Elizabeth Duncan- Salem College



EDUC 664: Week Thirteen Assignment- Mental Illness/Mental Disorders with School-aged Children and the Role of the Professional School CounselorsElizabeth DuncanSalem College: Fall 2014Mental Illness/Mental Disorders with School-aged Children and the Role of School CounselorsMillions of students are affected by mental illness/mental disorders in the United States. There are a number of illnesses and disorders that school aged children and their families face. Some examples of such illnesses or disorders include, attention-deficit/hyperactivity disorder (ADHD), Tourette syndrome, behavior disorders, mood and anxiety disorders, depression, autism spectrum disorders, and substance use disorders. In this paper I will specifically discuss depression and Autism Spectrum Disorders. Depression is generally associated with adults and that can sometimes mean that symptoms in children go undetected. Autism Spectrum Disorders are becoming more and more prevalent in schools, as well as, information on Autism Spectrum Disorders. Professional school counselors play an important role in students’ day-to-day lives. The role of a school counselor can play an especially important role in the lives of students whom may be affected by a mental illness or disorder. School counselors can be a part of early detection, personalized education plans, and avocation for the student. School counselors also play an important role in helping students fit into the social aspects of the school environment. In today’s society there has been such an enhancement of science and technology to help in the work for children with mental illnesses and or disorders. Such enhancements have manifested into resources for children, families, and schools. There are many resources that widely range in the level of patient help. Some resources are face-to-face, some are information based, some are in school and some are out of school. It is important for school counselors to know what resources are available to the school systems, as well as, available to the families’ diagnosed students. Mental Illness/Disorders and School Aged ChildrenMental health is important to overall health. Mental illness and mental disorders affect all school-aged children. Whether the child has been diagnosed with a mental illness or mental disorder or they have a classmate who has been diagnosed, all students deal with mental illness/disorder on a daily basis. The Centers for Disease Control and Prevention (CDC) says, “Mental disorders among children are described as serious changes in the ways children typically learn, behave, or handle their emotions” (2013). Symptoms of most mental illnesses/disorders begin in early childhood. Others may begin to see symptoms throughout teenage years. For all mental illnesses/disorders early diagnosis is key. Early detection and or diagnosis may minimize the long-term disability of mental disorders. The National Alliance on Mental Illness (NAMI) says, early detection/diagnosis “prevents the loss of critical development years that cannot be recovered” (2010). The earlier detection or diagnosis can be made the more time of success in schools a student has to work with. Also, the earlier a student receives the proper treatment, the less amount of time he or she may have in trouble. Many times a student with an undiagnosed mental illness/disorder may act out, therefore causing a lot of trouble for him or her and those around. Monitoring children’s mental health is a vital part of early diagnosis. Collecting and monitoring information about students’ mental health over time allows to quickly pinpoint any changes that may occur. Monitoring also helps increase the understanding of a child’s mental health needs. There is a chance to inform and increase research on mental illness/disorders. Lastly, monitoring allows for examining treatment and prevention efforts and effectiveness. (CDC, 2013) Mental illness/disorder affect children from all backgrounds. Race, sex, socio-economic, and ethnicity have very little, to nothing, to do with the likeliness that a child will be diagnosed. According to the CDC (2013), 13% to 20% of U.S. children experience a mental disorder, that’s close to 1 out of 5 children. The CDC goes on to report that an estimated $247 billion is spent each year to work on or with children with mental illness/disorder. Figure 1 shows a breakdown of mental illnesses/disorders tracked by the CDC (2013) for children ages 3 to 17. Figure 1Children with mental illness/disorders, especially depression, are at a higher risk of suicide. The Surgeon General reported, as stated by the Children’s Defense Fund (2010), that 90% of young people who commit suicide have a mental disorder. The Children’s Defense Fund also states, “children with mental health problems who have access to quality health care and comprehensive age-appropriate mental health screens and assessments have improved health and development” (2010). There are so many different mental illnesses/disorders or categories of mental illnesses/disorders. There are almost as many treatment options as there are diagnoses. Some people believe that psychosocial therapies can be effective, others believe in medication, some believe in a combination, while others believe in different treatments all together. Families of children diagnosed also benefit from participating in different forms of treatment, especially therapeutic treatments. When families work beside children with mental illnesses/disorders there is a probable higher level of success than children who may have to go through things alone. Children with a diagnosis cannot rely on just the outside sources (schools, therapies, centers, etc.), families are also resources and in order for those resources to be effective families need proper training and help as well. Consequences of untreated mental illnesses/disorders in children range from suicide, school failure, to criminal involvement. NAMI insists, “with appropriate identification, evaluation, and treatment, children and adolescents living with mental illness can lead productive lives” (2010). Depression and Autism Spectrum DisordersDepression Depression, sometimes temporary, sometimes not, affects how a person feels, thinks, and behaves. Most often depression is seen as an issue for adults, however, NAMI approximates that 11% of adolescents experience a depressive disorder by age 18. (2014) In grade school aged children boys and girls are affected by depression at almost equal numbers. In contrast, by adolescence girls are diagnosed at almost twice the number as boys. Children and adolescence that have dual diagnoses of Attention Deficit/Hyperactive Disorder (ADHD), anxiety disorders, or other illnesses/disorders are at a higher risk for depression. Also, students “experiencing considerable stress, trauma, facing a significant loss or a family history of mood disorders” (NAMI, 2014) have increased risks for depression. Recognizing symptoms is the first part of the recovery process for students affected by depression. The table in appendix B gives more details on the symptoms of depression, however a few examples are: difficulty with relationships, increased irritability, anger, or hostility, extreme sensitivity to rejection or failure, low self-esteem or guilt, social isolation or poor communication. In grade school children may complain of aches and pains because they are unable to fully express depression. Adolescence and teens may become more aggressive, begin to use drugs and alcohol, or do poorly in school. For some children episodes of depression may last 6 to 9 months, while others may experience an episode for years. Appendix B also gives more information on treatments for depression; some examples are medications, therapy, or a combination of both. Families need to work together with children and the school to help monitor mood and behavior. Communication is key and knowledge is power. When a young person is given a plan it is important for families and schools to help him or her stick to the plan for recovery. Autism Spectrum Disorder (ASD)Dr. Leo Kenner first introduced autism Spectrum Disorders in 1943. Autism Spectrum Disorders are developmental disabilities. There is no physical indication or look of an Autistic person. Autism Spectrum Disorders are characterized by communicative, interaction, behavior, and learning issues. Children with ASD range from highly gifted in the school to severely challenged in school. Some children need a lot of daily assistance and some need very little assistance. 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, as in, Duncan, 2014) “Autism spectrum disorder (ASD) diagnosis is often a two-stage process. The first stage involves general developmental screening during well-child 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., as in, Duncan, 2014). In most cases, by age 2 a diagnosis can be made. ASD now includes several conditions that used to be diagnosed separately. Those conditions are Autistic disorder, Pervasive Developmental Disorder-Not Otherwise Specified (PDD-NOS), and Asperger Syndrome. Symptoms for ASD are detailed in Appendix B, but some examples include problems with social, emotional, and communication skills, repetitive behaviors, trouble with changes, and avoiding eye contact. There are no traditional medical tests for Autism. The best defense is early detection/ diagnosis. In order to obtain an early diagnosis monitoring and observation is key. When families and schools are able to monitor students on a regular basis then they are able to detect differences immediately. Since ASD tends to be diagnosed in such young children, it is even more important for family members to keep a vigilant eye. “ASD occurs in all racial, ethnic, and socioeconomic groups, but is almost five times more common among boys than among girls. CDC estimates that about 1 in 68 children has been identified with autism spectrum disorder” (CDC, 2014) Treatments can be found in Appendix B. The Professional School Counselor’s Role Dr. Morris tells us, “ school counselors must be aware of the mental health challenges that students may face” (2014, p. 4). Schools are often the first place where mental health needs are recognized and addressed. Craigen, Grothaus, and Walley reiterate, “because children and adolescents spend a sizable portion of their time in the school setting, school counselors are situated to play a vital role in promoting mental health and preventing and assisting with the amelioration of the mental health concerns of students” (n.d., p. 12) The ASCA position statement on student mental health is an excellent resource for school counselors. The ASCA (2009) reminds that when students’ mental health needs go unmet it can create significant barriers to academic, person-social, and career development. School counselors should not be engaging in long-term therapy, but should be prepared to recognize and respond to mental health needs. (ASCA, 2009) ASCA also makes the strong point, “professional school counselors must focus their efforts on designing and implementing programs that promote educational success for all students, while acknowledging they may be the only counseling professional available to students and their families to help identify and address students’ mental health issues” (2009). Professional school counselors have to work within the boundaries and regulations of the ASCA Ethical Standards for School Counselors, The Family Educational Rights and Privacy Act (FERPA), legal regulations, and The ASCA National Model.The professional school counselor must create a comprehensive school counseling program to help all students succeed in academic, personal-social, and career development, no matter the mental health issues that may exist. The professional school counselor needs to ensure that students affected by mental health issues are able to overcome any barriers that may exist as a result of the mental health challenges. Though professional school counselors cannot provide long-term counseling they can and should provide resources and referrals that can. Referrals and resources should also be provided for other aspects of assistance and treatments. When professional school counselors provide guidance lessons there should be an element that helps enhance mental health awareness and eliminates the stereotypes and stigmas associated with mental health issues. Individual planning with students is a great way for professional school counselors to help students overcome barriers set in place by mental health issues. Another important aspect of the professional school counselor’s role is ensuring that educators, family members, and all stakeholders are educated about mental illness and the options available regarding treatments and assistance, signs, and symptoms. Collaboration is a key part of the overall role of professional school counselors and when dealing with mental health issues there is no difference. Professional school counselors must collaborate with community resources, other faculty members, family members, and students. Like all student issues, professional school counselors must advocate for students affected by mental health issues. Lastly, professional school counselors must participate in professional development opportunities that allow them to learn more about mental health issues and how to assist students affected by them. ConclusionMental health illnesses and disorders are becoming a more visible part of every day life for millions of Americans. Regardless of a diagnosis, all students are affected in one way or another by mental illness/disorder. Mental illness/disorders take different shapes and forms, but are all impactful. Depression and ASD are two specific illness/disorders that affect school aged children. Both illnesses/disorders benefit greatly from early detection and or diagnosis. All those involved need to be aware of signs, symptoms, and the best ways to act in a child’s best interest. Appendix B gives more information on these specific illness/disorders along with many others that affect school aged children. Possibly the most important part of this paper is the role of professional school counselors. Professional school counselors have the opportunity to interact with students almost everyday. By following the ASCA National Model, ASCA Ethical Standards, FERPA, and other regulations professional school counselors will create effective, comprehensive school counseling programs. Along with comprehensive plans, collaboration and advocating for students are all vital steps. Professional school counselors need to prepare themselves to work with and for students and families whom may be affected by mental health issues. ResourcesAmerican School Counselor Association (ASCA). (2009). The professional school counselor and student mental health. Retrieved from , R.E. "Depression in Young Children: Information for Parents and Education.” National Association of School Psychologists (NASP), n.d. Web. 22 Nov 2014. < for Disease Control and Prevention. (12, November 2014). Autism spectrum disorder (ASD). Retrieved from for Disease Control and Prevention (CDC), "Children’s Mental Health – New Report." Centers for Disease Control and Prevention: CDC 24/7: Saving lives. Protecting people. Centers for Disease Control and Prevention, 21 May 2013. Web. 21 Nov 2014. <;. Children's Defense Fund. “Children’s Defense Fund: Mental Health Fact Sheet." Children's Defense Fund. Children's Defense Fund, n.d. Web. 21 Nov 2014. <, T., Grothaus, T., & Walley, C. (n.d.). Confusion, crisis, and opportunity: Professional school counselor's role in responding to student mental health issues. Retrieved from Duckworth, K.J., ed. "Mental Illness: Depression in Children and Teens." National Alliance on Mental Illness (NAMI). National Alliance on Mental Illness, n.d. Web. 22 Nov 2014. <, E. A. (2014). EDUC 664 wk. 13 dq. Unpublished raw data, Education, Salem College, Winston-Salem, NC.Morris Sourbeer, A. (2014). . Lecture 13 Life transitions: Concluding and evaluating the counseling intervention August - December 2014. Retrieved from Salem College Moodlerooms: Institute of Mental Health. (n.d.). Autism spectrum disorder. Retrieved from Alliance on Mental Illness (NAMI). "Facts on Children's Mental Health in America." NAMI: National Alliance on Mental Illness. National Alliance on Mental Illness, n.d. Web. 21 Nov 2014. <;. Appendix A Lists Autism resources for North Carolina with links to nation wide resources (Including- Autism Speaks) ABC of NC Child Development Center:“Non-public, not-for-profit center providing quality individualized diagnostic, therapeutic, and educational services using evidence-based practices in the field of autism treatment for children with autism spectrum disorders (ASDs) and their families” ()A Professional Certification Program for educators, psychologists, speech pathologists, social workers, counselors and other professionals who work in the?field of Autism Spectrum Disorder. UNC system has a few TEACCH programs.Division of Mental Health: Helps ensure health and safety of N.C. residents by giving resources and informationCDC: Centers for Disease Control and Prevention Full of resources and vital information NAMI: National Alliance of Mental Illness Resources and information on all types of mental illnesses and or disorders Appendix BIllness/DisorderDescriptionSigns and Symptoms Treatments or ServicesPersuasive Development Disorder-Not Otherwise Specified (PDD-NOS)Neurobehavioral Disorder“PDD refers to the class of conditions to which autism belongs” (Yale School of Medicine, 2014) PDD is not a diagnosis, but PDD-NOS is and is also known as Atypical Personality DisorderAt this time there are no specific guidelines for this diagnosis and with no guidelines research is difficult 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.Atypical or inappropriate social behaviorUneven skill development (motor, sensory, visual-spatial organizational, cognitive, social, academic, behavioral)Poorly developed speech and language comprehension skillsDifficulty with transitionsDeficits in nonverbal and/or verbal communicationIncreased or decreased sensitivities to taste, sight, sound, smell and/or touchPerseverative (repetitive or ritualistic) behaviors (i.e., opening and closing doors repeatedly or switching a light on and off)(Brain Balance Achievement Centers, 2014)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 studentPlay therapy and social skills trainingImportant for family to advocate for these children because they are often overlooked.Autism Spectrum Disorders (ASD)First introduced in 1943 by Dr. Leo KennerAutism begins to manifest itself within the first few months of a child’s lifeCharacterized 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. “Autism spectrum disorder (ASD) diagnosis is often a two-stage process. The first stage involves general developmental screening during well-child 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 2Signs and symptoms vary from child to child.Make little to no eye contactDo not look or listen to people like others Fail to respond when spoken toDo not respond to their own nameDelayed communication developmentEcholalia- repeating words or phrases that they hearHave unusual tone when speaking, if they are verbalTrouble understanding, relating, and reacting to other people’s feelingsMissed social cuesIndividualized plans work bestMany nonverbal children respond well to sign languageBest for children to have routinesEarly intervention is keyUsing focused and challenging learning activitiesFamilies should get as much training as possibleMeasuring and recording progress and or lack of progressSocial skills trainingPlay therapyThere a few medications that may help with certain symptoms, but no real medication has been approved for Autism as a wholeUnder 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.). CuttingThe most common type of self-harm, deliberately cutting yourself to cope with pain. (Mayo Clinic, 2014, as in, Stambaugh, 2014)? “Cutting isn’t a suicide attempt, though it may look and seem that way. (Jed Foundation, 2014, as in, Stambaugh, 2014)”Scars from cutsFresh cuts or scratchesKeeping sharp objects on handWearing long sleeves in hot weather(Mayo Clinic, 2014, as in, Stambaugh, 2014)Individual psychotherapyHospitalizationSelf Injury/Self HarmSelf-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, as in Stambaugh, 2014)Scars, such as from burns or cutsFresh cuts, scratches, bruises or other woundsBroken bonesKeeping sharp objects on handWearing long sleeves or long pants, even in hot weatherClaiming to have frequent accidents or mishapsSpending a great deal of time alonePervasive difficulties in interpersonal relationshipsPersistent questions about personal identity, such as "Who am I?" "What am I doing here?"Behavioral and emotional instability, impulsivity and unpredictabilityStatements of helplessness, hopelessness or worthlessness (Mayo Clinic, 2014, as in Stambaugh, 2014)Individual psychotherapyMedications for depressionHospitalizationSubstance Abuse DisorderAccording to the DSM5, “Each specific sub- stance (other than caffeine, which cannot be diagnosed as a substance use disorder) is addressed as a separate use disorder (e.g., alcohol use disorder, stimulant use disorder, etc.), but nearly all substances are diagnosed based on the same overarching criteria (American Psychiatric Publishing, 2014, as in, Stambaugh, 2014).Behavioral changesPhysical ChangesSocial Changes(USDHHS, 2014, as in Stambaugh, 2014)Individual psychotherapyHospitalization or rehab institutionSeasonal Affective DisorderSAD- it’s a specific type of depression that’s related to the change in seasonsSpring and Summer SAD- depression, weight loss, insomnia, poor appetite, anxietySymptoms begin in the fall and usually end when spring begins and the weather warms up 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” (, as in, Brummer, 2014)Additional symptoms include: feeling hopeless, problems sleeping, agitated thoughts of suicide, low energy, hypersensitivity, appetite changesSAD is often treated with light therapy, medication, and psychotherapy. -Light Therapy- aka phototherapy. 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 situationsPanic DisorderPanic disorder comes along with the unpleasant and sudden episodes of panic attacks. The Mayo clinic defines panic attacks as, “sudden episode of intense fear that triggers severe physical reactions when there is not real danger or apparent cause. It’s the recurring, unexpected panic attacks and spent long periods in constant fear of another attack that lead to the condition of a panic disorder” (, as in, Brummer, 2014)Panic attacks begin suddenly, without warning. Attacks include the following symptoms:-Sense of doom or dangerRapid heart rate- Sweating- Trembling- Chills- Chest pain- Faintness- HyperventilationOne of the worst parts of panic attacks is the intense fear that you will have another one. Therefore avoiding situations where they may occur. Some people even develop agoraphobiaPanic attacks require medical attentionThey are very difficult to manage on your own.Panic attacks resemble a heart attackPsychotherapy and medication are the main treatment optionsCognitive behavioral therapy helps clients understand the attacks and disorder, along with maintaining the symptoms and attacksMedications reduced the symptoms and any depression that may be associated with the disorder. SSRIs, SNRIs, and BenzodiazepinesIt can take up to several weeks before to notice any improvements. Tourette’s SyndromeAccording 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” (Brummer, 2014).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. 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 Anxiety DisordersAnxiety disorders are characterized by either manifest anxiety or by self-defeating behavior patterns aimed at warding off anxiety (Brummer, 2014)“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, as in, Brummer, 2014).Common symptoms include: Feelings of panic, fear, and uneasinessProblems sleepingCold or sweaty hands and/or feetShortness of breathHeart palpitationsAn inability to be still and calmDry mouthNumbness or tingling in the hands or feetNauseaMuscle tensionDizziness (Retrieved from , as in Brummer, 2014). 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 antianxietyPsychotherapyCognitive behavioral therapyDietary and lifestyle changes relaxation therapy(Brummer, 2014) Dual Diagnosis and Integrated Treatment of Mental Illness and Substance Abuse Disorder“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, as in, McKenzie, 2014).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, as in, McKenzie, 2014).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, as in, McKenzie, 2014).A dual diagnosis may present in a variety of combinations of mental illnesses/disorders and addictions (The National Alliance on Mental Health, 2013b, as in McKenzie, 2014).“Abandoning friends or family in favor of new activities or a new crowdStruggling to keep up with school or workLying or stealing in order to continue an addictive behaviorStaying up late at night and sleeping during the dayTrying to quit using drugs, drinking, gambling or having unsafe sex, but relapsing repeatedlyExpressing feelings of guilt or regret about a compulsive behaviorSeeking out larger doses of drugs, more alcoholic beverages or more extreme high-risk behavior in order to get the same highExperiencing withdrawal symptoms after trying to quit a harmful substance or cutting down the dose” (Foundations Recovery Network, 2014, para 12, as in, McKenzie, 2014).“Deliberately withdraws from others, refusing offers of friendship or supportBelieves 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 rowFeels compelled to follow complicated rituals and maintain high standards of order in order to relieve internal anxietyHas trouble holding a job, keeping an apartment or maintaining friendships because of behavioral issues or mood swingsHas dramatic changes in mood and energy levelsUses drugs, alcohol or compulsive behaviors to manage moods or cope with stress” (Foundations Recovery Network, 2014, para 13, as in, McKenzie, 2014).For treatment to be effective, both the mental illness/disorder and the addiction must be considered (Foundations Recovery Network, 2014, as in, McKenzie, 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, as in, McKenzie, 2014).Psychiatric treatment will be more successful if the patient stops their drug and/or alcohol abuse (The National Alliance on Mental Illness, 2013a, as in, McKenzie, 2014).?Treatment for drug and/or alcohol abuse can include in-patient detox, self-help groups, cognitive-behavioral therapy, and even medication (The National Alliance on Mental Illness, 2013a, as in McKenzie, 2014).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, as in McKenzie, 2014)Bipolar Affective Disorder“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, as in, McKenzie, 2014).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, as in, McKenzie, 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, as in, McKenzie, 2014).Signs and Symptoms of a Manic Episode/Mania:?????????????????????????“A long period of feeling "high," or an overly happy or outgoing moodExtreme irritabilityTalking very fast, jumping from one idea to another, having racing thoughtsBeing easily distractedIncreasing activities, such as taking on new projectsBeing overly restlessSleeping little or not being tiredHaving an unrealistic belief in one's abilitiesBehaving impulsively and engaging in pleasurable, high-risk behaviors” (National Institute of Mental Health, n.d.a, para 13, as in, McKenzie, 2014).Signs and Symptoms of a Depressive Episode/Depression:???????????“An overly long period of feeling sad or hopelessLoss of interest in activities once enjoyed, including sex.Feeling tired or "slowed down"Having problems concentrating, remembering, and making decisionsBeing restless or irritableChanging eating, sleeping, or other habitsThinking of death or suicide, or attempting suicide” (National Institute of Mental Health, n.d.a, para 13, as in, McKenzie, 2014).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 pliance 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, as in, McKenzie, 2014). Borderline Personality Disorder“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, as in, McKenzie, 2014).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, as in, McKenzie, 2014).“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, as in, McKenzie, 2014).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 perceivedA 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 eatingRecurring suicidal behaviors or threats or self-harming behavior, such as cuttingIntense and highly changeable moods, with each episode lasting from a few hours to a few daysChronic feelings of emptiness and/or boredomInappropriate, intense anger or problems controlling angerHaving 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, as in, McKenzie, 2014)Unlike some illnesses/disorders where medication is the first treatment explored, talk therapy is usually the first treatment used for BPD (National Education?Alliance for Borderline Personality Disorder, 2014, as in, McKenzie, 2014).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 his or her 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, as in, McKenzie, 2014). Post-traumatic Stress Disorder (PTSD)Triggered by experiencing or witnessing a traumatic or terrifying event Can begin immediately after the event or years later, through flashbacksIntrusive MemoriesRecurring memories of the eventReliving the event through flashbacksNightmaresAvoidanceAvoiding thinking or remembering the eventAvoiding people, places, and things that are a reminder of the eventNegative Changes in Thinking/MoodNegative feelings about self or Or othersInability to have positive feelingsFeeling emotionally numbHopelessnessMemory problems, blocking out memoriesChanges in Emotional ReactionsIrritability, anger, aggressive behaviorsGuilt or shameSelf-destructive behaviorTrouble concentratingDifficulty sleepingEasily startled or frightenedSuicidal thoughts(Mayo Clinic Staff, 2014, as in, Curtis, 2015)PsychotherapyCognitive TherapyExposure TherapyMedicationsAntidepressantsAnti-anxiety medicationSleep aidsAttention Deficit Hyperactivity Disorder (ADD/ADHD)Behavior disorder (Kids Health, 2014, as in, Curtis, 2014)Symptoms must be present before age 7 and have a negative impact in more than one area of daily bined ADHDThe most common form of ADHDImpulsivityInattentivenessHyperactivityInattentive ADHDFormerly known as ADDInattentivenessDifficulty concentratingHyperactivity not a main symptomHyperactive-Impulsive ADHDCharacterized by hyperactivityConcentration, focus, and inattentiveness not a main symptom(WebMD, 2014, as in, Curtis, 2014)MedicationsStimulant MedicationsNon-stimulant MedicationsNon-medicinal home treatments and symptom management Major & Minor Depression“Major depression is a mood state that goes well beyond temporarily ? feeling sad or blue” (NAMI, What is Depression? 2014, as in, New, 2014).“It is a serious ? medical illness that affects one’s thoughts, feelings, behavior, mood and ? physical health” (NAMI, What is Depression? 2014, as in, New, 2014).“Depression is a ? life-long condition in which periods of wellness alternate with recurrences ? of illness”?(NAMI, What ?? is Depression? 2014, as in, New, 2014).Minor depression can include feelings?of sadness, loss of interest in activities, changes in weight and sleeping habits,?feelings of worthlessness (, 2014, as in, New, 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, as in, New, 2014). ? ?“There ? are three well-established types of treatment: medications, psychotherapy and electroconvulsive therapy ? (ECT)"?(NAMI, What is Depression? 2014, as in, New, 2014)."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, as in, 2014).Treatments that can ? work well with Major and Minor Depression include Cognitive Behavioral Therapy; Interpersonal Therapy, Psychodynamic Therapy, Psych education and Self-help and ? support groups (NAMI, What is Depression? 2014, as in, New, 2104). Dissociative Disorders“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, as in, New, 2104). ?“Thought to stem from trauma experienced by ? the individual” (NAMI, 2014, as in New, 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, as in, New, 2014).“Treatment for ? individuals with such a disorder may stress psychotherapy, although a?combination of psychopharmacological and psychosocial treatments is often ? used” (NAMI, 2014, as in, New, 2014).Multiple Personality Disorder“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, as in, New, 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” (, 2014, as in, New, 2014).“Often people living with DID are depressed or even ? suicidal and self-mutilation is common in this group" (NAMI, Mental Illnesses Dissociative Identity Disorder, 2014, as in, New, 2014). "Approximately one-third ? of individuals affected complain of auditory or visual hallucinations” (NAMI, Mental Illnesses Dissociative Identity Disorder, 2014, as in, New, 2014).“Treatment for ? DID consist primarily of psychotherapy with hypnosis” (NAMI, Mental Illnesses Dissociative Identity Disorder, 2014, as in, New, 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, as in, New, 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, as in, New, 2014)Anorexia“Treatment for ? DID consist 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, as in, Degraffenried, 2014)?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 (, as in, Degraffenried, 2014)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. Family-based 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. (, as in, Degraffenried, 2014) Bulimia“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.” (, as in, Degraffenried, 2014)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. (, as in, Degraffenried, 2014)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 , as in, Degraffenried, 2014) Schizoaffective Disorder“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. , as in, Degraffenried, 2014)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). (, as in, Degraffenried, 2014)“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”(, as in, Degraffenried, 2014))Medications used for depression symptoms:Antidepressant medicationsLithiumAntipsychotic medicationsMedications used for bipolar symptoms:Mood-stabilizers such as lithium or anti-convulsants, valproic acid (Depakote), lamotrigine (Lamictal), and carbamazepine (Tegretol) (, as in, Degraffenried, 2014) Schizophrenia“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.” (, as in, Degraffenried, 2014)“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.” (, as in, Degraffenried, 2014)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.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 (, as in, Degraffenried, 2014)“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.” (, as in, Degraffenried, 2014)“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.” (, as in, Degraffenried, 2014)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)?PerphenazinePsychosocial 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.” (, as in, Degraffenried, 2014) Obsessive- Compulsive DisorderHave 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 tidyDo 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.” (nimh., as in, Degraffenried, 2014)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.” (nimh., as in, Degraffenried, 2014)ReferencesBrummer, A. (2014). Week13dq1664. Unpublished raw data. Department of Education. Salem College, Winston-Salem, NC. Retrieved from , S. (2014). Week13DQ1. Unpublished raw data. Department of Education. Salem College, Winston-Salem, NC. Retrieved from , K. (2014). Mental health disorders. Unpublished raw data. Department of Education. Salem College, Winston-Salem, NC. Retrieved from , E. A. (2014). EDUC 664 wk. 13 dq. Unpublished raw data, Department of Education, Salem College, Winston-Salem, NC.McKenzie, S. (2014). Week 13 Discussion 1. Unpublished raw data. Department of Education. Salem College, Winston-Salem, NC Retrieved from , J. (2014). Week 13 DQ 1. Unpublished raw data. Department of Education. Salem College, Winston-Salem, NC. Retrieved from Stambaugh, A. (2014). Wk13dq1. Unpublished raw data. Department of Education. Salem College, Winston-Salem, NC. Retrieved from ................
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