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What is an IEP? How does it differ from a 504 Plan? Which special education program is the best fit for your child and her ADHD? Read on for a breakdown of special education laws and services for students with attention deficit disorder, learning disabilities, and other related conditions.

What Is an IEP?

An Individualized Education Plan (IEP) is guided by the Individuals with Disabilities Education Act (IDEA) and provides special education and related services to a student who is identified as having a disability that negatively impacts her ability to receive academic instruction. A student who receives special education services is entitled to modification of curriculum, classroom accommodations, specialized instruction, and related services such as occupational therapy, physical therapy, speech therapy and/or counseling.

A student with an IEP is re-evaluated every three years to determine continued eligibility. However, a parent can request a re-evaluation sooner than three years, but not less than one year. An IEP is also reviewed annually.

What Does an IEP Include?

A good IEP will include the following components:

Present Levels of Performance (PLP): This is a summary that describes current specific, measurable, objective baseline information for each area affected by the disability.

Goals: These are descriptions of what a student can reasonably be expected to accomplish within a 12-month period with the provision of special education services. Goals should be SMART: Specific, Measurable, Achievable Results, Time-limited.

Benchmarks and Objectives: Benchmarks are major milestones that specify skill or performance levels a student needs to accomplish to reach his annual goal. Objectives are measurable, intermediate steps between a student's PLP and the annual goals established for the student.

Least Restrictive Environment (LRE): According to IDEA, IEPs should provide the greatest exposure to and interaction with general education students and persons without disabilities.

Assistive Technology (AT): Every IEP must consider technology programs, services, or devices that a student must have to be successful.

Description of Special Education Services: This indicates the time, frequency, and any related services that the student needs, as well as the amounts of time these services will be provided. The amount of time and areas in which the student will be removed from the general education setting are also identified.

What Is a 504 Plan?

A 504 Accommodation Plan is guided by the Americans with Disabilities Act (ADA) to ensure that a student with a disability has access to accommodations that improve academic functioning.

In order to qualify for a 504 Plan, a student must have a diagnosis for a physical or emotional disability, or impairment (e.g., ADHD) that restricts one or more major life activities (e.g., attention, class participation).

A 504 Accommodation Plan can also provide extended time or small group administration for statewide testing for your child. It can allow for accommodations like frequent breaks, fidgets, or modified homework assignments.

Note that a student is not able to receive specialized instruction or related services, such as occupational therapy, speech therapy or physical therapy - through a 504 Accommodation Plan.

Who Qualifies for an IEP or a 504 Plan?

IDEA regulations issued by the U.S. Department of Education in 1999 make it clear that attention deficit hyperactivity disorder ( ADHD or ADD) is included in the list of "other health impairments" that could render a child eligible for special education services in an IEP. However, not all children with ADHD qualify for an IEP. To qualify, the ADHD must adversely affect a child's educational performance.

Students who do not meet the criteria spelled out by IDEA may still qualify for help under SECTION 504 of the Rehabilitation Act of 1973, also known simply as "Section 504" or "a 504 Plan."

IEP vs. 504 Plan

IEP plans under IDEA cover students who qualify for Special Education. Section 504 covers students who don't meet the criteria for special education but who still require some accommodations. Both ensure that students with disabilities have access to a free and appropriate public education.

Section 504 is actually a civil rights law, designed to protect the rights of individuals with disabilities in programs and activities that receive federal assistance from the Department of Education. A student is eligible as long he/she currently has or has had a physical or mental impairment which substantially limits a major life activity. Students who have ADHD may qualify if their ADHD "substantially limits" their ability to learn.

Instead of having an IEP, students who qualify under Section 504 are required to have a plan that specifies any accommodations that will be made in the classroom. Accommodations for the ADHD student may include allowing extra time to complete assigned work or breaking long assignments into smaller parts.

How Can I Get an IEP or 504 Plan for My Child?

What to Read Next:

Updated on November 24, 2019

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What Is an IEP? 504 Plan? Everything You Need to Know

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What is an IEP? How does it differ from a 504 Plan? Which special education program is the best fit for your child and her ADHD? Read on for a breakdown of special education laws and services for students with attention deficit disorder, learning disabilities, and other related conditions.

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People with psychotic disorders lose contact with reality and experience a range of extreme symptoms that usually includes: Hallucinations-hearing or seeing things that are not real, such as voices Delusions-believing things that are not true However, these symptoms can occur in people with other health problems, including bipolar disorder, dementia, substance abuse disorders, or brain tumors.

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Children with ADHD and oppositional defiant disorder are blatantly disobedient, disrespectful, and confrontational. Standard discipline strategies don't work. So what do you do? Follow the strategies in this video to restore order to your home.

Children with ADHD and oppositional defiant disorder take defiant behavior to the extreme. When your traditional discipline methods aren't working, what do you do?

In this video, learn eight new discipline strategies for parents of children with ADHD and ODD.

8 Discipline Rules for Oppositional Defiant Disorder

Children with oppositional defiant disorder are blatantly disobedient, disrespectful, and confrontational.

Standard discipline doesn't work. Instead, follow these strategies for how to discipline a child with oppositional defiant disorder:
1. Treat before you punish.
Never discipline your child for behaviors that are symptoms of attention deficit hyperactivity disorder ( ADHD or ADD). Opposition and defiance are sometimes neurological - not intentional. Once your treatment plan has impulsivity under control, you will know which acts are punishable.
2. Exercise away hostility.
A potent tonic for the brain is daily physical exercise for ADHD. It promotes healthy brain function and helps children control aggression.
3. Know your child's patterns.
Note when and where your child's anger flares. Documentation may help identify triggers and suggest effective interventions.
4. Be clear about rules and consequences.
Explain what behavior is expected, and exactly what consequences your child will face for breaking the rules. Then, consistently enforce those rules.
5. Stay cool-headed and under control.
Instead of overreacting - and teaching your child to fear mom or dad - breathe deep and be a model of how to behave when you're upset.
6. Use a code word like 'bubble gum.'
This is a private signal that tells your child to calm down. Your child can also use it to express that he is getting upset. Sometimes, just the words no and stop can push an emotional child over the edge.
7. Stay positive.
Boost your child's self-esteem by "catching" him behaving well and by doling out praise.
8. Call in the professionals.
In some cases, you may need outside help to reset the pattern of disruptive behavior in your home.

Work with a behavioral psychologist to root out the cause of aggression.

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Updated on August 12, 2019

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Oppositional Defiant Disorder Strategies: 8 Rules for Effective Discipline

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Children with ADHD and oppositional defiant disorder are blatantly disobedient, disrespectful, and confrontational. Standard discipline strategies don't work. So what do you do? Follow the strategies in this video to restore order to your home. Children with ADHD and oppositional defiant disorder take defiant behavior to the extreme.

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What is conduct disorder in children?

Conduct disorder is a type of behavior disorder. It's when a child has antisocial behavior. He or she may disregard basic social standards and rules. He or she may also:

Be irresponsible

Skip school or run away (delinquent behavior)

Steal or do other things to violate the rights of others

Physically harm animals or other people, such as committing assault or rape

These behaviors sometimes happen together. But one or more may occur without the others.

What causes conduct disorder in a child?

Experts believe that many factors play a role in conduct disorder. These are:

Some children with conduct disorders seem to have a problem in the frontal lobe of the brain. This interferes with a child's ability to plan, stay away from harm, and learn from negative experiences.

Some experts believe that a series of traumatic experiences occurs for a child to develop a conduct disorder. These experiences then often lead to depressed mood, behavior problems, and involvement in a deviant peer group.

Which children are at risk for conduct disorder?

A conduct disorder is more common in boys than in girls. It is also more likely to develop in children or teens who come from homes that are:

Children with these mental health problems are also more likely to have conduct disorder:

Mood or anxiety disorders

Posttraumatic stress disorder (PTSD)

Substance abuse

Attention-deficit/hyperactivity disorder (ADHD)

Learning problems or learning disorders

Children or teens who are considered to have a difficult temperament are more likely to develop behavior problems.

What are the symptoms of conduct disorder in a child?

Most symptoms seen in children with conduct disorder also happen at times in children without this problem. But in children with the disorder, these symptoms occur more often. They also interfere with learning, school adjustment, and sometimes with the child's relationships.

Each child's symptoms may vary. But the 4 main groups of behaviors are described below.

Aggressive conduct

Destructive conduct

Deceitfulness

Violation of rules or age-appropriate norms

These symptoms may look like other mental health problems. Have your child see his or her healthcare provider for a diagnosis.

How is conduct disorder diagnosed in a child?

A child psychiatrist or qualified mental health expert can diagnose a conduct disorder. He or she will talk with parents and teachers about the child's behavior and may observe the child. In some cases, your child may need mental health testing.

If you notice symptoms of conduct disorder in your child or teen, you can help by seeking a diagnosis right away. Early treatment can often prevent future problems.

How is conduct disorder treated in a child?

Treatment will depend on your child's symptoms, age, and general health. It will also depend on how severe the condition is.

Treatment for conduct disorder may include:

Cognitive-behavioral therapy. A child learns how to better solve problems, communicate, and handle stress. He or she also learns how to control impulses and anger.

Family therapy. This therapy helps make changes in the family. It improves communication skills and family interactions.

Peer group therapy. A child develops better social and interpersonal skills.

Medicines. These are not often used to treat conduct disorder. But a child may need them for other symptoms or disorders such as ADHD. These other disorders often occurs along with symptoms of conduct disorder.

How can I help prevent conduct disorder in my child?

Experts don't know exactly why some children develop conduct disorder. Things such as a traumatic experience, social problems, and biological factors may be involved. To reduce the risk for this disorder, parents can learn positive parenting strategies. They can be good role models for their children.. This can help to create a closer parent-child relationship and give the child with examples of how to respectfully treat other people, animals, and property. It can also create a safe and stable home life for the child.

How can I help my child live with conduct disorder?

Early treatment for your child can often prevent future problems. Here are things you can do to help your child:

Keep all appointments with your child's healthcare provider.

Take part in family therapy as needed.

Talk to your child's healthcare provider about other providers who will be involved in your child's care. Your child may get care from a team that may include counselors, therapists, social workers, psychologists, and psychiatrists. Your child's care team will depend on his or her needs and how serious the disorder is.

Tell others about your child's conduct disorder. Work with your healthcare provider and schools to develop a treatment plan.

Reach out for support. Being in touch with other parents who have a child with conduct disorder may be helpful. If you feel overwhelmed or stressed out, talk with your healthcare provider about a support group for caregivers of children with conduct disorder.

When should I call my child's healthcare provider?

Call your healthcare provider right away if your child:

Feels extreme depression, fear, anxiety, or anger toward him or herself or others

Feels out of control

Hears voices that others don't hear

Sees things that others don't see

Can't sleep or eat for 3 days in a row

Shows behavior that concerns friends, family, or teachers, and others express concern about this behavior and ask you to seek help

Call 911 if your child has suicidal thoughts, a suicide plan, and the means to carry out the plan. Never leave them alone until the situation is assessed and treatment laid out. This may include a hospital stay.

Key points about conduct disorder in children

Conduct disorder is a type of behavior disorder. It's when a child has antisocial behavior.

Both genetic and environmental factors may play a role.

Children with other mental health problems are more likely to have this disorder.

Symptoms are divided into 4 main groups. They are aggression, destruction, deceitfulness, and violation of rules.

Therapy that helps the child interact better with others is the main treatment. Therapy may include both individual and family counseling. Medicines may be needed for other problems, such as ADHD.

Reach out for support. Being in touch with other parents who have a child with conduct disorder may be helpful.

Call 911 if your child has suicidal thoughts, a suicide plan, and the means to carry out the plan. Never leave the child alone.

Next steps

Tips to help you get the most from a visit to your child's healthcare provider:

Know the reason for the visit and what you want to happen.

Before your visit, write down questions you want answered.

At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you for your child.

Know why a new medicine or treatment is prescribed and how it will help your child. Also know what the side effects are.

Ask if your child's condition can be treated in other ways.

Know why a test or procedure is recommended and what the results could mean.

Know what to expect if your child does not take the medicine or have the test or procedure.

If your child has a follow-up appointment, write down the date, time, and purpose for that visit.

Know how you can contact your child's provider after office hours. This is important if your child becomes ill and you have questions or need advice.

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Conduct disorder is a type of behavior disorder. It's when a child has antisocial behavior. He or she may disregard basic social standards and rules. He or she may also: Be irresponsible Skip school or run away (delinquent behavior) Steal or do other things to violate the rights of others Physically harm animals or other people, such as committing assault or rape These behaviors sometimes happen together.

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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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by Karen Young

If anxiety is making a menace of itself, the good news is that there are ways to take it back to small enough. First though, it's important to understand the telltale signs of anxiety and where they come from. When you understand this, anxiety will start to lose the power that comes from its mystery and its unpredictability.

Teens With Anxiety. A Few Things You Need to Know

Anxiety has absolutely nothing to do with strength, character or courage.

Sometimes it drops in for absolutely no reason at all.

Anxiety happens because your brain thinks there might be danger, even when there is no danger at all. Brains are smart, but they can all read things a little bit wrong sometimes.

Anxiety is soooo common. Almost as common as having feet. But not quite.

On average, about 1 in 5 young people have anxiety. Without a doubt, someone you know or care about will also struggle with anxiety from time to time. Stats don't lie. They don't gossip and they don't start scandals either, which is why they're so reliable. They're good like that.

Everyone experiences anxiety on some level.

Anxiety exists on a spectrum - some people get it a lot and some people get it a lot less, but we all experience anxiety on some level at some time in our lives - exams, job interviews, performances. Sometimes it can happen for no reason at all.

Anxiety is a feeling, not a personality.

Anxiety doesn't define you. It's a feeling - it will come, but it will always go, and it's as human as having a heartbeat.

Your brain that is strong, healthy and doing exactly what brains are meant to do.

Your brain is magnificent. It's just a little overprotective. It loves you like a favourite thing and it wants to keep you safe. And alive. Brains love keeping people alive. They adore it actually.

Anxiety can look a little something like this ...

Here are some of the common signs of anxiety in teenagers. If you have some of these, it doesn't mean that teenage anxiety is a problem for you. This list is a way to make sense of things that feel as though they're getting in your way, but if you experience some of them and you're travelling along beautifully, then there's no problem at all. Something is only a problem if it's causing you a problem.

Thoughts ...

Negative thoughts - what-ifs, thoughts about being judged or embarrassed, small thoughts that grow into big worries.

Excessive worry about physical symptoms (that a cut might become infected, that a headache might mean brain cancer).

Feelings ...

Fearful, worried, overwhelmed, out of control.

Dread, as though something bad is going to happen.

Panic that seems to come from nowhere.

Physically ...

Racing heart.

Tightening in the chest

Butterflies.

Tense muscles.

Shaking hands.

Feeling as though you're going to vomit.

Dizzy or light-headed.

Feeling as though you want to burst into tears.

Feeling angry.

These are all because of the surge of neurochemicals that happen when the body is in fight or flight mode. They can feel frightening, but they are all a very normal part of the way your brain and body protect you from possible danger (more about this later).

Behaviours ...

Skin picking (dermatillomania).

Pulling out hair (trichotillomania).

Nail biting.

Avoidance of people or situations, even if they are things that would probably be fun. (This isn't necessarily about wanting to avoid the people involved and more about wanting to avoid the anxiety that comes with certain situations such as parties or get-togethers or anything unfamiliar.)

You might have a bit of ...

Tummy trouble - (constipation, diarrhoea, irritable bowel).

In the gut are hundreds of millions of neurons. This is affectionately known as 'the brain in our gut'. These neurons are really important for mental health because they send information from the belly to the brain. When the environment in the gut is out of balance (not enough good bacteria, too many bad ones), the messages sent back to the brain can stir anxiety.

And those zzz's ...

Difficulty sleeping - either trouble falling asleep, or waking up and not being able to go back to sleep.

When you're still, quiet and trying to relax, negative thoughts or worries will see it as an invitation. They'll put on their fancy pants and get the party started in your head. Pushy little sleep-thieving pirates that they are.

Practical, powerful ways to help manage anxiety.

Understand why it feels the way it does.

Understanding why anxiety feels the way it does will be one of your greatest tools in managing it.

Anxiety happens because a part of your brain (the amygdala) thinks there might be something it needs to protect you from. When this happens, it surges your body with a mix of neurochemicals (including oxygen, hormones and adrenaline), designed to make you stronger, faster, more alert and more powerful so you can fight for your life or run for it. This is the fight or flight response. It's normal and healthy and it's in everyone. In people with anxiety, it's just a little quicker to activate.

amygdala can't always tell the difference between something that might hurt you (like a baseball coming at your head) and something that won't (like walking into a party) - and it doesn't care. All it wants to do is keep you safe.

" Your breathing changes from normal, slow breaths to short, shallow breaths. This is because your brain tells your body to conserve oxygen on breathing, and send as much as possible to the muscles so they can get ready to run or fight.
You might feel puffed or a bit breathless. You might also feel your cheeks burn red (from the blood rushing to your face) and your face become warm.
" If you don't fight or flee, the oxygen builds up in your body and the carbon dioxide drops.

You might feel dizzy or a bit confused.

" Your heart races to get the oxygen around your body.
Your heart can feel like it's beating out of your chest and you might feel sick.
" Fuel gets sent to your arms (for fight) and to your legs (for flight).
Your hands, arms and legs might feel tense or shaky.
" Your body starts cooling itself down to stop it from overheating if it has to fight or flee.

You might feel a bit clammy or sweaty.

You might feel butterflies in your belly. You might also feel sick, as though you're about to vomit, and your mouth might feel dry.

" The amygdala also controls your emotions so when it's in fight or flight, it's switched on to high volume. This means your emotions can be too.
You might burst into tears or get angry.
Everything you feel when you have anxiety is to do with your body getting ready to fight or flee, when there is actually no need for either. It's okay - there are things you can do about this. Let's talk about that ...

Dealing with Anxiety - The How-To

Mindfulness. But first to show you why.

A mountain of studies have shown that mindfulness can be a little bit magic in strengthening the brain against anxiety. In a massive analysis of a number of different mindfulness/anxiety studies, mindfulness was found to be ' associated with robust and substantial reductions in symptoms of anxiety.'

Mindfulness changes the brain the way exercise changes our body - but without the sweating and panting. Two of the ways mindfulness changes the brain are:

by strengthening the connections between the amygdala (the key player in anxiety) and the prefrontal cortex (the part of the brain that can calm big emotions (and anxiety counts as a big emotion). The stronger the connections, the more the pre-frontal cortex is able to weigh in during anxiety and calm things down.

Okay then. What else can mindfulness do?

So mindfulness hey? What is it exactly?

Mindfulness is about staying in the present and 'watching' your thoughts and feelings without hanging on to them for too long. It's this 'hanging on too long' that gives them the juice they need to become something bigger. Minds quite like to wander, especially anxious ones, so staying in the moment can take some practice. Here's the how:

Get comfy and close your eyes.

Now, what can you hear? What can you feel outside of you and inside your body? If your mind starts to wander, focus on your breathing again.

Is there an app for that?

There are some brilliant apps that can guide you through mindfulness. Here are three (with links) for you to have a look at:

Smiling mind - a free app has tailored programs for different ages.

Stop, Breathe, Think - start by choosing words to describe how you're feeling right now, and the app will suggest the best meditations based on where you're at.

Insight Meditation Timer - another free app with guided meditations from over 700 teachers. It also has a very excellent feature that shows a map of how many other people are meditating in the world (using the app) at the same time as you. How to make the world feel a little bit smaller and a little more connected. Nice.

gamma-aminobutyric acid is the name it likes to go by at scientific get-togethers and when it wants to make an impression). Neurochemicals are the suave little messengers in the brain that carry important info from one cell to another. GABA is the brain's calm down chemical - kind of like a sweet lullaby for the parts of the brain that are in very serious lullaby need. When the levels of GABA in the brain are low, there's nothing to calm the excitable neurons. Exercise is a really effective way to get the GABA in the brain to the right levels.

Any activity that gets your heart going counts as exercise.

If vigorous exercise and you are still in the getting to know you trying-to-like-you phase of your relationship, non-aerobic exercise like yoga can also ease anxiety.

Breathe. But practice, practice, practice. And then practice a little bit more.

Anxiety can feel like such a gangster at times, it can be hard to believe that something as simple and as normal as breathing can out-muscle it - but it can. Here's why. Strong, deep breathing initiates the relaxation response. The relaxation response was discovered by a Harvard cardiologist to be an automatic response that can neutralise the surge of neurochemicals that cause the awful physical feelings of anxiety. Because it's an automatic response, you don't need to believe it works, it just will - but you do have to initiate it.

Breathing is the switch that will activate the relaxation response and start to put the symptoms of anxiety back to small enough. Once you start slow deep breathing, your body will take over and do the rest. B

Food. You've gotta look after your belly

We used to think that anxiety or depression caused tummy trouble, but increasingly researchers are thinking that it actually works the other way - an unhappy belly can make an unhappy brain. The good news about this is that it doesn't take too much effort to put it right, but eating well is super-important.

There's absolutely nothing wrong with eating something unhealthily delicious now and then, but make sure that you're not overdoing it. The healthier your gut, the healthier your mental health. Gut bacteria are the rock stars of the mental health world. It's really important to keep yours happy, because, you know - cranky rock stars can be painful and annoying and cause more than a decent amount of trouble.

And finally ...

Make sure you love yourself a little louder. At adolescence, you're at a point in your life where the world is opening up to you. It's a world that needs your wisdom, your courage and your interesting and very wonderful take on things. Anxiety can have a way of shifting the focus too often to the negative, but the things about ourselves that we would like to change often have very wonderful strengths built into them. Of course you would always rather not have anxiety, but there are so many strengths in you. Spend plenty of time noticing them.

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Anxiety in Teens - How to Help a Teenager Deal With Anxiety - Hey Sigmund

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by Karen Young If anxiety is making a menace of itself, the good news is that there are ways to take it back to small enough. First though, it's important to understand the telltale signs of anxiety and where they come from.

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Your Adolescent - Anxiety and Avoidant Disorders
Excerpts from Your Adolescent on Anxiety and Avoidant Disorders
Everyone experiences anxiety. It is a natural and important emotion, signaling through stirrings of worry, fearfulness, and alarm that danger or a sudden, threatening change is near. Yet sometimes anxiety becomes an exaggerated, unhealthy response.

Given the array of changes and uncertainties facing a normal teenager, anxiety often hums along like background noise. For some teenagers, anxiety becomes a chronic, highpitched state, interfering with their ability to attend school and to perform up to their academic potential. Participating in extracurricular activities, making and keeping friends, and maintaining a supportive, flexible relationship within the family become difficult. Sometimes anxiety is limited to generalized, free-floating feelings of uneasiness. At other times, it develops into panic attacks and phobias.

Identifying the Signs
Anxiety disorders vary from teenager to teenager. Symptoms generally include excessive fears and worries, feelings of inner restlessness, and a tendency to be excessively wary and vigilant. Even in the absence of an actual threat, some teenagers describe feelings of continual nervousness, restlessness, or extreme stress.

In a social setting, anxious teenagers may appear dependent, withdrawn, or uneasy. They seem either overly restrained or overly emotional. They may be preoccupied with worries about losing control or unrealistic concerns about social competence.

Teenagers who suffer from excessive anxiety regularly experience a range of physical symptoms as well. They may complain about muscle tension and cramps, stomachaches, headaches, pain in the limbs and back, fatigue, or discomforts associated with pubertal changes. They may blotch, flush, sweat, hyperventilate, tremble, and startle easily.

Anxiety during adolescence typically centers on changes in the way the adolescent's body looks and feels, social acceptance, and conflicts about independence. When flooded with anxiety, adolescents may appear extremely shy. They may avoid their usual activities or refuse to engage in new experiences. They may protest whenever they are apart from friends. Or in an attempt to diminish or deny their fears and worries, they may engage in risky behaviors, drug experimentation, or impulsive sexual behavior.

Panic Disorder More common in girls than boys, panic disorder emerges in adolescence usually between the ages of fifteen and nineteen. Feelings of intense panic may arise without any noticeable cause or they may be triggered by specific situations, in which case they are called panic attacks. A panic attack is an abrupt episode of severe anxiety with accompanying emotional and physical symptoms.

During a panic attack, the youngster may feel overwhelmed by an intense fear or discomfort, a sense of impending doom, the fear he's going crazy, or sensations of unreality. Accompanying the emotional symptoms may be shortness of breath, sweating, choking, chest pains, nausea, dizziness, and numbness or tingling in his extremities. During an attack, some teens may feel they're dying or can't think. Following a panic attack, many youngsters worry that they will have other attacks and try to avoid situations that they believe may trigger them. Because of this fearful anticipation, the teen may begin to avoid normal activities and routines.

Phobias Many fears of younger children are mild, passing, and considered within the range of normal development. Some teenagers develop exaggerated and usually inexplicable fears called phobias that center on specific objects or situations. These intense fears can limit a teenager's activities. The fear generated by a phobia is excessive and not a rational response to a situation. The objects of a phobia usually change as a child gets older. While very young children may be preoccupied with the dark, monsters, or actual dangers, adolescents' phobic fears tend to involve school and social performance.

Several studies have revealed an increase in school avoidance in middle-school or junior-high years. With school avoidance, excessive worries about performance or social pressures at school may be at the root of the reluctance to attend school regularly. This leads to a cycle of anxiety, physical complaints, and school avoidance. The cycle escalates with the worsening of physical complaints such as stomachaches, headaches, and menstrual cramps. Visits to the doctor generally fail to uncover general medical explanations. The longer a teenager stays out of school, the harder it becomes for him to overcome his fear and anxiety and return to school. He feels increasingly isolated from school activities and different from other kids.

Some youngsters are naturally more timid than others, As their bodies, voices, and emotions change during adolescence, they may feel even more self-conscious. Despite initial feelings of uncertainty, most teens are able to join in if given time to observe and warm up. In extreme cases, called social phobia, the adolescent becomes very withdrawn, and though he wants to take part in social activities, he's unable to overcome intense self-doubt and worry. Gripped by excessive or unreasonable anxiety when faced with entering a new or unfamiliar social situation, the adolescent with social phobia becomes captive to unrelenting fears of other people's judgment or expectations. He may deal with his social discomfort by fretting about his health, appearance, or overall competence. Alternatively, he may behave in a clowning or boisterous fashion or consume alcohol to deal with the anxiety.

Because so much of a teenager's social life gets played out in school, social phobia may overlap with and be hard to distinguish from school avoidance. Some teens with social phobia may try to sidestep their anxious feelings altogether by refusing to attend or participate in school, Classroom and academic performance falls off, involvement in social and extracurricular activities dwindles, and, as a consequence, self-esteem declines.

Some teens may experience such a high level of anxiety that they cannot leave the house. This disorder, agoraphobia, seems to stem from feelings about being away from parents and fears of being away from home rather than fear of the world. In fact, a number of children who demonstrate severe separation anxiety in early childhood go on to develop agoraphobia as adolescents and adults.

Causes and Consequences
Most researchers believe that a predisposition towards timidity and nervousness is inborn. If one parent is naturally anxious, there's a good chance that their child will also have anxious tendencies. At the same time, a parent's own uneasiness is often communicated to the child, compounding the child's natural sensitivity. A cycle of increasing uneasiness may then be established. By the time this child reaches adolescence, his characteristic way of experiencing and relating to his world is tinged with anxiety. Some research suggests that children who are easily agitated or upset never learned to soothe themselves earlier in life.

In many cases, adolescent anxiety disorders may have begun earlier as separation anxiety, the tendency to become flooded with fearfulness whenever separated from home or from those to whom the child is attached, usually a parent. Adolescents can also have separation disorders. These teens may deny anxiety about separation, yet it may be reflected in their reluctance to leave home and resistance to being drawn into independent activity. Separation anxiety is often behind a teen's refusal to attend or remain at school.

School avoidance can follow a significant change at school, such as the transition into middle school or junior high. It may also be triggered by something unrelated to school, such as a divorce, illness, or a death in the family. Some youngsters become fearful about gang activities or the lack of safety in school.

A worried teenager performs less well in school, sports, and social interactions. Too much worry can also result in a teenager's failing to achieve to his potential. A teen who experiences a great deal of anxiety may be overly conforming, perfectionistic, and unsure of himself. In attempting to gain approval or avoid disapproval, he may redo tasks or procrastinate. The anxious youngster often seeks excessive reassurance about his identity and whether be is good enough.

Some teenagers with anxiety disorders can also develop mood disorders or eating disorders. Some teenagers who experience persistent anxiety may also develop suicidal feelings or engage in self-destructive behaviors; these situations require immediate attention and treatment. Anxious teens may also use alcohol and drugs to self-medicate or self-sootheor develop rituals in an effort to reduce or prevent anxiety.

How to Respond
If your teenager is willing to talk about his fears and anxieties, listen carefully and respectfully. Without discounting his feelings, help him understand that increased feelings of uneasiness about his body, performance, and peer acceptance and a general uncertainty are all natural parts of adolescence.

By helping him trace his anxiety to specific situations and experiences, you may help him reduce the overwhelming nature of his feelings. Reassure him that, although his concerns are real, in all likelihood he will be able to handle them and that as he gets older, he will develop different techniques to be better able to deal with stress and anxiety.

Remind him of other times when he was initially afraid but still managed to enter into new situations, such as junior high school or camp. Praise him when he takes part in spite of his uneasiness. Point out that you are proud of his ability to act in the face of considerable anxiety. Remember, your teenager may not always be comfortable talking about feelings that he views as signs of weakness. While it may seem at the moment as though he's not listening, later he may be soothed by your attempts to help.

If fearfulness begins to take over your teenager's life and limit his activities, or if the anxiety lasts over six months, seek professional advice. His doctor or teacher will be able to recommend a child and adolescent psychiatrist or other professional specializing in treating adolescents.

Managing anxiety disorders - as with any adolescent emotional disturbance - usually requires a combination of treatment interventions. The most effective plan must be individualized to the teenager and his family. While these disorders can cause considerable distress and disruption to the teen's life, the overall prognosis is good.

Treatment for an anxiety disorder begins with an evaluation of symptoms, family and social context, and the extent of interference or impairment to the teen. Parents, as well as the teenager, should be included in this process. School records and personnel may be consulted to identify how the teen's performance and function in school has been affected by the disorder.

The evaluating clinician will also consider any underlying physical illnesses or diseases, such as diabetes, that could be causing the anxiety symptoms. Medications that might cause anxiety (such as some drugs used in treating asthma) will be reviewed. Since large amounts of caffeine, in coffee or soft drinks, can cause agitation, a clinician might look at the youngster's diet as well. Other biological, psychological, family, and social factors that might predispose the youngster to undue anxiety will also be considered.

If a teenager refuses to go to school, a clinician will explore other possible explanations before labeling it school avoidance. Perhaps the teen is being threatened or harassed, is depressed, or has an unrecognized learning disability. He may also be skipping school in order to be with friends, not from anxiety about performance or separation.

If the teenager has engaged in suicidal or self-endangering behavior, is trying to self medicate through alcohol or drug use, or is seriously depressed, these problems should be addressed immediately. In such cases, hospitalization may be recommended to protect the youngster.

In most cases, treatment of anxiety disorders focuses on reducing the symptoms of anxiety, relieving distress, preventing complications associated with the disorder, and minimizing the effects on the teen's social, school, and developmental progress. If the problem manifests in school avoidance, the initial goal will be to get the youngster back to school as soon as possible.

Cognitive-Behavioral Therapy In many cases, cognitive-behavioral psychotherapy techniques are effective in addressing adolescent anxiety disorders. Such approaches help the teenager examine his anxiety, anticipate situations in which it is likely to occur, and understand its effects. This can help a youngster recognize the exaggerated nature of his fears and develop a corrective approach to the problem. Moreover, cognitive-behavioral therapy tends to be specific to the anxiety problem, and the teen actively participates, which usually enhances the youngster's understanding.

Other Therapies In some instances, long-term psychotherapy, and family therapy may also be recommended.

Medications When symptoms are severe, a combination of therapy and medication may be used. Antidepressant medications, such as nortriptyline (Pamelor), imipramine (Tofranil), doxepin (Sinequan), paroxetine (Paxil), sertraline (Zoloft), or fluoxetine (Prozac), or anxiety-reducing drugs, such as alprazolam (Xanax), clonazepam (Klonopin), or lorazepam (Ativan) may be prescribed in combination with cognitive or other psychotherapy. When tricyclic antidepressant medications such as imipramine are pre-scribed, your teen's physician may want to monitor for potential side effects by conducting periodic physical exams and occasional electrocardiograms (EKGs).
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See also;
Anxiety Disorders Resource Center
Facts for Families #47, The Anxious Child
Glossary of Symptoms and Illnesses; Anxiety
AACAP's Practice Parameter for the Assessment and Treatment of Children and Adolescents with Anxiety Disorders

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Your Adolescent - Anxiety and Avoidant Disorders

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Your Adolescent - Anxiety and Avoidant Disorders Excerpts from Your Adolescent on Anxiety and Avoidant Disorders Everyone experiences anxiety. It is a natural and important emotion, signaling through stirrings of worry, fearfulness, and alarm that danger or a sudden, threatening change is near. Yet sometimes anxiety becomes an exaggerated, unhealthy response.

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Overview

There is a commonly held misconception that eating disorders are a lifestyle choice. Eating disorders are actually serious and often fatal illnesses that are associated with severe disturbances in people's eating behaviors and related thoughts and emotions. Preoccupation with food, body weight, and shape may also signal an eating disorder. Common eating disorders include anorexia nervosa, bulimia nervosa, and binge-eating disorder.

Signs and Symptoms

Risk Factors

Treatments and Therapies

Join a Study

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There is a commonly held misconception that eating disorders are a lifestyle choice. Eating disorders are actually serious and often fatal illnesses that are associated with severe disturbances in people's eating behaviors and related thoughts and emotions. Preoccupation with food, body weight, and shape may also signal an eating disorder.

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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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If you are thinking of hurting yourself or are suicidal, dial "9-8-8" or text "START" to 741741. For life-threatening emergencies, dial "9-1-1" or go immediately to your nearest hospital emergency room.

The Depression and Bipolar Disorder Test is for informational purposes only and is not intended to provide a diagnosis for depression, bipolar disorder, or any other mental health condition. Based on your responses, the test determines the likelihood that you may have depression or bipolar disorder. Only a licensed medical or mental health provider can conduct a proper evaluation and make a diagnosis.

This test is not intended to provide specific medical advice and is not a substitute for professional care. If you or a family member experience symptoms of any mental health condition, or if you have personal questions or concerns, you should consult a licensed medical or mental health provider.

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Families for Depression Awareness - Depression and Bipolar Test

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We help families understand and cope with depression. Read and send our Family Profiles to others to help raise awareness, reduce stigma, and prevent suicides.