Glossary of Symptoms and Mental Illness Affecting
Teenagers
Being a teenager is not easy. Adolescents
feel all kinds of pressures -- to do well in school, to
be popular with peers, to gain the approval of parents,
to make the team, to be cool. In addition, many teenagers
have other special problems. For example, they may worry
about a parent being out of work or the family's financial
problems.
Adolescents may be hurt or confused by their parents'
divorce, or they may have to learn how to live with a
parent's alcoholism or mental illness. Despite these pressures,
it is important to remember that most teenagers develop
into healthy adults.
Unfortunately, some teenagers develop serious emotional
problems requiring professional help. This glossary of
brief definitions was developed to help teenagers, parents,
teachers, and others learn more about the major mental
illnesses, symptoms, and mental health issues which affect
teenagers. Please remember: All the problems described
in the glossary are treatable and some can be prevented.
In every case, the sooner a teenager gets help, the better.
ALCOHOL AND DRUG ABUSE
Use and abuse of drugs and alcohol by teens is very common
and can have serious consequences. In the 15-24 year age
range, 50% of deaths (from accidents, homicides, suicides)
involve alcohol or drug abuse. Drugs and alcohol also
contribute to physical and sexual aggression such as assault
or rape. Possible stages of teenage experience with alcohol
and drugs include abstinence (non-use), experimentation,
regular use (both recreational and compensatory for other
problems), abuse, and dependency.
Repeated and regular recreational use can lead to other
problems like anxiety and depression. Some teenagers regularly
use drugs or alcohol to compensate for anxiety, depression,
or a lack of positive social skills. Teen use of tobacco
and alcohol should not be minimized because they can be
"gateway drugs" for other drugs (marijuana,
cocaine, hallucinogens, inhalants, and heroin). The combination
of teenagers' curiosity, risk taking behavior, and social
pressure make it very difficult to say no. This leads
most teenagers to the questions: "Will it hurt to
try one?"
A teenager with a family history of alcohol or drug abuse
and a lack of pro-social skills can move rapidly from
experimentation to patterns of serious abuse or dependency.
Some other teenagers with no family history of abuse who
experiment may also progress to abuse or dependency. Therefore,
there is a good chance that "one" will hurt
you. Teenagers with a family history of alcohol or drug
abuse are particularly advised to abstain and not experiment.
No one can predict for sure who will abuse or become dependent
on drugs except to say the non-user never will.
Warning signs of teenage drug or alcohol abuse
may include:
Without treatment, this disorder can become chronic and
with severe starvation, some teenagers may die.
ANXIETY
Anxiety is the fearful anticipation
of further danger or problems accompanied by an intense
unpleasant feeling (dysphoria) or physical symptoms. Anxiety
is not uncommon in children and adolescents. Anxiety in
children may present as:
Separation Anxiety Disorder: Excessive
anxiety concerning separation from home or from those
to whom the child is attached. The youngster may develop
excessive worrying to the point of being reluctant or
refusing to go to school, being alone, or sleeping alone.
Repeated nightmares and complaints of physical symptoms
(such as headaches, stomach aches, nausea, or vomiting)
may occur.
Generalized Anxiety Disorder: Excessive
anxiety and worry about events or activities such as school.
The child or adolescent has difficulty controlling worries.
There may also be restlessness, fatigue, difficulty concentrating,
irritability, muscle tension, and sleep difficulties.
Panic Disorder: The presence of recurrent, unexpected
panic attacks and persistent worries about having attacks.
Panic Attack refers to the sudden onset of intense apprehension,
fearfulness, or terror, often associated with feelings
of impending doom.
There may also be shortness of breath, palpitations,
chest pain or discomfort, choking or smothering sensations,
and fear of "going crazy" or losing control.
Phobias: Persistent, irrational fears of a specific object,
activity, or situation (such as flying, heights, animals,
receiving an injection, seeing blood). These intense fears
cause the child or adolescent to avoid the object, activity,
or situation.
ATTENTION DEFICIT/ HYPERACTIVITY DISORDER (ADHD)
ADHD is usually first diagnosed during the elementary
school years. In some cases, symptoms continue into adolescence.
A teenager with Attention Deficit/Hyperactivity Disorder
has problems with paying attention and concentration and/or
with hyperactive and impulsive behavior. Despite good
intentions, a teenager may be unable to listen well, organize
work, and follow directions. Cooperating in sports and
games may be difficult. Acting before thinking can cause
problems with parents, teachers, and friends. These teens
may be restless, fidgety, and unable to sit still.
Attention Deficit/Hyperactivity Disorder occurs more
commonly in boys and symptoms are always present before
the age of seven. Problems related to ADHD appear in multiple
areas of a youngster's life and can be very upsetting
to the teen, his/her family, and people at school. Symptoms
of ADHD frequently become less severe during the late
teen years and in young adulthood.
BIPOLAR DISORDER (MANIC DEPRESSION)
Bipolar Disorder is a type of mood disorder with marked
changes in mood between extreme elation or happiness and
severe depression. The periods of elation are termed mania.
During this phase, the teenager has an expansive or irritable
mood, can become hyperactive and agitated, can get by
with very little or no sleep, becomes excessively involved
in multiple projects and activities, and has impaired
judgment.
A teenager may indulge in risk taking behaviors, such
as sexual promiscuity and anti-social behaviors. Some
teenagers in a manic phase may develop psychotic symptoms
(grandiose delusions and hallucinations). For a description
of the depressive phase see depression. Bipolar disorder
generally occurs before the age of 30 years and may first
develop during adolescence.
BULIMIA NERVOSA (BULIMIA) is a well known Eating Disorder.
Bulimia Nervosa occurs when an adolescent has repeated
episodes of binge eating and purging. Binges are characterized
by eating large quantities of food in a discrete period
of time. The teen also has feelings of being unable to
stop eating and loss of control over the amount of food
being eaten. Usually, after binge eating, they attempt
to prevent weight gain by self-induced vomiting, laxative
use, diuretics, enemas, medications, fasting, or excessive
exercise. These teen's self-esteem is strongly affected
by weight and body shape.
Serious medical problems can occur with Bulimia Nervosa
(e.g. esophageal or gastric rupture, cardiac arrhythmias,
kidney failure, and seizures). Other psychological problems
such as depression, intense moods, and low self-esteem
are common. Early diagnosis and treatment can improve
outcome and decrease the risk of worsening depression,
shame, and harmful weight fluctuations.
CONDUCT DISORDER
Teenager's with conduct disorder have a repetitive and
persistent pattern of behavior in which they violate the
rights of others, or violate norms or rules that are appropriate
to their age. Their conduct is more serious than the ordinary
mischief and pranks of children and adolescents.
Severe difficulties at home, in school, and in the community
are common, and frequently there is very early sexual
activity. Self-esteem is usually low, although the adolescent
may project an image of "toughness." Teenagers
with this disorder have also been described as "delinquent"
or "anti-social." Some teenagers with conduct
disorder may also have symptoms of other psychiatric disorders
(see ADHD, depression, alcohol and drug abuse).
DEPRESSION
Though the term "depression" can describe a
normal human emotion, it also can refer to a psychiatric
disorder. Depressive illness in children and adolescents
includes a cluster of symptoms which have been present
for at least two weeks.
In addition to feelings of sadness and/or irritability,
a depressive illness includes several of the following:
Change of appetite with either significant weight loss
(when not dieting) or weight gain
Change in sleeping patterns (such as trouble falling
asleep, waking up in the middle of the night, early morning
awakening, or sleeping too much)
Loss of interest in activities formerly enjoyed
Loss of energy, fatigue, feeling slowed down for no
reason, "burned out" Feelings of guilt and
self blame for things that are not one's fault
Inability to concentrate and indecisiveness
Feelings of hopelessness and helplessness
Recurring thought of death and suicide, wishing to die,
or attempting suicide Children and adolescents with depression
may also have symptoms of irritability, grumpiness, and
boredom. They may have vague, non-specific physical complaints
(stomachaches, headaches, etc.). There is an increased
incidence of depressive illness in the children of parents
with significant depression.
LEARNING DISORDERS
Learning Disorders occur when the child or adolescent's
reading, math, or writing skills are substantially below
that expected for age, schooling, and level of intelligence.
Approximately 5% of students in public schools in the
United States are identified as having a learning disorder.
Students with learning disorders may become so frustrated
with their performance in school that by adolescence they
may feel like failures and want to drop out of school
or may develop behavioral problems. Special testing is
always required to make the diagnosis of a learning disorder
and to develop appropriate remedial interventions. Learning
disorders should be identified as early as possible during
school years.
OBSESSIVE- COMPULSIVE DISORDER (OCD)
Teenagers with OCD have obsessions and/or compulsions.
An obsession refers to recurrent and persistent thoughts,
impulses, or images that are intrusive and cause severe
anxiety or distress. Compulsions refer to repetitive behaviors
and rituals (like hand washing, hoarding, ordering, checking)
or mental acts (like counting, repeating words silently,
avoiding). The obsessions and compulsions also significantly
interfere with the teen's normal routine, academic functioning,
usual social activities, or relationships.
PHYSICAL ABUSE
Physical abuse occurs when a person responsible for a
child or adolescent's welfare causes physical injury or
harm to the child. Examples of abusive treatment of children
include: hitting with an object, kicking, burning, scalding,
punching, and threatening or attacking with weapons. Children
and adolescents who have been abused may suffer from depression,
anxiety, low selfesteem, inability to build trusting relationships,
alcohol and drug abuse, learning impairments, and conduct
disorder.
POST- TRAUMATIC STRESS DISORDER (PTSD)
PTSD can occur when a teenager experiences a shocking,
unexpected event that is outside the range of usual human
experience. The trauma is usually so extreme that it can
overwhelm their coping mechanisms and create intense feelings
of fear and helplessness.
The traumatic event may be experienced by the individual
directly (e.g. physical or sexual abuse, assault, rape,
kidnaping, threatened death), by observation (witness
of trauma to another person), or by learning about a trauma
affecting a close relative or friend. Whether teens develop
PTSD depends on a combination of their previous history,
the severity of the traumatic event, and the amount of
exposure.
Symptoms include:
