Archive for October, 2011

Generalized Anxiety Disorder: What Parents Need to Know

Wednesday, October 26th, 2011
A teen singing.

Generalized anxiety disorder most commonly affects those between adolescence and middle age. Image via Wikipedia

Overview

Everyone worries about things, even children and teenagers.  Whether the worry is over the upcoming history test, getting a date to the prom, or making the soccer team, anxiety is a normal part of everyday life.  However, in some people, normal everyday worries can become excessive and everyday things can cause severe anxiety.  This type of anxiety is called Generalized Anxiety Disorder (GAD) and it affects about 3% of the U.S.population each year, including one in eight children.

Generalized Anxiety Disorder is characterized by exaggerated anxiety and unwarranted worry about everyday problems.  People with this disorder may obsess about the worst case scenario in every situation and are unable to stop their anxiety from spiraling out of control.  Women are two times as likely to have the disorder and it most commonly affects those between adolescence and middle age.

 

Teens and young adults with the disorder may not do as well in school, may be susceptible to substance abuse problems, and may struggle with social milestones if it is not treated.  However, with the right combination of treatment, support, and assistance, children with GAD can learn to manage their symptoms and successfully navigate their lives.

 Symptoms

People with GAD experience consistent, persistent, chronic worry or anxiety about things that do not warrant this level of anxiety for more than 6 months.

One of the key differences between the anxiety everyone experiences and GAD is that everyday anxiety is temporary and GAD is not.  Adults and children with GAD can experience heightened anxiety all day, every day and it can interfere with their normal activities.  It is common for those with GAD to use avoidance as a tool for managing their anxiety.  An adolescent who is experiencing temporary anxiety will respond to comforting words, reassurances, and a list of the reasons they don’t need to be anxious.  The anxiety of a child or teen with GAD will not be soothed by these techniques.

In addition to the chronic nature of the anxious thoughts and feelings someone with GAD experiences, there are also some physical symptoms that are often present with the disorder including:

  • Unexplained fatigue and problems sleeping
  • Restlessness, edginess, and irritability
  • Gastrointestinal problems including  nausea and diarrhea
  • Difficulties concentrating and headaches

Causes

Generalized anxiety disorder has no known cause but stress, traumatic events, heredity, and biological factors may contribute to its onset.  It is relatively common and can affect people of all ages.  Although it generally develops gradually over time, many people with the disorder cannot remember a time when they did not experience some level of anxiety.

Treatment

Many people with GAD respond well to cognitive behavioral therapy, medication, or a combination of both.  Therapy can be beneficial in helping a person with the disorder to identify their triggers and modify their thought patterns and behavior.  Techniques for easing anxiety and promoting relaxation can also be beneficial to those with GAD.

It is very common for people with GAD to have a co-existing disorder.  Depression, substance abuse, and other anxiety disorders are commonly seen in those with the disorder.  Getting diagnosis and treatment for any co-existing conditions is an important part of overall treatment for GAD.

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Is Obsessive Compulsive Disorder Affecting My Teenager?

Monday, October 24th, 2011
Obsessive Compulsive Disorder in Teenagers and Adolescents

Does your teenager have OCD? Read more to find out.

It can be difficult in this age of acronyms to know when your teenager’s behavior is appropriate for their developmental stage of life of when it’s something that a parent should be concerned about.   With anxiety disorders like Obsessive Compulsive Disorder (OCD), it is even harder to find.  The difference between the two is the impact it has on the child’s daily life. 

What is Obsessive Compulsive Disorder?

Obsessive Compulsive Disorder (OCD) is an anxiety disorder that causes those who suffer from it to experience persistent anxiety, fear, or distressing thoughts and/or exhibit a ritualized behavior as a method to control their anxiety.  For example, a child might be so afraid of germs, they wash their hands every 15 minutes.  The obsessive nature of these thoughts and their compulsion to perform the ritual interfere with the teenager’s daily life.

Someone who is afraid of germs may develop a ritual that involves washing their hands a certain number of times at certain points over the course of the day.  A child who is worried about their house burning down may develop a ritual involving checking their smoke alarms and fire extinguishers to ensure they are operating.  It is important to remember that someone with Obsessive Compulsive Disorder does not believe they can control their compulsions and that these rituals offer only a temporary respite from their anxiety.

People with Obsessive Compulsive Disorder, both children and adults, may realize that their behavior is out of the ordinary but this is not always the case in children.   OCD may be accompanied by other conditions including depression and eating disorders and affects the same number of males and females.  In many cases, Obsessive Compulsive Disorder first presents during adolescence or the teen years.

What Causes Obsessive Compulsive Disorder?

Obsessive Compulsive Disorder is a brain disorder.  Research has shown that it does tend to run in families but there is no clear indication of why one person develops the condition and another doesn’t.  But the truth is clear, that OCD is no one’s fault, and especially does not occur because of something a parent did, or did not do.

What are the Symptoms of Obsessive Compulsive Disorder?

A person suffering from Obsessive Compulsive Disorder will display many of the following symptoms:

  • Repetitive thoughts that are distressing or cause anxiety about several different things.  Common obsessive topics include germs, dirt, crime, sexual acts, cleanliness, violence, or hurting others.
  • Ritual behavior patterns associated with their obsessions that they complete over and over to alleviate the anxiety.  Rituals can involve actions like repetitive hand washing, locking and unlocking doors or windows, counting, and performing things in a specific way again and again.
  • Performing rituals can be distressing and are not a source of comfort or pleasure although they do alleviate feelings of anxiety temporarily.
  • Obsessive thoughts and rituals occupy at least one hour a day and impact the person’s daily life.

Symptoms may come and go over time and it is not uncommon for people suffering from OCD to use avoidance techniques to try and keep their anxiety from being triggered. 

How is Obsessive Compulsive Disorder Diagnosed?

As with many mental health conditions, start with your medical provider who can rule out any physical conditions that may be contributing or causing the symptoms.  This doctor can refer you to a mental health practitioner for diagnosis and treatment. 

How is Obsessive Compulsive Disorder Treated?

Traditional treatment for Obsessive Compulsive Disorder involves both medication and exposure therapy.  This type of therapy is often combined with cognitive behavioral therapy to provide desensitization and alternative coping strategies.  Recent research supported by the National Institutes of Health’s (NIH) National Institute of Mental Health shows that children and teens respond most effectively to treatment with antidepressants in conjunction with therapy. 

If you are concerned that your child or teen is experiencing obsessive thoughts and compulsive behaviors, work with a professional who can assess your child’s behavior and advise you on the appropriate course of action.

 

Cutting and Self Harm- What Parents Need to Know

Tuesday, October 18th, 2011
Cutting and Self Harm- What Parents Need to Know

Why do teens cut themselves? Read more to find out. Image via WikipediaOn a good day, it can be difficult for parents to understand their teenagers. The teen years can be a mix of intense emotions, physical changes, peer pressure, and hormonal overload that can leave teens feeling like visitors in their own bodies. Lacking the emotional maturity and coping skills to deal with this onslaught, some teens turn to cutting and other destructive behaviors for relief. For parents everywhere, this terrifying trend is impossible to understand. To help, here are the basics.

On a good day, it can be difficult for parents to understand their teenagers.  The teen years can be a mix of intense emotions, physical changes, peer pressure, and hormonal overload that can leave teens feeling like visitors in their own bodies.  Lacking the emotional maturity and coping skills to deal with this onslaught, some teens turn to cutting and other destructive behaviors for relief.  For parents everywhere, this terrifying trend is impossible to understand.  To help, here are the basics.

What is Self Harm?

Any behavior that involves deliberately inflicting injury on your own body is considered self harm.  This includes behaviors like cutting, head banging, and burning.  Teenagers use these behaviors as coping strategies to deal with intense emotions that they don’t know how to handle.  It is important for parents to understand that self harm behaviors are not suicide attempts, although they can be a cry for help.

Common forms of self harm include severe scratching, cutting, poisoning, carving into skin, hitting, piercing the skin, biting, and burning.  It is common for people who self harm to use more than one method to cause injury.  The most common locations for self injury are those that are easily reached including legs, arms, and the front of the body.

Why Do Teens Hurt Themselves?

For some teens, self harm provides a respite of some sort.  It may be an outlet for intense emotional turmoil or it could offer a release of mounting tension.  In some teens it even brings a sense of calm and quiet.

Self harm can also be an expression of control in a world that feels completely of control or a distraction from emotional pain.  Teens may use self harm as a way to release emotions, to give their internal feelings an external representation.  In some cases, self harm is a cry for help, while in others it is simply a way to attract attention and manipulate other people.

What Causes it

There is no specific condition that causes teens to self harm.  While teens are the most prevalent sufferers, people of all ages may use self injury as a mechanism for dealing with difficult emotions. Self harm can also manifest in people who are suffering from mental illnesses like depression or eating disorders.

There are, however, some risk factors that can increase the likelihood of a teenager turning to self harm as an emotional outlet.  These factors are:

  • Age – Teenagers in the highest risk age group
  • Mental Health – People who struggle to manage negative emotions, have difficulty with impulse control, and who suffer from specific mental illnesses are more prone to self harm.
  • Life Experiences – Teens who suffered abuse, neglect, or loss during their childhood are more likely than their peers to self harm.

What to Watch For

Most teens that self harm are secretive about their struggle because they are confused and ashamed by their own behavior.  Signs to watch out for are scars, cuts, scratches, wounds, burns, and broken bones.  Teens who wear long sleeves and pants in summer or claim clumsiness as the reason for their injuries may be trying to hide their self injuries.

How to Get Help

If you have a child that is harming themself, consult your medical practitioner and request an evaluation.  These professionals can help guide you in raising the issue with your child and getting them the help they need.  Psychotherapy is the most common treatment for self harm which may include individual counseling for your teen and family group.

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ADHD Awareness Week, October 16-22, 2011

Sunday, October 16th, 2011

How much do you know about ADHD?  Odds are that unless you or one of your family members are one of the 13 million Americans living with the condition, you probably know less than you think and much of what you know may be incorrect.  The organizations behind the ADHD Awareness Coalition are working to change that with this year’s ADHD Awareness Week theme.  The focus of this year’s campaign is education and information.  People across the country will be urged to “Get the Facts about ADHD”.

For those with ADHD, the stigma attached to the diagnosis remains a real problem.  Decades of scientific research and the acceptance of ADHD as a legitimate diagnosable condition by the medical and mental health communities have not changed the fact that many people continue to question whether or not ADHD is real.  You would not tell a diabetic that they should be able to control their blood sugar themselves and if they can’t it is because they aren’t trying hard enough.  And yet, for many with ADHD, this is the message they are consistently given about their condition.  Changing how people view ADHD can change the lives of those who live with it and open up opportunities for them to thrive and contribute in new and different ways.

In recognition of ADHD Awareness Week, here are the seven facts you need to know about ADHD as outlined by the ADHD Awareness Coalition.  For more information about the coalition or ADHD Awareness Week, visit http://www.adhdawarenessweek.org/.

1.       ADHD is Real

ADHD is a brain-based disorder caused by a neurotransmitter imbalance.  Although ADHD symptoms can be varied in different individuals, it is a diagnosable condition that is listed in the American Psychiatric Association’s Diagnostic and Statistical Manual for Mental Disorders (DSM-IV-TR).  It is recognized by every major medical, psychological, and educational group in the U.S including the American Medical Association, American Academy of Pediatrics, National Institute of Mental Health, Centers for Disease Control and Prevention, American Psychiatric Association, American Academy of Child & Adolescent Psychiatry and the U.S. Department of Education.

2.       ADHD is a Common, Non-Discriminatory Disorder

An estimated 13 million children and adults in the U.S have ADHD.  These people span every race, age, gender, religion, and socio-economic group.  According to the CDC, 9.5% of children in America have been diagnosed with ADHD which means almost 1 in every 10 children is living with the condition.  Although it was initially thought to be a childhood condition that resolved after adolescence, new research has shown that many adults continue to be impacted through their lifetime.

3.       Diagnosing ADHD is a Complex Process

There is a specific diagnostic criterion for ADHD that doctors and mental health professionals use to determine whether or not an individual has ADHD.  However, the incidence of co-existing conditions whose symptoms can mirror or mask ADHD symptoms make this process difficult.  While there is not an ADHD blood test that will definitively determine whether or not someone has ADHD, there are tools and testing available to diagnosticians that enable diagnosis.

4.       Other Mental Health Conditions Often Occur Along with ADHD

It is very common for someone with ADHD to also have some other mental health disorder.   One of the most prevalent co-existing conditions is anxiety disorders which impact 30% of children and 25-40% of adults with ADHD.  Depression is also common amongst those with ADHD and will affect almost 70% at some point in their lifetime.  Those with ADHD are also more likely than those without ADHD to have a sleep and substance abuse disorders.

5.       ADHD is Not Benign

ADHD can impact almost every area of a person’s life.  For children, it can cause issues in school, with learning, in social development, and in building and sustaining relationships.  For adults, it can affect employment, relationships, financial management, and health management.  People with ADHD are more likely to get traffic tickets, be in traffic accidents, get divorced, and develop substance abuse problems.

6.       ADHD is Nobody’s Fault

ADHD is a highly genetic neurological disorder.  Things like family history, gender and environmental toxins may be factors that increase the likelihood of someone developing the condition.  It is not caused by sugar, television, bad parents, bad teachers, lack of morals, food allergies, or laziness.

7.       ADHD Treatment is Multi-Faceted

Most people with ADHD use a combined approach to treatment which may include psychotherapy, medication, coaching, behavior modification, and education.

Doorways specializes in the treatment of ADHD for teens, tweens and young adults.  If you suspect your child has ADHD, please contact your family medical practitioner.

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Helping your Teen Athlete Eat Healthy

Tuesday, October 4th, 2011

Everyone knows that teenagers often have bigger appetites because of their rapid growth.  Teen athletes, who can burn through as many as 5,000 calories a day, need even more food than their peers.  If they don’t get enough calories it affects their energy level and can impact their athletic performance.  In some cases, insufficient calories may even cause problems with their overall growth.  But it isn’t enough for teen athletes to eat enough calories; it is also important that they are taking in the right mix of nutrients and have a relatively balanced diet.

 

Breakfast

Parents can help support the nutritional needs of their teen athletes by starting each day with a healthy breakfast.  Have carbohydrate and protein filled choices such as whole grain bagels, peanut butter, eggs, yogurt and oatmeal available for a quick and healthy breakfast at home or on the go.

Diet

Everyone needs to eat a balanced diet but for teen athletes this is even more important. Their bodies are still growing which means they need the right mix of nutrients to support that growth while also providing the building blocks to boost performance and repair minor injuries.  According to KidsHealth.org, a teen athlete’s diet should be 60-65% carbohydrates, 12-15% protein, and 20-30% healthy fats.  Each of these three is equally important to your teen athlete’s development and performance.  Carbohydrates provide the main fuel source for their body, while protein helps build muscle.  Fats like those found in avocados and fish are critical to athletic performance because they provide the fuel for sustained energy.

Hydration

Teen athlete’s need to pay particular attention to their water intake and be diligent about keeping themselves hydrated.  Drinking water throughout the day as well as before, during, and after physical exertion is the best way to maintain the optimal level of hydration in the body.  When teen athletes become dehydrated, they may feel more tired, have less energy, and be less able to perform as expected on the field.

Calories

While there is no set amount of calories that all teen athletes need each day, the requirements are higher for teens that are active in sports or other physical activities.  On average, teen athletes may need 2,000 calories more per day than their less athletic friends.  The actual number is dependent on the person however and varies based on weight, sport, and age.  The best way to determine the right amount of calories for your teen athlete is to work with a registered dietitian.

Snacks

One of the best ways to help teen athletes get the balanced diet and number of calories they need is to ensure they have healthy, energy boosting snacks available throughout the day.  If your teen has practice directly after school they may be hitting their worst energy slump of the day just as practice is starting.  Depending on what time lunch period is, it may have been 3 or more hours since their last meal and by the time practice is over, they may have gone for seven or more hours without anything substantial to eat.  Pack snacks in their sports bag for before and after practice to ensure they have the energy to power through.   Healthy and energy-boosting snack choices include nuts, dried fruits and fresh fruits and vegetables.

 

By Rachel Daberkow, MS. RD.

 

Sources:

http://www.childrenshospital.org/az/Site988/mainpageS988P0.html

http://www.livestrong.com/article/289346-teenage-athletic-diet/

http://www.livestrong.com/article/74741-eating-teenage-athlete/

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