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INTRODUCTION
Being a teenager is not easy. Adolescents
feel all kinds of pressures—to
do well in school, to be popular with
peers, to gain the approval of parents,
to make the team, to be cool. In addition,
many teenagers have other special
problems. For example, they may worry
about a parent being out of work or
the family’s financial problems.
Adolescents may be hurt or confused
by their parents divorce or they may
have to learn how to live with a parent’s
alcoholism or mental illness. Despite
these pressures, it is important to
remember that most teenagers develop
into healthy adults.
Unfortunately, some teenagers develop
serious emotional problems requiring
professional help. This glossary of
brief definitions was developed to
help teenagers, parents, teachers
and others learn more about the major
mental illnesses, symptoms and mental
health issues which affect teenagers.
If you or someone you know has a problem
in one of these areas, you can get
help by contacting UPLIFT or one of
the organizations listed at the end
of this brochure. Please remember:
All the problems described in this
glossary are treatable and some can
be prevented. In every case, the sooner
the teenager gets help, the better.
Click on a term to see the definition
or get more information:
ALCHOLHOL
& DRUG ABUSE
ANOREXIA NERVOSA
ANXIETY
ATTENTION DEFICIT/HYPERACTIVE DISORDER
(ADHD)
BIPOLAR DISORDER
BULIMIA NERVOSA (BULIMIA)
CONDUCT DISORDER
LEARNING DISORDERS
OBSESSIVE COMPULSIVE DISORDER (OCD)
PHYSICAL
ABUSE
POST-TRAUMATIC STRESS DISORDER (PSTD)
PSYCHOSIS
SCHIZOPHRENIA
SEXUAL ABUSE
SUICIDE
TOURETTE'S SYNDROME
FOR MORE INFORMATION
ALCHOLHOL
& DRUG ABUSE
Use and abuse of drugs and alcohol
by teens is very common and can have
serious consequences. In the 15-24
year age range, 50% of deaths (from
accidents, homicides, suicides) involve
alcohol or drug abuse. Drugs and alcohol
also contribute to physical and sexual
aggression such as assault or rape.
Possible stages of teenage experience
with alcohol and drugs include abstinence
(non-use), experimentation, regular
use (both recreational and compensatory
for other problems), abuse and dependency.
Repeated and regular recreational
use can lead to other problems like
anxiety and depression. Some teenagers
regularly use drugs or alcohol to
compensate for anxiety, depression
or a lack of positive social skills.
Teen use of tobacco and alcohol should
not be minimized because they can
be “gateway drugs” for other
drugs (marijuana, cocaine, hallucinogens,
inhalants and heroin). The combination
of teenagers’ curiosity, risk
taking behavior and social pressure
make it very difficult to say no.
This leads most teenagers to the question:
“Will it hurt to try one?”
A
teenager with a family history of
alcohol or drug abuse and lack of
pro-social skills can move rapidly
from experimentation to patterns of
serious abuse or dependency. Some
other teenagers with no family history
of abuse who experiment may also progress
to abuse or dependency. Therefore,
there is a good chance that “one”
will hurt you. Teenagers with a family
history of alcohol or drug abuse are
particularly advised to abstain and
not experiment, No one can predict
for sure who will abuse or become
dependent on drugs except to say the
non-user never will. Warning signs
of teenage drug or alcohol may include:
(1) a drop in school performance,
(2) a change in groups of friends,
(3) delinquent behavior, and (4) deterioration
in family relationships.
There
may also be physical signs such as
red eyes, a persistent cough and change
in eating and sleeping habits. Alcohol
or drug dependency may include blackouts,
withdrawal symptoms and further problems
in functioning at home, school or
work.
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ANOREXIA
NERVOSA
Anorexia Nervosa occurs when an adolescent
refuses to maintain body weight at
or above the minimal normal weight
for age and height. The weight loss
is usually self imposed and is usually
less than 85% of expected weight.
The condition occurs most frequently
in females, however, it can occur
in males. Generally, the teenager
has an intense fear of gaining weight
or becoming fat even though underweight.
Self evaluation of body weight and
shape may be distorted and there may
be denial of the potential health
hazard caused by the low body weight.
Physical
symptoms which can occur with Anorexia
Nervosa include: (1) absence of regular
menstrual cycles, (2) dry skin, (3)
low pulse rate, and (4) low blood
pressure.
Behavioral changes such as: (1) social
withdrawal, (2) irritability, (3)
moodiness, and (4) depression commonly
occur.
Without
treatment, this disorder can become
chronic and with severe starvation,
some teenagers may die.
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ANXIETY
Anxiety is the fearful anticipation
of further danger or problems accompanied
by an intense unpleasant feeling (dysphoria)
or physical symptoms. Anxiety is not
uncommon in children and adolescents.
Anxiety in children may present as:*
Separation Anxiety Disorder: Excessive
anxiety concerning separation from
home or from those to whom the child
is attached. The youngster may develop
excessive worrying to the point of
being reluctant or refusing to go
to school, being alone or sleeping
alone. Repeated nightmares and complaints
of physical symptoms (such as headaches,
stomach aches, nausea or vomiting)
may occur.
- Generalized
Anxiety Disorder: Excessive anxiety
and worry about events or activities
such as school. The child or adolescent
has difficulty controlling worries.
There may also be restlessness,
fatigue, difficulty concentrating,
irritability, muscle tension and
sleep difficulties.
- Panic
Disorder: The presence of recurrent,
unexpected panic attacks and persistent
worries about having attacks. Panic
Attack refers to the sudden onset
of intense apprehension, fearfulness
or terror, often associated with
feelings of impending doom. There
may also be shortness of breath,
palpitations, chest pain or discomfort,
choking or smothering sensations
and fear of “going crazy”
or losing control.
- Phobias:
Persistent, irrational fears of
a specific object, activity or situation
(such as flying, heights, animals,
receiving an injection, seeing blood).
These intense fears cause the child
or adolescent to avoid the object,
activity or situation.
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ATTENTION
DEFICIT/HYPERACTIVE DISORDER (ADHD)
ADHD is usually first diagnosed during
the elementary school years. In some
cases, symptoms continue into adolescence.
A teenager with Attention Deficit/Hyperactivity
Disorder has problems with paying
attention and concentration and/or
with hyperactive and impulsive behavior.
Despite good intentions, a teenager
may be unable to listen well, organize
work and follow directions. Cooperating
in sports and games may be difficult.
Acting before thinking can cause problems
with parents, teachers and friends.
These teens may be restless, fidgety
and unable to sit still.
Attention
Deficit/Hyperactive Disorder occurs
more commonly in boys and symptoms
are always present before the age
of seven. Problems related to ADHD
appear in multiple areas of a youngster’s
life and can be very upsetting to
the teen, his/her family and people
at school. Symptoms of ADHD frequently
become less severe during the late
teen years and in young adulthood.
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BIPOLAR
DISORDER
Bipolar Disorder is a type of disorder
with marked changes in mood between
extreme elation or happiness and severe
depression. The periods of elation
are termed mania. During this phase,
the teenager has an expansive or irritable
mood, can become hyperactive and agitated,
can get by with very little or no
sleep, becomes excessively involved
in multiple projects and activities
and has impaired judgment. A teenager
may indulge in risk taking behaviors,
such as sexual promiscuity and anti-social
behaviors. Some teenagers in a manic
phase may develop psychotic symptoms
(grandiose delusions and hallucinations).
For a description of the depressive
phase, see Depression. Bipolar generally
occurs before the age of 30 years
and may first develop during adolescence.
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BULIMIA
NERVOSA (BULIMIA)
Bulimia Nervosa occurs when an adolescent
has repeated episodes of binge eating
and purging. Binges are characterized
by eating large quantities of food
in a discrete period of time. The
teen also has feelings of being unable
to stop eating and loss of control
over the amount of food being eaten.
Usually, after binge eating, they
attempt to prevent weight gain by
self-induced vomiting, laxative use,
diuretics, enemas, medications, fasting
or excessive exercise. These teen’s
self-esteem is strongly affected by
weight and body shape. Serious medical
problems can occur with Bulimia Nervosa
(e.g. esophageal or gastric rupture,
cardiac arrhythmias, kidney failure
and seizures). Other psychological
problems such as depression, intense
moods and low self esteem are common.
Early diagnosis and treatment can
improve outcome and decrease the risk
of worsening depression, shame and
harmful weight fluctuations.
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CONDUCT
DISORDER
Teenager’s with Conduct Disorder
have a repetitive and persistent pattern
of behavior in which they violate
the rights of others or violate norms
or rules that are appropriate to their
age. Their conduct is more serious
than the ordinary mischief and pranks
of children and adolescents. Difficulty
at home, in school and in the community
is common and frequently there is
very early sexual activity. Self-esteem
is usually low, although the adolescent
may project an image of “toughness.”
Teenagers with this disorder have
also been described as “delinquent”
or “anti-social.” some teenagers
with Conduct Disorder may also have
symptoms of other psychiatric disorders
(see ADHD, Depression, Alcohol &
Drug Abuse).
DEPRESSION
Though the term ”depression”
can describe a normal human emotion,
it can also can refer to a psychiatric
disorder. Depressive illness in children
and adolescents includes a cluster
of symptoms which have been present
for at least two weeks. In addition
to feelings of sadness and/or irritability,
a depressive illness includes several
of the following:
- Change
of appetite with either significant
weight loss (when not dieting) or
weight gain
- Change
in sleeping patterns (such as trouble
falling asleep, waking up in the
middle of the night, early morning
awakening or sleeping too much)
- Loss
of interest in activities formerly
enjoyed
- Loss
of energy, fatigue, feeling slowed
down for no reason, “burned
out”
- Feelings
of guilt and self blame for things
that are not one’s fault
- Inability
to concentrate and indecisiveness
- Feelings
of hopelessness and helplessness
- Recurring
thoughts of death and suicide, wishing
to die or attempting suicide
Children
and adolescents with depression may
also have symptoms of irritability,
grumpiness and boredom. They may have
vague, non-specific physical complaints
(stomach aches, headaches, etc.).
There is an increased incidence of
depressive illness of the children
of parents with significant depression.
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LEARNING
DISORDERS
Learning disorders occur when the
child or adolescent’s reading,
math or writing skills are substantially
below that expected for age, schooling
and level of intelligence. Approximately
5% of students in public schools in
the United States are identified as
having a learning disorder. Students
with learning disorders may become
so frustrated with their performance
in school that by adolescence they
may feel like failures and want to
drop out of school or may develop
behavior problems. Special testing
is always required to make the diagnosis
of a learning disorder and to develop
appropriate remedial interventions.
Learning disorders should be identified
as early as possible during school
years.
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OBSESSIVE
COMPULSIVE DISORDER (OCD)
Teenagers with OCD have obsessions
and/or compulsions. An obsession refers
to recurrent and persistent thoughts,
impulses or images that are intrusive
and cause severe anxiety or distress.
Compulsions refer to repetitive behaviors
and rituals (like hand washing, hoarding,
ordering, checking) or mental acts
(like counting, repeating words silently,
avoiding). The obsessions and compulsions
also significantly interfere with
the teen’s normal routine, academic
functioning, usual social activities
or relationships.
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PHYSICAL
ABUSE
Physical abuse occurs when a person
responsible for a child or adolescent’s
welfare causes physical injury or
harm to the child. Examples of abusive
treatment of children include: hitting
with an object, kicking, burning,
scalding, punching and threatening
or attacking with weapons. Children
and adolescents who have been abused
may suffer from depression, anxiety,
low self-esteem, inability to build
trusting relationships, alcohol and
drug abuse, learning impairments and
Conduct Disorder.
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POST-TRAUMATIC
STRESS DISORDER (PSTD)
PTSD can occur when a teenager experiences
a shocking, unexpected event that
is outside the range of usual human
experience. The trauma is usually
so extreme that it can overwhelm their
coping mechanisms and create intense
feelings of fear and helplessness.
The traumatic event may be experiences
by the individual directly (e.g. physical
or sexual abuse, assault, rape, kidnapping,
threatened death), by observation
(witness of trauma to another person),
or by learning about a trauma affecting
a close friend or relative. Whether
teens develop PTSD depends on a combination
of their previous history, the severity
of the traumatic event and the amount
of exposure.
Symptoms include:
- Recurrent,
intrusive and distressing memories
of the event
- Recurrent,
distressing dreams of the event
- Acting
or feeling as if the traumatic event
were recurring
- Intense
psychological distress when exposed
to reminders of the traumatic event
and consequent avoidance of those
stimuli
- Numbing
of general responsiveness (detachment,
estrangement from others, decreased
interest in significant activities)
- Persistent
symptoms of increased arousal (irritability,
sleep disturbances, poor concentration,
hyper-vigilance, anxiety).
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PSYCHOSIS
Psychotic
disorders include severe mental disorders
which are characterized by extreme
impairment of a person’s ability
to think clearly, respond emotionally,
communicate effectively, understand
reality and behave appropriately.
Psychotic symptoms can be seen in
teenagers with a number of serious
mental illnesses, such as depression,
Bipolar Disorder (manic depression),
Schizophrenia and with some forms
of drug and alcohol abuse. Psychotic
symptoms include delusions and hallucinations.
Delusion: A false, fixed, odd or unusual
belief firmly held by the patient.
The belief is not ordinarily accepted
by other members of the person’s
culture or subculture. There are delusions
of paranoia (others are plotting against
them), grandiose delusions (exaggerated
ideas of one’s importance or
identity) and somatic delusions (a
healthy person believing that he/she
has terminal illness).
Hallucination: A sensory perception
(seeing, hearing feeling and smelling)
in the absence of outside stimulus.
For example, with auditory hallucinations,
the person hears voices when there
is no one talking.
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SCHIZOPHRENIA
A psychotic disorder characterized
by severe problems with a person’s
thoughts, feelings, behavior and use
of words or language. Psychotic symptoms
often include delusions and/or hallucinations.
These delusions in schizophrenia are
often paranoid and persecutory in
nature. Hallucinations are usually
auditory and may include hearing voices
speaking in the third person, as well
as to each other, commenting on the
patients’ deeds and actions.
Schizophrenia does not mean “split
personality”. Most people develop
Schizophrenia before 30 years of age
with some having their first episode
in the teenage years.
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SEXUAL
ABUSE
Teenage sexual abuse occurs when an
adolescent is used for gratification
of an adult’s sexual needs or
desires. Severity of sexual abuse
can range from fondling to forcible
rape. The most common forms of sexual
abuse encountered by girls include:
exhibitionism, fondling, genital contact,
masturbation and vaginal, oral or
anal intercourse. Boys may be sexually
abused through fondling, mutual masturbation,
fellatio or anal intercourse. Adolescents
who have been sexually abused may
also suffer from depression, anxiety,
PTSD, feelings of worthlessness and
helplessness, learning impairments
and destructive behaviors.
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SUICIDE
Suicide is the third leading cause
of death (behind accidents and homicide)
for teenagers. Each year more than
5,000 U.S. teenagers commit suicide.
The warning signs and risk factors
associated with teen suicide include:
depression, previous suicide attempts,
recent losses, frequent thought about
death and the use of drugs or alcohol.
A teenager planning to commit suicide
may also give verbal hints such as
“nothing matters,” or “I
won’t be a problem for you any
more.” They may also give away
favorite possessions or become suddenly
cheerful after a long period of sadness.
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TOURETTE'S
SYNDROME
Tourette’s Syndrome is characterized
by multiple motor tics and at least
one vocal tic. A tic is a sudden,
rapid movement of some of the muscles
in the body that occurs over and over
and doesn’t serve any purpose.
The location, frequency and complexity
of tics changes over time. Motor tics
frequently involve the head, central
body, legs and arms. They may result
in simple movements such as eye blinking
or more complex movements such as
touching and squatting. Vocal tics
can include sounds such as grunts,
barks, sniffs, snorts, coughs and
obscenities.
Tourette’s
Syndrome is always diagnosed before
the age of 18—most commonly appearing
around seven years of age. It occurs
more often in males than females and
symptoms are usually present for life.
The severity of Tourette’s varies
a great deal over time, but improvements
can occur during late adolescents
and in adulthood. Teens with Tourette’s
Syndrome often have additional problems
with obsessions, compulsions, hyperactivity,
distractibility and impulsiveness.
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FOR
MORE INFORMATION
American Academy of Child & Adolescent
Psychiatry
3615 Wisconsin Avenue NW, Washington,
D.C. 20016
1-800-333-7636
National
Association of Anorexia Nervosa &
Associated Disorders
P.O. Box 7, Highland Park, IL 60035
(847) 831-3438
Anxiety
Disorders Association of America
11900 Parklawn Drive, Rockville MD
20852
(301) 231-9350
ERIC
Clearinghouse on Disabilities &
Gifted Education
1920 Association Drive, Reston, VA
20191
1-800-328-0272
National
Alliance for the Mentally Ill
200 N. Glebe Road, Suite 1015, Arlington,
VA 22203
1-800-950-6264
National
Institute of Mental Health
5600 Fishers Lane, Rockville, MD 20857
(301) 443-4513
UPLIFT
P. O. Box 664, Cheyenne, WY 82003
(888) UPLIFT 3 (875-4383)
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