Wednesday, June 5th, 2013
When worry becomes all incompassing, it could be more than normal worry. Generalized Anxiety Disorder (Photo credit: Adams999)
Life provides ample opportunity to worry. From natural disasters to job losses, there are many legitimate things for adults to worry about and we all do it, even our kids. While their worries may be different than ours, they are just as real and just as valid. But for both adults and teens, worry sometimes moves from everyday concern into excessive anxiety. When worry becomes all encompassing, when it begins to impact every day activities, it can stop being normal worry and become Generalized Anxiety Disorder.
Severe non-specific anxiety is often diagnosed as Generalized Anxiety Disorder (GAD) and it is estimated to affect about 3% of the U.S. adult population. GAD also affects about one out of every eight children. People with GAD experience excessive and unwarranted levels of anxiety about normal everyday events and possibilities. Often, the anxiety is related to things that do not warrant the level of anxiety being experienced. It is also not uncommon for those with GAD to focus on the worst possible outcome of every situation to the exclusion of everything else. When these negative thoughts take root, it can feel impossible for the person with the condition to stop them.
When teenagers have this condition, they can struggle in all areas of their lives. The residual impact of untreated GAD during the teen years can last throughout their lives. GAD can make it difficult to concentrate at school, impacting grades, college options, and future employment. It can cause irritability and make people unwilling to engage in or participate in social situations. When this happens, teens can miss important social milestones, fail to form friendships, and struggle with feelings of loneliness and ostracism. The significant and long-lasting consequences of GAD in teens underscores the importance of seeking treatment rather than waiting for the problems to resolve themselves. The good news is that with proper treatment, teenagers can overcome GAD by learning to manage their symptoms.
The difference between someone who worries a lot and someone with GAD is the level of anxiety they experience and how long the anxiety lasts. GAD causes persistent, chronic anxiety that lasts for at least 6 months. Unlike worrying about a date for the prom or about getting a good grade on a test, GAD is consistently present; symptoms are often experienced all day, every day. Another differentiating factor for those with GAD is that calming methods, and even repeated reassurances, do not help to ease the feelings brought on by GAD.
People with GAD also experience physical symptoms including unexplained fatigue, problems sleeping, restlessness, edginess, irritability, difficulties concentrating and headaches. It is also common for those with this condition to also suffer from gastrointestinal problems including nausea and diarrhea.
While there is no known cause for GAD, it is associated with several factors that seem to increase the risk of it developing. These factors include stress, heredity, and experiencing traumatic events. People with this condition generally respond well to therapy, medication, or a combination of both.
Tuesday, May 21st, 2013
There has been a lot of press in recent years about the many post-9/11 veterans coming home with PTSD or Post Traumatic Stress Disorder. What many people don’t realize is that you don’t have to survive a war to be affected by this condition. Anyone, including children and teenagers, who experiences a traumatic event can develop the disorder and many who do will require treatment to overcome its challenges and obstacles. When left undiagnosed or untreated, PTSD can cause long-term problems that negatively impact quality of life. Because of the potential for lasting consequences, it is important for parents to understand what can cause the disorder, what symptoms teenagers with PTSD often experience, and how to get help for the disorder.
When the Worst Happens
There is no question that traumatic events impact everyone who is touched by them. Survivors and witnesses of trauma often experience a period of extraordinary stress and undergo a period of extreme emotional response following the event. Many of those touched by trauma will have trouble sleeping, experience difficulty concentrating, and develop anxiety specific to the circumstances of the event. These are all normal reactions experienced when we are exposed to trauma.
But these normal post-traumatic responses are generally worst immediately following the event and then begin to fade and dissipate in the days and weeks that follow. In some cases, however, these responses do not fade but intensify instead lasting for months or even longer. This is when our response shifts from a normal reaction to a diagnosable disorder.
Cause and Effect
Although PTSD is directly caused by experiencing some form of trauma, there is not a specific list of traumatic events or circumstances that cause PTSD. It can result from catastrophic events that impact thousands like an earthquake to individually impacting events like sexual abuse. However, experiencing trauma, no matter how catastrophic, does not guarantee that any specific individual will develop PTSD. The important thing to understand is that anyone who experiences trauma including those who are directly involved, those who are peripherally involved, and even those who simply witness the event, can develop this condition, but not everyone will. Even if someone has experienced multiple “smaller” incidences of traumatic events, they can end up with PTSD symptoms that are very disruptive and interfering.
Why One and Not the Other
There is no clear distinction between people who develop PTSD and people who don’t. There are some theories that PTSD stems from a disruption in the fight or flight response, the physiological response we experience when faced with fear, danger, or trauma. This is the biological process responsible for the surge of adrenaline we get when someone almost hits us while changing lanes or that makes it possible for a mother to lift a car off of her child. It is one of our base survival responses and is triggered during traumatic experiences. The thinking is that for some people, the exposure to trauma changes the way this biological process works, creating a new, very sensitive trigger that is directly correlated to the traumatic event. This new trigger sets off the fight or flight reaction outside of the normal parameters which creates the anxiety, fear, flashbacks, and other symptoms associated with PTSD.
If you are concerned that your teen may be suffering from PTSD, schedule an appointment with a mental health practitioner to have them evaluated. For many people, PTSD does not resolve on its own or get better over time which is why getting help is the best path to recovery.
Wednesday, June 27th, 2012
Do you know when your teen needs more help than you can provide? (Photo credit: kevinthoule)
The teenage years can be troublesome and traumatic. Faced with a myriad of pressures from every direction, teenagers often feel that they need twist and morph themselves into someone else in order to fit into other people’s molds. This is made more difficult because they are only beginning to discover who they are and what they want. They feel pressured to look a certain way, get good grades, fit in with friends, make the team, get the part, and be popular and sometimes that pressure can be too much. Teens also have to deal with other issues like family financial problems, divorce, and illness. Although the majority of teenagers make it through these tumultuous times to become well-adjusted adults, some teens struggle enough that they need professional help.
For parents, understanding when a teenager’s behavior is normal teen angst and when it is not is one of the biggest challenges. In order to get teens the help they need to successfully navigate whatever challenges they are facing, parents need to know what to look for, what to expect, and when to seek help. Here is a list of the most common mental health issues teens experience to help parents know when it’s time to seek outside help.
Bipolar Disorder – A teen with bipolar disorder has periods of mania and periods of depression. When they are in a manic period, they may be extremely happy, hyperactive, and/or irritated. They get by on very little sleep, get involved in multiple projects and activities, and may participate in risky behavior. When they are in a depressive period, they display the signs of depression.
Depression – When teens are clinically depressed, they experience feelings of sadness and irritability along with several other symptoms that can include changes in appetite or sleep, rapid weight loss or gain, fatigue, loss of interest in previously enjoyable activities, problems concentrating, feeling hopeless, and suicidal thoughts.
General Anxiety Disorder – Feelings of anxiety are common in teens, but in some cases these feelings can rise to the level of a disorder. Teens may worry excessively about situations, events, or activities to the extent that it interferes with their normal life. Symptoms include feeling restless, having trouble sleeping, being irritable, and being unwilling or unable to participate in everyday activities.
Obsessive-Compulsive Disorder (OCD) – Teenagers dealing with OCD have distressing thoughts or impulses that occur over and over and repetitive behavior patterns like hand washing, counting, and hoarding that interrupt their ability to live their life normally.
Anorexia Nervosa – Teens with anorexia nervosa do not eat enough to maintain a healthy body weight. Signs and symptoms include being significantly underweight, dry skin, low blood pressure, depression, moodiness, and unwillingness to eat around others.
Bulimia – Teens with bulimia participate in a cycle of bingeing and purging, eating a large amount of high calorie food and then inducing vomiting. Bulimics may also use laxatives, exercise, diuretics, and diet pills to prevent weight gain. Signs of bulimia include obsessing over weight, exercising hours at a time, eating in secret, spending time in the bathroom directly after eating, and low self esteem.
Trauma and Abuse
Teens who have been physically, emotionally, or sexually abused or who have lived through a traumatic event may need assistance to overcome the lasting damage these circumstances can cause. Teens may experience Post-Traumatic Stress Disorder (PTSD), anxiety, depression, substance abuse, suicidal tendencies, and self harm.
According to the American Academy of Child & Adolescent Psychiatry, suicide is the third leading cause of death amongst teenagers. Warning signs include depression, frequent thoughts of and conversation about death, substance abuse, previous attempts, and traumatic events.
Wednesday, June 20th, 2012
Do you know if your teen struggles with BDD? (image via chiesADIbeinasco on Flickr)
Everyone has days when they just don’t feel attractive. Call it a bad hair day or a fat jeans day or whatever you want; it happens to all of us. Now imagine feeling that way, all day, every day. This is what it is like to have Body Dysmorphic Disorder (BDD). BDD is an all-consuming preoccupation with some perceived flaw or defect in personal appearance. People with Body Dysmorphic Disorder cannot turn off the voice in their head that is consistently criticizing how they look, making them feel unattractive, and damaging their self worth.
The unrelenting nature of Body Dysmorphic Disorder can lead to suicidal thoughts and behavior. It can also lead to serial cosmetic surgery that is both unnecessary and does not offer relief. The all-consuming nature of this condition is elevates it to the level of a mental illness. Everyone has a bad hair day once in awhile, but for people with BDD there are no good days.
Like other chronic anxiety disorders, Body Dysmorphic Disorder has a broad range of symptoms and those with the condition may experience all, some, or any combination of them. Common symptoms include:
- Preoccupation with physical appearance or any specific aspect of physical appearance
- Spending significant amounts of time looking in the mirror
- Belief that there is a deformity or defect that doesn’t exist
- Avoidance of mirrors
- Constant need for others to provide assurance on attractiveness
- Serial cosmetic surgery
- Unwillingness to have picture taken
- Avoiding social situations
- Wearing clothes or makeup specifically to cover perceived flaws
People with BDD can obsess over their appearance as a whole or any specific body part. There are some areas of the body that are more commonly the object of the obsession including:
- Skin/Complexion including obsessing over wrinkles or acne
- Hair and Baldness
- Breast Size and Genital
- Muscle Size
It is not uncommon for the obsessive thoughts to shift from one body part to another over time as the disorder centers on obsessive thoughts rather than actual physical attributes. In some cases, these thoughts can become so powerful that they result in delusional behavior.
There is nothing specific that is known to cause Body Dysmorphic Disorder. Experts in the field agree that, similar to other mental illnesses, it may be caused by a combination of factors like chemical or structural differences in the brain, negative life experience relating to body image, and genetics.
Like any anxiety disorder, Body Dysmorphic Disorder can make it difficult to live life to the fullest and lead to other problems. People with BDD may also experience Obsessive-compulsive Disorder (OCD), Depression, eating disorders, social phobia, and other anxiety disorders. They may have to spend time in the hospital to treat their disorder and choose to undergo unnecessary medical procedures to fix the imagined flaws and defects. They can become socially isolated, lack close personal relationships, and their disorder can make it difficult to go to work or attend school. This disorder can also result in suicidal thoughts and tendencies.
Diagnosis and Treatment
Body Dysmorphic Disorder can be diagnosed by a doctor or mental health provider using a series of tests including a physical exam, blood tests, and a psychological evaluation. However, BDD can be difficult to diagnose if the person with the disorder does not fully participate in any testing by sharing feelings and thoughts openly. Diagnosis can also be complicated because BDD shares symptoms and traits with other mental illnesses which must be ruled out in order to get to the right diagnosis. The diagnostic criteria for BDD include extreme preoccupation with some aspect of physical appearance that causes problems in other areas of life.
Treatment of BDD is most successful when the person with the disorder is engaged and willing to participate in the process. BDD is commonly treated with cognitive behavioral therapy and may also include the use of medication. In severe cases, hospitalization may be required in order to protect the wellbeing of the person with the condition.
Wednesday, November 16th, 2011
PTSD and Teens. Image via Wikipedia
PTSD, or Post Traumatic Stress Disorder, used to be something associated only with war veterans and abuse survivors but it can affect anyone who experiences a traumatic event. Even though teens and adolescents may show different symptoms than adults , they can suffer from the same disorder and usually require treatment to overcome the challenges it presents. Understanding the causes and contributing factors can help parents identify when their children need help and how to get them the help they need.
What is PTSD?
Post traumatic stress disorder describes the development of a set of symptoms following a traumatic experience. Everyone who is impacted by trauma may feel extreme stress and suffer from strong emotional responses, difficulties with normal activities like sleeping, eating, and concentrating, and anxiety or fear related to the circumstances of the event. However, not everyone impacted by trauma also develops PTSD.
Those who suffer from Post Traumatic Stress Disorder will have symptoms for a month or longer and their symptoms don’t abate with time. In some cases, symptoms do not start directly following the event and may actually get worse as time passes.
What Causes PTSD?
Experiencing a traumatic event like a car accident, natural disaster, violent crime, or physical assault can cause Post Traumatic Stress Disorder. It is not necessary for someone to be injured or even to have directly participated in the event in order to develop PTSD. In some cases, merely witnessing an event can lead to the disorder. It is important to note that not everyone who experiences trauma will develop Post Traumatic Stress Disorder just like not everyone who has the same experience will respond in the same way.
One theory about why some people develop PTSD has to do with our bodies fight or flight response, the chemical reaction triggered by fear or danger. This physiological response is meant to enable us to protect ourselves and respond in critical survival situations. But in some people, a traumatic event disrupts this response, causing the same kind of chemical reaction in circumstances where it isn’t necessarily warranted. This can lead to feelings of anxiety, severe stress, fear, and danger when there is no external cause of those feelings.
There are some risk factors that can elevate someone’s likelihood of developing Post Traumatic Stress Disorder. These risk factors include previous experience with traumatic events, a history of mental illness, lack of social support after the event, and being injured as part of the event. There are also factors that can make someone more resilient and thereby reduce their risk of PTSD including strong post-event support, feeling positive about how they handled the event, and specific coping strategies for dealing with stressful events.
What are the Symptoms of PTSD?
Regardless of when PTSD develops, there are some characteristic symptoms that develop after the experience. People may experience any combination of these symptoms.
- Mental images of the event or it’s aftermath
- Avoidance of people, places, or things that are reminders of the event
- Unwillingness to talk about the event or discuss what happened
- Emotional detachment
- Edginess, irritability, and hyper-vigilance
- Trouble sleeping
- Inability to concentrate
- Depression and survivor guilt
- Angry outbursts
While teens and older adolescents may show symptoms similar to adults, they may also act out and become disruptive and destructive. In young children and some adolescents, PTSD can cause a different set of symptoms including bedwetting, forgetting how to speak, refusing to speak, repeatedly acting out the traumatic event, and having unusual separation anxiety from parents or other adults.
How is PTSD Diagnosed?
PTSD is diagnosed by a doctor, psychiatrist, or psychologist based on a personal interview. In order to be diagnosed, a person must display a certain set of symptoms for at least one month. The set of symptoms must include one symptom related to re-experiencing the event like nightmares or flashbacks. They must also be experiencing at least three avoidance symptoms like refusing to talk about the event or to participate in any activity relating to the event. Additionally, the person must suffer from at least two different symptoms showing hyper-arousal like irritability and edginess.
PTSD is treatable and sufferers can make a complete recovery but it doesn’t generally resolve without assistance. PTSD is most commonly treated with counseling or therapy and in some circumstances medication to treat underlying depression or other conditions may be used to help mitigate the effects of the disorder. If you are concerned that your teen or young child may be suffering from PTSD, schedule an appointment with their doctor to rule out any medical causes of their symptoms and get a referral for a qualified practitioner.
Wednesday, October 26th, 2011
Generalized anxiety disorder most commonly affects those between adolescence and middle age. Image via Wikipedia
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.
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
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.
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.
Monday, August 29th, 2011
November 9th, 2011
(Anxiety and Eating Disorder treatment in preadolescent males)
Presented by Sam Lample along with Rachel Daberkow for Sierra Tucson Professional Networking