor before taking any over-the-counter supplements for your condition.

Your doctor may also recommend certain lifestyle changes, including regular exercise, a consistent sleep schedule, and a healthy diet. These can help complement your medical treatments, but shouldn't replace them.

With appropriate and long-term treatment, the recovery outlook for an affective disorder is good.

It's important to understand that in most cases, these are chronic conditions. Most often they have to be treated long-term.

While some cases are severe, most people with affective disorders who are being treated can live a normal life.

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Affective disorders are a set of psychiatric disorders, also called mood disorders. The main types of affective disorders are depression and bipolar disorder. Symptoms vary by individual and can range from mild to severe. A psychiatrist or other trained mental health professional can diagnose an affective disorder.

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Module 5 ~ Disruptive, Impulse-Control and Conduct & Neurodevelopmental Disorders

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Module 5 ~ Disruptive, Impulse-Control and Conduct & Neurodevelopmental Disorders

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Disruptive, Impulse-Control and Conduct Disorder

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Disruptive, Impulse-Control and Conduct Disorder

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What are Disruptive, Impulse-Control and Conduct Disorders

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What is Conduct Disorder?|Child Psychology

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What is Conduct Disorder?|Child Psychology

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How to Understand...this 1:35 minute video will explain Conduct Disorder, it's seriousness and impulses.

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What Is Conduct Disorder? | Child Psychology

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Module 6 ~ Obsessive-Compulsive (OCD) & Related Disorders

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Module 6 ~ Obsessive-Compulsive (OCD) & Related Disorders

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Obsessive-compulsive disorder (OCD) usually begins in adolescence or young adulthood and is seen in as many as 1 in 200 children and adolescents. OCD is characterized by recurrent intense obsessions and/or compulsions that cause severe discomfort and interfere with day-to-day functioning

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Obsessive-Compulsive Disorder In Children And Adolescents

No. 60; Updated October 2018

Obsessive-compulsive disorder (OCD) usually begins in adolescence or young adulthood and is seen in as many as 1 in 200 children and adolescents. OCD is characterized by recurrent intense obsessions and/or compulsions that cause severe discomfort and interfere with day-to-day functioning. Obsessions are recurrent and persistent thoughts, impulses, or images that are unwanted and cause marked anxiety or distress. Frequently, they are unrealistic or irrational. They are not simply excessive worries about real-life problems or preoccupations. Compulsions are repetitive behaviors or rituals (like hand washing, keeping things in order, checking something over and over) or mental acts (like counting, repeating words silently, avoiding). In OCD, the obsessions or compulsions must cause significant anxiety or distress, or interfere with the child's normal routine, academic functioning, social activities, or relationships.

The obsessive thoughts may vary with the age of the child and may change over time. A younger child with OCD may have persistent thoughts that harm will occur to himself or a family member, for example an intruder entering an unlocked door or window. The child may compulsively check all the doors and windows of his home after his parents are asleep in an attempt to relieve anxiety. The child may then fear that he may have accidentally unlocked a door or window while last checking and locking, and then must compulsively check over and over again.

An older child or a teenager with OCD may fear that he will become ill with germs, AIDS, or contaminated food. To cope with his/her feelings, a child may develop "rituals" (a behavior or activity that gets repeated). Sometimes the obsession and compulsion are linked; "I fear this bad thing will happen if I stop checking or hand washing, so I can't stop even if it doesn't make any sense."

Research shows that OCD is a brain disorder and tends to run in families, although this doesn't mean the child will definitely develop symptoms if a parent has the disorder. A child may also develop OCD with no previous family history.

Children and adolescents often feel shame and embarrassment about their OCD. Many fear it means they're crazy and are hesitant to talk about their thoughts and behaviors. Good communication between parents and children can increase understanding of the problem and help the parents appropriately support their child.

Most children with OCD can be treated effectively with a combination of psychotherapy (especially cognitive and behavioral techniques) and certain medications, for example, serotonin reuptake inhibitors (SSRIs). Family support and education are also central to the success of treatment. Seeking help from a child and adolescent psychiatrist is important both to better understand the complex issues created by OCD as well as to get treatment

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obsessive-compulsive disorder in children and adolescents ocd

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Obsessive-Compulsive Disorder In Children And Adolescents

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Obsessive-Compulsive Disorder In Children And Adolescents No. 60; Updated October 2018 Obsessive-compulsive disorder (OCD) usually begins in adolescence or young adulthood and is seen in as many as 1 in 200 children and adolescents. OCD is characterized by recurrent intense obsessions and/or compulsions that cause severe discomfort and interfere with day-to-day functioning.

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Overview

Childhood schizophrenia is an uncommon but severe mental disorder in which children and teenagers interpret reality abnormally. Schizophrenia involves a range of problems with thinking (cognitive), behavior or emotions. It may result in some combination of hallucinations, delusions, and extremely disordered thinking and behavior that impairs your child's ability to function.

Childhood schizophrenia is essentially the same as schizophrenia in adults, but it starts early in life - generally in the teenage years - and has a profound impact on a child's behavior and development. With childhood schizophrenia, the early age of onset presents special challenges for diagnosis, treatment, education, and emotional and social development.

Schizophrenia is a chronic condition that requires lifelong treatment. Identifying and starting treatment for childhood schizophrenia as early as possible may significantly improve your child's long-term outcome.

Symptoms

Schizophrenia involves a range of problems with thinking, behavior or emotions. Signs and symptoms may vary, but usually involve delusions, hallucinations or disorganized speech, and reflect an impaired ability to function. The effect can be disabling.

In most people with schizophrenia, symptoms generally start in the mid- to late 20s, though it can start later, up to the mid-30s. Schizophrenia is considered early onset when it starts before the age of 18. Onset of schizophrenia in children younger than age 13 is extremely rare.

Symptoms can vary in type and severity over time, with periods of worsening and remission of symptoms. Some symptoms may always be present. Schizophrenia can be difficult to recognize in the early phases.

Early signs and symptoms

Schizophrenia signs and symptoms in children and teenagers are similar to those in adults, but the condition may be more difficult to recognize in this age group.

Early signs and symptoms may include problems with thinking, behavior and emotions.

Thinking:

Problems with thinking and reasoning

Bizarre ideas or speech

Confusing dreams or television for reality

Behavior:

Withdrawal from friends and family

Trouble sleeping

Lack of motivation - for example, showing up as a drop in performance at school

Not meeting daily expectations, such as bathing or dressing

Bizarre behavior

Violent or aggressive behavior or agitation

Recreational drug or nicotine use

Emotions:

Irritability or depressed mood

Lack of emotion, or emotions inappropriate for the situation

Strange anxieties and fears

Excessive suspicion of others

Later signs and symptoms

As children with schizophrenia age, more typical signs and symptoms of the disorder begin to appear. Signs and 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; that certain gestures or comments are directed at you; that you have exceptional ability or fame; that another person is in love with you; or that 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, hallucinations 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. 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 several ways, from childlike silliness to unpredictable agitation. Behavior is not focused on a goal, which makes it 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, speaks in a monotone, or doesn't add hand or head movements that normally occur when speaking. Also, the person may avoid people and activities or lack the ability to experience pleasure.

Compared with schizophrenia symptoms in adults, children and teens may be:

Less likely to have delusions

More likely to have visual hallucinations

Symptoms may be difficult to interpret

When childhood schizophrenia begins early in life, symptoms may build up gradually. Early signs and symptoms may be so vague that you can't recognize what's wrong. Some early signs can be mistaken for typical development during early teen years, or they could be symptoms of other mental or physical conditions.

As time goes on, signs may become more severe and more noticeable. Eventually, your child may develop the symptoms of psychosis, including hallucinations, delusions and difficulty organizing thoughts. As thoughts become more disorganized, there's often a "break from reality" (psychosis) frequently requiring hospitalization and treatment with medication.

When to see a doctor

It can be difficult to know how to handle vague behavioral changes in your child. You may be afraid of rushing to conclusions that label your child with a mental illness. Your child's teacher or other school staff may alert you to changes in your child's behavior.

Seek medical care as soon as possible if you have concerns about your child's behavior or development.

Suicidal thoughts and behavior

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

Causes

It's not known what causes childhood schizophrenia, but it's thought that it develops in the same way as adult schizophrenia does. Researchers believe that a combination of genetics, brain chemistry and environment contributes to development of the disorder. It's not clear why schizophrenia starts so early in life for some and not for others.

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

Increased immune system activation, such as from inflammation

Older age of the father

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

Taking mind-altering (psychoactive) drugs during teen years

Complications

Left untreated, childhood schizophrenia can result in severe emotional, behavioral and health problems. Complications associated with schizophrenia may occur in childhood or later, such as:

Suicide, suicide attempts and thoughts of suicide

Self-injury

Anxiety disorders, panic disorders and obsessive-compulsive disorder (OCD)

Depression

Abuse of alcohol or other drugs, including nicotine

Family conflicts

Inability to live independently, attend school or work

Social isolation

Health and medical problems

Being victimized

Legal and financial problems, and homelessness

Aggressive behavior, although uncommon

Prevention

Early identification and treatment may help get symptoms of childhood schizophrenia under control before serious complications develop. Early treatment is also crucial in helping limit psychotic episodes, which can be extremely frightening to a child and his or her parents. Ongoing treatment can help improve your child's long-term outlook.

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Childhood schizophrenia - Symptoms and causes

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Childhood schizophrenia is an uncommon but severe mental disorder in which children and teenagers interpret reality abnormally. Schizophrenia involves a range of problems with thinking (cognitive), behavior or emotions. It may result in some combination of hallucinations, delusions, and extremely disordered thinking and behavior that impairs your child's ability to function.

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Schizophrenia can be hard to spot in teens. Sometimes it can be tough to see the difference between ordinary teenage moodiness and signs of more serious illness, although this disease usually begins in late adolescence or young adulthood.

It helps to know what symptoms to watch for and when you should check with your doctor.

What to Look For

Symptoms in teens can come on gradually over days, weeks, several months or more. This is called the prodromal period. The early symptoms of schizophrenia can sometimes look like those of other problems such as anxiety or depression.

Especially at first, symptoms may look like the stuff of typical teen years: bad grades, changing friends, trouble sleeping, or irritability.

But there are some early warning signs in teens that show up as changes in thinking, emotions, and behavior.

Changes in Thinking

Lack of concentration or being able to follow a train of thought

Seeing or hearing things that aren't real (hallucinations)

Confusing TV and dreams with reality

Strange ideas that may not make sense (for example, thinking that parents are stealing things or that an evil spirit possesses him or her)

Paranoia -- thinking that people are after him or talking about him

Dwelling unreasonably on the past

Changes in Emotions

Being extremely moody or irritable

Angry outbursts

Severe fearfulness or anxiety

Changes in Behavior

Unblinking, vacant expression

Awkward or unusual movements of the face or body

Talking to himself, using odd speech that you can't understand, or making rapid shifts in topics

Inappropriate responses, such as laughing during a sad movie

Trouble "reading" social cues in others

Problems making and keeping friends

Becoming more and more isolated

Poor personal grooming and self-care

Substance abuse

Threatening behaviors

When to Call a Doctor

If you notice symptoms like these, your teen needs to be checked by a doctor right away. That's especially true if anyone on either side of his family has had schizophrenia.

The doctor will ask your teen questions about his thinking and behavior, possibly perform a brief physical exam, and give him blood or urine tests to make sure there isn't another medical condition or drug abuse problem that's to blame.

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Schizophrenia can be hard to spot in teens. Sometimes it can be tough to see the difference between ordinary teenage moodiness and signs of more serious illness, although this disease usually begins in late adolescence or young adulthood. It helps to know what symptoms to watch for and when you should check with your doctor.

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Resources ~ School Counselors are Qualified

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Resources ~ School Counselors are Qualified

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School counselors promote positive student behaviors to create a safe, effective learning environment for all students.

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Addressing Mental Health Needs in Our Schools: Supporting the Role of School Counselors

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Traci P. Collins School counselors are a well-positioned resource to reach the significant number of children and adolescents with mental health problems. In this special school counseling issue of The Professional Counselor, some articles focus on systemic, top-down advocacy efforts as the point of intervention for addressing child and adolescent mental health.

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Teens Advice

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Teens Tell Parents How To Approach Mental Health Issues | TODAY