Because adolescents are prone to mood swings and often feel out of control, it can be hard to identify the difference between a mental health disorder and normal teen behavior. Indicators… withdrawn socially, continual anger, irritability, bad moods or depression, dramatic changes in appetite or sudden weight loss or gain

Early identification and effective intervention is the key to successfully treating a mental health disorder and preventing future disability.  Mental health disorders in children and adolescents are caused by biology, environment, or a mix of both. Many factors in a teens environment can affect his or her mental health, such as exposure to violence, extreme stress, and loss. Take the ACE’s test [ACEs are adverse childhood experiences that harm children’s developing brains so profoundly that the effects show up decades later].

In psychiatry, psychology and mental health counseling comorbidity refers to the presence of more than one diagnosis occurring in an individual at the same time. However, in psychiatric classification, comorbidity does not necessarily imply the presence of multiple diseases, but instead can reflect our current inability to supply a single diagnosis that accounts for all symptoms.

Below is just a general overview of the various mental health disorders and symptoms. If you suspect that your child shows symptoms, check with a doctor, do not self-diagnose.

Mental Health Disorders vs Teenage Brain

Resources on the Teenage Brain

My teen is moody. My teen is always sleeping. My teen is argumentative. My teen is impulsive. He never seems to consider the consequences of his actions. Is this normal?

A specific region of the brain called the amygdala is responsible for instinctual reactions including fear and aggressive behavior. This region develops early. However, the frontal cortex, the area of the brain that controls reasoning and helps us think before we act is still changing and maturing into adulthood and does not fully mature until 24 years old. Other changes during adolescence include a rapid increase in the connections between the brain cells and refinement of brain pathways. Nerve cells develop myelin, an insulating layer which helps cells communicate. All these changes are essential for the development of coordinated thought, action, and behavior. Images of the brain in action show that teen brains function differently than adults when decision-making and problem solving. Teen actions are guided more by the amygdala and less by the frontal cortex.

Things to consider… The teen brain is more susceptible to stress than the adult brain. Teenage brains are susceptible to addiction and mental illness. There is evidence to suggest that the teen brain responds to alcohol differently than the adult brain. Drinking in youth, and intense drinking are both risk factors for later alcohol dependence.

It can be difficult to tell the difference between typical teen behavior and symptoms of mental illness. Signs of mental illness in adolescents can include… excessive worrying or sadness, extreme mood changes, prolonged irritability or anger, avoiding friends and isolating, changes in sleeping or eating habits, abuse of substances, confused thinking, difficulty concentrating , difficulty perceiving reality, suicidal thoughts, inability to handle daily activities.

There are great books and articles about the teenage brain. View the links below.

  • Books & Articles
    • Teenage Brains By David Dobbs, National Geographic
      Moody. Impulsive. Maddening. Why do teenagers act the way they do? Viewed through the eyes of evolution, their most exasperating traits may be the key to success as adults.
    • The Female Brain  By Louann Brizendine
      Why are women more verbal than men? Why do women remember details of fights that men can’t remember at all? Why do women tend to form deeper bonds with their female friends than men do with their male counterparts? These and other questions have stumped both sexes throughout the ages. The latest findings show how the unique structure of the female brain determines how women think, what they value, how they communicate, and who they love.
    • Brainstorm: The Power and Purpose of the Teenage Brain By Daniel J. Siegel
      Between the ages of 12 and 24, the brain changes in important, and oftentimes maddening, ways. It’s no wonder that many parents approach their child’s adolescence with fear and trepidation. If parents and teens can work together to form a deeper understanding of the brain science behind all the tumult, they will be able to turn conflict into connection and form a deeper understanding of one another.
  • Websites & Videos

Types of Anxiety Disorders

  • General Anxiety Disorder
  • Social Anxiety Disorder
  • Situational Anxiety
  • Post Traumatic Stress Disorder – PTSD
  • Panic Disorder
  • Obsessive Compulsive Disorder – OCD
  • Specific Phobias Agoraphobia

Symptoms of Anxiety Disorders

  • Feelings of panic, fear, and uneasiness Numbness or tingling in the hands or feet
  • Problems sleeping Not being able to be still and calm
  • Cold or sweaty hands or feet Shortness of breath
  • Heart palpitations Dry mouth
  • Nausea Muscle tension
  • Dizziness
  • Adolescents may appear withdrawn, highly uneasy, fearful, overly emotional, unresponsive or unrestrained.

Types of Behavioral Disorders

  • Disruptive behavioral disorders
  • Oppositional Defiant Disorder – ODD
  • Conduct Disorder
    causes children and adolescents to act out their feelings or impulses toward others in destructive ways. Adolescents with conduct disorder usually have little care or concern for others.
  • Emotional disorders
    a disability classification used in educational settings that allows educational institutions to provide special education and related services to students that have poor social or academic adjustment that cannot be better explained by biological abnormalities or a developmental disability.
  • Pervasive developmental disorders
    five disorders characterized by delays in the development of multiple basic functions including socialization and communication
  • Dissociative disorders – multiple personalities

Symptoms of Behavioral Disorders

  • Easily getting annoyed or nervous
  • Often appearing angry
  • Putting blame on others
  • Refusing to follow rules or questioning authority
  • Arguing and throwing temper tantrums
  • Having difficulty in handling frustration
  • Starting fights, abusing animals and threatening to use a weapon on others
  • Lying, theft, aggression, truancy, fire setting, and vandalism
  • Difficulty relating to people, objects, and events; for example, lack of eye contact, pointing behavior, and lack of facial responses.

Types of Eating Disorders

  • Anorexia Nervosa – adolescent is intensely afraid of gaining weight and doesn’t believe that he/she is underweight
  • Bulimia Nervosa – adolescent is compelled to binge and then to prevent weight gain, they rid bodies of food by vomiting, abusing laxatives, taking enemas, or exercising obsessively.
  • Binge Eating Disorder – characterized by recurrent episodes of eating large quantities of food; a feeling of a loss of control during the binge; experiencing shame, distress or guilt afterwards; and not regularly using  measures such as purging to counter the binge eating.

Symptoms of Eating Disorders

  • Feelings of panic, fear, and uneasiness Numbness or tingling in the hands or feet
  • Problems sleeping Not being able to be still and calm
  • Cold or sweaty hands or feet Shortness of breath
  • Heart palpitations Dry mouth
  • Nausea Muscle tension
  • Dizziness
  • Adolescents may appear withdrawn, highly uneasy, fearful, overly emotional, unresponsive or unrestrained.
  • Frequent episodes of consuming very large amounts of food but without behaviors to prevent weight gain, such as self-induced vomiting.

Types of Developmental Disorders

  • ADHD – Attention-Deficit/Hyperactivity Disorder
    Inattentive, Hyperactive/Impulsive or Combined (a combination of the first two types)
  • Autism
  • Learning Disabilities (ie: dyslexia)
  • Communication Disorders

Symptoms of Developmental Disorders

  • Unable to focus attention and is often impulsive and easily distracted.
  • Difficulty remaining still, taking turns, and keeping quiet.
  • Blurts out answers before questions have been completed.
  • Frequently become bored easily, fail to concentrate even for short periods of time, and can be disruptive.
  • Slow to process information and directions. Does not appear to listen.
  • Struggles to follow through with instructions
  • Has difficulty with organization
  • Girls… Frequently talking, often outgoing. May interrupt impulsively. Many girls with ADHD express their restlessness verbally. May be slow to pick up on social cues and may even be verbally aggressive when she feels frustrated. Difficulty maintaining focus or completing tasks, easily distracted, disorganized, forgetful, daydreaming, careless
  • In making the diagnosis, children should have six or more symptoms of the disorder present; adolescents 17 and older and adults should have at least five of the symptoms present. 

NOTE… ADHD presents differently in girls, Symptoms are often more subtle.

  • A late or missed diagnosis means girls don’t get the academic services and accommodations that could help them succeed and research indicates that undiagnosed ADHD can jeopardize their self esteem and, in some cases, their mental health.
  • Boys externalize while girls are more likely to blame themselves, turning their anger and pain inward.
  • Girls with ADHD are more likely to experience major depression, anxiety and eating disorders than girls without.
  • Bright, inattentive girls often compensate for inattention by becoming super-organized or hyper-focused on school work. Such girls often succeed in school, but their private struggle remains a secret.
  • ADHD is often hard to detect in girls until they reach puberty and hormone changes can cause dramatic mood swings and disruptive behavior.
  • A girl who has kept her ADHD hidden until puberty may appear to blow up suddenly when female hormones flood her body.
  • Teenage girls with ADHD appear to be at greater risk for eating disorders. Likely to be overweight and to suffer from rejection and low self-esteem.
  • Girls whose ADHD isn’t diagnosed and treated by the time they reach puberty are at risk for developing other psychological disorders, such as anxiety and depression. Adolescent girls who don’t receive help for ADHD and co-existing psychological problems are at high risk for addictive behaviors, such as over-eating, smoking, alcohol abuse and sexual promiscuity.
  • ADD and ADHD girls alike begin to show more risky sexual and other behaviors.
    They may use drugs or alcohol both due to increasing impulsivity and to self-medicate.
  • Shoplifting, teen pregnancy, and eating disorders are also found more often in females with ADD.
  • Often girls with ADD are misdiagnosed with depression. The symptoms of ADD and depression overlap: low energy levels, disorganization, social withdrawal, and trouble concentrating. The unrecognized ADD can lead to major coping problems, which in turn lead to actual depression on top of the ADD.

Types of Mood Disorders

  • Major Depressive Disorder
  • Minor Depressive Disorder
  • Substance Induced
  • Dysthymic Disorder
  • Recurrent Brief Depression
  • Disruptive Mood Dysregulation Disorder
  • Bipolar Disorder
  • Seasonal Affective Disorder (SAD)

Symptoms of Mood Disorders

  • Lack of motivation
  • Changes in appetite
  • Fatigue and low energy.
  • Changes in sleep patterns. Trouble sleeping or daytime sleepiness.
  • Vague physical complaints
  • Negative thoughts about self and low self esteem
  • Feelings of worthlessness
  • Feelings of loneliness
  • Feelings of sadness, hopelessness and helplessness
  • Problems concentrating
  • Poor performance in school
  • Lack of enthusiasm, energy or motivation
  • Indecision, lack of concentration or forgetfulness
  • Withdrawal from friends and activities
  • Extreme fatigue or disinterest
  • Overreaction to criticism
  • Restlessness and agitation
  • Anger and rage
  • Frequent crying
  • Changes in eating or sleeping patterns
  • Substance abuse
  • Problems with authority
  • Thoughts of suicide or preoccupation with death
  • Trouble concentrating or making decisions
  • Teens may experiment with drugs or alcohol or become sexually promiscuous to avoid feelings of depression. They may express their depression through hostile, aggressive, risk-taking behavior.
  • Bipolar  in adolescents is marked by exaggerated mood swings between extreme lows (depression) and highs (manic phases). Periods of moderate mood occur in between. During manic phase, adolescent may talk nonstop, need very little sleep, and show unusually poor judgment.

Types of Personality Disorders

  • Schizoid personality disorder
  • Paranoid personality disorder
  • Borderline personality disorder
  • Histrionic personality disorder
  • Narcissistic personality disorder
  • Obsessive-compulsive personality disorder (not obsessive-compulsive disorder)

Symptoms of Personality Disorders

  • Eccentric [Paranoid, Schizoid, Schizotypal]
  • Dramatic/Emotional [Antisocial, Borderline, Histrionic, Narcissistic]
  • Fear-Related [Avoidant, Dependent, Obsessive-Compulsive Personality Disorder]
  • May experience difficulties in cognition, emotiveness, interpersonal functioning, or impulse control.
  • Behavior can result in maladaptive coping skills, which may lead to problems that induce anxiety, distress, or depression.

Types of Psychotic Disorders

  • Schizophrenia
  • Schizoaffective Disorder
  • Delusional Disorder

Symptoms of Psychotic Disorders

  • hallucinations
  • delusions
  • catatonia
  • disorganized speech
  • disordered thoughts
  • grossly disorganized
  • catatonic behavior
  • inability to experience pleasure
  • Young people with schizophrenia have psychotic periods when they may have hallucinations, withdraw from others, and lose contact with reality. Often confused with Bipolar Disorder with psychotic features.

Types of Self Harm

  • Cutting yourself
  • Punching yourself or punching things
  • Burning yourself with cigarettes, matches, or candles
  • Pulling out your hair
  • Poking objects through body openings
  • Breaking your bones or bruising yourself

Symptoms of Self Harm

  • Self harm or thinking about hurting yourself—is a sign of emotional distress and can turn into a coping mechanism.
  • Self-harm is not a mental illness, but a behavior that indicates a lack of coping skills.
  • Several illnesses are associated with self harm, including depression, eating disorders, anxiety, borderline personality disorder or post-traumatic distress disorder.
  • Self-harm isn’t the same as attempting suicide.

Interesting Articles & Links

  • DSM-5, the new mental illness ‘bible,’ may list Internet addiction among illnesses… READ

Types of Substance Use Disorders

  • Getting drunk or high on drugs on a regular basis
  • Lying about alcohol or other drug use
  • Avoiding others to get drunk or high
  • Giving up activities once enjoyed to drink or use drugs
  • Planning drinking in advance, hiding alcohol or drinking or using drugs alone
  • Having to drink more to get the same high
  • Drinking and driving
  • Believing that to have fun, drinking or drug use are necessary
  • Experiencing frequent hangovers
  • Blacking out
  • Pressuring others to drink or use drugs
  • Taking risks, including sexual risks
  • Becoming victims to perpetrators of violence
  • Feeling run-down, hopeless, depressed or even suicidal
  • Acting selfish and not caring about others
  • Talking excessively about drinking or using drugs
  • Getting in trouble with the law
  • Getting suspended from school for an alcohol- or other drug-related incident

Symptoms of Substance Use Disorders

  • Difficulty concentrating
  • Personality changes
  • General lack of motivation and energy
  • Sleep disturbances
  • Appetite changes
  • Oversensitivity
  • Moodiness
  • Nervousness
  • Having unplanned and unprotected sex
  • Declining grades and school failure
  • Depression
  • Loss of interest in family and friends
  • Excessive need for privacy, secretive or suspicious behavior
  • Suffering serious injuries from driving under the influence or engaging in other risky behavior

Suicide Ideation

  • Suicidal ideation means wanting to take your own life or thinking about suicide without actually making plans to commit suicide.
  • The term suicidal ideation is often used more generally to refer to having the intent to commit suicide, including planning how it will be done.
  • Whether suicide ideation is active or passive, the goal is the same… terminating one’s life.

RISK FACTORS…

  • Previous suicide attempt
  • Major physical illnesses, especially with chronic pain
  • Mental health disorders
  • Impulsive and/or aggressive tendencies
  • History of trauma or abuse
  • Family history of suicide
  • Precipitants/triggering events leading to humiliation, shame, or despair
  • Social Risk Factors… Chaotic family history, Lack of social support and increasing isolation, Legal difficulties/contact with law enforcement/incarceration

Warning signs of Suicide Contemplation

  • Suicide threats, direct and indirect
  • Obsession with death
  • Poems, essays and drawings that refer to death
  • Giving away belongings
  • Dramatic change in personality or appearance
  • Irrational, bizarre behavior
  • Overwhelming sense of guilt, shame or rejection
  • Changed eating or sleeping patterns
  • Severe drop in school performance

SUICIDE RISK ASSESSMENT

  • Current Thoughts
    Are suicidal thoughts present?
    When did these thoughts begin?
    How persistent are they?
    Can they control them?
    What has stopped the person acting on their thoughts so far?
  • Suicide Plan
    Has the person made any plans?
    Is there a specific method and place?
    How often does the person think about the plan?
  • History
    Has the person felt like this before?
    Has the person harmed themselves before?
    What were the details and circumstances of the previous attempts?
    Are there similarities in the current circumstances?
  • Access
    Does the person have access to means to carry out their plan?
    How deadly is the method?

QUESTIONS TO ASK

  • “Sometimes, people in your situation lose hope; I’m wondering if you may have lost hope, too?”
  • “Are you feeling hopeless about the present or future?”
  • “Did anything specific precipitate the suicidal thoughts?”
  • “Have things been so bad lately that you have thoughts that you would rather not be here?”
  • “What would it accomplish if you were to end your life?”
  • “Do you feel as if you’re a burden to others?”
  • “Have you had thoughts about taking your life?
    How often in the past year?”
  • “Have you ever tried to kill yourself or attempt suicide?”
  • “When did you have these thoughts?”
  • “Do you have a plan to take your life? Is there something that would trigger the plan?”

TALKING ABOUT DEPRESSION…

  • Where are you today on a scale of 0-10?
  • What would it take to make you an 8?
  • Tell me what you do know.
  • I need you to recognize where you are
  • What do you need inside? (not external – friends, phone. etc)
  • It is hard to honor ourselves when we are sad
  • Pick one thing that you do have control of.
  • Rebel in a healthy way — Safety & Respect
  • Focus on learning how to handle conflict

Interesting Articles & Links

  • What a Parent Can do… READ
  • Do’s and Don’ts… READ
  • Teen Suicide Statistics… READ
  • Suicide Rates Climb In U.S., Especially Among Adolescent Girls… READ or LISTEN

Types of Tic Disorders

  • Transient tic disorder
  • Chronic motor or vocal tic disorder
  • Combined vocal and multiple motor tic disorder ~ Tourette Syndrome

Symptoms of Tic Disorders

  • Short-lasting sudden movements (motor tics) or uttered sounds (vocal tics) occur suddenly during what is otherwise normal behavior. Tics are often repetitive, with numerous successive occurrences of the same action
    Stress and sleep deprivation seem to play a role in both the occurrence and severity of motor tics.
  • P.A.N.D.A.S. ~ Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections. Diagnosed when OCD and/or tic disorders suddenly appear following a strep infection or symptoms of OCD or tic symptoms suddenly become worse following a strep infection.
  • “Rage Attacks” are not tantrums. The “goal” seems to be to discharge or release some tension that’s been built up. Some people describe them as “storms” that come without warning
  • Sensory Defensiveness or Dysregulation… Overly sensitive to touch, movement, sights
  • Inability to habituate to sounds and fear with unexpected noises, Easily distracted, Avoids tastes, smells, or textures normally tolerated by children that age, Activity level that is unusually high or unusually low, Impulsive, lacking in self-control, Inability to unwind or calm self, Poor self-concept, Social and/or emotional problems, Difficulty making transitions from one situation to another, Delays in speech, language, or motor skills, Delays in academic achievement, Seeks out movement activities, but poor endurance and tires quickly
  • About half of people with Tourette’s also have symptoms of attention deficit hyperactivity disorder (ADHD).
  • Tourette’s can also cause problems with… Anxiety, learning disabilities such as dyslexia, OCD

Video Gaming & Cell Phone Dependence

  • Most people are able to keep video games (& cell phones) as a leisure activity that doesn’t interfere with the rest of their lives, but some people develop a dependence.
  • For a person who is already experiencing an emotional struggle, the feeling of accomplishing game tasks, combined with the social connection some games provide, can become addicting in a very real sense.
  • For the teen who is struggling socially, having trouble adapting to life changes, or feeling stressed about friends, school, or family, video games provide an enticing release: modern games are fully immersive and often never-ending, allowing teens to escape into a safe world with constant rewards.
  • As time goes on, the initial feelings of happiness and relaxation associated with the game fade, and the addict starts to play more and more in an attempt to get the same positive feeling.
  • Eventually, this leads to a feeling of helplessness over and dependency on gaming.
  • Teen Cell Phone Addiction is usually referred to as a Behavioral Disorder, characterized by a teen’s chronic using of, and obsession with, a cell phone.

Symptoms of Video Gaming & Cell Phone Dependence

  • Falling away from normal social activities and extracurricular activities, drop in grades, lying about gaming, irritable, distracted, or upset when unable to play, weight gain or loss, poor sleep patterns
  • A need to use the cell phone more and more often in order to achieve the same desired effect.
  • Persistent failed attempts to use cell phone less often. Preoccupation with cell phone.
  • Withdrawal, when cell phone is not being used (anger, tension, depression, irritability, restlessness)

Interesting Articles & Links

  • DSM-5, the new mental illness ‘bible,’ may list Internet addiction among illnesses… READ
  • Watch out: Cell phones can be addictive… READ
  • Cell Phone Addiction Is So Real People Are Going to Rehab for It… READ
  • Cell Phones: A Potentially Deadly Addiction… READ
  • What Causes an Addiction to Video Games? READ

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