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Mental Health Disorders in Adolescents

Mental Health Disorders in Adolescents: A Guide for Parents, Teachers, and Professionals

Eric P. Hazen
Mark A. Goldstein
Myrna Chandler Goldstein
Foreword by Michael S. Jellinek
Copyright Date: 2011
Published by: Rutgers University Press
Pages: 350
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  • Book Info
    Mental Health Disorders in Adolescents
    Book Description:

    Mental Health Disorders in Adolescentsprovides essential information to help parents, educators, and general practitioners find effective ways to identify and treat psychiatric disorders that many teens face. The first of two reader-friendly sections, "Recognizing the Problem, Finding Help, and Negotiating the System," is designed to help caregivers navigate the often confusing adolescent mental health system. Readers will find comprehensive information about when and how to seek help and the kinds of treatments that are available, including a detailed discussion of psychiatric medications and psychotherapy options. "Common Psychiatric Problems in Adolescence," the second section, offers information on specific psychiatric disorders, including symptoms and warning signs, diagnostic evaluations, treatment options, prognosis, and associated risks for each disorder.Additionally, Eric P. Hazen, Mark A. Goldstein, and Myrna Chandler Goldstein have compiled two practical appendices-one provides a list of resources, organizations, books, websites, and phone numbers for further information and support. The other serves as a "treatment organizer" to help parents know what school and medical data to bring to a psychiatric evaluation and teach them how to keep track of important discussions related to their child's treatment.By recognizing the early symptoms of a psychiatric disorder, adults may be able to save a teen's life.Mental Health Disorders in Adolescentsoffers real options to anyone searching for ways to help at-risk teens.

    eISBN: 978-0-8135-5234-7
    Subjects: Health Sciences

Table of Contents

  1. Front Matter
    (pp. i-vi)
  2. Table of Contents
    (pp. vii-viii)
  3. Foreword
    (pp. ix-x)
    Michael S. Jellinek

    Throughout history, adolescence has posed challenges to parents. Some of these challenges are a result of our social evolution. When we lived in primitive circumstances, adolescents—what we now think of as tenth graders in high school—were a critical resource for survival. Once physically mature, teenagers took responsibility for gathering or hunting food as well as having the children needed for family and group survival. In a less complicated world, our high schoolers, too young to drink, drive, and vote and in our view in constant need of supervision, are biologically capable of being quite productive citizens.

    In modern...

  4. Preface
    (pp. xi-xii)
    Eric P. Hazen, Mark A. Goldstein and Myrna Chandler Goldstein
  5. Acknowledgments
    (pp. xiii-xiii)
    EPH and MAG
  6. 1 Introduction
    (pp. 1-14)

    Adolescence is a challenging time even under the best of circumstances. Overnight, a polite, happy child may appear to transform into a surly, rebellious teen. Trying as the changes that occur during adolescence may be, they serve a greater purpose: to help children who are wholly dependent on their parents for most of their needs to develop into healthy, independent adults with a secure sense of identity and the ability to think effectively through the problems that life may throw at them. The majority of adolescents manage this transition without a great deal of turmoil. However, the rapid physical, psychological,...

  7. Part I: Recognizing the Problem, Finding Help, and Negotiating the System

    • 2 Introduction to Mental Health Treatment for Adolescents
      (pp. 17-36)

      Parents unfamiliar with the mental health system who are trying to find help for their child may feel that they have fallen down the rabbit hole into a strange new land filled with confusing terms and an array of seemingly well-meaning providers whose roles are not always clear. Even parents who work in the health care field are often surprised to find that in the United States in the twenty-first century mental health problems are treated quite differently than other illnesses and that the system for treating psychiatric illness can be quite confusing. This goal of this chapter is to...

    • 3 Finding Treatment
      (pp. 37-46)

      It is often difficult for parents to know when to seek a psychiatric evaluation for children with problems that arise during adolescence. The normal adolescent developmental process typically involves rapid and dramatic changes in behavior. Your once pleasant, mild-mannered child may seem to turn surly and withdrawn overnight. The bodily changes of puberty and shifting social pressures of adolescence are common stressors for teens. Parents of adolescents may feel surprised when their children discuss their problems with their peers and rely less on adults for support. This is all part of natural development and identity formation. So with all these...

    • 4 Psychotherapy
      (pp. 47-58)

      One of the oldest forms of psychiatric treatment is psychotherapy, and it remains one of the most powerful tools available for treating mental illness and promoting psychological health.Psychotherapyis a general term that encompasses a broad variety of treatments for individuals, families, and groups. The common thread of these treatments is that they are primarily talk based and the changes that occur through them are brought about by the interaction between the patient and the therapist. In the preceding chapter, we discussed the process of obtaining an initial evaluation and finding a therapist who is a good fit for...

    • 5 Psychiatric Medications
      (pp. 59-78)

      Medications are one of the most effective tools available for the treatment of mental illness. Compared to the previous generation of medications, many newer medications have been shown to be useful for the treatment of mental issues in adolescents, and increasing numbers of teens are prescribed these agents. However, parents are frightened by the idea of giving psychiatric medication to their teenage child, and many questions arise: When should medication be considered? What risks does it carry? Will it work, and if so, how long will my child need to continue taking it?

      This chapter presents an overview of commonly...

  8. Part II: Common Psychiatric Problems in Adolescence

    • 6 Major Depressive Disorder
      (pp. 81-97)

      Depression is one of the most common psychiatric conditions affecting adolescents and may be one of the most devastating. It is estimated that 4 to 8 percent of adolescents are suffering from major depressive disorder at any given time, and by the age of eighteen, about 20 percent of adolescents will have experienced the symptoms of clinical depression. Unfortunately, as common as depression is, it frequently goes unrecognized. Many of the symptoms of depression make it more likely for depressed teens to keep their suffering to themselves. A sense of guilt or worthlessness may make teenagers feel that telling others...

    • 7 Bipolar Disorder
      (pp. 98-111)

      Bipolar disorder, formerly known as manic-depressive disorder, is estimated to affect more than five million adults in the United States, or 2.6 percent of the population in a given year. Until recently, it was believed to be relatively rare in children and adolescents. Over the past decade, however, the number of diagnoses of bipolar disorder made in younger patients has increased dramatically. There is some controversy surrounding this trend, and many people in both medicine and the media have argued that bipolar disorder is being overdiagnosed in teenagers. Others have countered that bipolar disorder is often overlooked and left untreated...

    • 8 Anxiety Disorders
      (pp. 112-128)

      Feelings of worry are a usual part of everyone’s life. Adolescence, with its rapid physical and emotional changes, increasing demands at school, and shifting social climate, may be a particularly anxiety-provoking time. During adolescence, some degree of anxiety is normal and may even serve a useful purpose. The teen who has been extremely stressed from attempting to write a twelve-page term paper in one night, after procrastinating for weeks, may remember that uneasy feeling with the next assignment and begin to think about changing his or her behavior. For many teenagers, however, anxiety is more than just an occasional, uncomfortable...

    • 9 Psychotic Disorders
      (pp. 129-142)

      Psychosis is a condition in which the affected person has lost contact with reality. Psychosis may be the result of other psychiatric problems, such as substance abuse or a severe mood disorder, or it may present on its own, independent of any clear external causes. Although psychotic disorders are relatively uncommon during adolescence compared to other psychiatric problems such as depression and anxiety, primary psychotic disorders such as schizophrenia often begin to emerge during the adolescent years. Psychosis during adolescence is usually an extremely frightening and severely disrupting experience for teens and families alike. Without proper treatment it poses significant...

    • 10 School-Related Problems
      (pp. 143-153)

      School is where adolescents spend many of their waking hours. As a cornerstone of adolescent development, school is more than a place to learn academics. When it goes well, school serves as a safe foundation from which teens can develop self-confidence, find adult role models, learn to negotiate social relationships, work through challenges, and practice the intellectual and interpersonal skills that they will need in adult life. School has the potential to serve as a laboratory of sorts for teens, where they can channel their developmental drive to experiment and take chances in healthy ways, such as trying out for...

    • 11 Attention-Deficit/Hyperactivity Disorder
      (pp. 154-167)

      Attention-deficit/hyperactivity disorder (ADHD) is a chronic condition that affects children, adolescents, and adults. ADHD affects 5 to 8 percent of children and adolescents, and it is believed to be the most common mental disorder diagnosed in childhood. Approximately 65 percent of children with ADHD continue into adolescence with symptoms related to their illness. The spectrum of ADHD varies from childhood to adolescence, making ADHD more difficult to diagnose in adolescents because observable hyperactivity, seen more commonly in preadolescents and young children, is less likely to be noted in teens. Moreover, children are unlikely to have academic failure problems.

      It seems...

    • 12 Substance Abuse
      (pp. 168-191)

      Adolescence is a time for experimentation. New interests, friends, and self-expression are all part of the process. Therefore, it is not surprising that adolescence is a time when problems with substance abuse first emerge. Because teens often fail to consider the long-term consequences of their actions and have a tendency to see themselves as being impervious to harm, they are particularly vulnerable.

      Although most teens may experiment with alcohol, tobacco, or marijuana without developing a problem, a significant minority will progress to patterns of problem usage. If this occurs, an adolescent has the best chance of overcoming a substance abuse...

    • 13 Personality Disorders
      (pp. 192-202)

      Personality disorders are a distinct group of psychiatric disorders that involve persistent patterns of inflexible, unhealthy ways of interacting with others and distorted responses to life events. These patterns of behavior are markedly different from the normal range of behavior in a culture and may cause the teen a significant degree of distress or lead to an impairment in healthy functioning.

      Because most psychiatric disorders seem, to varying degrees, foreign to the true nature of the affected adolescent, personality disorders are somewhat different from other psychiatric illnesses, The illness leads to changes in the teen’s thoughts or behaviors, and these...

    • 14 Behavioral Disorders: Oppositional Defiant Disorder and Conduct Disorder
      (pp. 203-211)

      Testing limits, taking risks, and challenging authority are normal, albeit trying, aspects of adolescent development. However, for some adolescents these behaviors go too far. Teens may become entranced in a pattern of negative behavior that places them at risk for serious legal, social, or academic consequences. When an adolescent goes beyond the occasional bad decision or argument with parents to a persistent pattern of active defiance, rule breaking, or criminal activities, a psychiatric evaluation may be warranted.

      In this chapter, we discuss the behavioral disorders: oppositional defiant disorder (ODD) and conduct disorder. These two related disorders are common in adolescents...

    • 15 Eating Disorders
      (pp. 212-226)

      Eating disorders are a group of serious psychiatric problems that have the highest fatality rate of all mental disorders. Though often thought to be a modern problem, behaviors similar to bingeing and purging have been described since ancient Roman times. In the 1880s,anorexia nervosawas coined to describe individuals who voluntarily limit their intake and then endure weight loss. By contrast, it has been only in the past thirty years that the termbulimiawas introduced to describe the bingeing and purging behaviors identified in some women with eating disorders.

      In the past forty years, increasingly more adolescents, both...

    • 16 Obsessive-Compulsive Disorder and Tic Disorders
      (pp. 227-247)

      Obsessive-compulsive disorder (OCD) and tic disorders have similarities. In both cases, an adolescent’s sense of self comes under assault as he or she experiences thoughts or urges that do not seem to make sense and feel impossible to control. OCD is characterized by bizarre, disturbing, intrusive thoughts or images and repetitive behaviors that are difficult to resist, while tic disorders, such as Tourette’s disorder, involve sudden, repetitive, habitual movements or vocalizations known as tics. As with OCD, most teens with tic disorders recognize the problem and wish that they could stop. Unfortunately, they just cannot help themselves.

      Tic disorders and...

    • 17 Reactions to Stress, Loss, and Illness
      (pp. 248-261)

      Under the best of circumstances, adolescence is a stressful time. The rapid developmental changes coupled with the shifts that occur in an adolescent’s family and social relationships may be challenging to manage. Some teens face the additional burden of managing a major stressor in their lives. Academic difficulties and traumatic events such as sexual abuse are discussed in other chapters. In this chapter, we review some of the more common forms of significant stress in the life of an adolescent: loss of a loved one, parental divorce or separation, and chronic medical illness. It is important to understand a general...

    • 18 Reactions to Trauma
      (pp. 262-276)

      Every year, many adolescents are confronted with a traumatic event. Trauma can take many forms, including witnessing or being a victim of natural disasters, accidents, sexual abuse, or violence including dating or relationship violence. Traumatic events may be sudden and short-lived, such as an accident, or they may be ongoing, such as suffering from repeated physical abuse from a caregiver.

      Although trauma is difficult to quantify, it appears that rates of exposure to traumatic events during adolescence are high and may exceed rates of exposure during adulthood. In 2007, the National Youth Risk Behavior Survey, a poll of high school...

    • 19 Dangerous Behavior: Suicide, Self-Injury, and Violence
      (pp. 277-293)

      An adolescent’s safety is the first priority for parents, teachers, and mental health professionals. Although most psychiatric treatments take time, when adolescents’ safety or the safety of those around them is at risk, urgent intervention may be required. Adolescents are particularly prone to engage in dangerous and lethal behaviors. And unfortunately, they are at increased risk for suicide.

      Suicide, self-injury, and violence are all complex behaviors with multiple causes. So there is no single approach to addressing these problems that will work for every adolescent. Nonetheless, there are steps that parents can take to help maintain the safety of their...

    • 20 Autism Spectrum Disorders
      (pp. 294-306)
      Charles Henry

      In the 1940s, Leo Kanner used the term “infantile autism” to describe a group of children in his psychiatric practice who had trouble with social development, rigid behaviors, and communication delays. Despite considerable research that has occurred since then, Kanner’s initial descriptions have remained central to the modern diagnosis of autism. Autism was originally thought to be a rare disorder, with investigations during the 1980s indicating an incidence of about 1 in 2,500 children. More recent studies, however, have raised concern about a potential increase in the number of children suffering from the disorder. Data from the Centers for Disease...

    • 21 Conclusion
      (pp. 307-312)

      Psychiatric problems commonly begin during adolescence. Because of the critical developmental processes that are unfolding during this time, these problems have the potential to have lifelong effects, including low self-esteem, occupational underachievement, difficulties with relationships, substance abuse, and unhealthy ways of managing stress. Because adolescents are a work in progress, they tend to be more amenable to change than adults. Intervention during this critical period of development can have profound and lasting effects.

      It is often challenging for parents to obtain the help a teen requires. Since adolescence is a time of rapid change, knowing when it is appropriate to...

  9. Appendix A: Resources
    (pp. 313-319)
  10. Appendix B: Treatment Organizer
    (pp. 320-324)
  11. Index
    (pp. 325-337)
  12. Back Matter
    (pp. 338-338)