Seasonal Affective Disorder and Other Mental Health Issues. Mental Health Issues and Juvenile Justice. Acronyms

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1 Seasonal Affective Disorder and Other Mental Health Issues Keith Neuber, M.S. I K.A.N. Presentations keith@ikan2.com Mental Health Issues and Juvenile Justice Individual Mental Health Implications for conduct Implications for assessment Implications for intervention Acronyms Shortcut to confusion ADD, ADHD, ODD, OCD, PTSD, SAD, CD Lingo I read about it in the tabloids General understanding professional publications (Diagnostic and Statistical Manual of Mental Disorders DSM IV/V published by the American Psychiatric Association) Clinical Diagnosis Licensed professional 1

2 General Understanding Categories Range of severity Contributors Symptoms Implications for intervention Categories Anxiety Related Conduct Related Mood Related Anxiety Related Attention Deficit Disorder Overanxious Disorder Obsessive/Compulsive Disorder Post Traumatic Stress Disorder 2

3 Attention Deficit Disorder Disorder of biology Physical energy production exceeds mental ability to control Average range of intelligence Onset prior to age seven With or without hyperactivity Attention Deficit Disorder Symptoms (at least 8 present for 6 months) Fidgeting Difficulty remaining seated Easily distracted Difficulty waiting one s turn Often blurts out answers Difficulty following through with instructions Difficulty sustaining attention Shifting from one task to another Difficulty playing quietly Talks excessively Interrupts/intrudes Failure to listen to what is said Loses things necessary to complete a task Engages in thrill seeking behavior Attention Deficit Disorder Intervention strategies Medical Counseling environmental structure Educational 3

4 Overanxious Disorder Contributors Environmental factors Trauma Role models Biochemical Overanxious Disorder Excessive or unrealistic worry over a six month period Symptoms (4 present over 6 months) Excessive/unrealistic worry about future events Excessive/unrealistic concern about past behavior Excessive/unrealistic concern about their competence Somatic complaints without physical basis Marked self-consciousness Excessive need for reassurance Inability to relax Overanxious Disorder Treatment implications Counseling Medication Life management 4

5 Obsessive/Compulsive Disorder Contributors Environmental factors Trauma Biochemical Modeling Obsessive/Compulsive Disorder Obsession Recurrent/persistent ideas, thoughts, impulses, images that are intrusive Individual attempts to ignore/neutralize them Individual realizes they are a product of their own mind Compulsion Repetitive behaviors that are performed in response to an obsession Behaviors are intended to neutralize or prevent discomfort Individual recognizes that their reactions are unreasonable Obsessive/Compulsive Disorder Treatment implications Counseling Medication 5

6 Post Traumatic Stress Disorder Distressing event outside the range of typical human experience Duration of at least one month Post Traumatic Stress Disorder Symptoms Distressing recollection of event Recurrent dreams Flashbacks Intense stress when exposed to symbolic representations of the event Difficulty sleeping Irritability or anger outbursts Difficulty concentrating Hyper-vigilance Exaggerated startle response Physical responses to exposure of symbolic representations Post Traumatic Stress Disorder Manifestations Efforts to avoid thoughts of the trauma Efforts to avoid activities that arouse thoughts of the trauma Inability to recall aspects of the trauma Marked disinterest in significant developmental activities Feelings of detachment Restricted range of affect Sense of fore-shortened future 6

7 Post Traumatic Stress Disorder Treatment Intensive counseling Conduct Related Disorders Oppositional Defiant Disorder Conduct Disorder Oppositional Defiant Disorder Contributors Chaotic/unstructured environment Parental inconsistency Environmental disruption Mistreatment 7

8 Oppositional Defiant Disorder Cognitive disorder issues associated with attitude Symptoms (at least 5 over 6 months) Often loses temper Often argues with adults Often defies adult rules/requests Often deliberately annoys other people Often blames others for their own mistakes Often touchy/easily annoyed Often spiteful or vindictive Frequent using of obscene language Oppositional Defiant Disorder Implications for intervention Counseling Structured environment with logical consequences Predictable interactions with authority figures Conduct Disorder Conduct Disorder Unclear origin Biology Environment 8

9 Conduct Disorder Symptoms (6 month period of persistent conduct disturbance with at least 3 of the following) 2 or more instants of stealing without confronting the victim Running away at least twice Frequent lying Deliberate fire setting Frequent truancy/absence from work Breaking into others property Deliberate destruction of property Cruelty to animals Forced sexual activity More than one fight with a weapon Frequent initiation of fights Stealing with confrontation of the victim Cruelty to other people Conduct Disorder Manifestations Pain balances pain Lack of consequential thinking Desire for immediate gratification Alliances with similar individuals Passion for power Escapist behavior Conduct Disorder Treatment implications Range of severity (least restrictive environment) Resistant to change Ownership of consequences for choices 9

10 Mood Related Disorders Seasonal Affective Disorder Major Depressive Episode Bi-polar Disorder Seasonal Affective Disorder Onset occurs around the same time each year generally with the onset of fall Saps the energy form the individual and results in mood changes Caused by a change in the chemistry of the body Seasonal Affective Disorder The holiday blues can refer to someone who is moody, sad or melancholy during the holiday season Holiday blues may result from Significant life events Onset of memories Disappointments Unmet cultural/media generated expectations Disruptions in life circumstances 10

11 Seasonal Affective Disorder Holiday blues result from thoughts and feelings and can dissipate quickly with a change in circumstance Seasonal Affective Disorder is biological, may last well into the winter months and is unlikely to improve by a change in the person s current situation Seasonal Affective Disorder Depressed mood Sense of hopelessness Anxiety Loss of energy Heavy laden feeling in arms and legs Social withdrawal Oversleeping Loss of interest in things you enjoy Appetite changes Weight gain Difficulty concentrating Seasonal Affective Disorder Light Therapy Pharmaceutical Interventions 11

12 Seasonal Affective Disorder Think medically first Meet with your physician to discuss symptoms Make sure that your physician is aware of any medicines you are taking Meet with a counselor to discuss situations you are encountering that create stress Seasonal Affective Disorder Consider your life style Get regular exercise and fresh air Increase your exposure to sunlight Create a brighter/sunnier environment Eat healthy Minimize consumption of alcoholic beverages Major Depressive Disorder Biochemical Environmental influences/triggers Associated attitude properties 12

13 Major Depressive Disorder Major Depressive Disorder Symptoms (5 present over a two week period) Depressed/irritable mood Diminished interest in pleasure (anhedonia) Significant weight gain/loss Hyper-somnia/insomnia Psychomotor retardation/agitation Fatigue/loss of energy Feelings of worthlessness Decreased concentration or indecisiveness Thoughts of death or suicide Major Depressive Disorder Intervention strategies Chemical Lifestyle management Counseling Bi-Polar Disorder Cyclical disorder featuring both manic and depressive episodes Implications for intervention Medication Counseling 13

14 Opportunities Developing a general understanding of mental health issues can be useful in: Better understanding the actions and attitudes of youth we work with Guiding staff to connect youth to appropriate resources Engaging youth and collaterals in establishing meaningful service plans Anticipating actions and reactions to intervention Overcoming resistance to change Cautions Mental health issues are complex The similarity of symptoms for different mental health related problems may lead to incorrect conclusions. Only a licensed professional can make a clinical diagnosis. Consult a licensed professional if you have questions about a youth mental health. Avoid using acronyms and labels. Focus on the behaviors and attitudes. Avoid stereo-typing and drawing conclusions without sufficient facts 14

CHILD / ADOLESCENT HISTORY

CHILD / ADOLESCENT HISTORY PERSON FILLING OUT THIS FORM DATE PATIENT NAME: DATE OF BIRTH AGE APPOINTMENT DATE: HOME TELEPHONE: MOTHER NAME: _ OCCUPATION WK TEL FATHER NAME: OCCUPATION _ WK TEL YOU ARE