Attention-deficit hyperactivity disorder, often referred to by the initials ADHD, is a mental disorder commonly diagnosed in children and adolescents, which can continue into adulthood. According to recent statistics in the United States alone over six million children 4-17 years of age have been diagnosed with ADHD.
Children with the disorder can have difficulty focusing on a task or sustaining attention, an inability to control behavior or impulsiveness, along with hyperactivity. While some individuals affected by ADHD struggle with a single problem such as inattentiveness, others may be more challenged by both hyperactive and impulsive behaviors. Most of those diagnosed with ADHD manifest a combination of symptoms.
ADHD can affect how an individual functions at school and in social interactions. For adults with the disorder, job performance may also be impaired. ADHD is more commonly diagnosed in males than females and in most cases the exact causes of the disorder are unclear. Additionally, individuals affected by ADHD may be predisposed to having an anxiety disorder, conduct disorder, depression, learning disabilities, as well as substance abuse issues.
Diagnosis of ADHD is based on a pattern of symptoms and requires a comprehensive evaluation to rule out other medical or psychiatric conditions. While symptoms for some may lessen with age, the issues associated with ADHD often persist into adulthood. Treatment for the disorder can involve behavioral interventions, coping strategies and medications.
Oppositional defiant disorder (ODD) refers to a specific pattern of behavioral symptoms that are exhibited by a child or teen for a period of at least six months. Characterized by a combination of negative behaviors that are often directed at authority figures, conduct associated with the disorder may include angry or irritable moods, argumentative and defiant behavior, as well as acting in a spiteful or vindictive manner.
Although it can be normal to display some oppositional behaviors at certain stages of child development, in individuals with ODD the conduct goes beyond what is considered acceptable for a particular age group. Signs of ODD are often apparent in early childhood, but may appear before early adolescence. ODD often impacts social and academic functioning. In addition, many children with the disorder may also be affected by other mental health conditions including, ADHD, mood disorders, anxiety, conduct disorder, or learning disabilities.
While the excessive behaviors associated with ODD are typically present at home, they may or may not be as evident in outside settings. The severity of the disorder depends on the number of settings in which the behavior is seen to occur. For some children with ODD, the number of settings may expand over time.
It is estimated that 2%-16% of children have ODD. While the exact cause of the disorder remains a mystery, it is believed that certain biological, genetic and environmental factors can contribute to its development. Treatment for ODD can involve multiple types of psychotherapeutic approaches for both the child and family. Medications may also be employed in cases of co-existing conditions.
Depression is a mental health disorder that can affect children and adolescents as well as adults. According to statistics, in the United States approximately 1% of preschoolers, 2% of school age children, and 5-8% of adolescents are affected by this mood disorder.
With mental health disorders that affect children and adolescents, it can be hard for parents to distinguish passing behaviors that may be within the normal range for a particular age group, from mood or conduct that might be indicative of an underlying psychiatric disorder. Further evaluation is in order when excessive and persistent symptoms interfere with the child or adolescent’s ability to function and interact with others.
Children and adolescents who are depressed may exhibit a spectrum of symptoms, including some of the following behaviors:
- Lack interest in previously enjoyable activities
- Frequent sadness, excessive crying
- Pessimism, hopelessness
- Extreme sensitivity, low self-esteem
- Lack of energy
- Social isolation
- Complaints of physical aches and pains that cannot be attributed to other medical conditions
- Poor concentration
- Problems at school
- Change in sleeping and/or eating patterns
- Conflict with authority
- Substance abuse
- Thoughts of suicide
Exactly which symptoms of depression are expressed can vary with age. In young children behaviors such as aggression, anger and excessive crying may be most evident. It is also important to note that depression in children and teenagers may manifest itself differently from the disorder in adults, with a behavior like irritability being more prominent.
Children, who have a family history of depression, have experienced psychosocial adversity, as well as those who have other anxiety, attention, learning, conduct, or eating disorders are at a higher risk for developing depression. Furthermore, an occurrence of depression in adolescence may predispose an individual to subsequent episodes of depression in adult life as well as other psychosocial difficulties. Nevertheless, depression is a treatable illness. With early diagnosis and the appropriate professional care the symptoms can be managed, recovery is more likely, and there is an increased chance that any subsequent episodes will be less severe.
Anxiety disorders are among the most common types of mental health problems that occur in childhood and adolescence.
While experiencing a certain amount of anxiety and apprehension may be within the normal range of behavior for a particular age group, children and adolescents with an anxiety disorder exhibit excessive responses to a presenting set of circumstances. The fear or dread they experience can be so overwhelming as to impair normal daily function.
Children and adolescents with an anxiety disorder may have trouble sleeping, exhibit a decline in academic functioning, as well as have difficulties with peer interactions and family relationships. The physical manifestations associated with anxiety disorders can include trembling, sweating and shortness of breath, or complaints of other ailments such as stomachaches, headaches, and muscle aches.
Some of the most common anxiety and related disorders include:
- Generalized Anxiety Disorder (GAD)
- Social Anxiety
- Obsessive Compulsive Disorder (OCD)
- Panic Disorders (PD)
- Specific Phobias (SD)
- Separation Anxiety Disorder (SAD)
- Post Traumatic Stress Disorder (PTSD)
Genetic and environmental factors may contribute to an individual’s risk of developing an anxiety disorder. In some individuals more than one type of anxiety disorder is present. Also, anxiety disorders can comorbid with other psychiatric disorders like depression or ADHD.
Left untreated, anxiety disorders that begin in childhood can persist into adulthood. Depending on the severity of the diagnosed anxiety disorder and the level of impairment, treatment for a child or adolescent may include a variety of psychotherapeutic approaches including cognitive behavioral, parent training, and family therapy. In some cases, medications or a combination of therapy and medications may be recommended.
An adjustment disorder can happen at any age but is quite common in children and adolescents. A child or adolescent with an adjustment disorder experiences an excessive, unhealthy, and maladaptive reaction to a stressful event or life change beginning within three months of the precipitating event.
Children and adolescents may develop an adjustment disorder in response to a variety of upsetting or disruptive life events such as a family move, the loss of a family member or beloved pet, divorce, serious illness or the birth of a sibling. Adjustment disorders occur in all cultures and with equal frequency in girls and boys.
An adjustment disorder can cause significant impairment to normal daily activities and function. The symptoms that a child or adolescent will experience can vary and depend on a number of factors. An adjustment disorder may occur with a depressed mood, anxiety, conduct disturbances, or a combination of these symptoms. Since the symptoms of an adjustment disorder can overlap with other medical or psychiatric conditions, the diagnosis can be challenging. Early recognition and intervention can help a child work on coping skills and to improve their abilities to process emotions. Treatment for the disorder may include psychotherapy, family therapy, peer group therapy, and medication.
Post-traumatic stress disorder, commonly referred to as PTSD, is a debilitating mental disorder caused by exposure to a single emotionally and/or physically traumatic event or by being subjected to ongoing traumatic events. While the disorder can occur at any stage of life, it is estimated that about 4% of children under the age of 18 who have been exposed to trauma will experience post-traumatic stress disorder. According to statistics, PTSD affects more girls than boys.
Post-traumatic stress disorder in children and adolescents may be the result of experiencing or bearing witness to violence, abuse, natural disasters, accidents or illness. While the symptoms of the disorder usually appear within the first three months of the trauma, in some cases it can take several months or even years for PTSD to surface.
Children and adolescents affected by PTSD suffer emotional, mental and physical distress when faced with reminders and memories of their trauma. They may experience reliving the event, along with the associated pain and fear that it originally produced. Symptoms of PTSD may include intrusive thoughts, emotional numbing, social withdrawal, hypervigilance, as well as other behavioral and cognitive changes.
A child or adolescent's emotional and mental response to trauma can vary depending upon the type and extent of the incident as well as his or her individual constitutional characteristics. For some children the symptoms of the disorder may resolve on its own after a few months. However, untreated PTSD can be very detrimental to a child or adolescent’s well being and result in continued emotional suffering, persistent negative behavior, physical ailments as well as other mental health disorders.
Treatment for children and adolescents who have experienced trauma or have PTSD can include a variety of trauma focused psychotherapeutic approaches.
An impulse control disorder is a mental health problem that involves an inability or failure to control an impulse that results in harm to oneself or others. Typically motivated by cravings or feelings of arousal, an individual with an impulse control disorder will experience release and derive pleasure from having engaged in a destructive behavior or act. Furthermore, despite being aware of the negative consequences, someone with an impulse control disorder cannot stop himself or herself from repeatedly engaging in harmful behavior.
Commonly diagnosed in childhood or adolescence, an impulse control disorder can cause impairment to normal daily function as well as familial and social interactions.
Impulse control disorders seen in children and adolescents may include:
- Compulsive Sexual Behaviors
- Intermittent Explosive Disorder
In some cases, other mental health disorders can be comorbid with an impulse control disorder. While no specific reason for the emergence of an impulse control disorder has been identified, it is believed that a combination of genetic, environmental and biochemical factors can contribute to an individual’s risk of developing one.
Early diagnosis and intervention offers the best prognosis. Without the appropriate care, the consequences of an impulse control disorder can become more severe. Treatment for children and adolescents with an impulse control disorder is aimed at giving them the skills to control their impulses and more effectively manage their emotions.
Acting out occurs when a child exhibits persistent out-of-control and unrestrained behavior as a means of gaining relief from tension or anxiety. Conduct associated with acting out is more emotional, aggressive, disruptive and potentially destructive than simple misbehavior.
A child may act out in response to an upsetting ongoing situation, as a means of getting attention from adults, to impress peers, or due to other untreated mental health disorders, unrecognized sensory issues or undiagnosed learning disabilities. Acting out behaviors can include temper tantrums, frequent arguments, self-harm, abusive actions toward people or animals, stealing or vandalizing property, promiscuity, substance abuse as well as other antisocial behaviors.
A child who acts out may require professional help if the behavior persists and is having lasting negative effects on his or her quality of life and impairing daily function as well as social and familial interactions. Any behavior considered unsafe, self-injurious or damaging to others requires prompt evaluation and care.
Treatment for acting out behaviors depends upon the child’s age, the extent and severity of the behavior as well as the presence of comorbid disorders. With proper therapeutic intervention and treatment many children and adolescents can develop the tools to better understand their emotions and behavior and more effectively manage them.