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The School Counselor and Student Mental Health 

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The School Counselor and Student Mental Health 

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This pdf provides an oversight of school counselors and their role in advocating for student's mental health

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National Institute of Mental Health gives an overview of Schizophrenia, associated symptoms, risk factors, and treatment.

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National Institute of Mental Health (NIMH)

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What is schizophrenia?

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

What are the signs and symptoms of schizophrenia?

What are the risk factors for schizophrenia?

How is schizophrenia treated?

How can I find help for schizophrenia?

How can I find a clinical trial for schizophrenia?

Where can I learn more about schizophrenia?

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

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Obsessive Compulsive Behaviors in the Classroom

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Obsessive Compulsive Behaviors in the Classroom

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Mind Matters Psychiatry is a treatment center that evaluates and treats ADHD and other disorders in adolescents.

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Anxiety and Depression Association of America

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Anxiety and Depression Association of America

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ADAA is an organization that works to prevent, cure, and treat individuals with anxiety and depression.

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Anxiety and Depression Association of America, ADAA

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

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

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The Holiner Psychiatric Group provides treatment for anxiety disorders to children, adolescents, and adults.

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Founded by Doctor Joel Holiner in 1983, The Holiner Psychiatric Group is a Dallas Psychiatric services center that has been honored to serve the DFW metroplex for over three decades. Dr. Holiner is board certified by the American Board of Psychiatry & Neurology and specializes in addiction psychiatry.

Our office is a full-service practice committed to providing high-quality inpatient and outpatient services for children, adolescents, adults and seniors. Our clinical and support staff is dedicated to providing our patients with a positive and helpful experience with their medical care.

Please feel free to roam our site to meet our clinicians, learn about our services and keep up with our latest news. To provide the finest and most accurate patient care possible, as well as meet patient needs, The Holiner Psychiatric Group offers many specialty services.

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Dallas TX Psychiatric Services | TMS Therapy | Holiner Psychiatric Group

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Founded by Doctor Joel Holiner in 1983, The Holiner Psychiatric Group is a Dallas Psychiatric services center that has been honored to serve the DFW metroplex for over three decades. Dr. Holiner is board certified by the American Board of Psychiatry & Neurology and specializes in addiction psychiatry.

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Teenager describes what having anxiety disorder feels like

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Teenager describes what having anxiety disorder feels like

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When and how to make a referral for mental health

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When and how to make a referral for mental health

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Most children and parents will have some distress or upset - so how do I know when a child or family needs additional help?

Ask your patients (and their parents) about reactions and coping.

Listen for ongoing or severe traumatic stress symptoms.

Consider a referral for a more thorough evaluation with a mental health professional if:

Traumatic stress reactions are severe or prolonged (more than a month).

Traumatic stress reactions interfere with recovery or with returning to normal activities.

Consider: Is the child participating in daily activities to the extent possible given their medical condition? Are stress reactions interfering with treatment adherence? Are new fears or worries troubling the child or parent?

Steps for making a referral Effective mental health treatment for traumatic stress Online resources - help in finding a mental health professional Distinguishing between types of mental health professionals
Therapist Resource Guide: There are many ongoing stressors that children and families endure after diagnosis of an illness or an injury. This guide focuses specifically on medical traumatic stress and responses that children and families may have.

Steps for making a referral

Mention concerns you have identified.
Say something like: "I'm concerned that (you are / your child is) having these upsetting thoughts and feelings. It might be useful to talk with a specialist who can help your family more."

Involve child and family in making a plan.
Ask for their ideas about what is needed now
Say something like: "What issues or difficulties are impacting you / your family the most right now? What would help make things better?"

Ask for permission to offer advice. Present advice as range of possibilities; be sure to incorporate patient/family ideas

Say something like: "I have some suggestions that have helped other patients in the past in situations similar to yours. May I share them with you?"

Range of possibilities might include: patient education materials / websites; speaking with social worker, local clergy, school counselor; seeking out support group, referral to therapist / community mental health center.

Ask about their readiness to act on this now or in the future.
Say something like: "Is this (suggested plan) something you would be willing to do when you leave today, or if you need it next week...month?"

Ask about barriers to potential plans / referrals, and strategies to overcome barriers.
Say something like: "What kinds of things would interfere with following-up on this plan we just discussed? How can we work through this so you end up getting the help you need.?"

Involve the child and parent in setting the agenda*:*Adapted from Wissow et al. (2008)

Keep the door open.

If your patient or their parents are not quite ready to act on a suggested referral now, arrange to follow up to see how your patient is doing.

You might say: "I'd like to talk with you again in a few weeks to see how things are going."

Promote continuity of care.
If your care for this patient is ending, ask permission to communicate your concerns about traumatic stress reactions or risk factors to the child's primary care provider, or to other providers who will continue to take care of this patient.

Facilitating collaboration between pediatric health care and mental health providers: The American Academy of Pediatrics Task Force on Mental Health has developed tools to facilitate collaboration between pediatric health care providers and mental health professionals, including a Physician Referral and Feedback Form template

Effective mental health treatment for traumatic stress

There are very good and helpful treatments for children who continue to have traumatic stress symptoms.
What treatment approaches are effective?
Evidence-based treatments include cognitive-behavioral treatment approaches, and in particular Trauma-Focused Cognitive Behavior Therapy (TF-CBT).

Click here for a fact sheet about effective treatments for youth trauma from the National Child Traumatic Stress Network.

A recent article includes informative summaries of effective mental health treatments for child traumatic stress symptoms, and guidance for health care professionals:
Cohen, J, Kelleher, K, Mannarino, A.. Identifying, treating, and referring traumatized children: The role of pediatric providers. Archives of Pediatric and Adolescent Medicine 2008;162(5):447-452 How can I help parents find effective treatment for their child?
When helping parents find a counselor or therapist to help their child with traumatic stress symptoms, you might suggest that they ask prospective therapists questions such as:

Do you have experience working with children after trauma?

What is your approach to working with this type of problem?

What is your success rate?

How do you work with parents?

The National Child Traumatic Stress Network offers useful tips and information about finding a mental health professional to help children and their families after trauma.

Online resources - help in finding a mental health professional

The National Child Traumatic Stress Network (NCTSN) has trauma-trained, child mental health professionals and community-based treatment centers in 35 states in the US. For information about or referral to a NCTSN center near you, please go to the NCTSN Organizational Members site.
American Psychological Association - Psychologist Locator National Association of Social Workers - Find a Licensed Social Worker American Academy of Child and Adolescent Psychiatrists - Psychiatrist Finder Anxiety Disorders Association of America - Find a Therapist Sidran Institute Help Desk - Locate Trauma Resources ISTSS Clinician Directory - Find a Clinician, Counselor or Mental Health Professional
Distinguishing between types of mental health professionals

Psychologists are professionals who have earned a doctoral degree (Ph.D. or Psy.D.) after 4-6 years of graduate-level training in human behavior and development, psychological testing and evaluation, and psychotherapy. Psychologists are licensed by the state in which they practice.

Psychiatrists are physicians (M.D. or D.O.) who have completed medical school, plus additional advanced training in the evaluation and treatment of psychiatric disorders and emotional and behavioral problems. Psychiatrists are licensed by the state in which they practice. As medical doctors, psychiatrists can prescribe and monitor medications.

Clinical Social Workers are professionals who have earned a master's degree (M.S.W.) after 2-3 years of graduate training. Clinical Social Workers are licensed by the state in which they practice (LCSW or similar credential - varies by state).

Marriage and Family Therapists are professionals who have completed a master's degree (M.A. or M.S.) after 2-3 years of graduate training. Some Marriage and Family Therapists have completed a required amount of clinical hours and passed a state-administered examination to become licensed marriage and family therapist (LMFT).

Licensed Professional Counselors (LPC) & Licensed Mental Health Counselors (LMHC) are mental health professionals who have earned a master's degree (M.A. or M.S.) after 2-3 years of graduate training and have obtained a required amount of clinical experience and passed a state-administered licensing examination.

For more information on the training and credentialing of mental health professionals, see Mayo Clinic: Mental health providers.

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When and How to Refer for Mental Health Care

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Pediatric providers can follow specific steps to determine if and how to refer a child and familiy for further mental health services after a medically traumatic event. Providers can also become familiar with current evidence-based treatments and online resources for mental health services for traumatic stress.

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Mayo clinic gives insight on Depression Disorder, symptoms in adults, children and teens, and treatment needed.

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Overview

What is depression? A Mayo Clinic expert explains.

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

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

What is depression?

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

What causes depression?

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

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

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

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

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

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

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

Feelings of sadness, tearfulness, emptiness or hopelessness

Angry outbursts, irritability or frustration, even over small matters

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

Sleep disturbances, including insomnia or sleeping too much

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

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

Anxiety, agitation or restlessness

Slowed thinking, speaking or body movements

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

Trouble thinking, concentrating, making decisions and remembering things

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

Unexplained physical problems, such as back pain or headaches

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

Depression symptoms in children and teens

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

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

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

Depression symptoms in older adults

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

Memory difficulties or personality changes

Physical aches or pain

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

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

Suicidal thinking or feelings, especially in older men

When to see a doctor

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

When to get emergency help

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

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

Call your doctor or mental health professional.

Contact a suicide hotline.

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

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

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

Reach out to a close friend or loved one.

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

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

More Information

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Causes

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

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

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

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

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

Risk factors

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

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

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

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

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

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

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

Abuse of alcohol or recreational drugs

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

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

Complications

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

Examples of complications associated with depression include:

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

Pain or physical illness

Alcohol or drug misuse

Anxiety, panic disorder or social phobia

Family conflicts, relationship difficulties, and work or school problems

Social isolation

Suicidal feelings, suicide attempts or suicide

Self-mutilation, such as cutting

Premature death from medical conditions

Prevention

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

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

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

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

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

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Depression (major depressive disorder) - Symptoms and causes

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

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Teen twins share experience of Binge eating

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Teen twins share experience of Binge eating

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The First Time Since Love Triangle Turned Deadly

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Life Of Identical Twins With Identical Eating Disorders

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Identical Twins Share Intimate Details Of Their Shared Eating Disorders

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Identical twins Taylor and Tricia share how they see themselves, and each other and what they feel about their disease as they battle matching eating disorders. http://drphil.com Subscribe to Dr. Phil: http://bitly.com/SubscribeDrPhil LIKE us on Facebook: http://bitly.com/DrPhilFacebook Follow us on Twitter: http://bitly.com/DrPhilTwitter Dr. Phil uses the power of television to tell compelling stories about real people.

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Counseling Youth with Attention Deficit Hyperactivity Disorder

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Counseling Youth with Attention Deficit Hyperactivity Disorder

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New Horizon Center for Healing is a treatment center located in Dallas-Fort Worth provides quality outpatient mental health services.

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North Dallas, McKinney Counseling Center

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Counseling & Psychiatric Mental Health Services -McKinney, TX

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New Horizons Center for Healing provides counseling, psychiatric and mental health services for Dallas and North Dallas. We are located in McKinney, TX.

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Depression and Bipolar Support Alliance (DBSA)

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Depression and Bipolar Support Alliance (DBSA)

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DBSA is a national organization that focuses on mood disorders such as depression and bipolar disorder. DBSA provides hope, support, help, and
education to improve lives of those with mood disorders.

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

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

Treatment Options

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

Daily tools empower your wellness journey

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

Start with Strengths

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

Keep Daily Logs

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

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

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DBSA - Depression and Bipolar Support Alliance

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

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Teens Health is a website that provides information on eating disorder, such as different types of eating disorders, causes and effects eating disorders, treatment plans, and many more.

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What Are Eating Disorders?

Eating disorders are problems that affect a person's eating behaviors as well as their attitudes and feelings about food - and about their body.

Eating disorders affect a person's mental health and can cause serious harm to a person's physical health.

There are several types of eating disorders.

What Are the Different Types of Eating Disorders?

Common types of eating disorders are anorexia, bulimia, binge eating, and avoidant/restrictive food intake disorder (ARFID).

Anorexia. People with anorexia:

eat very little on purpose, leading to a very low body weight

have an intense fear of weight gain and fear looking fat

have a distorted body image and see themselves as fat even when they are very thin

People with anorexia are very strict about what and how much they will eat. They may think about food or calories almost all the time.

To lose weight, some people with anorexia fast or exercise too much. Others may use laxatives, diuretics (water pills), or enemas.

Bulimia. People with bulimia:

overeat and feel out of control to stop, called binge eating

do things to make up for overeating, such as:

make themselves throw up on purpose after overeating, called purging

use laxatives, diuretics, weight loss pills, fast, or exercise a lot to prevent weight gain

judge themselves based on body shape and weight

People with bulimia eat much more (during a set period of time) than most people would. If a person regularly binges and purges, it may be a sign of bulimia. Unlike people with anorexia who are very low weight, people with bulimia may be thin, average weight, or overweight. People with bulimia often hide their eating and purging from others.

Binge eating. People with binge eating disorder:

overeat and feel out of control to stop

eat large amounts even when they are not hungry

may feel upset or guilty after binge eating

often gain weight and may become very overweight

Many people with binge eating disorder eat faster than normal. They may eat alone so others don't see how much they are eating. Unlike people with bulimia, those with binge eating disorder do not make themselves throw up, use laxatives, or exercise a lot to make up for binge eating. If a person binge eats at least once a week for 3 months, it may be a sign of binge eating disorder.

ARFID. People with avoidant/restrictive food intake disorder:

are not interested in food or avoid foods

lose weight, or don't gain expected amount of weight

are not afraid of gaining weight

don't have a poor body image

People with ARFID don't eat because they are turned off by the smell, taste, texture, or color of food. They may be afraid that they will choke or vomit. They don't have anorexia, bulimia, or another medical problem that would explain their eating behaviors.

How Do Eating Disorders Affect Health and Emotions?

Eating disorders can cause serious problems throughout the body.

Anorexia can lead to health problems caused by undernutrition and low body weight, such as:

low blood pressure

slow or irregular heartbeats

feeling tired, weak, dizzy, or faint

constipation and bloating

irregular periods

weak bones

delayed puberty and slow growth

People with anorexia may find it hard to focus and have trouble remembering things. Mood changes and emotional problems include:

feeling alone, sad, or depressed

anxiety and fears about gaining weight

thoughts of hurting themselves

Bulimia can lead to health problems caused by vomiting, laxatives, and diuretics, such as:

low blood pressure

irregular heartbeats

feeling tired, weak, dizzy, or faint

blood in vomit or stool (poop)

tooth erosion and cavities

swollen cheeks (salivary glands)

People with bulimia may have these emotional problems:

low self-esteem, anxiety, and depression

alcohol or drug problems

thoughts of hurting themselves

Binge eating can lead to weight-related health problems, such as:

diabetes

high blood pressure

high cholesterol and triglycerides

fatty liver

sleep apnea

People with binge eating disorder may:

have low self-esteem, anxiety, or depression

feel alone, out of control, angry, or helpless

have trouble coping with strong emotions or stressful events

ARFID may lead to health problems that stem from poor nutrition, similar to anorexia. People with ARFID may:

not get enough vitamins, minerals, and protein

need tube feeding and nutrition supplements

grow poorly

People with ARFID are more likely to have:

What Causes Eating Disorders?

There's no one cause for eating disorders. Genes, environment, and stressful events all play a role. Some things can increase a person's chance of having an eating disorder, such as:

poor body image

too much focus on weight or looks

dieting at a young age

playing sports that focus on weight (gymnastics, ballet, ice skating, and wrestling)

having a family member with an eating disorder

mental health problems such as anxiety, depression, or OCD

How Are Eating Disorders Diagnosed?

Health care providers and mental health professionals diagnose eating disorders based on history, symptoms, thought patterns, eating behaviors, and an exam.

The doctor will check weight and height and compare these to previous measurements on growth charts. The doctor may order tests to see if there is another reason for the eating problems and to check for problems caused by the eating disorder.

How Are Eating Disorders Treated?

Eating disorders are best treated by a team that includes a doctor, dietitian, and therapist. Treatment includes nutrition counseling, medical care, and talk therapy (individual, group, and family therapy). The doctor might prescribe medicine to treat binge eating, anxiety, depression, or other mental health concerns.

The details of the treatment depend on the type of eating disorder and how severe it is. Some people are hospitalized because of extreme weight loss and medical complications.

What if I Have an Eating Disorder?

If you think you may have an eating disorder:

Tell someone. Tell a parent, teacher, counselor, or an adult you trust. Let them know what you're going through. Ask them to help.

Get help early. When an eating disorder is caught early, a person has a better chance of recovery. Make an appointment with your doctor or an eating disorders specialist.

Go to all appointments. Treatment takes time and effort. Work hard to learn about yourself and your emotions. Ask questions any time you have them.

Be patient with yourself. There's so much to learn, and change happens a little at a time. Take care of yourself and be with people who support you.

Where Can I Learn More About Eating Disorders?

For more information on eating disorders, visit the National Eating Disorders Association (NEDA).

For more help and support, the National Association of Anorexia Nervosa and Associated Disorders (ANAD) offers these free resources:

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Eating disorders are problems that affect a person's eating behaviors as well as attitudes and feelings about food and their body. This article for teens describes how different eating disorders impact a person's health and emotions.

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Child Mind Institute provides an overview of conduct disorder, signs and symptoms, risk factors, and treatment.

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

What is conduct disorder?

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

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

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

What are the symptoms of conduct disorder?

Symptoms of conduct disorder include:

Not caring about social norms of good behavior

Ignoring the rights and feelings of other people

Enjoying causing harm, lying or manipulating people

Committing physical or sexual violence

Hurting animals

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

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

How is conduct disorder diagnosed?

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

What are the risk factors for conduct disorder?

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

Having a parent or sibling with conduct disorder

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

Experiencing abuse or neglect

Being bullied or having friends who encourage negative behavior

How is conduct disorder treated?

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

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

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

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

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

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Quick Guide to Conduct Disorder - Child Mind Institute

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

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Tips for Parents in managing OCD at home

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Tips for Parents in managing OCD at home

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When you're the parent of an anxious child, you assume that your role is to provide reassurance, comfort, and a sense of safety. Of course you want to support and protect a child who is distressed and, as much as possible, avert her suffering. But in fact, when it comes to a child with an anxiety disorder like obsessive compulsive disorder, trying to shield her from things that trigger her fears can be counterproductive for the child. By doing what comes naturally to a parent, you are inadvertently accommodating the disorder, and allowing it to take over your child's life.

That's why parents have a surprisingly important role in treating anxiety disorders in children. The gold standard in pediatric OCD treatment is a form of cognitive-behavioral therapy called exposure and response prevention. The therapy involves "exposing" the child to her anxieties in a gradual and systematic way, so she no longer fears and avoids those objects or situations; "response prevention" means she is not allowed to perform a ritual to manage fears. Because parents become so involved in their children's OCD, research has shown that including parents in treatment and assigning them as "co-therapists" improves effectiveness.

The fear hierarchy

In therapy the child, parents, and therapist create a "fear hierarchy" in which they collaboratively identify all of the feared situations, rate them on a scale of 0-10, and tackle them one at a time. For example, a child with fears about germs and getting sick would repeatedly confront "contaminated" situations and objects until her fear subsides and she can tolerate the activity. The child would start with a low-level anxiety item, such as touching clean towels, and build to more difficult items such as holding half-eaten food from the trash.

Response prevention involves preventing the child from performing the behavior that serves to decrease the anxiety. For example, a boy with a fear of germs would have to abstain from washing his hands after touching the doorknob, or the garbage. Through gradual exposure he learns that what he "fears" usually does not come true, so that new learning can take place. It also teaches him that he can tolerate uncomfortable feelings.

Practice at home

Much of the work in CBT involves practice outside of sessions, requiring parents to participate in the treatment. Children are assigned "homework" and asked to continue practicing facing their fears in a variety of settings. Since exposure and response prevention evokes anxiety and requires considerable follow-up, family involvement and support is essential.

For a child with a fear of contamination, the parents may encourage him to do the dishes, or to become a "human vacuum cleaner," which is what clinicians call picking up small scraps of garbage from the carpet. A child with fears of vomiting might write a comic about "Vomit Man" in session with his therapist, and then practice reciting it aloud to his parents.

The problem with reassurance

But parents have a bigger role than backup when it comes to practicing exposures at home. Since OCD can be a crippling disorder for children, relatives often become excessively involved in a child's symptoms in order to help the child function. For instance, many children with OCD, as well as other anxiety disorders, seek constant reassurance from family members. Reassurance-seeking is used by children to manage fears, and many parents provide it, even though it's excessive, in order to make their child feel better in the moment.

Reassurance-seeking is one of the many forms of "family accommodation." This phenomenon refers to the manner in which family members participate in the rituals the child uses to manage his anxiety, as well as how they modify personal and family routines in order to accommodate him.

Many children suffering from OCD are unable to tolerate uncertainty, and they ask their parents to provide them with definitive answers. For example, it is not uncommon to hear an anxious child ask their parent "Am I going to get sick from eating this?" or "Is everything going to be okay?" although the answer may have already been provided several times.

Parents can easily become frustrated because they feel like no matter how many times their child's questions are answered, they are never satisfied. Answering their child's questions becomes an endless cycle, and the child never learns that he can indeed tolerate the uncertainty.

Accommodating fears

There are many other forms of accommodation. Families may stop taking vacations, going out to restaurants, or even change the way they speak in order to avoid anxiety-provoking situations for their child. They may avoid particular names, numbers, colors, and sounds that trigger anxiety.

"OCD can be very overwhelming to families and can really interfere with how families can normally function," said Dr. Jerry Bubrick, a clinical psychologist at the Child Mind Institute who specializes in anxiety and OCD. "The family decisions are made to accommodate the anxiety, rather than the best interests of the family."

To the family of a patient we'll call John, a 12-year old boy who was treated at the Child Mind Institute for OCD, this is all too familiar. John had fears about contamination and gaining weight and thus he avoided any food that was considered "unhealthy," took up to seven showers a day, and didn't play with his siblings or hug his parents in the belief that they were contaminated.

"We didn't go out to a restaurant for months," said John's mother. "He didn't have any friends come over. We didn't have any of our friends come over. Our house was a safe place."

But accommodating John's anxiety didn't stop it from taking over more and more of his life. John's mother described the peak of his OCD as an extremely challenging time for her family. "It was really hard because it's like we had lost our son. He was so trapped in the OCD. We couldn't physically touch him. There was no spontaneity anymore. We couldn't even sit across the table and talk anymore."

Reinforcing anxiety

While the parents who accommodate their child are well intentioned, family accommodation is known to reinforce their child's symptoms. Since anxiety is maintained through avoidance, family members who accommodate their child are causing the symptoms to become even more fixed.

"Before I knew what accommodation was, I thought I was helping," said John's mother. "I was heartbroken when I found out the definition of accommodation. I was devastated to know I was feeding the OCD instead of helping John."

Naming the child's OCD is one way to reduce the stigma associated with it, and makes the child feel like the anxiety is not who she is. For example, a child may name her OCD "The Bully" or "The Witch." John's mother continues: "Divorcing the OCD from John has been huge. Now the family has a common enemy, everyone is in on the battle. Before it was an unnamed invader. Now we know who we're fighting."

Building coping skills

Through treatment, parents learn new ways to respond when their children get "stuck" and how to encourage their child to rely on coping skills or to "boss back" their anxiety, instead of relying on their parents to help them through it. The children eventually become much more independent, and the parents may start to realize that anxiety is no longer in charge of their families.

Grandparents and siblings can also become involved in family accommodation, although they are not typically included in treatment as regularly as parents are.

"Since grandparents and siblings are more a part of the child's outside world, they may be more likely to accommodate because they want to maintain peace," said Dr. Bubrick. "They should be a involved in the treatment so they don't undermine it."

Helping kids face fears

Through treatment, family members learn to help their children face their fears instead of avoiding them. Instead of comforting the child, it becomes the parent's job to remind him of the skills he has developed in treatment and to use them in the moment.

"Now I'm helping John and I'm not feeding the OCD," said John's mom. A lot of that is letting John know that he has strength to fight the OCD. Reminding him of the strategies instead of making the world better for him."

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Kids and OCD: The Parents' Role in Treatment | Child Mind Institute

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When you're the parent of an anxious child, you assume that your role is to provide reassurance, comfort, and a sense of safety. Of course you want to support and protect a child who is distressed and, as much as possible, avert her suffering.

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How Counselors Help Students Manage Their Mental Health

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How Counselors Help Students Manage Their Mental Health

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The prevalence of mental illness in children has reached an all time high, and it's a public health issue that up until recently has been widely ignored. According to the Centers for Disease Control and Prevention, ¹ an estimated 1 in 5 children are diagnosed with "mental disorders such as ADHD, Tourette syndrome, behavioral issues, mood and anxiety disorders, autism spectrum disorders, or substance abuse disorders."

Left undiagnosed or untreated, children's mental disorders can cause a number of problems both at home and in the classroom, affecting the way children learn, behave, and handle their emotions. Despite this, nearly 80 percent of adolescents who would benefit from mental health treatment do not receive it, and this disproportionately affects children of color and the uninsured.²

This gap in treatment for students can be explained by a number of factors. Counselors, parents, and teachers are constantly battling with challenges that include mental health stigma, budget constraints, inadequate insurance coverage, and availability of mental health services in the community.³

For students who do receive a diagnosis, schools are often the first providers of mental health resources. ⁴

The Role of the School Counselor

Throughout the week, many students spend more time in the classroom than they spend with their parents. As such, teachers, counselors, and other school staff are among the first to notice concerning changes in behavior that could signal a mental or behavioral health issue.
While teachers arguably spend the most time with their students, a study by the research journal School Psychology Quarterly found that a mere 34 percent of teachers surveyed felt that they had the skills needed to identify mental health issues in students and find resources for students with mental health conditions. ⁵

As such, school counselors become a crucial part of the education team, collaborating with teachers, administrators, parents, and social workers to ensure that each student receives the care and resources necessary to succeed in their academic and personal lives. ⁶
School counselors allocate much of their focus to designing and implementing programs which promote the academic and personal success for all of their students. These responsibilities include:

Enhancing the awareness of mental health in their schools, and aiming to remove shame and stigma

Provide external referrals, which may include short-term counseling or crisis intervention

Recognize and respond to warning signs, such as sudden changes in grades or attendance, disciplinary problems, or visible problems at home

Provide individual focus to students about issues surrounding their mental health, academic well being, and social and emotional needs

Provide resources and support for teachers, administrators, and parents ⁷

Barriers to Mental Health Treatment

Counselors are a vital part of the educational team, and in an ideal world, children would have adequate access to school counselors. But when districts are confronted with budget cuts, counselors are often among the first to be laid off.

As it stands, the national student-to-counselor ratio is much higher than the average 250-1 ratio recommended by the American School Counselors Association. ⁸ At some schools, the student-to-counselor ratio is as high as 781:1. ⁹

Additionally, counselors must also operate based on the mental health services readily available in their communities, and not all communities are equally prepared to handle mental health concerns.

When left unmet, students mental health needs can pose serious barriers to social and educational development. Counselors are a necessary part of an educational staff, as they have the unique qualifications required to provide education, intervention, and referral services to children, parents, and teachers. Although school counselors typically do not act as long-term therapists, they help foster an environment where mental health stigma is erased, help bridge the gap between student and community resources, and make sure the developmental needs of all students are met.

Students who obtain their Master's Degree in Counseling from Wake Forest University Online enter the field prepared to help students, parents, and teachers manage student mental health.

¹ http://www.cdc.gov/features/childrensmentalhealth/

² http://www.ncbi.nlm.nih.gov/pubmed/12202276

³ http://www.edweek.org/ew/articles/2014/06/20/36cottle.h33.html

4 http://digitalcommons.brockport.edu/cgi/viewcontent.cgi?article=1599&context=ehd_theses

5 https://edsource.org/2013/task-force-recommends-including-mental-health-training-in-teacher-credential/33503

6 http://www.mn2020.org/issues-that-matter/education/dont-forget-school-counselors-in-mental-health-debate

7 http://www.schoolcounselor.org/asca/media/asca/positionstatements/ps_studentmentalhealth.pdf

8 https://www.counseling.org/government-affairs/public-policy/public-policy-news-view/position-papers/2013/02/11/student-support-act-reducing-the-student-to-counselor-ratio

9 http://www.counseling.org/PublicPolicy/PDF/2010-2011_Student_to_Counselor_Ratio.pdf

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How Counselors Help Students Manage Their Mental Health - WFU Online Counseling

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The prevalence of mental illness in children has reached an all time high, and it's a public health issue that up until recently has been widely ignored. According to the Centers for Disease Control and Prevention, ¹ an estimated 1 in 5 children are diagnosed with "mental disorders such as ADHD, Tourette syndrome, behavioral issues, mood and anxiety disorders, autism spectrum disorders, or substance abuse disorders."

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Family experience with children diagnosed with Schizophrenia

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Family experience with children diagnosed with Schizophrenia

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NIMH provides an overview of Bipolar Disorder, signs and symptoms, risk factors, and treatment.

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National Institute of Mental Health (NIMH)

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Overview

Bipolar disorder (formerly called manic-depressive illness or manic depression) is a mental disorder that causes unusual shifts in mood, energy, activity levels, concentration, and the ability to carry out day-to-day tasks.

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

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

Bipolar II Disorder- defined by a pattern of depressive episodes and hypomanic episodes, but not the full-blown manic episodes that are typical of Bipolar I Disorder.

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

Sometimes a person might experience symptoms of bipolar disorder that do not match the three categories listed above, which is referred to as "other specified and unspecified bipolar and related disorders."

Bipolar disorder is typically diagnosed during late adolescence (teen years) or early adulthood. Occasionally, bipolar symptoms can appear in children. Bipolar disorder can also first appear during a woman's pregnancy or following childbirth. Although the symptoms may vary over time, bipolar disorder usually requires lifelong treatment. Following a prescribed treatment plan can help people manage their symptoms and improve their quality of life.

Signs and Symptoms

Risk Factors

Treatments and Therapies

Join a Study

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Bipolar disorder (formerly called manic-depressive illness or manic depression) is a mental disorder that causes unusual shifts in mood, energy, activity levels, concentration, and the ability to carry out day-to-day tasks. There are three types of bipolar disorder. All three types involve clear changes in mood, energy, and activity levels.

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Eating Recovery center provides eating disorder treatment for adolescents and children.

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"If I could pick one thing that Eating Recovery Center taught me, it would definitely be 'fearless.' You gave me the recovery tools to run after my problems, to catch them, and solve the issue. I am able to celebrate my body with kindness and passion. Thank you, Eating Recovery Center for not only saving my life but, for giving me a full life of gratitude. Thank you!"

Sara B.

former Eating Recovery Center patient

"Eating Recovery Center of Washington helped me realize there is life beyond my eating disorder. They reminded me that recovery doesn't have to be perfect. I work hard every day to maintain recovery. It's not easy, but it's worth it."

Megan C.

former Eating Recovery Center Washington patient

The role of nutrition services is very important in the treatment of an eating disorder. Our dietitians work with patients who are often terrified of eating, to help them eat, achieve a balanced pattern of nutrition and reach a healthy weight for optimal recovery.

Marla Scanzello, MS, RD

Director of Dietary Services

At Eating Recovery Center, our treatment philosophy emphasizes thorough assessment, innovative evidence-based interventions and comprehensive discharge planning to support lasting recovery outside of the structured treatment environment.

Jane Miceli, MD

Medical Director of Adult Inpatient and Residential Services

Dedication, caring and wisdom are evident in all aspects of the treatment program at Eating Recovery Center. Our highly-skilled, compassionate staff, combined with our commitment to implementing evidence-based techniques, can pull someone out of the depths of an eating disorder and start them on the road to recovery.

Nadine Dexter, RN, MSN

Chief Nursing Officer

The role of nutrition services is very important in the treatment of an eating disorder. Our dietitians work with patients who are often terrified of eating, to help them eat, achieve a balanced pattern of nutrition and reach a healthy weight for optimal recovery.

Marla Scanzello, MS, RD

Director of Dietary Services

If you suspect your child has an eating disorder, trust your instincts-parents often know if something is wrong. Educate yourself through research or talk to medical and mental health professionals, and identify your support system. Don't let your child's eating disorder isolate you, don't dwell on the past and don't lose hope. Identify what you want to work towards for your family, and take committed action toward that end.

Elizabeth Easton, PsyD

Clinical Director of Child and Adolescent Services at Eating Recovery Center

We have worked hard to stop the shaming and blaming of families and have moved toward an understanding that families are an integral part of eating disorders treatment, not only in helping an individual respond well to treatment, but also go onto lasting recovery.

Ovidio Bermudez, MD, FAAP, FSAHM, FAED, F.iaedp, CEDS

Chief Clinical Officer and Medical Director of Child & Adolescent Services

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Dallas Eating Disorder Treatment Center | Eating Recovery Center

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"If I could pick one thing that Eating Recovery Center taught me, it would definitely be 'fearless.' You gave me the recovery tools to run after my problems, to catch them, and solve the issue. I am able to celebrate my body with kindness and passion.

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OCD & Anxiety Specialist of Dallas is treatment center that focus on providing treatment to individuals with anxiety and OCD.

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OCD & Anxiety Specialists of Dallas - Kim Rockwell-Evans, PhD

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Anxiety and OCD do not have to control your life.
If anxiety and obsessions are holding you back from engaging in the life you desire, Dr. Kim Rockwell-Evans can provide you with the guidance you've been seeking.

Find relief with the support of an anxiety specialist.
Long recognized throughout North Texas as one of the most effective practitioners treating OCD and anxiety disorders, Dr. Rockwell-Evans offers action-oriented, practical treatment that will empower you to overcome your anxieties and regain control of your life.

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OCD & Anxiety Specialists of Dallas - Kim Rockwell-Evans, PhD

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Anxiety and OCD do not have to control your life. If anxiety and obsessions are holding you back from engaging in the life you desire, Dr. Kim Rockwell-Evans can provide you with the guidance you've been seeking. Find relief with the support of an anxiety specialist.