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Centers for Disease Control and Prevention

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

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

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

What are common childhood mental disorders?

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

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

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

Read more about related conditions.

What are the symptoms of childhood mental disorders?

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

Can childhood mental disorders be treated?

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

Get help finding treatment

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

Who is affected?

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

What is the impact of mental disorders in children?

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

Public health includes mental health

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

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

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

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

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

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

Resources

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

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The purpose of the responsive services component is to intervene on behalf of those students whose immediate personal concerns or problems put their continued personal-social, career, and /or educational development at risk. Although counselors respond to any concerns presented by students, some topics have been identified as having high priority and/or relevance within the school setting. Topics of priority in Fort Worth ISD include:

School-based issues, such as

attendance

school attitudes and behaviors

peer relationships

study skills

being new to the school

emergent issues in intervention or prevention of a traumatic event; and

violence on campus (school safety)

academic success

school drop-outs

severe stress

substance abuse

school-age pregnancy

gang pressures/involvement

harassment issues

career decision

financial aid

college choice

Personal issues, such as

death of a family member or friend

family divorce

family abuse

harassment issues

adolescent and child suicide

child abuse and neglect

Parents Role in the Responsive Services
Parent involvement with and participation in activities of this component are essential to helping children overcome barriers to their educational process. They refer their children for help, work with school staff to specify their children's issues and give permission for needed student services including on-going counseling.

Some responses are preventive: interventions with students who are on the brink of choosing an unhealthy or inappropriate solution to their problems or being unable to cope with a situation. Some responses are remedial: interventions with students who have already made unwise choices or have not coped well with problem situations.

In this component as in the others, locally identified needs will dictate the priorities for problem topics and for the groups of students to be served. A developmental guidance and counseling program includes supplemental guidance and counseling services for students targeted by special funding sources such as students in compensatory, gifted, migrant, special, or career and technology education programs.

The school counselors counsel individuals or small groups of students, appraise individuals for the purpose of problem identification, consult with teachers and parents, refer students and/or their parents and teachers to other specialists or special programs, coordinate programs and services with other specialists, and follow-up with students to monitor their progress toward resolution of their problems. If applicable, they train and supervise peer facilitators. Often they conduct guidance sessions in response to teachers' requests to address problems of particular groups, such as competitiveness or stress with classroom groups of gifted students.

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Prevention & Crisis Response / Responsive Services

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The purpose of the responsive services component is to intervene on behalf of those students whose immediate personal concerns or problems put their continued personal-social, career, and /or educational development at risk. Although counselors respond to any concerns presented by students, some topics have been identified as having high priority and/or relevance within the school setting.

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Strategies for ADHD: How Counselors Help Today's Students Succeed

More than 6 million children between the ages of 4 and 17 had been diagnosed with attention deficit hyperactivity disorder (ADHD) as of 2011, according to the Centers for Disease Control and Prevention External link . It's a complicated disorder with a long history. In order to cope with the symptoms, children with ADHD need continuous support from parents, teachers, and school counselors. School counselors are especially poised to serve as a key intermediary between parents and teachers and can be essential in helping students with ADHD thrive.
The Difference Between ADD and ADHD

The term "attention deficit disorder" was first coined in 1980 when the Diagnostic and Statistical Manual (DSM) - the industry standard publication for psychiatric diagnoses - published its third edition. Since then, "ADD" and "ADHD" have become relatively ubiquitous in American vocabularies, yet they do not exist simultaneously. In fact, they are mutually exclusive terms.

As research poured in in the 1980s and 1990s, the DSM adjusted the nomenclature to reflect new findings. Specifically, "attention deficit hyperactivity disorder" was introduced in the 1987 edition and appeared again in 1994, this time with three subtypes: predominantly inattentive subtype, predominantly hyperactive/impulsive subtype, and combined subtype. With the DSM 5, these have been re-termed as "presentations" (i.e., predominantly inattentive presentation, predominantly hyperactive/impulsive presentation, and combined presentation) owing to the research suggesting that children can have different presentations over time. The Attention Deficit Disorder Association External link has a helpful fact sheet with more details on the evolution of ADHD's nomenclature and its subtypes on its website.

Ultimately, while many use the terms "ADD" and "ADHD" interchangeably, the latter is technically the correct, up-to-date term External link .

Symptoms of ADHD

According to the Mayo Clinic External link , symptoms of ADHD often appear in early childhood, with diagnoses typically occurring before age 12. Typical symptoms of ADHD include fidgeting, excessive daydreaming, continual forgetfulness or losing things, taking needless risks, talking too much, limited self-control, misreading social cues and struggles with social interactions such as taking turns or getting along with others

Some may think, "Don't most children experience these 'symptoms' at one point or another during childhood?" - and they'd be right. The difference for children with ADHD is that these behaviors never subside and often worsen over time, and must result in impairment in key domains of functioning (e.g., social, familial, and academic), and often co-occur in two or more settings. Ultimately, ADHD is chronic for many affected children, impeding their social and academic lives well beyond their childhood and adolescence. According to the nonprofit Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD) External link , "more than 75% of children with ADHD continue to experience significant symptoms in adulthood." As such, school counselors and educators have an opportunity to support children and teens with ADHD to develop effective techniques to manage their symptoms in school, and maintain them into adulthood.

More than 75% of children with ADHD continue to experience significant symptoms in adulthood.

Helping Students with ADHD

Children with ADHD can have a particularly hard time managing their symptoms in school environments. For example, experiencing difficulty sitting still during class, having trouble waiting for a turn during an activity or conversation, or being unable to play quietly and independently are not only disruptive behaviors, they also interfere with a student's social, emotional, and academic development and functioning.

With up to roughly 11 percent of children External link ages 4 to 17 diagnosed with ADHD, school counselors serve as an important support system for children with ADHD and their families, as well as an essential resource for teachers and other professionals who work with students in and outside of the classroom. Because ADHD manifests itself in many different ways (most children are diagnosed with a combined form of ADHD External link ), counselors should be equipped with several strategies to address the many ways symptoms may occur in students.

With up to roughly 11 percent of children External link ages 4 to 17 diagnosed with ADHD, school counselors serve as an important support system

Before jumping into strategies and suggestions, it's critical to understand what skills, specifically, students coping with ADHD need help developing. "Children need to learn to develop impulse control and time management skills, as well as the ability to focus or concentrate on an undesired task," said Rebecca Newman, an early childhood mental health consultant for the Child Center of NY External link . If the development of these skills is ignored, "they may experience continual frustration, fatigue, poor self-esteem, or embarrassment," she said.

A big part of successfully managing ADHD symptoms is providing structure. The National Institute for Mental Health says External link that keeping the same routine every day and addressing any changes (such as school assemblies or field trips) as far in advance as possible is imperative. Helping students stay organized is another way to provide structure while keeping them on track with demands and expectations from homework, clubs, and sports.

Strategies for School Counselors

Evidence-based interventions (EBIs) are a primary way school counselors can provide support to students coping with ADHD. EBIs are an important part of managing ADHD symptoms, and usually occur outside of where a change in behavior is needed, such as a classroom.

Anil Chacko External link , a professor for Counseling@NYU's online master's in school counseling program, said there are specific strategies that school counselors can implement when working with students who have ADHD.

"School counselors should utilize methods that support students' time management, planning, and organization," Chacko said, citing the work of Joshua Langberg External link at VCU and Howard Abikoff External link at NYU's School of Medicine - both leaders in ADHD research for children and adolescents. "I would also encourage school counselors to work directly with parents to create a school-home note system to support cross-setting changes."

Research as recent as 2016 found that with early intervention for behavioral therapy External link , children who received behavioral therapy first before other interventions (such as medication) received "four fewer rules violations an hour at school than the medication-first group." This is not to say medical treatments should be dismissed, as they have proven benefits for helping children as well, but rather demonstrates the importance of a school counselor's role in encouraging behavior modification. This form of therapy is also cost-effective, as the reports found behavior-first therapy cost roughly $700 less per year compared to medication-first treatment. The CDC agrees both behavioral therapy and medication External link are important for treatment moving forward.

These intervention techniques can be implemented at any point in a student's academic career; it's equally applicable for elementary students as it is for high schoolers. What's more, social and emotional learning is increasingly appearing External link in schoolwide curricula, which can further support a student coping with ADHD in a formal classroom setting, as well.

Strategies for Teachers

In addition to EBIs, school counselors can train teachers to support children coping with ADHD in the classroom. It can be as simple as suggesting that teachers implement point- or token-based systems in class to reward good behavior, or as robust as dedicating a day of in-service training to identify symptoms and provide additional intervention strategies.

As for some immediate tips, for students who are easily distracted (predominantly inattentive), the National Resource Center (NRC) on ADHD External link suggests:

Seating the student near the teacher's desk or away from distractions like windows or the corridor.

Splitting longer assignments into smaller segments, and providing more breaks during class time.

For students who squirm and fidget often (predominantly hyperactive/impulsive), the NRC recommends:

Seating students in an area where there will be the least disruption, such as along the side of the classroom.

Creating opportunities for movement throughout the day, such as completing assignments sitting on the floor or helping with class activities (e.g., handing out activity sheets).

Newman adds that using "first/then" statements - such as "First push your chair in, then come sit for story time" - with children, and directing them to assist during class time will help them both refocus their energy and also feel valuable. A general best practice is for school counselors, teachers, and parents to offer praise and reward when children coping with ADHD exhibit good behavior.

The NRC has additional resources for teachers on supporting students with ADHD for reading External link , writing External link , and math External link accommodations, and general classroom instruction External link .

Strategies for Parents

ADHD is a relatively well-known mental disorder and is subsequently stigmatized - discussions of ADHD as a "fake" disorder on mainstream news sites External link don't help, either. As such, ADHD is oversimplified or even appropriated with things like "AD/HD" T-shirts and an endless meme stream across the internet. Beyond the web, stigmas of ADHD are found in television. Season 2 of Netflix's wildly successful Unbreakable Kimmy Schmidt references an ADHD medication, Dyziplen, that transforms rambunctious kids into slow-moving, deadpan pseudo-robots.

A big part of empowering children to manage their ADHD is providing them with interventions, therapies, medications, and lots of support from adults in all aspects of their life. But when it comes to stigma, speaking up in defense of your child is a great way to fight it, just as this parent did External link in reaction to the Kimmy Schmidt episode last year.

When it comes to stigma, speaking up in defense of your child is a great way to fight it.

While misconceptions of ADHD are seemingly omnipresent, there are many strategies parents can use for helping their child with ADHD at home:

Additionally, Chacko encourages parents to learn more about available behavior parent training programs - arguably the most well-studied and effective "therapy" for children with ADHD and related oppositional problems.

"It's important to remember that many students with ADHD also have a learning disability or learning issues," Chacko said. "School counselors, teachers and parents should appreciate that the challenges these children face may be more than just 'ADHD.' "

As with many misunderstood mental disorders, the best way to change the conversation is through an amplified voice. In terms of supporting parents, school counselors can educate them on support groups External link , online forums External link , and through websites like CHADD External link .
Republished with permission: Counseling@NYU, the online masters in school counseling program from NYU Steinhardt.

Fine Print

ADD and ADHD are used interchangeably for Attention-Deficit/Hyperactivity Disorder.

Any information or suggestions in this article are solely the opinion of the author(s) and should not replace the advice of appropriate medical, legal, therapeutic, financial or other professionals. We do not test or endorse any product, link, author, individual or service listed within.

© 2006 - 2017, by The ADD Resource Center. All Rights Reserved.

To view HUNDREDS of articles and videos on ADD/ADHD, go to addrc.org

Posted on Category:Tagged with:
Categories School Issues
Tags ADD, ADHD, counseling, Education, school, Students

More than 6 million children between the ages of 4 and 17 had been diagnosed with attention deficit hyperactivity disorder (ADHD) as of 2011, according to the Centers for Disease Control and Prevention External link . It's a complicated disorder with a long history. In order to cope with the symptoms, children with ADHD need continuous support from parents, teachers, and school counselors. School counselors are especially poised to serve as a key intermediary between parents and teachers and can be essential in helping students with ADHD thrive.
More than 75% of children with ADHD continue to experience significant symptoms in adulthood.

With up to roughly 11 percent of children External link ages 4 to 17 diagnosed with ADHD, school counselors serve as an important support system

Seating the student near the teacher's desk or away from distractions like windows or the corridor.

Splitting longer assignments into smaller segments, and providing more breaks during class time.

Seating students in an area where there will be the least disruption, such as along the side of the classroom.

Creating opportunities for movement throughout the day, such as completing assignments sitting on the floor or helping with class activities (e.g., handing out activity sheets).

When it comes to stigma, speaking up in defense of your child is a great way to fight it.

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Strategies for ADHD: How Counselors Help Today's Students Succeed

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Strategies for ADHD: How Counselors Help Today's Students Succeed More than 6 million children between the ages of 4 and 17 had been diagnosed with attention deficit hyperactivity disorder (ADHD) as of 2011, according to the Centers for Disease Control and Prevention External link . It's a complicated disorder with a long history.

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The adjective "schizophrenic" needs to be removed from counselors' vocabulary, says Elizabeth Prosek, a counselor and assistant professor at the University of North Texas (UNT).

Schizophrenia has a great deal of stigma and negative connotations associated with it, and referring to clients in the first person can lessen these, she says.

"I encourage counselors to advocate for what clients with schizophrenia can do rather than [focusing on] the limitations of experiencing psychosis," says Prosek, who has counseled clients with severe mental health disorders and served on a support team for individuals with schizophrenia living independently. "I once heard someone discuss the 'aggressive nature' of those diagnosed with schizophrenia. I could not help but wonder where that perception evolved. In my experience, clients did not demonstrate aggressive behavior or language."

Counselors, as part of a multidisciplinary treatment team of helping professionals, can play a critical role in the lives of people diagnosed with schizophrenia, say Prosek and Kara Hurt, a licensed professional counselor who works with clients with schizophrenia at an inpatient psychiatric hospital.

Prosek and Hurt, who is also a doctoral student at UNT, recently collaborated to write a practice brief on schizophrenia for the American Counseling Association's Center for Counseling Practice, Policy and Research (see sidebar below).

In the brief, the duo describes schizophrenia as a lifelong illness characterized by negative symptoms, including "delusions, hallucinations (most commonly auditory), disorganized thinking or speech and disorganized or abnormal motor behavior." The estimated prevalence rate for schizophrenia is 1 percent of the population in Western, developed countries.

For counselors, empathy should play a big part in therapy - from knowing the many side effects of schizophrenia medications to fully understanding what it is like to live with hallucinations and psychosis, say Prosek and Hurt. Special training and workshops can help counselors understand the nuances of the disorder, as can materials from mental health agencies (see "for more information" below).

Prosek once attended a seminar at which participants sat through the experience - virtually - of living with hallucinations, experiencing paranoia and hearing voices intertwined with the dialogue of another person.

Prosek and Hurt led a course this past year in which they showed videos of clients with schizophrenia explaining their own experiences.

"When the students in the class debriefed after the video, many confirmed that hearing firsthand from a client decreased their misperceptions about the disorder," says Prosek. "Watching a video of a client with schizophrenia who was articulate and successful in a career reduced stigma of the disorder. Also, I noticed that when person-first language is used when discussing clients with schizophrenia [as opposed to using the term "schizophrenic"], negative connotations are immediately lessened."
What do counselors need to know about schizophrenia?
Elizabeth Prosek: Living with psychosis can be scary and challenging. When working with those diagnosed with schizophrenia, demonstrating empathic concern is essential to build a therapeutic relationship. In my experience, clients appreciated my willingness to embrace their perspective of psychosis. I think all of the clients I worked with experienced their psychosis uniquely, and it was imperative that I understood their lived experience.

Kara Hurt: Schizophrenia affects the client's support system, not just the client. In my experience, it is just as important to provide counseling and support to family members and loved ones of people diagnosed with schizophrenia as it is to provide support and counseling to clients with schizophrenia. All of us counselors can help provide services in some way that help clients diagnosed with schizophrenia and those that love them.

EP: Counselors may provide family members and friends with psychoeducation on the symptoms and treatment options for schizophrenia. Furthermore, counselors may assist family members and friends to build empathy for the experiences of those diagnosed with schizophrenia. There are support groups for family members through the National Alliance on Mental Illness (NAMI). Find a local NAMI support group through nami.org.

For those clients who do not have a familial support system, encouraging the development of a community support network may be essential for the social and emotional well-being of clients diagnosed with schizophrenia. Regardless of diagnosis, humans in general seek "belongingness" in their community, and those diagnosed with schizophrenia are no different.
What advice would you give about working with clients diagnosed with schizophrenia?
EP: Recognizing strengths can be a great first step to creating an appropriate treatment plan. Several of the clients I counseled had creative interests, such as art and music, and we developed interventions to promote participation in those activities.

Also, I recommend communication with all professionals working with the client. In my experience, collaborating with the client's psychiatrist and case manager allowed for a holistic approach when addressing current therapeutic needs. Having a multidisciplinary team also allows for clients to more easily transition in and out of inpatient psychiatric hospitalization when necessary. With the appropriate releases of information, all professionals involved can be aware of how the client's psychosis presented, any medication changes and any changes in treatment recommendations after an inpatient hospitalization stay.

It did not take long after beginning my work with clients diagnosed with schizophrenia for me to recognize the need for socialization. Several of my clients lived in isolation but longed for social relationships. In collaboration with case managers, I organized social outings for clients, which allowed for a more genuine community-living experience. There are several community resources for clients diagnosed with serious mental health disorders, such as supported-work programs. Having knowledge of such programs in the community will serve as great referral sources for clients diagnosed with schizophrenia.
With what other types of issues can clients diagnosed with schizophrenia present?
KH: One of the presenting issues that I had not expected when I started working with clients diagnosed with schizophrenia was substance abuse. One client in particular stands out in my mind because of the extent of his illicit drug use, which worsened his paranoia and other delusions. When working with clients with schizophrenia, you may need to reconsider your assumptions to appreciate that these clients have many of the same kinds of problems as other clients.

EP: I agree. Substance misuse was prevalent among the clients diagnosed with schizophrenia that I worked with as well. I also observed many secondary diagnoses, including anxiety and depression. I connect the anxiety and depressive symptoms back to the potential isolation clients experienced. Furthermore, it seems to me hearing voices and feeling out of touch from reality would lead to feelings of anxiety. Helping my clients accurately explain symptoms to their psychiatrists allowed for more precise medication prescriptions.
What are some common misperceptions about schizophrenia?
EP: One of the common misperceptions I hear frequently when describing a client with schizophrenia is the term "medication noncompliance." I advocate for this phrase to be removed from counselor language. From my observations, when clients did not take medications regularly or as prescribed, it was not with intentional noncompliance, but rather there was confusion when medication regimens became complex or changed with frequency. Moreover, several antipsychotic medications have uncomfortable side effects. On a bad day, when a client is not feeling well, he or she might not feel inclined to perpetuate the experience by taking medications that may worsen physical symptoms. In counseling sessions, taking time to hear clients' concerns or complaints about side effects may help clients feel validated in their experience.

What challenges do counselors face in this area?

EP: I think there may be a perception that clients with schizophrenia only need a case manager and psychiatrist. From my perspective, counselors can play a vital role in the treatment team. Never underestimate the power of a space in which a client's experience is heard and valued.

KH: I think it is absolutely critical to have good supervision when working with a client diagnosed with schizophrenia. I have felt frustrated with my perceptions of clients' lack of progress or insight, but with supportive supervision, I have been able to be more flexible with my therapeutic expectations and shift my perspective to be a better counselor for my clients. I cannot underestimate the value of good supervision. It can help you gain awareness of potential burnout and the need for regular self-care.

EP: Supervision is helpful. I often felt frustrated with the mental health care system and how clients with schizophrenia became victims of gaps in continuity of care. I agree with Kara that there is a greater potential for burnout when working with clients in and out of crisis.

Another challenge for counselors might be understanding the differences in antipsychotic medications most commonly prescribed for clients with schizophrenia. Actually, Kara introduced me to an app (named Epocrates) that provides names, descriptions and side effects for medications. I remember when I first started working with this population, I had a hard time differentiating the medications the clients were prescribed. There are several research studies published outlining effectiveness and common side effects of antipsychotic medications which may be helpful to read.

Going back to one of Kara's original statements about the importance of family supports, it may be challenging to help family understand the experience of schizophrenia. Counselors can serve as a good source of information to help educate and support family members. Consequently, family members can better support the client diagnosed with schizophrenia.

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For more information
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ACA Center for Counseling Practice, Policy and Research practice briefs
Prosek and Hurt's information sheet on schizophrenia is one of 30 practice briefs available to American Counseling Association members through the Center for Counseling Practice, Policy and Research.

The briefs, which range from working with victims of domestic violence to animal-assisted therapy to posttraumatic stress disorder, are written by ACA members who are experts on that particular topic. New practice briefs are being added regularly.

The practice briefs are designed to be practical, evidence-based resources for ACA members, says Victoria Kress, executive editor of the ACA center's practice briefs project and a professor at Youngstown State University in Ohio.

Counselors can use the practice briefs as a refresher on topics they may not encounter very often, such as schizophrenia, or as a jumping-off point for further research. Each brief contains links to in-depth sources and data on a topic, as well as therapy models and other tools.

Kress says each practice brief is written and edited to be practical and succinct, with focused bursts of information on topics that counselors in all works settings may encounter, from divorce and autism to perfectionism and suicide prevention.

The plan is to post 15 to 20 new briefs each year, Kress says, including on each of the new disorders added to the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders.

Kress began soliciting practice briefs from ACA members, then editing and posting the briefs on the ACA website, close to two years ago. The idea grew out of ACA past president Bradley Erford's focus on counselor use of evidence-based practices, Kress says.

"Counselors don't always have access to, or the time to read, journal articles," she says. "We wanted to provide an outlet for ACA members to sit down and get a quick overview. ... It was really born out of this idea that counselors should be using evidence-based practices. We know that counselors are busy and have competing demands. ... The ultimate idea is that it will improve their practice. It's better for their clients and the profession."

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Bethany Bray is a staff writer for Counseling Today. Contact her at bbray@counseling.org

Follow Counseling Today on Twitter @ACA_CTonline and on Facebook: facebook.com/CounselingToday

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What counselors need to know about schizophrenia - Counseling Today

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The adjective "schizophrenic" needs to be removed from counselors' vocabulary, says Elizabeth Prosek, a counselor and assistant professor at the University of North Texas (UNT). Schizophrenia has a great deal of stigma and negative connotations associated with it, and referring to clients in the first person can lessen these, she says.

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How to use mindfulness for depression in 5 steps - Flow Neuroscience

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How much mindfulness is enough to reduce depression? Easy guide to starting your mindfulness practice for depression. Including beginner exercises and theory.

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Child Mind Institute | Transforming Children’s Lives.

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

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Depressive disorders are characterized by persistent feelings of sadness and worthlessness and a lack of desire to engage in formerly pleasurable activities. Depression is not a passing blue mood, which almost everyone experiences from time to time, but a complex mind-body illness that interferes with everyday functioning. It not only darkens one's outlook, but it is also commonly marked by sleep problems and changes in energy levels and appetite. It alters the structure and function of nerve cells so that it disrupts the way the brain processes information and interprets experience. Despite feelings of hopelessness and worthlessness, depression is a treatable condition. It can be treated with psychotherapy or medication, or a combination of both.

Depression is a common condition in modern life. According to the National Institutes of Health, each year more than 16 million adults in the United States experience at least one episode of major depression. The likelihood that a person will develop depression at some point in life is approximately 10 percent. Prolonged social stress and major disruption of social ties are known risk factors for depression, and major negative life events such as loss of a loved one, or loss of a job, increase the subsequent risk of depression. Significant adversity early in life, such as separation from parents or parental neglect or abuse, may create vulnerability to major depression later in life by setting the nervous system to over-respond to stress.

Definition

A depressive disorder is a condition that involves the body, mood, and thoughts. It saps motivation and interferes with normal functioning of daily life. It typically causes pain both to the person experiencing the mood disturbance and those who care about him or her.

By definition, the symptoms must be present for at least two weeks. It is not a sign of personal weakness or a condition that can be willed or wished away. Depression tends to be episodic, with bouts lasting weeks or months. Although symptoms tend to remit spontaneously over time, some form of treatment is important to reduce the likelihood of recurrent episodes. Appropriate treatment can help most people who suffer from depression.

Depressive disorders come in different forms, as is the case with other illnesses such as heart disease. Three of the most common types of depressive disorders are described here. However, all forms are marked by variation in the number of symptoms as well as their severity and persistence.

Major depressive disorder, or major depression, is manifested in a persistently sad mood accompanied by a number of other symptoms that interfere with the ability to work, study, sleep, eat, and enjoy once pleasurable activities. A disabling episode of depression may occur only once but more commonly occurs several times in a lifetime. Depression is more than a disorder only from the neck up. It also affects the function of many systems in the body. Researchers have established, for example, that immune function is often compromised in depressive states, and impaired immune function may in part underlie the link of depression to such other disorders as heart disease.

Dysthymic disorder, or persistent depressive disorder, also called dysthymia, involves symptoms of sad or down mood most days for most of the day over a long term (two years or longer) but the depressed mood is not disabling, although it impairs functioning to some degree. Many people with dysthymia also experience major depressive episodes at some time in their lives.

Some forms of depressive disorder involve a slight variation of features or develop under specific circumstances.

Premenstrual dysphoric disorder manifests in the week before the onset of menses, subsides within days after onset of menstruation, and remits in the week after menstruation. According to the National Institutes of Health, 3 to 8 percent of women of reproductive age meet strict criteria for premenstrual dysphoric disorder.

Major depression with psychotic features, or psychotic depression, occurs when a severe depressive illness is accompanied by delusions and hallucinations, The psychotic features may be mood-congruent with the depression-that is, consistent with the depressive themes of personal inadequacy, guilt, nihilism, or death. Or the delusions and hallucinations may be mood-incongruent, not involving such depressive themes.

Major depression with postpartum onset, or postpartum depression, is diagnosed if a woman develops a major depressive episode during pregnancy or within four weeks after delivery. It is estimated that 3 to 6 percent of women experience postpartum depression.

Major depression with seasonal patterns, or seasonal affective disorder (SAD), is characterized by the onset of a depressive illness during particular times of the year. Typically, the depression develops during the winter months, when there is limited natural sunlight, and completely remits in the spring and summer months. In a minority of cases of major depression with seasonal patterns, the depression occurs during the summer months. SAD may be effectively treated with light therapy, but nearly half of those with SAD do not respond to light therapy alone. Antidepressant medication and psychotherapy can reduce SAD symptoms, either alone or in combination with light therapy.

Symptoms

The following signs and symptoms are cataloged by the DSM-5 as signifiers of major depressive disorder and at least five must be present during the extended period of low mood or loss of pleasure in once-enjoyable pursuits.

Persistent sad, anxious, or empty mood most of the day, most days

Feelings of worthlessness or excessive guilt

Loss of interest or pleasure in activities that were once enjoyed, including sex

Persistent loss of energy or fatigue

Difficulty thinking, concentrating, remembering, or making decisions

Insomnia, early-morning awakening, or oversleeping (hypersomnia)

A significant change in appetite, resulting in unintended weight loss or weight gain

Observable psychomotor agitation or restlessness, or psychomotor slowing

Feelings of hopelessness or pessimism; recurrent thoughts of death or suicide, suicide attempts

Not everyone experiences every symptom, nor do people experience the same symptoms to the same degree. Symptoms may vary not only between individuals but over time in the same individual. Some people have observable behavioral changes, including disrupted sleep and appetite changes. Others have no physical symptoms but their outlook on life grows notably more pessimistic.

The most widely reported symptom of depression is low mood and a sense of hopelessness about life and one's own prospects. Many people can relate to such sentiments and have experienced them at some point. But for a person who is experiencing depression, this outlook is persistent and does not remit. If someone reports that they have felt this way for two weeks or more, they should be encouraged to seek professional help.

Causes

There is no single cause of depression. Rather, evidence indicates it results from a combination of genetic, biological, environmental, and psychological factors.

Research deploying brain-imaging-such as magnetic resonance imaging (MRI)-and other technologies shows that the brains of people who have depression look different than those of people without depression. The parts of the brain responsible for regulating mood, thinking, sleep, appetite, and behavior appear to function abnormally. But these changes do not reveal why the depression has occurred.

There are many pathways to depression. Genetic factors may play a complex role in setting the level of sensitivity to certain kinds of events, including the level of nervous system reactivity to stress and other challenges. Scientists know there is no single gene involved: many genes likely play a small role in contributing to vulnerability; acting together with environmental or other factors.

However, depression can occur in people without family histories of it as well. There is significant evidence that harsh early environments-especially experiences of severe adversity such as abuse or neglect in childhood -can create vulnerability to later depression by altering the sensitivity of the nervous system to distressing or threatening events.

Experiences of failure, rejection, social isolation, loss of a loved one, or frustration or disappointment in achieving a healthy relationship or any other life goal often precede an episode of depression. For that reason, many researchers regard the negative mood state of depression as a painful signal that basic psychological needs are not being met and that new strategies are needed. They also suggest that depression to some degree results from a lack of skills in processing negative feelings; some of the most effective therapies for depression teach what can be considered basic mental hygiene, cognitive and emotional tools for dealing with negative feelings. Trauma, which can overwhelm emotional processing mechanisms, is another common trigger for depressive episodes.
Depression in Women
Women experience depression about twice as often as men. Biological, life cycle, hormonal, and other factors-including experiential ones-unique to women may be linked to their higher depression rate. Researchers have shown that hormones directly affect brain regions that influence emotions and mood, and they are further exploring how hormone cycles can give rise to depressive states. Some women may be susceptible to the severe form of premenstrual syndrome called premenstrual dysphoric disorder (PMDD). Women are also vulnerable to depression after giving birth, when hormonal and physical changes, along with the new responsibility of caring for a helpless infant can be overwhelming. Many women also uniquely face such proven chronic stresses as juggling work and home responsibilities, single parenthood, domestic abuse, and caring for children and aging parents.

Ongoing research probes why some people faced with enormous challenges develop depression, while others with similar challenges do not.
Depression in Men
Millions of men in the U.S. and around the world also suffer the psychic pain of depression. Research and clinical evidence establish that while both women and men can develop the standard symptoms of depression, they often experience depression differently and may have different ways of coping with the symptoms. Men may be more willing to acknowledge fatigue, irritability, loss of interest in work or hobbies, and sleep disturbances rather than feelings of sadness, worthlessness, and excessive guilt. Some researchers question whether the standard definition of depression and the diagnostic tests based upon it adequately capture the condition as it occurs in men.

Depression can also affect the physical health of men differently from women. One study shows that, although depression is associated with an increased risk of coronary heart disease in both men and women, only men experience an elevated death rate.

Instead of acknowledging their feelings or seeking help in the form of appropriate treatment, men may turn to alcohol or drugs when they are distressed. They may also be angry, irritable, and, sometimes, violently abusive. Some men deal with emotional distress by throwing themselves compulsively into their work, attempting to hide their depression from themselves, family, and friends. Other men may respond to depression by engaging in reckless behavior, taking risks, and putting themselves in harm's way.

Encouragement and support from concerned family members can be lifesaving. In the workplace, employee assistance programs or worksite mental health programs can be particularly important in helping men understand depression as a real disorder that needs treatment.
Depression in the Elderly
Contrary to some popular thinking, depression is not a normal accompaniment to aging. On the contrary, older people tend to experience rising levels of satisfaction with their lives. However, when older adults do develop depression, the condition may be overlooked because it can manifest less in feelings of sadness or grief and more in irritability or general apathy. Elders often voice feelings of tiredness. Also, depression tends to affect memory, and in the elderly depression can show up as confusion or problems with attention. Aging brings many life changes that can be triggers for depression, including loss of a loved one, loss of employment and sense of purpose, loss of robustness, or good health.

In addition, medical conditions that occur more frequently with age, such as heart disease, stroke, and cancer, may cause depressive symptoms. Or the medications used for such conditions may carry side effects that contribute to depression.

There is a type of depression that develops in later life, known as vascular depression, sometimes also called arteriosclerotic depression or subcortical ischemic depression. It results from cerebrovascular damage that occurs with cardiovascular disease. Brain-imaging studies show that areas of blood vessel damage restrict blood flow to regions of the brain involved in emotion and mood regulation or to the brain's white matter. Those who develop vascular depression often have a history of hypertension or high blood pressure. Vascular depression may manifest in paranoia, aggressive tendencies, apathy, and slowing of movement. There are deficits in executive function. Diagnosis may involve magnetic resonance imaging (MRI) to detect vascular pathology in specific parts of the brain. Vascular depression tends not to respond to antidepressant medication; instead, the first line of approach may be forms of psychosocial support and or cognitive behavioral therapy.

The majority of older adults with depression improve when they receive treatment with psychotherapy, antidepressant medication, or a combination of the two. Research has shown that psychotherapy alone can be effective in prolonging periods free of depression.

More than four times as many men as women die by suicide in the U.S., even though women make more suicide attempts during their lives. In light of the research indicating that suicide is often associated with depression, the high suicide rate among men may reflect the fact that many men with depression do not seek adequate diagnosis and treatment.

Report remarks about suicide to the depressed person's therapist, if they have one. Invite the depressed person for walks, outings, to the movies, and other activities. Keep trying. Although diversions and company are needed, too many demands may increase feelings of failure. Remind your friend or relative that with time and treatment, the depression will lift. Psychology Today maintains a list of suicide prevention hotline resources in various countries as well as an extensive therapy directory.

Treatment

Depression, even in the most severe cases, is a highly treatable disorder. The sooner treatment begins, the more effective it is and the greater the likelihood that recurrence can be prevented.

Appropriate treatment for depression starts with a physical examination by a physician. A number of medications, as well as some medical conditions, including viral infections and thyroid disorder, can cause depression-like symptoms and must be ruled out. Once a physical cause of depression is ruled out, a psychological evaluation can be conducted, either by the examining physician or via referral to a mental health professional.

An evaluation should include a detailed inquiry into the history and nature of current symptoms and prior episodes and their management as well as any family history of depression and its treatment. From this information, the severity of current symptoms can be rated; this information serves as a baseline for measuring improvement over time and guides the course of treatment.

Once diagnosed, depression can be treated with psychotherapy, medication, or a combination of both. Medication may help reduce symptoms while psychotherapy addresses the negative thoughts, feelings, and beliefs that give rise to distress and that need to be managed in more productive ways.
Psychotherapies
For mild to moderate depression, psychotherapy is generally considered the best treatment option. Psychotherapy is important in helping patients develop strategies for dealing with the situations that give rise to depression and to effectively manage the negative thoughts and feelings that mark the distress. Both cognitive-behavioral therapy (CBT), and interpersonal therapy (IPT) have been widely tested and shown to be effective in treating depression. By teaching new ways of thinking and behaving, CBT gives people skills to disarm negative styles of thinking and behaving. IPT helps people understand and work through troubled personal relationships that may cause or exacerbate their depression.

Studies have indicated that for adolescents, a combination of medication and psychotherapy may be the most effective approach to treating major depression and reducing the likelihood of recurrence. Similarly, a study examining depression treatment among older adults found that patients who responded to initial treatment of medication and IPT were less likely to have recurring depression if they continued their combination treatment for at least two years.
Medications
Antidepressants target various neurochemicals-notably serotonin, norepinephrine, and dopamine -known to be involved in the relay of signals through various brain circuits. Nevertheless, it is not entirely clear how they work or why they can take weeks or months to produce a positive effect-the brain is a highly complex organ.

The most popular medications are called selective serotonin reuptake inhibitors (SSRIs). SSRIs include fluoxetine (Prozac), citalopram (Celexa), and sertraline (Zoloft), among others. Serotonin and norepinephrine reuptake inhibitors (SNRIs) are similar to SSRIs and include venlafaxine (Effexor) and duloxetine (Cymbalta). Now in use for decades, SSRIs and SNRIs coexist with older classes of antidepressants: tricyclics-named for their chemical structure-and monoamine oxidase inhibitors (MAOIs). The SSRIs and SNRIs tend to have fewer major side effects than the older drugs. However, medications affect everyone differently and there is no one-size-fits-all medication. Tricyclics and MAOIs remain important antidepressants. Finding a medication regimen that works for any particular patient may take trials of more than one antidepressant and more than one type of antidepressant.

Antidepressants typically take time to work. Patients must take regular doses for at least three to four weeks before they are likely to experience a full therapeutic effect and continue taking the medication to maintain improved mood and to prevent a relapse of the depression. Although antidepressants are not habit-forming or addictive, abruptly ending an antidepressant treatment can cause withdrawal symptoms or lead to a relapse. Some individuals, such as those with chronic or recurrent depression, may need to stay on the medication indefinitely.

Despite the relative safety and popularity of SSRIs and other antidepressants, some studies have suggested that they may have unintentional effects on some people, especially adolescents and young adults. The U.S. Food and Drug Administration requires a "black box" warning label on all antidepressant medications to alert the public about the potential increased risk of suicidal thinking or attempts in children, adolescents, and young adults taking antidepressants.

Side effects can limit the usefulness of SSRIs, SNRIs, tricyclics, and MAO inhibitors. People taking MAOIs must adhere to significant food and medicinal restrictions-from wine and cheese to decongestants-to avoid potentially serious interactions. Patients taking an MAO inhibitor should receive a complete list of prohibited foods, medicines, and substances at the time of prescription. The most common side effects of tricyclic antidepressants include dry mouth, constipation, difficulty emptying the bladder, sexual problems, blurred vision, dizziness, and daytime drowsiness. The most common side effects associated with SSRIs and SNRIs include headache, nausea, nervousness and insomnia, agitation, and decreased libido.

The newest medication in the antidepressant arsenal is ketamine, an agent long used safely as an anesthetic. In randomized, controlled trials, a molecular variant of ketamine, called esketamine, has recently been found safe and effective as a treatment for depression. Administered by nasal spray, it acts very rapidly to improve mood. Further, studies show that it also reduces suicidal thinking. It is not fully clear how esketamine produces its antidepressant effects, but the drug has a mechanism of action that is different from any other available antidepressant. It binds to NMDA receptors in the brain, blocking uptake of the excitatory neurotransmitter glutamate, which causes a rapid increase in glutamate levels. The glutamate burst ultimately strengthens neural circuits in areas of the brain involved in motivation, memory, and mood, known to be impaired in depression. The new drug, trade-named Spravuto, is intended for adults with treatment-resistant depression and, because of its potential for abuse, is administered in doctors' offices.
Herbal Therapy
Over the years, there has been considerable interest in the use of herbs for the treatment of both depression and anxiety. St. John's wort ( Hypericum perforatum), often used in Europe, has aroused interest in the United States as well, as it has been used for centuries in many folk and herbal remedies. A number of modern studies have tested the effectiveness of St. John's wort for depression.

According to the National Center for Complementary and Integrative Health: "St. John's wort isn't consistently effective for depression. Do not use it to replace conventional care or to postpone seeing your health care provider. St. John's wort limits the effectiveness of many prescription medicines. Combining St. John's wort and certain antidepressants can lead to a potentially life-threatening increase in your body's levels of serotonin, a chemical produced by nerve cells."
Neurostimulation Therapies
Electroconvulsive therapy (ECT) is useful, particularly for individuals whose depression is severe or life-threatening, or for those who cannot take antidepressant medication. ECT often is effective in cases where antidepressant medications do not provide sufficient relief of symptoms. In recent years, ECT has been much improved. A muscle relaxant is given before treatment, which is done under brief anesthesia. Electrodes are placed at precise locations on the head to deliver electrical impulses. The stimulation causes a brief (about 30 seconds) seizure within the brain. The person receiving ECT does not consciously experience the electrical stimulus. For full therapeutic benefit, at least several sessions of ECT, typically given at the rate of three per week, are required.
Lifestyle Changes
Research shows that a number of factors in daily living have a positive effect on mood states. These include a nutrient-rich diet, physical activity, exposure to sunlight and outdoors, and social activity. Lifestyle changes that address these factors are increasingly considered a wise course in any treatment plan.
How to Help Yourself If You Are Depressed
Depressive disorders can make a person feel exhausted, worthless, helpless, and hopeless. Such negative thoughts and feelings make people feel like giving up. It is important to realize that such negative views are part of the disorder and typically do not reflect actual circumstances. Negative thinking fades as treatment begins to take effect. In the meantime:

Try to be with other people and to confide in someone; it is usually better than being alone and secretive.

Participate in activities that may make you feel better.

Even mild exercise, going to a movie or a ball game, or participating in religious, social, or other activities can help.

Expect your mood to improve gradually; it takes time.

Because depression distorts thinking, it is advisable to postpone important decisions until the depression lifts. Before deciding to make a significant transition-change jobs, get married, or divorce-discuss it with others who know you well and have a more objective view of your situation.

Let family and friends help you.

The most important thing anyone can do for a depressed person is to help him or her get an appropriate diagnosis and treatment. It may require making an appointment on their behalf and accompanying them to the doctor. Encouraging a loved one to stay in treatment is helpful.Emotional support is also invaluable. This involves understanding, patience, affection, and encouragement. Engage the depressed person in conversation and listen carefully. Do not disparage feelings expressed, but point out realities and offer hope.

National Institutes of Health

Archives of Internal Medicine

Psychopharmacology Bulletin

Find a depression therapist.

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Depressive disorders are characterized by persistent feelings of sadness and worthlessness and a lack of desire to engage in formerly pleasurable activities. Depression is not a passing blue mood, which almost everyone experiences from time to time, but a complex mind-body illness that interferes with everyday functioning.

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Understanding bipolar disorder

Most people have emotional ups and downs from time to time. But if you have a brain condition called bipolar disorder, your feelings can reach abnormally high or low levels.

Sometimes you may feel immensely excited or energetic. Other times, you may find yourself sinking into a deep depression. Some of these emotional peaks and valleys can last for weeks or months.

There are four basic types of bipolar disorder:

Bipolar 1 and 2 disorders are more common than the other types of bipolar disorder. Read on to learn how these two types are alike and different.

All types of bipolar disorder are characterized by episodes of extreme mood. The highs are known as manic episodes. The lows are known as depressive episodes.

The main difference between bipolar 1 and bipolar 2 disorders lies in the severity of the manic episodes caused by each type.

A person with bipolar 1 will experience a full manic episode, while a person with bipolar 2 will experience only a hypomanic episode (a period that's less severe than a full manic episode).

A person with bipolar 1 may or may not experience a major depressive episode, while a person with bipolar 2 will experience a major depressive episode.

What is bipolar 1 disorder?

You must have had at least one manic episode to be diagnosed with bipolar 1 disorder. A person with bipolar 1 disorder may or may not have a major depressive episode. The symptoms of a manic episode may be so severe that you require hospital care.

Manic episodes are usually characterized by the following:

The symptoms of a manic episode tend to be so obvious and intrusive that there's little doubt that something is wrong.

What is bipolar 2 disorder?

Bipolar 2 disorder involves a major depressive episode lasting at least two weeks and at least one hypomanic episode (a period that's less severe than a full-blown manic episode). People with bipolar 2 typically don't experience manic episodes intense enough to require hospitalization.

Bipolar 2 is sometimes misdiagnosed as depression, as depressive symptoms may be the major symptom at the time the person seeks medical attention. When there are no manic episodes to suggest bipolar disorder, the depressive symptoms become the focus.

As mentioned above, bipolar 1 disorder causes mania and may cause depression, while bipolar 2 disorder causes hypomania and depression. Let's learn more about what these symptoms mean.

Mania

A manic episode is more than just a feeling of elation, high energy, or being distracted. During a manic episode, the mania is so intense that it can interfere with your daily activities. It's difficult to redirect someone in a manic episode toward a calmer, more reasonable state.

People who are in the manic phase of bipolar disorder can make some very irrational decisions, such as spending large amounts of money that they can't afford to spend. They may also engage in high-risk behaviors, such as sexual indiscretions despite being in a committed relationship.

An episode can't be officially deemed manic if it's caused by outside influences such as alcohol, drugs, or another health condition.

Hypomania

A hypomanic episode is a period of mania that's less severe than a full-blown manic episode. Though less severe than a manic episode, a hypomanic phase is still an event in which your behavior differs from your normal state. The differences will be extreme enough that people around you may notice that something is wrong.

Officially, a hypomanic episode isn't considered hypomania if it's influenced by drugs or alcohol.

Depression

Depressive symptoms in someone with bipolar disorder are like those of someone with clinical depression. They may include extended periods of sadness and hopelessness. You may also experience a loss of interest in people you once enjoyed spending time with and activities you used to like. Other symptoms include:

tiredness

irritability

trouble concentrating

changes in sleeping habits

changes in eating habits

thoughts of suicide

Scientists don't know what causes bipolar disorder. Abnormal physical characteristics of the brain or an imbalance in certain brain chemicals may be among the main causes.

As with many medical conditions, bipolar disorder tends to run in families. If you have a parent or sibling with bipolar disorder, your risk of developing it is higher. The search continues for the genes which may be responsible for bipolar disorder.

Researchers also believe that severe stress, drug or alcohol abuse, or severely upsetting experiences may trigger bipolar disorder. These experiences can include childhood abuse or the death of a loved one.

A psychiatrist or other mental health professional typically diagnoses bipolar disorder. The diagnosis will include a review of both your medical history and any symptoms you have that are related to mania and depression. A trained professional will know what questions to ask.

It can be very helpful to bring a spouse or close friend with you during the doctor's visit. They may be able to answer questions about your behavior that you may not be able to answer easily or accurately.

If you have symptoms that seem like bipolar 1 or bipolar 2, you can always start by telling your doctor. Your doctor may refer you to a mental health specialist if your symptoms appear serious enough.

A blood test may also be part of the diagnostic process. There are no markers for bipolar disorder in the blood, but a blood test and a comprehensive physical exam may help rule out other possible causes for your behavior.

Doctors usually treat bipolar disorder with a combination of medications and psychotherapy.

Mood stabilizers are often the first drugs used in treatment. You may take these for a long time.

Lithium has been a widely used mood stabilizer for many years. It does have several potential side effects. These include low thyroid function, joint pain, and indigestion. It also requires blood tests to monitor therapeutic levels of the drug as well as kidney function. Antipsychotics can be used to treat manic episodes.

Your doctor may start you on a low dose of whichever medication you both decide to use in order to see how you respond. You may need a stronger dose than what they initially prescribe. You may also need a combination of medications or even different medications to control your symptoms.

All medications have potential side effects and interactions with other drugs. If you're pregnant or you take other medications, be sure to tell your doctor before taking any new medications.

Writing in a diary can be an especially helpful part of your treatment. Keeping track of your moods, sleeping and eating patterns, and significant life events can help you and your doctor understand how therapy and medications are working.

If your symptoms don't improve or get worse, your doctor may order a change in your medications or a different type of psychotherapy.

Bipolar disorder isn't curable. But with proper treatment and support from family and friends, you can manage your symptoms and maintain your quality of life.

It's important that you follow your doctor's instructions regarding medications and other lifestyle choices. This includes:

Including your friends and family members in your care can be especially helpful.

It's also helpful to learn as much as you can about bipolar disorder. The more you know about the condition, the more in control you may feel as you adjust to life after diagnosis.

You may be able to repair strained relationships. Educating others about bipolar disorder may make them more understanding of hurtful events from the past.

Support groups, both online and in person, can be helpful for people with bipolar disorder. They can also be beneficial for your friends and relatives. Learning about others' struggles and triumphs may help you get through any challenges you may have.

The Depression and Bipolar Support Alliance maintains a website that provides:

personal stories from people with bipolar disorder

contact information for support groups across the United States

information about the condition and treatments

material for caregivers and loved ones of those with bipolar disorder

The National Alliance on Mental Illness can also help you find support groups in your area. Good information about bipolar disorder and other conditions can also be found on its website.

If you've been diagnosed with bipolar 1 or bipolar 2, you should always remember that this is a condition you can manage. You aren't alone. Talk to your doctor or call a local hospital to find out about support groups or other local resources.

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Bipolar 1 vs. Bipolar 2: Know the Difference

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Bipolar 1 disorder and bipolar 2 disorder cause your feelings to hit unusual highs and lows. These emotional peaks and valleys can last for weeks or months. Learn about the differences between these common mental health conditions and what you can do for diagnosis, treatment, support options, and more.

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What to do when kids wont sit still and be quiet counselor teacher strategies

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A condition exhibiting one or more of the following characteristics over a long period of time and to a marked degree that adversely affects a child's educational performance:

An inability to learn that cannot be explained by intellectual, sensory, or health factors.

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

Inappropriate types of behavior or feelings under normal circumstances.

A general pervasive mood of unhappiness or depression.

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

Emotional disability includes schizophrenia. The term does not apply to children who are socially maladjusted, unless it is determined that they have an emotional disturbance.
General Characteristics of Emotional Disturbance vs. Social Maladjustment
A student who receives special education services under the category of Emotional Disability has emotional problems of some kind that are adversely affecting his/her educational performance. Usually schools look at grades, discipline records, and performance on achievement tests to quantify educational impact. In determining eligibility for Emotional Disability, several evaluations are typically completed. A school will conduct psychological testing by a school psychologist, which will include cognitive testing and social/emotional measures ( rating scales, interviews, observations). Educational testing is typically completed to determine current levels of achievement in reading, writing, math, and other educational areas. Additionally, a Sociocultural evaluation or interview by a school social worker is typically completed with a parent to rule out environmental factors and obtain a developmental history. (See SPED testing for more information)

Often, the most difficult part of determining eligibility for special education services in this category is determining if the student has an emotional disability or social maladjustment. The following is adapted from a chart that was shown at a training I attended by Bruce Bracken. He adapted it from Social Maladjustment: A Guide to Differential Diagnosis and Educational Options (Wayne County Regional Educational Service Agency - Michigan, 2004).

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A condition exhibiting one or more of the following characteristics over a long period of time and to a marked degree that adversely affects a child's educational performance: An inability to learn that cannot be explained by intellectual, sensory, or health factors. An inability to build or maintain satisfactory interpersonal relationships with peers and teachers.

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The Dawn Wellness Centre and Rehab Thailand

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35 Anxiety Coping Skills: A List of Effective Remedies

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When stress begins to reach uncomfortable levels, our anxiety coping skills list can help you bring your emotions back to a place where they are easier to handle.

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25 Grounding Techniques for Anxiety - Choose Mental Health

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Struggling with anxiety can be debilitating. Choose Mental Health considers 25 grounding techniques for anxiety.

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Children's Mental Health Disorder Fact Sheet