Know the Signs of Mental Illness

Know the Signs of Alcohol and Drug Abuse

Reading Lists

     Read about seeking Professional Therapy
     Read about Infant/Early Childhood Mental Health
     Read about Childhood Trauma
     Read about The Overscheduled Child
     Read about Peer Pressure

Diagnosis Related Links

Know the Signs of Mental Illness

Childhood Depression
Anorexia Nervosa
Bulimia Nervosa
Attention Deficit Disorder
Self Injury in Adolescents
Anxiety Disorders
Schizophrenia
Disruptive Behavior Disorders

Childhood Depression

The behavior of depressed children and teenagers may differ from the behaviorof depressed adults. Child and adolescent psychiatrists advise parents to beaware of signs of depression in their children.
If one or more of these signs of depression persist, parents should seek help:

• Frequent sadness, tearfulness, crying
• Hopelessness
• Decreased interest in activities or inability to enjoy previously favorite activities
• Persistent boredom, low energy
• Social isolation, poor communication
• Low self-esteem and guilt
• Extreme sensitivity to rejection or failure
• Increased irritability, anger or hostility
• Difficulty with relationships
• Frequent complaints of physical illnesses such as headaches or stomachaches
• Frequent absences from school or poor performance in school
• Poor concentration
• A major change in eating and/or sleeping patterns
• Talk of or efforts to run away from home
• Thoughts or expressions of suicide or self-destructive behavior

What can parents or caregivers do?

If parents or another adult in a young person's life suspect a problem with depression, they should:

• Be aware of the behaviors that concern them and note how long the behaviors have beengoing on, how often they occur, and how severe they seem
• See a mental health professional or the child's doctor for evaluation and diagnosis
• Get accurate information from libraries, helplines, and other sources
• Ask questions about treatments and services
• Talk to other families with similar problems in the community
• Find a family support group such as NAMI

Source: "The Depressed Child", American Academy of Child & Adolescent Psychiatry, No 4 (updated 8/98). National Association for Mental Health (NAMI Facts)"Facts About Childhood Depression".

Read more about Childhood Depression

Anorexia Nervosa

Anorexia nervosa is characterized by intense fear of gaining weight or becoming fat, refusal to maintain weight that is over the lowest weight considered normal for age and height, distorted body image, and/or absence of at least three consecutive menstrual cycles. Subtypes include Restricting (during the current episode the person has not engaged in binge-eating or purging behavior, i.e. self-induced vomiting or the misuse of laxatives, diuretics or enemas) and Binge-Eating/Purging (during the current episode the person has regularly engaged in binge-eating or purging behavior, i.e. self-induced vomiting or the misuse of laxatives, diuretics, or enemas).

SIGNS/SYMPTOMS:

• Intense fear of gaining weight
• Belief that they are fat although they are actually extremely thin
• Restriction of calories
• Avoids social situations where she/he may have to eat in front of other people
• Unusual eating habits or rituals
• Obsessive or compulsive exercise
• Hyperactivity or fatigue
• Isolation from friends and family

PHYSICAL EFFECTS OF ANOREXIA NERVOSA:

• Dry skin, sallow complexion
• Irregular or ceased menstrual cycle for females
• Growth of fine hair over body and face
• Purple nail beds and clod extremities
• Hair loss
• Cardiac problems
• Dizziness, low blood pressure, fainting
• Changes in metabolism and energy
• Malfunctioning of pancreas
• Damaged kidneys
• Osteoporosis

Read more about Eating Disorders

Bulimia nervosa

Bulimia nervosa is characterized by binging (consuming large amounts of food at one sitting while feeling out of control),purging (getting rid of food by using laxatives, vomiting, or exercising excessively), dissatisfaction with one's body, and fear of gaining weight. Subtypes include Purging (during current episode, the person has regularly engaged in self-induced vomiting or the misuse of laxatives, diuretics or enemas) or Non-Purging (during current episode, the person has used other inappropriate compensatory behaviors, such as fasting or excessive exercise).

SIGNS/SYMPTOMS:

• Fear of being fat
• Eats in secret
• Goes to the bathroom immediately following meals
• Hoards food
• Mood swings
• Abuse of alcohol or other substances
• Over-exercising
• Isolation from family and friends

PHYSICAL EFFECTS OF BULIMIA NERVOSA:

• Damaged teeth and swollen cheeks
• Dehydration, weakness, fatigue
• Electrolyte imbalance
• Bleeding and infection of the throat
• Enlargement of lymph or salivary glands
• Digestive and intestinal problems
• Muscle spasms and headaches
• Irregular menstrual cycle for females

Attention Deficit Disorder

Attention Deficit Disorder (ADD) is a syndrome usually characterized by serious and persistent difficulties resulting in poor attention span, weak impulse control and sometimes hyperactivity. ADD is a chronic disorder which can begin in infancy and extend through adulthood while having negative effects on a child’s life at home, school, and within the community. ADD has a subtype that includes hyperactivity (ADHD). It is a treatable condition, however, it is not curable.

ADD is a complex disorder that affects approximately 3-6% of the population (the risk factor increases to 70% for children who have relatives with ADD). Boys with ADD outnumber girls by 3 to 1, although ADD in girls is underdiagnosed.

SIGNS:

• Poor attention span/inattentiveness
• Weak impulse control
• Often, but not always, hyperactivity
• Fidgets, squirms, or seems restless
• Has difficulty remaining seated
• Easily distracted
• Difficulty waiting their turn
• Blurts out answers
• Difficulty following instructions
• Difficulty sustaining attention
• Shifts from one uncompleted task to another
• Difficulty playing quietly
• Talks excessively
• Interrupts or intrudes on others
• Does not seem to listen
• Often loses things necessary for the task
• Frequently engages in dangerous actions

Read more about ADHD

Self Injury in Adolescents

Self injury is the act of deliberately destroying body tissue, at times to change a way of feeling. Some adolescents may self-mutilate to take risks, rebel, reject their parents’ values, state their individuality, or to be accepted. Others may injure themselves out of hopelessness, worthlessness or because they have suicidal thoughts. Some report the act allows the tension to be released from their bodies. Others report feeling hurt, angry, fear and hate.

SIGNS OF SELF INJURY:

• Carving
• Scratching
• Branding
• Marking
• Picking of Skin and Hair
• Burning/Abrasions
• Cutting
• Head-banging
• Bruising
• Hitting
• Tattooing
• Excessive Body Piercing
• Biting

Read more about Self Injury in Adolescents

Anxiety Disorders

All children experience anxiety, however, if anxieties become severe and interfere with the daily activities of childhood comprehensive evaluation and treatment may be warranted.

SIGNS OF OBSESSIVE COMPULSIVE DISORDEROBSESSIONS

• Recurrent persistent thoughts, impulses or images that are intrusive and cause impairment
• The thoughts, impulses, etc., are not excessive worry about real life problems
• The person attempts to ignore or suppress the thoughts, etc.
• The person recognizes the thoughts are a product of his or her mind

COMPULSIONS

• Repetitive behaviors (washing, checking) or mental acts (counting, praying) that the person feels driven to do in response to obsession
• Behaviors or mental acts that are aimed at preventing or reducing distress or preventing some dreaded event, and the acts are clearly excessive

Separation Anxiety

• Constant thoughts and fears about safety of self and parents
• Refusing to go to school
• Frequent stomach aches and other physical complaints
• Overly clingy
• Worry about sleeping away from parents
• Panic or tantrums at the time of separation
• Trouble sleeping or nightmares

Generalized Anxiety Disorder (Overanxious Disorder of Childhood)

• Excessive anxiety and worry
• Difficult to control the worry
• Restlessness or feeling "on edge"
• Easily fatigued
• Difficulty concentrating
• Irritability
• Muscle tension
• Sleep disturbance

Schizophrenia

Schizophrenia is a mental disorder that is characterized by having psychotic symptoms as the defining feature. "Psychotic" refers generally to the presence of prominent delusions or hallucinations. There is no known single cause. Genetic factors may play a part because it has long been known to run in families. Essential characteristics of schizophrenia include positive and negative symptoms.

SIGNS OF SCHIZOPHRENIA:

• Positive Symptoms
• Excess or distortion in normal functioning
• Delusional thinking
• Disorganized speech and behavior
• Auditory or visual hallucinations


• Negative Symptoms
• Reductions in normal or existing functioning
• Flattening of emotional expression
• Diminished thought process
• Decrease in goal directed behavior

STATISTICS:

• About 1% of the population develops schizophrenia
• More than 2 million Americans suffer from it in a given year
• Males and females are affected equally
• Onset usually occurs in late teens to early thirties
• Children over the age of 5 years can develop schizophrenia, but it is rare before adolescence
• There is a common misconception that schizophrenia is the same as "split personality" which is untrue
• Studies indicate that people with schizophrenia are not especially prone to violence and are, more often, withdrawn and prefer to be left alone

Disruptive Behavior Disorders

SIGNS OF OPPOSITIONAL DEFIANT DISORDER:

• Pattern of negative, hostile and defiant behaviors
• Often loses temper
• Often argues with adults
• Often actively defies or refuses to comply to adult requests
• Often deliberately annoys people
• Often blames others for mistakes or misbehavior
• Often angry and resentful
• Often spiteful or vindictive

SIGNS OF CONDUCT DISORDER:

• Repetitive, persistent pattern of behavior in which the basic rights of others are violated
• Agression to people and animals
• Bullies, threatens, intimidates
• Initiates physical fights
• Used a weapon that can cause serious harm
• Physically cruel to people
• Physically cruel to animals
• Forced someone into engaging in sexually activity
• Destruction of Property
• Deliberately engaged in firesetting
• Deliberately destroyed property
• Deceitfulness or Theft
• Broken into house or building
• Lies to obtain goods/services
• Stolen items of nontrivial value without confronting victim
• Serious Violation of Rules
• Stays out at night despite parental prohibitions
• Has run away from home overnight at least two times
• Truancy from school

Intermittent Explosive Disorder

Intermittent explosive disorder refers to violent outbursts of rage also characterized as rage or anger attacks. This rare disorder usually occurs in individuals between late adolescence and late twenties. The diagnosis can be made only after other mental disorders have been ruled out, such as Antisocial Personality Disorder, Borderline Personality Disorder, Psychotic Disorder, Manic Disorder, Conduct Disorder or Attention Deficit/Hyperactivity Disorder.

SIGNS:

• Failure to resist aggressive impulses that result in serious assaultive acts or destruction of property
• The degree of aggressiveness expressed during an episode is grossly out of proportion to any provocation or precipitating psychosocial stressor
• Aggressive episodes are not due to the direct physiological effects of a substance (i.e. drugs or medications) or a general medical condition (i.e. head trauma, Alzheimer’s Disease)
• The individual may describe the aggressive episodes as "spells" or "attacks" in which the explosive behavior is preceded by a sense of tension or arousal and is followed immediately by a sense of relief. Later, the individual may feel upset, remorseful, regretful, or embarrassed about the behavior.

Know the Signs of Alcohol and Drug Abuse

Many people abuse alcohol or drugs without being addicted and addiction begins with abuse. It may be difficult to tell the signs of alcohol and drug abuse from signs of depression. Also mental health and substance abuse problems often occur together. Nevertheless, there are signs of alcohol and/or drug abuse that a parent can watch for.

Changes in Physical Appearance:

• Lack of personal cleanliness
• Red eyes and frequent use of eye drops
• Runny nose, congestion, coughing

Changes in Eating and Sleeping Habits:

• Difficulty falling asleep
• Excessive napping
• Significant weight loss or gain
• Poor appetite

Changes in Behavior and Personality:

• Abrupt changes in mood
• Hostility, defiance of rules
• Depression, "I don't care" attitude
• Lack of responsibility: not doing chores, homework
• Blaming, lying, making excuses
• Loss of memory, shortened attention span, disordered thought patterns
• Withdrawal from family, isolation, secretiveness

Changes in School or Job Performance:

• Lowered grades, neglected homework
• Frequent tardiness and absenteeism
• Falling asleep in class
• Discipline problems

Physical Evidence of Drug Use:

• Liquor missing or watered down
• Fake I.D.
• Roach clips, rolling papers
• Bong, pipes, small screens
• Baggies containing dried leaves, seeds
• "Stash cans" often disguised as cola or beer cans
• Burning incense, room deodorizers
• Prescription medication disappearing

Changes in Friends or Interests:

• Friends rarely introduced and seldom come to house
• More time spent in room or away from home
• Secrecy about actions or possessions
• Hobbies, sports or extracurricular activities are given up
• Stays out past curfew

Positive Attitude Toward Drugs and Alcohol:

• Pro-drug messages on posters or clothing
• Strong defense of the occasional use of drugs by peers
• Concern expressed by others over his/her use
• Easily angered when confronted about chemical use

This substance abuse reading list was prepared in collaboration with the Hamilton County Alcohol and Drug Addiction Services Board.

Read more about Alcohol and Drug Abuse and Dependence

READING LISTS

The following reading lists were prepared in connection with the Barnes & Noble lecture series.

Eating Disorders
Childhood Trauma
Knowing When to Seek Professional Therapy for My Child
Infant/Early Childhood Mental Health
Cutting and Self-Mutilation
The Overscheduled Child
Peer Pressure
ADHD
Adolescent Obesity
Depressed Children: They're Not Little Adults

Many free publications are available from the National Clearinghouse for Alcohol and Drug Information www.health.org