Stuck in a tunnel
HE L PING CHIL DR EN WI T H ME NTA L HE A LT H I S S U ES
Presentation Objectives
• Understanding the basics of mental health in children
• Understanding the warning signs of mental health issues in children
• Understanding mental health disorders
• Understanding Mood Disorders
• Understanding Dissociative Disorders
• Where to go for help
THE BASICS
U N D E RS TA ND ING ME N TA L H E A LT H I N CH I L D RE N
What is mental health in children?
“Mental health in childhood means reaching
developmental and emotional milestones, and
learning healthy social skills and how to cope
when there are problems” (CDC, 2014).
What are mental disorders in
children?
“Mental disorders among children are described
as serious changes in the way children typically
learn, behave, or handle their emotions” (CDC,
2014)
Attention-Deficit/Hyperactivity Disorder
Autism Spectrum Disorders
Mood and Anxiety Disorders
Tourette Syndrome (TS)
DEPRESSION
A DEEPER LOOK DOWN THE TUNNEL
DEPRESSION
S Y MP TO MS
DEPRESSION
T RE AT ME N T S
DISSOCIATIVE DISORDERS
A DEEPER LOOK DOWN THE TUNNEL
DISSOCIATIVE DISORDERS
S Y MP TO MS
DISSOCIATIVE DISORDERS
T RE AT ME N T S
RESOURCES FOR HELP
•
Resources in our local area in NC:
• Division of Mental Health: www.ncdhhs.gov
• Mental Health Association of Central Carolinas: mhacentralcarolinas.org
• Mental Health Association in Greensboro: www.mhag.org
•
Online Help:
• American Psychiatric Association: http://www.psychiatry.org/
• Centers for Disease Control and Prevention: http://m.cdc.gov/
• National Institute of Mental Health: http://www.nimh.nih.gov/index.shtml
• National Alliance on Mental Illness: http://www.nami.org/
• NC Division of Mental Health, Developmental Disabilities and Substance Abuse Services:
http://www.ncdhhs.gov/mhddsas/
REFERENCES
• MentalHealth.gov. (2014). Personality Disorders. Retrieved from
MentalHealth.gov: http://www.mentalhealth.gov/what-to-look-for/personality-disorders/index.html
• Mentalheath.gov. (2014). Depression. Retrieved from MentalHealth.gov: http://www.mentalhealth.gov/whatto-look-for/mood-disorders/depression/
• NAMI. (2014). Dissociative Disorders. Retrieved from National Alliance on Mental
Illness: http://nami.org/Content/ContentGroups/Helpline1/Dissociative_Disorders.htm
• NAMI. (2014). Mental Illnesses Dissociative Identity Disorder. Retrieved from National Alliance on Mental
Illness: http://www.nami.org/Template.cfm?Section=By_Illness&Template=/ContentManagement/ContentDis
play.cfm&ContentID=165620&MicrositeID=0
• NAMI. (2014). What is Depression? Retrieved from National Alliance on Mental
Illness: http://www.nami.org/template.cfm?section=Depression
• New, Julie (2014). Week 13 DQ 1. Winston-Salem, NC: Salem College
• New, Julie (2014). Moving too fast. Winston-Salem, NC: Salem College
• WEBMD. (2014). Depression Health Center. Retrieved from WebMD:
http://www.webmd.com/depression/guide/depression-symptoms-and-types
Appendix A
MAJOR AND MINOR DEPRESSION; DISSOCIATIVE DISORDERS; MULTIPLE
PERSONALITY DISORDER
Additional Studies
O T HER D I S ORD ERS T H AT C AN A F FE CT C H I LD REN
Disorder Information
Major and Minor Depression
Signs & Symptoms
Treatments, Services,
Support Agencies
“Major depression is a mood state that
goes well beyond temporarily feeling
sad or blue” (NAMI, What is
Depression?, 2014). “It is a serious
medical illness that affects one’s
thoughts, feelings, behavior, mood and
physical health” (NAMI, What is
Depression?, 2014). “Depression is a
life-long condition in which periods of
wellness alternate with recurrences of
illness” (NAMI, What is Depression?,
2014).
Depression can include feelings of
sadness, loss of interest in activities,
changes in weight and sleeping habits,
feelings of worthlessness
(Mentalheath.gov, 2014). There are
many types of depression and they can
be minor to major and continue for
many years. Types of depression include
disorders such as “Atypical, postpartum,
bipolar, seasonal and psychotic”
(WEBMD, 2014)
“There are three well-established types
of treatment: medications,
psychotherapy and electroconvulsive
therapy (ECT). A new treatment called
transcranial magnetic stimulation
(rTMS), has recently been cleared by
the FDA for individuals who have not
done well on one trial of an
antidepressant” (NAMI, What is
Depression?, 2014). Treatments that can
work well with Major and Minor
Depression include Cognitive
Behavioral Therapy; Interpersonal
Therapy, Psychodynamic Therapy,
Psychoeducation and Self-help and
support groups (NAMI, What is
Depression?, 2014).
Disorder Information
Dissociative Disorders
Signs & Symptoms
Treatments, Services,
Support Agencies
“They are marked by a
dissociation from or
interruption of a person's
fundamental aspects of waking
consciousness (such as one's
personal identity, one's
personal history, etc.)” (NAMI,
2014). “Thought to stem from
trauma experienced by the
individual” (NAMI, 2014).
“Symptoms of these disorders,
or even one or more of the
disorders themselves, are also
seen in a number of other
mental illnesses, including
post-traumatic stress disorder,
panic disorder, and obsessive
compulsive disorder” (NAMI,
2014).
“Treatment for individuals with
such a disorder may stress
psychotherapy, although a
combination of
psychopharmacological and
psychosocial treatments is
often used” (NAMI, 2014).
Disorder Information
Multiple Personality
Disorder
Signs & Symptoms
Treatments, Services,
Support Agencies
“Is a dissociative disorder
involving a disturbance of identity
in which two or more separate and
distinct personality states (or
identities) control an individual's
behavior at different times”
(NAMI, Mental Illnesses
Dissociative Identity Disorder,
2014)
“Often people living with DID are
depressed or even suicidal and selfmutilation is common in this
group. Approximately one-third of
individuals affected complain of
auditory or visual hallucinations”
(NAMI, Mental Illnesses
Dissociative Identity Disorder,
2014).
Problems that personality disorders
can cause include “interfering with
a person’s life, (they can) create
problems at work and school and
cause issues in personal and social
relationships” (MentalHealth.gov,
2014)
“Treatment for DID consists
primarily of psychotherapy with
hypnosis” (NAMI, Mental
Illnesses Dissociative Identity
Disorder, 2014). “The therapist
attempts to make contact with as
many alters as possible and to
understand their roles and
functions in an individual’s life”
(NAMI, Mental Illnesses
Dissociative Identity Disorder,
2014). “The goal of the therapist is
to enable the individual to achieve
breakdown of the patient's separate
identities and their unification into
a single identity” (NAMI, Mental
Illnesses Dissociative Identity
Disorder, 2014)
Appendix B
PERSUASIVE DEVELOPMENT DISORDER -NOT OTHERWISE SPECIFIED (PDD-NOS)
& AUTISM SPECTRUM DISORDERS (ASD)
Disorder
Description
Persuasive
Development
Disorder-Not
Otherwise Specified
(PDD-NOS)

Neurobehavioral
Disorder

Atypical or inappropriate
social behavior

“PDD refers to the class
of conditions to which
autism belongs” (Yale
School of Medicine,
2014)

Uneven skill development
(motor, sensory, visual-spatial
organizational, cognitive,
social, academic, behavioral)

Poorly developed speech and
language comprehension
skills

Difficulty with transitions
At this time there are
no specific guidelines
for this diagnosis and
with no guidelines
research is difficult

Deficits in nonverbal and/or
verbal communication

Increased or decreased
sensitivities to taste, sight,
sound, smell and/or touch

Symptoms start at later
ages than Autism
symptoms


Children diagnosed
with PDD-NOS have an
under-connectivity of
electrical activity within
and between the
hemispheres of the
brain.
Perseverative (repetitive or
ritualistic) behaviors (i.e.,
opening and closing doors
repeatedly or switching a light
on and off)


PDD is not a diagnosis,
but PDD-NOS is and is
also known as Atypical
Personality Disorder
Signs & Symptoms
(Brain Balance Achievement Centers,
2014)
Treatments

Integrate physical,
sensory-motor, and
cognitive exercises with
simple dietary changes
to correct the
underlying connection
issue and reduce or
eliminate negative
symptoms and
behaviors. (Brain
Balance Achievement
Center, 2014)

Tailored plans for each
student

Play therapy and social
skills training

Important for family to
advocate for these
children because they
are often overlooked.
Disorder
Description
Signs & Symptoms
Treatments
Autism Spectrum
Disorders (ASD)
First introduced in 1943 by Dr. Leo
Kenner
Autism begins to manifest itself within
the first few months of a child’s life
Characterized by social interaction issues
and delayed or deviant communication
development (Yale School of Medicine,
2014)
There is a range of multiple symptoms,
levels of impairment, and skills that make
up the Autism Spectrum.
Signs and symptoms vary from child to child
Make little to no eye contact
Do not look or listen to people like others
Fail to respond when spoken to
Do not respond to their own name
Delayed communication development
Echolalia- repeating words or phrases that they
hear
Have unusual tone when speaking, if they are
verbal
Trouble understanding, relating, and reacting to
other people’s feelings
Missed social cues
Individualized plans work best
“Autism spectrum
disorder (ASD)
diagnosis is often a
two-stage process. The
first stage involves
general developmental
screening during wellchild checkups with a
pediatrician or an early
childhood health care
provider. The second
stage involves a
thorough evaluation by
a team of doctors and
other health
professionals with a
wide range of
specialties” (National
Institute of Mental
Health, n.d.).
Reliable diagnosis can
usually be made by
age 2
Many nonverbal children respond
well to sign language
Best for children to have routines
Early intervention is key
Using focused and challenging
learning activities
Families should get as much
training as possible
Measuring and recording progress
and or lack of progress
Social skills training
Play therapy
There a few medications that may
help with certain symptoms, but no
real medication has been approved
for Autism as a whole
Under IDEA: “free screenings and
early intervention services to
children from birth to age 3. IDEA
also provides special education and
related services from ages 3 to 21”
(National Institute of Mental Health,
n.d.).
Appendix C
D UA L D I A G N O S I S ; S U B S TA N C E A B U S E D I S O R D E R ; B I P O L A R A F F E C T I V E
DISORDER
Disorder Information
Dual Diagnosis
Signs & Symptoms
Treatments, Services,
Support Agencies
“Dual diagnosis is a term used to describe people
with mental illness who also have problems with
drugs and/or alcohol” (The National Alliance on
Mental Illness, 2013b, p. 1).
Dual diagnosis is more common than you might
think – “many people with mental illness have
ongoing substance abuse problems, and many people
who abuse drugs and alcohol also experience mental
illness” (The National Alliance on Mental Health,
2013a, para 1).
Almost 1/3 of those with all mental illnesses and
about 1/2 of those with severe mental illnesses are
also substance abusers. Greater than 1/3 of those who
abuse alcohol and greater than 1/2 of those who
abuse drugs also have a mental illness (The National
Alliance on Mental Health, 2013a).
A dual diagnosis may present in a variety of
combinations of mental illnesses/disorders and
addictions (The National Alliance on Mental Health,
2013b).
“Abandoning friends or family in favor of new
activities or a new crowd
Struggling to keep up with school or work
Lying or stealing in order to continue an addictive
behavior
Staying up late at night and sleeping during the day
Trying to quit using drugs, drinking, gambling or
having unsafe sex, but relapsing repeatedly
Expressing feelings of guilt or regret about a
compulsive behavior
Seeking out larger doses of drugs, more alcoholic
beverages or more extreme high-risk behavior in
order to get the same high
Experiencing withdrawal symptoms after trying to
quit a harmful substance or cutting down the dose”
(Foundations Recovery Network, 2014, para 12).
“Deliberately withdraws from others, refusing offers
of friendship or support
Believes things that aren’t true (delusions) or has
sensory experiences that aren’t shared by others
(hallucinations)
Expresses feelings of despair, hopelessness or
worthlessness for two or more weeks in a row
Feels compelled to follow complicated rituals and
maintain high standards of order in order to relieve
internal anxiety
Has trouble holding a job, keeping an apartment or
maintaining friendships because of behavioral issues
or mood swings
Has dramatic changes in mood and energy levels
Uses drugs, alcohol or compulsive behaviors to
manage moods or cope with stress” (Foundations
Recovery Network, 2014, para 13).
For treatment to be effective, both the mental
illness/disorder and the addiction must be considered
(Foundations Recovery Network, 2014).
Because of the variety of combinations of addictions
(alcohol and/or drugs) and mental illnesses/disorders
(mood disorder, anxiety disorder, personality
disorder, or eating disorder), no single treatment will
work for everyone (Foundations Recovery Network,
2014).
Psychiatric treatment will be more successful if the
patient stops their drug and/or alcohol abuse (The
National Alliance on Mental Illness, 2013a).
Treatment for drug and/or alcohol abuse can include
in-patient detox, self-help groups, cognitivebehavioral therapy, and even medication (The
National Alliance on Mental Illness, 2013a).
Treatment of the mental illness/disorder will depend
on which mental illness/disorder the patient suffers
from (Foundations Recovery Network, 2014; The
National Alliance on Mental Illness, 2013a).
Services and Support Agencies:
The National Alliance on Mental Illness (NAMI)
Mental Illness, Drug Addiction, and Alcoholism
(MIDAA)
Foundations Recovery Network (dualdiagnosis.org)
Substance Abuse and Mental Health Services
Administration (SAMHSA)
National Network of Depression Centers (NNDC)
Disorder Information
Bipolar Affective Disorder
Signs & Symptoms
Treatments, Services,
Support Agencies
“Bipolar disorder, also known as manic-depressive illness, is
a brain disorder that causes unusual shifts in mood, energy,
activity levels, and the ability to carry out daily tasks”
(National Institute of Mental Health, n.d.a, para 1).
The four types of bipolar affective disorder are:
Bipolar affective disorder I - at least one episode of mania or
at least two mixed episodes with or without depression.
Bipolar affective disorder II - one or more episodes of
depression followed by a milder, manic episode.
Cyclothymia - a milder form of bipolar affective disorder in
which symptoms are less severe but longer lasting. It can turn
into a full bipolar affective disorder.
Rapid cycling bipolar disorder - your mood switches from
mania to depression very quickly and then back again, with at
least four episodes of either mania or depression within the
period of a year (Bupa, 2014).
The onset of bipolar disorder is usually in a person's late teens
or early adult years, with at least 50% of all cases occurring
before the age of 25 (National Institute of Mental Health,
n.d.a).
The onset of bipolar disorder is usually in a person's late teens
or early adult years, with at least 50% of all cases occurring
before the age of 25 (National Institute of Mental Health,
n.d.a).
“Bipolar disorder, also known as manic-depressive illness, is a
brain disorder that causes unusual shifts in mood, energy,
activity levels, and the ability to carry out daily tasks”
(National Institute of Mental Health, n.d.a, para 1).
Bipolar disorder is an illness which can require long-term
treatment. Skilled medical management is needed.
Different medications are used to treat acute episodes of
mania and of depression, and other medications ('mood
stabilizers') are used to keep episodes at bay or to augment
acute treatments, in other words, a distinction is made
between management of acute episodes and maintenance.
Psychological therapies, such as counseling and
psychotherapy, are unlikely to be effective by themselves, but
are valuable in combination with physical therapies .
Every person is different - he or she may need medication or
combinations of medications that are quite different from
somebody else with bipolar disorder.
Compliance with medications is important for long term
stability.
Depending on the nature of the illness and how it is managed,
hospitalization can sometimes be required.
Treatments should take account the rare possibility of organic
or medical causes for bipolar disorder (particularly if the
person is 40 or older at the time of their first manic episode).
Some psychotropic medications (e.g. antidepressant drugs)
can cause mania, as can some steroids or stimulant drugs.
Recurring mania is usually due to poor compliance with
medication, or the particular medication not working properly.
The use of medications during pregnancy is an extremely
important issue and needs consultation with an expert (Black
Dog Institute, 2014, para 1).
Services and Support Agencies:
The National Alliance on Mental Illness (NAMI)
National Institute of Mental Health, National Institutes of
Health (NIMH)
Depression and Bipolar Support Alliance (DBSA)
Helpguide.org
Black Dog Institute
International Bipolar Foundation (IBPF)
“A long period of feeling "high," or an overly happy or
outgoing mood. Extreme irritability; Talking very fast,
jumping from one idea to another, having racing thoughts;
Being easily distracted; Increasing activities, such as
taking on new projects; Being overly restless; Sleeping
little or not being tired; Having an unrealistic belief in
one's abilities Behaving impulsively and engaging in
pleasurable, high-risk behaviors” (National Institute of
Mental Health, n.d.a, para 13).
The four types of bipolar affective disorder are:
Bipolar affective disorder I - at least one episode of mania
or at least two mixed episodes with or without depression.
Bipolar affective disorder II - one or more episodes of
depression followed by a milder, manic episode.
Cyclothymia - a milder form of bipolar affective disorder in
which symptoms are less severe but longer lasting. It can
turn into a full bipolar affective disorder.
Rapid cycling bipolar disorder - your mood switches from
mania to depression very quickly and then back again, with
at least four episodes of either mania or depression within
the period of a year (Bupa, 2014).
“An overly long period of feeling sad or hopeless
Loss of interest in activities once enjoyed, including sex.
Feeling tired or "slowed down"
Having problems concentrating, remembering, and making
decisions
Being restless or irritable
Changing eating, sleeping, or other habits
Thinking of death or suicide, or attempting suicide”
(National Institute of Mental Health, n.d.a, para 13).
Disorder Information
Borderline Personality
Disorder
Signs & Symptoms
Treatments, Services,
Support Agencies
“Borderline personality disorder (BPD) is a serious mental
illness that centers on the inability to manage emotions
effectively. The disorder occurs in the context of
relationships: sometimes all relationships are affected,
sometimes only one… Other disorders, such as depression,
anxiety disorders, eating disorders, substance abuse and
other personality disorders can often exist along with BPD”
(National Education Alliance for Borderline Personality
Disorder, 2014, para 1).
People with borderline personality disorder often: have
difficulty controlling their thoughts and emotions, are
impulsive and reckless, and have unstable relationships with
other people (National Institute of Mental Health, n.d.b).
To be diagnosed with BPD one must show a long-term pattern
of at least five of these symptoms.
“Extreme reactions—including panic, depression, rage, or
frantic actions—to abandonment, whether real or perceived
A pattern of intense and stormy relationships with family,
friends, and loved ones, often veering from extreme closeness
and love (idealization) to extreme dislike or anger
(devaluation)
Distorted and unstable self-image or sense of self, which can
result in sudden changes in feelings, opinions, values, or plans
and goals for the future (such as school or career choices)
Impulsive and often dangerous behaviors, such as spending
sprees, unsafe sex, substance abuse, reckless driving, and
binge eating
Recurring suicidal behaviors or threats or self-harming
behavior, such as cutting
Intense and highly changeable moods, with each episode
lasting from a few hours to a few days
Chronic feelings of emptiness and/or boredom
Inappropriate, intense anger or problems controlling anger
Having stress-related paranoid thoughts or severe dissociative
symptoms, such as feeling cut off from oneself, observing
oneself from outside the body, or losing touch with reality”
(National Institute of Mental Health, n.d.b, para 8).
Several treatments have been shown to be effective in the
treatment of BPD:
Dialectical behavior therapy (DBT) – a problem solving way
of treating BPD created specifically for that purpose. It
encourages the patient to focus on their current emotion and
tries to help them find a balance between accepting and
changing their behaviors. It is the most effective treatment for
BPD.
Cognitive Behavior Therapy (CBT) – helps patients become
aware of the way they think and act that may be negative or
inaccurate.
Mentalization-based therapy (MBT) – helps patients become
aware of what others are thinking and feeling.
Transference-focused therapy (TFT) – by using the
relationship with the therapist as a conduit for understanding,
the patient learns about their own emotions and interpersonal
problems.
Medications – can’t be used to cure BPD, but it can help
manage some of the other conditions which are often seen in
patients with BPD, such as depression, impulsiveness, and
anxiety.
Self-care – patients are encouraged to take care of themselves
through exercise, diet, and nutrition, as well as proper use of
medications in order to manage symptoms of BPD (National
Education Alliance for Borderline Personality Disorder,
2014).
Services and Support Agencies:
National Education Alliance for Borderline Personality
Disorder (NEA.BPD)
Treatment and Research Advancements National Association
for Personality Disorder (TARA)
Borderline Personality Disorder Resource Center
Mental Health America (MHA)
“Seemingly mundane events may trigger symptoms. For
example, people with BPD may feel angry and distressed
over minor separations—such as vacations, business trips, or
sudden changes of plans—from people to whom they feel
close. Studies show that people with this disorder may see
anger in an emotionally neutral face and have a stronger
reaction to words with negative meanings than people who
do not have the disorder” (National Institute of Mental
Health, n.d.b, para 9).
Appendix D
A N O R E X I A ; B U L I M I A ; S C H I ZOA F F EC T I V E D I S O R D E R ; S C H I ZO P H R E N I A
Disorder Information
Anorexia
Signs & Symptoms
Treatments, Services,
Support Agencies
“Anorexia nervosa is an eating disorder that causes
people to obsess about their weight and the food they
eat. People with anorexia nervosa attempt to maintain
a weight that's far below normal for their age and
height. To prevent weight gain or to continue losing
weight, people with anorexia nervosa may starve
themselves or exercise excessively”
(www.mayoclinic.org).
If you're concerned that a loved one may have
anorexia, watch for these possible red flags:
•Skipping meals
•Making excuses for not eating
•Eating only a few certain "safe" foods, usually those
low in fat and calories
•Adopting rigid meal or eating rituals, such as cutting
food into tiny pieces or spitting food out after
chewing
•Cooking elaborate meals for others but refusing to
eat
•Repeated weighing of themselves
•Frequent checking in the mirror for perceived flaws
•Complaining about being fat
•Not wanting to eat in public (www.mayoclinic.org)
Medical Care: may initially require feeding through a
tube that's placed in their nose and goes to the
stomach (nasogastric tube).
Restoring a Health Weight:
A dietitian can offer guidance on a healthy diet,
including providing specific meal plans and calorie
requirements that will help you meet your weight
goals.
Psychotherapy:
•Individual therapy. This type of therapy can help
you deal with the behavior and thoughts that
contribute to anorexia. A type of talk therapy called
cognitive behavioral therapy (CBT) is commonly
used. Therapy may be done in day treatment
programs, but in some cases, may be part of
treatment in a psychiatric hospital.
•Family-based therapy. This therapy begins with the
assumption that the person with the eating disorder is
no longer capable of making sound decisions
regarding his or her health and needs help from the
family. An important part of family-based therapy is
that the family is involved in making sure that
healthy-eating patterns are followed. This type of
therapy can help resolve family conflicts and muster
support from concerned family members. Familybased therapy can be especially important for
children with anorexia who still live at home.
•Group therapy. This type of therapy gives you a way
to connect to others facing eating disorders. And
informal support groups may sometimes be helpful.
(www.mayoclinic.org)
Disorder Information
Bulimia
Signs & Symptoms
Treatments, Services,
Support Agencies
“Bulimia nervosa is an eating disorder characterized
by frequent episodes of binge eating, followed by
frantic efforts to avoid gaining weight. It affects
women and men of all ages.”
(www.thehelpingguide.org)
Warning Signs:
*Calluses or scars on the knuckles or hands from
sticking fingers down the throat to induce vomiting.
• Puffy “chipmunk” cheeks caused by repeated
vomiting.
• Discolored teeth from exposure to stomach acid
when throwing up. May look yellow, ragged, or
clear.
• Not underweight – Men and women with bulimia
are usually normal weight or slightly overweight.
Being underweight while purging might indicate a
purging type of anorexia.
• Frequent fluctuations in weight – Weight may
fluctuate by 10 pounds or more due to alternating
episodes of bingeing and purging.
(www.thehelpingguide.org)
Breaking the binge-and-purge cycle: The first
phase of bulimia treatment focuses on stopping the
vicious cycle of bingeing and purging and restoring
normal eating patterns. You learn to monitor your
eating habits, avoid situations that trigger binges,
cope with stress in ways that don’t involve food, eat
regularly to reduce food cravings, and fight the urge
to purge.
• Changing unhealthy thoughts and patterns: The
second phase of bulimia treatment focuses on
identifying and changing dysfunctional beliefs
about weight, dieting, and body shape. You explore
attitudes about eating, and rethink the idea that
self-worth is based on weight.
• Solving emotional issues: The final phase of
bulimia treatment involves targeting emotional
issues that caused the eating disorder in the first
place. Therapy may focus on relationship issues,
underlying anxiety and depression, low self-esteem,
and feelings of isolation and loneliness. (www.the
helpingguide.org)
Disorder Information
Schizoaffective Disorder
Signs & Symptoms
According to the DSM-IV-TR, people who
experience more than two weeks of psychotic
symptoms in the absence of severe mood
disturbances—and then have symptoms of either
depression or bipolar disorder—may have
schizoaffective disorder. Schizoaffective disorder is
thought to be between the bipolar and schizophrenia
diagnoses as it has features of both.” (www.
nami.org)
Depressive symptoms associated with schizoaffective
disorder can include: hopelessness, helplessness,
guilt, worthlessness, disrupted appetite, disturbed
sleep, inability to concentrate, and depressed mood
(with or without suicidal thoughts).
Manic (bipolar) symptoms associated with
schizoaffective disorder can include increased energy,
decreased sleep (or decreased need for sleep),
distractibility, fast (pressured) speech, and increased
impulsive behaviors (sexual activities, drug and
alcohol abuse, gambling or spending large amounts of
money). (www.Nami.org)
Treatments, Services,
Support Agencies
“Treatments such as cognitive behavioral therapy to
target psychotic symptoms, supports groups including
NAMI’s Family-to-Family to increase family and
community support, peer support and connection, and
work-and-school rehabilitation, such as social skills
training, are very helpful for people with
schizoaffective disorder. Maintaining a healthy
lifestyle is also of critical importance: the role of good
sleep hygiene, regular exercise, and a balanced diet
cannot be underestimated.” (www.nami.org)
Medications used for depression symptoms:
antidepressant medications
lithium
antipsychotic medications
Medications used for bipolar symptoms:
mood-stabilizers such as lithium or anti-convulsants,
valproic acid (Depakote), lamotrigine (Lamictal), and
carbamazepine (Tegretol) (www.nami.org)
Disorder Information
Schizophrenia
Signs & Symptoms
“Schizophrenia is a severe brain disorder in which
people interpret reality abnormally. Schizophrenia
may result in some combination of hallucinations,
delusions, and extremely disordered thinking and
behavior. Schizophrenia isn't a split personality or
multiple personality. The word "schizophrenia" does
mean "split mind," but it refers to a disruption of the
usual balance of emotions and thinking.
Schizophrenia is a chronic condition, requiring
lifelong treatment.” (www.mayoclinic.org)
Schizophrenia involves a range of problems with thinking
(cognitive), behavior or emotions. Signs and symptoms may
vary, but they reflect an impaired ability to function.”
(www.mayoclinic.org)
Signs may include:
•Delusions: These are false beliefs that are not based in
reality.
•Hallucinations: These usually involve seeing or hearing
things that don't exist.
•Disorganized thinking (speech): Disorganized thinking is
inferred from disorganized speech. Effective communication
can be impaired, and answers to questions may be partially or
completely unrelated.
•Extremely disorganized or abnormal motor behavior: This
may show in a number of ways, ranging from childlike
silliness to unpredictable agitation. Behavior is not focused on
a goal, which makes it hard to perform tasks. Abnormal motor
behavior can include resistance to instructions, inappropriate
and bizarre posture, a complete lack of response, or useless
and excessive movement.
•Negative symptoms. This refers to reduced ability or lack of
ability to function normally.
“Schizophrenia involves a range of problems with
thinking (cognitive), behavior or emotions. Signs and
symptoms may vary, but they reflect an impaired
ability to function.” (www.mayoclinic.org)
Some of the early symptoms of schizophrenia in teenagers are
common for typical development during teen years, such as:
•Withdrawal from friends and family
•A drop in performance at school
•Trouble sleeping
•Irritability or depressed mood
•Lack of motivation
Compared with schizophrenia symptoms in adults, teens may
be:
•Less likely to have delusions
•More likely to have visual hallucinations
(www.mayoclinic.org)
Treatments, Services,
Support Agencies
“In men, schizophrenia symptoms typically start in the early to
mid-20s. In women, symptoms typically begin in the late 20s.
It's uncommon for children to be diagnosed with schizophrenia
and rare for those older than 45.” (www.mayoclinic.org)
“Schizophrenia requires lifelong treatment, even when
symptoms have subsided. Treatment with medications and
psychosocial therapy can help manage the condition. During
crisis periods or times of severe symptoms, hospitalization may
be necessary to ensure safety, proper nutrition, adequate sleep
and basic hygiene.” (www.mayoclinic.org)
Medications Typically used:
•Aripiprazole (Abilify); Asenapine (Saphris); Clozapine
(Clozaril); •Iloperidone (Fanapt); •Lurasidone (Latuda);
•Olanzapine (Zyprexa);
•Paliperidone (Invega); •Quetiapine (Seroquel)
•Risperidone (Risperdal); •Ziprasidone (Geodon);
•Chlorpromazine; •Fluphenazine;
•Haloperidol (Haldol); •Perphenazine;
Psychosocial Interventions:
“Once psychosis recedes, psychological and social
(psychosocial) interventions are important — in addition to
continuing on medication. These may include:
•Individual therapy. Learning to cope with stress and identify
early warning signs of relapse can help people with
schizophrenia manage their illness.
•Social skills training. This focuses on improving
communication and social interactions.
•Family therapy. This provides support and education to
families dealing with schizophrenia.
•Vocational rehabilitation and supported employment. This
focuses on helping people with schizophrenia prepare for, find
and keep jobs.” (www.mayoclinic.org)
Disorder Information
Obsessive-Compulsive
Disorder
Signs & Symptoms
Treatments, Services,
Support Agencies
People with OCD generally:
Have repeated thoughts or images
about many different things, such as
fear of germs, dirt, or intruders; acts of
violence; hurting loved ones; sexual
acts; conflicts with religious beliefs; or
being overly tidy
Do the same rituals over and over such
as washing hands, locking and
unlocking doors, counting, keeping
unneeded items, or repeating the same
steps again and again. Can't control the
unwanted thoughts and behaviors. Don't
get pleasure when performing the
behaviors or rituals, but get brief relief
from the anxiety the thoughts cause.
Spend at least 1 hour a day on the
thoughts and rituals, which cause
distress and get in the way of daily life.”
(www.nimh.nih.gov)
OCD is generally treated with
psychotherapy, medication, or both
“A type of psychotherapy called
cognitive behavior therapy is especially
useful for treating OCD. It teaches a
person different ways of thinking,
behaving, and reacting to situations that
help him or her feel less anxious or
fearful without having obsessive
thoughts or acting compulsively.”
(www.nimh.nih.gov)
Appendix E
P O S T T R A U M AT I C S T R E S S D I S O R D E R ; AT T E N T I O N D E F I C I T H Y P E R A C T I V I T Y
DISORDER
Disorder Information
PTSD
Signs & Symptoms
Treatments, Services,
Support Agencies
PTSD is triggered by experiencing or
witnessing a traumatic or terrifying
event
can begin immediately after the event
or years later, through flashbacks
Negative Changes in Thinking/Mood
negative feelings about self or
others
inability to have positive feelings
feeling emotionally numb
hopelessness
memory problems, blocking out
memories
Changes in Emotional Reactions
irritability, anger, aggressive
behaviors
guilt or shame
self-destructive behavior
trouble concentrating
difficulty sleeping
easily startled or frightened
suicidal thoughts
(Mayo Clinic Staff, 2014)
Treatments
Psychotherapy
Cognitive Therapy
Exposure Therapy
Medications
Antidepressants
Anti-anxiety medication
Sleep aids
Services & Support Agencies
U.S. Department of Veteran
Affairs www.ptsd.va.gov offering
support groups and information
on managing and coping with
PTSD
ADAA - Anxiety & Depression
Association of America www.adaa.org
provides information about PTSD
Intrusive Memories
recurring memories of the event
reliving the event through
flashbacks
nightmares
Avoidance
avoiding thinking or
remembering the event
avoiding people, places, and
things that are a reminder of the
event
Disorder Information
ADHD
Signs & Symptoms
Treatments, Services,
Support Agencies
Is a behavior disorder (KidsHealth,
2014)
symptoms must be present before age 7
and have a negative impact in more
than one area of daily life
Combined ADHD
the most common form of ADHD
impulsivity
inattentiveness
hyperactivity
Inattentive ADHD
formerly known as ADD
inattentiveness
difficulty concentrating
hyperactivity not a main
symptom
Hyperactive-Impulsive ADHD
characterized by hyperactivity
concentration, focus, and
inattentiveness not a main
symptom
(WebMD, 2014)
Treatments
Medications
Stimulant Medications
Non-stimulant Medications
Non-medicinal home treatments
and symptom management
Services & Support Agencies
ADDA - Attention Deficit
Disorder
Association www.adda.org with
support groups in Raleigh, NC
and a list of medical professionals
and therapists
CHADD - Children & Adults with
ADHD www.chadd.org providing
information on support groups,
professional services and a virtual
chapter of CHADD
Disorder Information
ADHD
Signs & Symptoms
Treatments, Services,
Support Agencies
Is a behavior disorder (KidsHealth,
2014)
symptoms must be present before age 7
and have a negative impact in more
than one area of daily life
Combined ADHD
the most common form of ADHD
impulsivity
inattentiveness
hyperactivity
Inattentive ADHD
formerly known as ADD
inattentiveness
difficulty concentrating
hyperactivity not a main
symptom
Hyperactive-Impulsive ADHD
characterized by hyperactivity
concentration, focus, and
inattentiveness not a main
symptom
(WebMD, 2014)
Treatments
Medications
Stimulant Medications
Non-stimulant Medications
Non-medicinal home treatments
and symptom management
Services & Support Agencies
ADDA - Attention Deficit
Disorder
Association www.adda.org with
support groups in Raleigh, NC
and a list of medical professionals
and therapists
CHADD - Children & Adults with
ADHD www.chadd.org providing
information on support groups,
professional services and a virtual
chapter of CHADD
Appendix F
S E L F H A R M ; C U T T I N G ; S U B S TA N C E A B U S E D I S O R D E R ;
Disorder Information
Cutting
Signs & Symptoms
The most common type of selfharm, deliberately cutting yourself
to cope with pain. (Mayo Clinic,
2014) “Cutting isn’t a suicide
attempt, though it may look and
seem that way. (Jed Foundation,
2014)”

Scars from cuts

Individual psychotherapy

Fresh cuts or scratches

Hospitalization

Keeping sharp objects on
hand

Wearing long sleeves in hot
weather
(Mayo Clinic, 2014)
Treatments, Services,
Support Agencies
Disorder Information
Self Injury/Self Harm
Signs & Symptoms
Treatments, Services,
Support Agencies
Self-injury, also called self-harm, is the act of
deliberately harming your own body, such as
cutting or burning yourself. It's typically not
meant as a suicide attempt. Rather, self-injury
is an unhealthy way to cope with emotional
pain, intense anger and frustration. (Mayo
Clinic, 2014)

Scars, such as from burns or cuts

Individual psychotherapy

Fresh cuts, scratches, bruises or other
wounds

Medications for depression

Hospitalization

Broken bones

Keeping sharp objects on hand

Wearing long sleeves or long pants,
even in hot weather

Claiming to have frequent accidents or
mishaps

Spending a great deal of time alone

Pervasive difficulties in interpersonal
relationships

Persistent questions about personal
identity, such as "Who am I?" "What
am I doing here?"

Behavioral and emotional instability,
impulsivity and unpredictability

Statements of helplessness,
hopelessness or worthlessness (Mayo
Clinic, 2014)
Disorder Information
Substance Abuse Disorder
Signs & Symptoms
According to the DSM5, “Each Symptoms of substance use
specific sub- stance (other than disorders may include:
caffeine, which cannot be

Behavioral changes
diagnosed as a substance use

Physical Changes
disorder) is addressed as a
separate use disorder (e.g.,

Social Changes
alcohol use disorder, stimulant (USDHHS, 2014)
use disorder, etc.), but nearly
all substances are diagnosed
based on the same overarching
criteria (American Psychiatric
Publishing, 2014).
Treatments, Services,
Support Agencies

Individual psychotherapy

Hospitalization or rehab
institution
Appendix G
S E A S O N A L A F F E C T I V E D I S O R D E R ; TO U R E T T E ’ S S Y N D R O M E ; A N X I E T Y
DISORDERS
Disorder Information
Seasonal Affective Disorder
Signs & Symptoms
Treatments, Services,
Support Agencies
SAD- it’s a specific type of depression
that’s related to the change in seasons
People become lethargic, no energy,
moody, melancholy
-According to the staff at the Mayo
clinic, “Seasonal affective disorder is a
subtype of major depression that comes
and goes based on seasons, therefore
there may be symptoms of major
depression that come with SAD”
(retrieved from www.mayoclinic.org).
-Additional symptoms include: feeling
hopeless, problems sleeping, agitated
thoughts of suicide, low energy,
hypersensitivity, appetite changes
(weight gain).
-SPRING AND SUMMER SAD
- depression, weight loss, insomnia,
poor appetite, anxiety
SAD is often treated with light therapy,
medication, and psychotherapy.
-Light Therapy- aka photo therapy.
You literally sit in front of a special
light therapy box so that you are
exposed to a bright light. This seems to
cause a change in brain chemicals that
are associated to mood.
-Light therapy works best for
individuals who have fall/winter SAD.
It starts working within days to two
weeks and there are few side effects.
-Medications- most people benefit from
antidepressants
-Psychotherapy- aka talk therapy. This
includes; identifying and changing
negative thoughts, learning healthy
ways of dealing with SAD, and
managing stressful situations
Symptoms begin in the fall and usually
end when spring begins and the weather
warms up
Disorder Information
Panic Disorder
Panic Disorder
Signs & Symptoms
-Panic attacks begin suddenly, without
warning.
Panic disorder comes along with the
-attacks include the following
unpleasant and sudden episodes of panic symptoms: sense of doom or danger
attacks. The Mayo clinic defines panic
- rapid heart rate
attacks as, “sudden episode of intense
- sweating
fear that triggers severe physical
- trembling
reactions when there is not real danger
- chills
or apparent cause. It’s the recurring,
- chest pain
unexpected panic attacks and spent long - faintness
periods in constant fear of another attack - hyperventilation
that lead to the condition of a panic
- One of the worst parts of panic attacks
disorder” (Retrieved from
is the intense fear that you will have
www.mayoclinic.org).
another one. Therefore avoiding
situations where they may occur. Some
people even develop agoraphobia
Treatments, Services,
Support Agencies
- Panic attacks require medical attention
- They are very difficult to manage on
your own.
- Panic attacks resemble a heart attack
- Psychotherapy and medication are the
main treatment options
- Cognitive behavioral therapy helps
clients understand the attacks and
disorder, along with maintaining the
symptoms and attacks
- Medications reduced the symptoms
and any depression that may be
associated with the disorder. SSRIs,
SNRIs, and Benzodiazepines
- It can take up to several weeks before
to notice any improvements.
Disorder Information
Tourette’s Syndrome
According the Mayo Clinic Staff,
“Tourette’s Syndrome is a nervous
system disorder that starts in childhood.
It involves unusual repetitive
movements or unwanted sounds that
can’t be controlled”
Signs & Symptoms
Treatments, Services,
Support Agencies
-Signs and symptoms show up between
the ages of 2 and 12.
- Males are 3 to 4 times more likely than
females to develop this syndrome.
- The symptoms become more
controllable after the teen years.
- Symptoms include: simple tics, eye
blinking, head jerking, shoulder
shrugging, finger flexing, hiccupping,
yelling, throat clearing, and barking (yes
barking).
- These are often involuntary actions.
- There is no cure, you can live a normal
life span with Tourette Syndrome.
- No medication is helpful to everyone,
none completely eliminate symptoms.
- Possible helpful medications include:
Haldol or Orap. These drugs block the
neurotransmitter dopamine in the brain
(used to control tics). Then there are
botox injections and stimulant
medications such as Adderall.
- Therapy may include psychotherapy,
behavior therapy and deep brain
stimulants
Disorder Information
Anxiety
Signs & Symptoms
Treatments, Services,
Support Agencies
Anxiety disorders are characterized by
either manifest anxiety or by selfdefeating behavior patterns aimed at
warding off anxiety.
-“Although anxiety can be experienced
in a variety of ways, there are three
basic patterns. Phobia’s acute stress
disorder, and posttraumatic stress
disorder involve a fear aroused be an
identifiable object or situation” (Alloy,
Riskind, & Manos, 2005, p.151).
Common symptoms include:

Feelings of panic, fear, and
uneasiness

Problems sleeping

Cold or sweaty hands and/or feet

Shortness of breath

Heart palpitations

An inability to be still and calm

Dry mouth

Numbness or tingling in the hands
or feet

Nausea

Muscle tension

Dizziness (Retrieved from
http://www.webmd.com/anxietypanic).
-Although the exact treatment approach
depends on the type of disorder, one or a
combination of the following therapies
may be used for most anxiety disorders:
-Medication such as antidepressants and
antianxiety
- Psychotherapy
- Cognitive behavioral therapy
- Dietary and lifestyle changes
- Relaxation therapy