Archives for August 2016

Anxiety often gets a bad rap. Feelings of anxiety allow us to recognize difficult situations and gear up our bodies and minds to tackle them. Olympic athletes experience anxiety before competing. Teenagers experience anxiety before taking a college entrance exam. Toddlers experience anxiety when their bedrooms go dark. Anxiety, at its root, is a natural, evolutionary response to a perceived danger.

But sometimes feelings of anxiety arise even when they are disassociated from an immediate trigger. Distressing fears may become persistent, severe, and interfere with the ability to function in everyday life, for both children and adults.

Adult Anxiety
Anxiety disorders can be broken down into a number of different types depending on the symptoms or triggers, including:

• Generalized Anxiety Disorder
• Panic Disorder
• Social Anxiety Disorder
• Phobias
• Obsessive-Compulsive Disorder
• Post-Traumatic Stress Disorder

Symptoms of these anxiety disorders can manifest in adults and older children in many similar ways, with teens being particularly susceptible to social anxiety disorder. But additional anxiety disorders are particular to younger children, such as:

• Separation Anxiety Disorder
• Selective Autism

Adults suffering from any of these anxiety disorders often know that their reactions, symptoms, and feelings are extreme. But children, because they lack the experience or cognitive ability, are often unaware that their behavior is out-of-the-ordinary.

Child Anxiety
Although the National Institutes of Health recognizes that the “core risk phase” for the development of many adult anxiety disorders are the childhood and adolescent years, diagnosing childhood anxiety orders can be tricky for several reasons.

First, depending on the age, young children may not have yet developed the cognitive or communicative ability to articulate the precise nature and depth of their fears or feelings.

Second, a natural part of a child’s development includes distinct periods of anxious behavior. A jittery, wailing toddler truly believes that her mother has disappeared when she shuts herself behind the bathroom door. A three-year-old may scream in panic and cower in a closet whenever he hears thunder. Mental health professionals are trained to separate normal developmental anxiety behavior from the potential of a more pernicious anxiety disorder.

Recognizing and diagnosing anxiety disorders in children is crucial, for studies have shown that early intervention and parental response training can make all the difference for a child’s future. If your child exhibits anxious behavior that seems particularly intense, or that you fear may lay outside the age frame of normal development, don’t hesitate to speak to your pediatrician or contact a pediatric mental health professional.

Few events are more distressing to a parent than when their child receives a diagnosis of a chronic, challenging mental condition like autism. Yet approximately one in seventy American children were diagnosed last year, according to the Center of Disease Control. Although the rates have been increasing over the past three decades, a portion of that increase is due to broadened diagnostic criteria.

Autism is not one single, fixed condition, but a term used to encompass a group of complex developmental disorders that vary in symptoms and severity. Two of the major types are autistic disorder and Asperger’s syndrome.

Autistic Disorder
A child diagnosed with autistic disorder is a child who shows symptoms involving language, communication, and social difficulties, as well as unusual and sometimes obsessive behaviors. For example, a child may speak infrequently or struggle to be understood. He may avoid making eye contact and fail to pick up on social cues. He also may display unusual behaviors like spinning wheels, flapping their hands, or rocking endlessly. They can be hypersensitive to outside stimuli and may overreact in response. There can also be some academic challenges due to intellectual disabilities.

Autistic disorder is often called “classic autism,” because it encompasses the behaviors most people associate with the word autism.

Asperger’s Syndrome
Asperger’s syndrome wasn’t an official diagnosis until the early 1990s, when it was first added to the World Health Organization’s diagnosis manual and a couple years later to the American Psychiatric Associations’ manual of mental disorders. Until then, many psychiatrists used the term “high functioning autistic” to describe children who met the later criteria of Asperger’s syndrome.

Like children with an autistic disorder, children with Asperger’s syndrome will also experience difficulty expressing their feelings as well as in interpreting other people’s expressions, body language, and subtle verbal clues. They may struggle to maintain eye contact and speak in rigid or unemotional cadences. They are often rigidly scheduled, highly sensitive to change, and have intense, specific, brilliantly developed interests.

The major difference between these two types of autism is in the intellectual capacity. Children with Asperger’s syndrome generally have normal to extremely high IQs. The character Dr. Sheldon Cooper on The Big Bang Theory, played by actor Jim Parsons, portrays a TV-exaggerated example of the syndrome.

There is a third major type of autism spectrum disorder with the unwieldy name “pervasive developmental disorder not otherwise specified,” or PDD-NOS. This tends to be given to children who express some, but not all, autistic disorder symptoms, or express them more mildly. Knowing where your child falls on the autism spectrum is the first step in diagnosis and treatment. If you have any concerns, your pediatrician can guide you to a mental health professional for assessment.

Mental illness diagnosis, treatment, and classification have evolved considerably since the time of the ancient Greeks, when any kind of unusual mood or behavioral condition was thought to be due to an imbalance in the blood’s humors. Prior to 1980, when the term bipolar disorder became official, most professionals described the symptoms attributed to bipolar disorder using the more vivid but less specific term: Manic depression.

The latest fictional poster child for bipolar disorder is the brilliant but emotionally unstable character Carrie Mathison on the Showtime series Homeland played by the Emmy-winning actress Claire Danes. Her behavior highlights the two major poles that characterize the condition. One extreme includes extended, high-energy, frantic, sleepless, and sometimes hallucinogenic manic episodes while the other extreme involves extended, extremely low-energy, depressive and sometimes suicidal episodes.

Since about 4% of the American population has been diagnosed with bipolar disorder, it’s possible that the last house party you attended included at least one officially-diagnosed guest. As in any complex mental disorder, there are variations in level and frequency of manifestation.

Bipolar disorder is broken down into these five sub-types, depending on symptoms and severity:

• Bipolar I, where suffers experience extreme manic and sometimes mixed manic-depressive episodes.
• Bipolar II, where suffers have deep depressive episodes and manic ones of a lesser extreme.
• Cyclothymia, where suffers experience swings over years but of a milder extreme.
• Rapid Cycling, where suffers experience multiple cycles within a year’s time.
• Not Otherwise Specified (NOS), where suffers’ symptoms don’t follow any of the above patterns.

Because of the separate and diverse behaviors, diagnosis can be difficult. Suffers more commonly seek help during depressive episodes, which can easily lead to a misdiagnosis of depression or anxiety. Manic episodes that include hallucinations or psychotic symptoms may be misdiagnosed as schizophrenia, personality, or delusional disorders. If you suspect you or a loved one may be suffering from bipolar disorder or any other mental health disability, don’t hesitate to call a mental health professional to get tested. The sooner you get help, the sooner you can live better.