Month: August 2020

Categories
PTSD Trauma

Recognizing the Symptoms of PTSD in Teens

Post-traumatic stress disorder (PTSD) is a serious and potentially underreported issue among teens. Sources of trauma are varied and can include both acute and chronic causes such as child abuse, school shootings, gang violence, and automobile accidents. Left undiagnosed or inadequately treated, PTSD can lead to several comorbid mental health conditions, a much higher rate of suicide, and trouble with social interaction.

Among children and teens, about 14-43 percent experience a type of trauma. Roughly 3-15 percent of young girls and 1-6 percent of young boys are diagnosed with PTSD. Among teens identified with PTSD, 47 percent were recorded to struggle with depression as well. Diagnosed teens were more likely than their peers to engage in high-risk behaviors and self-harm, and had trouble adjusting to and interacting with peers without PTSD.

While it’s a condition that affects millions of Americans, PTSD (and trauma in general) can often be misunderstood. It’s important to recognize the early symptoms of PTSD in teens and children, in order to seek help as early as possible.

Defining Trauma

Trauma and traumatic events are two separate concepts. Trauma is a personal emotional response to a severe event, or a chronic accumulation of overwhelming stressors. Not all traumatic events cause trauma in a person, and not all instances of trauma lead to a disorder. Trauma is, despite its terrible nature, a normal response. We go through emotional and physical shock after a sudden loss, assault, or other type of traumatic event.

Similarly, being exposed to upsetting situations repeatedly can also cause trauma, such as with first responders to mass casualty events, social workers, medical professionals, soldiers, and police officers confronted with violent cases. Like a buzzer, some of these examples can eventually cause shock to run through our system. In rare occasions, a traumatic response can leave the buzzer on almost permanently.

Rather than being in a state of shock and denial for a few days to a few weeks, the symptoms and feelings of trauma might persist for months and years. When the personal response to a traumatic event is particularly severe or long-lasting, it becomes a disorder. While the main cause of PTSD is trauma, there are factors that make it more or less likely for teens to develop PTSD. Recurring trauma increases the chances of PTSD, for example, as does a history of anxiety and traumatic stress in the family.

Being left alone or having no system for support or recovery after trauma can also cause it to linger for much longer and develop PTSD. PTSD can cause a change in the brain’s reaction to stress, especially anything reminiscent of the trauma, and one aspect PTSD is that it causes the body’s fight-flight-freeze response to go haywire.

The Three Main Symptoms

When trauma lingers and develops into PTSD, it continues to leave a mark on a person’s life in one or more ways, usually along the lines of three basic symptoms:

    • Re-experiencing: Symptoms people usually think of when they think of PTSD tend to be forms of re-experiencing – flashbacks, bad dreams, sudden images and intrusive thoughts, and unwanted recollection. Sometimes, symptoms of re-experiencing are triggered by outside reminders. At other times, they can occur out of nowhere.
    • Avoidance: Some people develop emotional numbness to anything associated with the trauma. They avoid or grow distant towards people, places, and things. Avoidance in PTSD can be extreme and may even include signs of dissociation or disconnection from oneself or reality.
    • Agitation: These are symptoms of extreme alertness and arousal. Someone who is excessively jumpy, easily angered, and struggles with sleep may be experiencing symptoms of agitation.

Most symptoms of PTSD fall within the three major categories of symptoms and represent intense unresolved fear and unconscious attempts at coping with that fear. Due to PTSD’s effects on the brain and the way we perceive stress, teens diagnosed with PTSD may be more likely to develop comorbid mental health conditions and are more susceptible to things like substance use disorder.

Common Signs and Symptoms of PTSD in Teens

Some of the signs of PTSD in teens include:

    • Panic attacks
    • Recurring nightmares after the fact
    • Restlessness and insomnia
    • High irritability
    • Easily startled
    • Emotionally numb or distant
    • Isolating oneself from friends and family
    • Avoiding places and things
    • Struggling at school or work
    • More open to high-risk behavior
    • More likely to react violently towards others (this is more common among teens than children or adults)
    • Struggling to maintain a relationship
    • Openly discussing suicidal ideas
    • Reacting viscerally to traumatic triggers (heart rate hikes, hyperventilation)

Researchers find PTSD symptoms differ slightly between children, teens, and adults. For example, children are likely to incorporate elements of their trauma into play, because they are reliving their trauma by re-enacting it. Teens tend to display more violent behavior if exposed to violence versus children or adults.

PTSD vs. Acute Stress Disorder

Acute stress disorder (ASD) is a different condition that arises in the first month after a traumatic event. When someone is exhibiting severe symptoms similar to PTSD immediately after a horrific event, they are generally experiencing ASD. These symptoms become PTSD when they last longer than a month.

Another difference is that PTSD symptoms can and do sometimes occur with a delay – a teen can survive a tragic accident or terrible assault and be “fine” for weeks and months, and then begin displaying symptoms of PTSD months after the event occurred. Extremely rare cases have even recorded PTSD onset occurring a year after trauma.

Seeking Help

A diagnosis of PTSD is not made lightly. It is normal to feel shaken up after a traumatic event. But it is equally important not to dismiss what might be a mental disorder. PTSD can leave its mark on the brain and turn every day into a nightmare. Seeking help as early as possible can help reduce the impact PTSD has on a teen’s life. Consider seeking a diagnosis from a psychiatrist or take a screening test and bring the results to a mental health professional.

Categories
Obsessive-Compulsive Disorder (OCD)

A Parent’s Guide to Understanding OCD in Teens

Obsessive-compulsive disorder can be an incredibly difficult condition to manage. Even mild cases can present a teen with extraordinary challenges in everyday settings, and adolescence is a particularly difficult time for individuals with OCD due to increased rates of victimization, and the effects of prolonged bullying on the symptoms of OCD themselves. Understanding OCD in teens is incredibly important for parents to know – how it affects their teen’s thinking and behavior, and how they can best help their teen cope with the disorder.

Understanding OCD (Obsessive-Compulsive Disorder)

At its heart, OCD is a mental health condition closely related to anxiety. When a person is diagnosed with OCD, it means that they present with symptoms of two major behavioral and cognitive signs: obsessions and compulsions. Obsessions are deep-seated and intrusive worries that present themselves are unavoidable and persistent in a teen’s mind, much like the little intrusive thoughts we generally experience, but far stronger.

Picture walking past your dog with a pot of boiling hot soup, and for an instant, experiencing the fleeting thought of what might happen if you dropped the pot. Such violent and disturbing thoughts are not harmful in isolation, and if you can ignore and move past them immediately, then they are no cause for concern. But a person with OCD experiences similar thoughts much more consistently, and far more strongly. These thoughts are much harder to shut out or move past, which is why compulsions develop.

Compulsions are behaviors that help someone with obsessive thoughts cope. They may seem completely unrelated or totally nonsensical on the outside, but they provide some measure of momentary or short-term relief before the obsessions start up again. In this way, a teen with OCD is usually stuck within a perpetual cycle of obsessions and compulsions, feeling bombarded by intrusive thoughts which can only be shut out by performing compulsive, ritualistic or repetitive actions.

How OCD Is Commonly Managed

Treatment for OCD in teens differs from individual to individual, depending on the nature and severity of their thoughts and behaviors, but most cases involve behavioral therapy that walks a teen through their thoughts and helps them avoid both the compulsion and the obsession by triggering an obsession and changing their response.

Teens with OCD go through a slow and gradual process of learning to shut out intrusive thoughts, disregard them, and dissociate themselves and their own thinking from the OCD – learning to separate normal logic from their condition. This is part of behavioral therapy. Treatment for OCD isn’t always easy or successful, and it can take time for changes to occur, particularly if the symptoms are severe.

Medication can help with co-occurring issues, such as anxiety issues and depressive thinking as a result of their condition and the effect it has had on their life, but there is no drug that treats OCD itself. Therapy is often a teen’s best bet at learning to manage and cope with their OCD to the point that they can lead a more normal and self-sufficient life.

Common Issues of OCD in Teens

Adolescence is tough enough as it is. But teens with OCD face unique challenges. Dealing with the changes that early adulthood bring while struggling with reality can be painfully difficult, for teens and parents alike. Here are some ways in which the symptoms of OCD may affect your teen’s treatment.

Your Teen Might Struggle With Accepting Their Diagnosis

Mental health issues are still heavily stigmatized, particularly among teens. If your teen has not fully accepted their diagnosis yet, then chances are that it might be difficult for them to come to terms with the idea that they need help. Teens live in a world of labels and groups, and the last thing they want to be is labeled crazy, or in need of medication and therapy.

Furthermore, your teen might have a false understanding of what OCD is, and they might feel that their symptoms don’t fit their preconceptions. They might reject their diagnosis because they worry that going into therapy will affect their chances at getting into a good college or pursuing their dream career.

One way of helping your teen accept their diagnosis is by offering learn more about OCD with them. While they might not like the idea of being “labeled”, their diagnosis is nothing more than a single facet of a whole – and if they don’t try to do something about it now, it will become an all-consuming problem in the future, especially if they’re hoping to avoid therapy as a way to do better in school in preparation for that future.

You May Be Inadvertently Feeding Their Compulsions

When we have children, we want the best for them. We also don’t want to see them suffer. And even though we understand it helps them grow, we sometimes find ourselves in the way of certain challenges that they have to overcome. While managing OCD is scary and difficult, the last thing a parent should do is actively encourage in compulsions.

If you find yourself doing extra loads of laundry or scrubbing surfaces multiple times or otherwise acquiescing to your teen’s strange requests because you think it might help them with their anxiety, understand that compulsions, while effective in the short term, are cyclical, and will always lead back to obsessions.

Therapy works on breaking the cycle. Avoid feeding your teen’s compulsions and avoid excessively reassuring them to help them get out of distress. Instead, work with a professional to learn how to alternatively cope with your teen’s specific obsessions and compulsions and help them avoid them.

Your Teen May Avoid Telling You Things

Obsessive thoughts can be violent, aggressive, and even repelling. Teens are especially caught up with sexuality and their budding feelings for other people, and their OCD might develop in a way that causes them to feel inappropriately towards family, pets, or things. These feelings have nothing to do with your teen themselves but are part of how the disorder takes things we fear or don’t want to think of and thrusts them into the forefront.

As such, your teen may try to hide obsessions and symptoms from you, out of embarrassment and out of fear of judgment. It’s important that both you and your teen understand that you can separate OCD from your child and recognize that it is a very different thing living inside their mind.

OCD Cannot Be Reasoned With

It’s important to remember that OCD does not obey rational thought. It certainly has its own internal logic, but you may not ever understand it, and you cannot simply convince your teen to stop acting a certain way. There is no profound realization to “snap” out of OCD. It takes time and extensive therapy, and lots of adjustment. By supporting your teen throughout the therapeutic process, identifying symptoms, and avoiding anything that might feed them, you can help your teen slowly overcome their condition.

Categories
Mental Health

The Ultimate List of Psychological Disorders

This list is not meant to note down every single disorder known to the psychiatric community – for that, we refer readers to the American Psychiatric Association (APA), and the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition, published in May 2013.

There is no list more comprehensive and complete than the DSM itself, which serves as a continuously updated body of knowledge providing a consensus on various conditions, many of which have only recently been discovered and studied, others of which have been the subject of study and interest for decades.

Instead, this list is meant to provide readers and parents with an overview of what psychological disorders and related mental health conditions teens commonly struggle with, as well as how each of these psychological disorders are defined.

Neurodevelopmental Disorders

Neurodevelopmental disorders refer to conditions related to an abnormal or slowed development of the brain, usually identified in early childhood or infancy. These include a vast array of conditions defined by diminished brain function in regards to things like regulating emotion, self-control, learning ability, and intellect. Some examples of neurodevelopmental disorders include:

Intellectual Disability

Intellectual disability is a neurodevelopmental disorder characterized by severe cognitive delays. Children who are diagnosed with an intellectual disability will struggle to learn and interact with the world around them at the same pace as their peers. They may score significantly lower in IQ tests, take longer to learn to walk and crawl, and develop communicative skills at a slower pace.

Autism Spectrum Disorder

Now better understood as a complex disorder with a variety of symptoms, autism is best defined as a neurodevelopmental disorder with symptoms such as reduced social skills, problems with nonverbal communication, repetitive behaviors, and more.

Attention-Deficit/Hyperactivity Disorder

Attention-deficit/hyperactivity disorder (ADHD) is characterized by inattention, hyperactivity, and impulsive behavior. While it is usually diagnosed in children, it does last into adulthood (as do many other neurodevelopmental conditions), and it affects many adults as well.

Learning Disorders

Learning disorders refer to conditions such as dyslexia, dyscalculia, and dysgraphia. While not limited to these conditions, learning disorders are usually characterized by severe difficulty with information processing, often due to differences in the brain.

Communication Disorders

Communication disorders are characterized by a limited ability to speak, including slurred or stuttered speaking and other forms of verbal difficulty. Communication disorders can also include nonverbal and graphic communication problems, and their symptoms vary from mild to very severe.

Obsessive-Compulsive Disorder

Obsessive-compulsive disorder (OCD) is a condition split into two major components: obsessions and compulsions.

    • Obsessions are often delusional or illogical thoughts that are intrusive and persistent and remain with a person for years or decades. They can range from severe paranoia of germs or the strong belief that something terrible might happen.
    • Compulsions are coping mechanisms born out of these intrusive obsessions, often just as nonsensical as the obsessions themselves. They may be ritualistic or repetitive or exist as a strict rule set to be followed before every action. OCD symptoms can range from mild to severe depending on how they impede on day-to-day living, but even mild cases require long-term treatment.

Personality Disorders

Personalities are a complex interplay of behavior, thinking, and feeling. The APA describes personalities as “individual differences in characteristic patterns”, and while people come with all sorts of personalities, some patterns of thinking and behaving are far outside of the norm and suggest disorder. Personality disorders can be split into three major clusters:

    • Cluster A (Eccentric): Cluster A is characterized by odd thinking and delusions, and includes paranoid personality disorder, schizotypal personality disorder, and schizoid personality disorder.
    • Cluster B (Dramatic): Cluster B is characterized by overly dramatic behavior, manipulation, and antisocial behavior. Cluster B includes antisocial personality disorder, narcissistic personality disorder, borderline personality disorder, and histrionic personality disorder.
    • Cluster C (Anxious): Cluster C is characterized by signs of severe anxiety and paranoia. It includes avoidant personality disorder, obsessive-compulsive personality disorder (not to be confused with OCD), and dependent personality disorder.

Disruptive Disorders

Disruptive behavior disorders, which include conduct disorder, impulse control disorder, oppositional defiant disorder, and other related conditions (such as the more well-known examples of pyromania and kleptomania) refer to behavioral disorders characterized by a severe number of dangerous behaviors, often identified during childhood and adolescence.

Disruptive disorders don’t refer to isolated incidents or mistakes. To diagnose a child with a disruptive behavior disorder, they must display aggressive and dangerous behavior on multiple occasions, with long-lasting symptoms, and a variety of settings and situations (i.e. it doesn’t only occur at school).

Trauma and Stress Disorders

Trauma and/or stress disorders usually refer to two disorders: acute stress disorder and post-traumatic stress disorder (PTSD). Acute stress disorder refers to symptoms of a stress disorder developing immediately after a stressful or traumatic event but lasting no more than about a month. Post-traumatic stress, on the other hand, can last years or longer, and can develop after an acute stress disorder or as late as six months after the traumatic event occurred.

The effect trauma can have on the mind is best described by the word’s original meaning: a mark is left on the survivor, and stress disorders are characterized by symptoms of carrying that mark, including avoidant symptoms and dissociation, as well as intrusive thoughts and flashbacks, and prominent symptoms of anxiety and depression.

Dissociative Disorders

Dissociative disorders center on the concept of dissociation, which is described as splitting from oneself, from reality, or from both. A person can dissociate from who they are, or they can dissociate from the moment. Symptoms of dissociation are varied and may occur after emotional or physical trauma to the head. They include dissociative amnesia, dissociative fugue, depersonalization, and dissociative identity disorder (previously called multiple personality disorder).

Eating Disorders

Eating disorders often co-occur with other conditions and may in some cases be heavily related to body dysmorphic disorder (an anxiety disorder centered around appearance). The two eating disorders most people are familiar with are bulimia nervosa and anorexia nervosa. Others include binge eating disorder, pica, avoidant/restrictive food intake disorder, and rumination disorder.

Mood Disorders

Mood disorders include two major types of disorder: depression, and bipolar disorder. Depressive disorders come in many shapes and sizes, including dysthymia, major depressive disorder, perimenstrual dysphoric disorder, perinatal depression, seasonal affective disorder, and persistent depressive disorder among others.

Bipolar disorder is characterized by a cycle between a state with depressive episodes and a state with manic episodes. These shifts occur only a handful of times a year, and anything more than four shifts per year is considered a rapid cycling bipolar disorder. Bipolar is also split into two types: bipolar I involves severe mania and depression, while bipolar II involves milder symptoms of mania (hypomania) coupled with severe depression.

Anxiety Disorders

Anxiety disorders are a group of disorders characterized by excessive or extreme fear or worry. Some common forms of anxiety disorders include general anxiety disorder, social anxiety disorder, panic disorder, agoraphobia, and other phobias. Anxiety disorders are some of the most common psychiatric conditions in the world and affect more people than any other type of mental health issue.

While there are several different types of anxiety (particularly when counting specific phobias, which are real and debilitating), their ongoing theme is a persistent and irrational fear. It is normal to worry and feel unease given the appropriate situation, but sometimes, an overload of stress and other conditions can lead to a continued state of panic and fear even in a calm setting.

Substance Use Disorders

Substance use disorders are the DSM equivalent of an addiction, with a strict diagnostic criterion to differentiate between recreational use, problem use, and a disorder. An addiction, as defined by the NIDA, is the continued and compulsive use of an addictive substance despite negative consequences.

A substance use disorder is characterized by a series of social, psychological, and physical symptoms indicating frequent drug use. Substance use disorder can vary from mild to severe, with different symptoms and treatments. Not all substances are addictive, and most substance use disorders are generally limited to the following types of addictive drugs:

    • Stimulants
    • Depressants
    • Psychedelics
    • Opioids

Like opioids, marijuana does not cleanly fall into any category and is considered its own type of psychoactive drug. While many of these drugs have medical uses (from anti-anxiety medication to painkillers like codeine and various cannabinoids), they can also cause a substance use disorder.

Seeking Help for Psychological Disorders

Many of the conditions listed above are a lifelong issue and cannot be “cured”. However, they can be managed, and in most cases, especially when addressed with professional attention in the teen years, they can be mitigated to the point that the patient can live a long and prosperous life despite their diagnosis.

Some of the most brilliant people in the world have struggled with psychological disorders and related issues, and we must come to learn that these problems, when managed in a proper way, do not necessarily impede on a person’s potential or their chances for a happy life.

However, addressing psychological disorders and other mental health related issues in a timely fashion is critical. Some conditions respond best to treatment when treated as soon as possible. Be sure to work with a reputable clinic or team of professionals when seeking ways to help your teen (or yourself) cope with psychological disorders.

Categories
Eating Disorders

Signs of Anorexia to Watch for in Teens

Anorexia nervosa is one of the most common eating disorders in teens, and a condition that has risen in prevalence over the last few decades. It’s largely characterized by unhealthy and unsustainable weight loss, a consistently below-average body mass index (BMI), and a very low body weight in the absence of any contributing diseases or conditions.

Anorexia is commonly mentioned in contrast to bulimia. Where bulimia is characterized by binge eating and purging behavior (i.e. laxative use, induced vomiting, etc.), anorexia is characterized by controlling and reducing body weight largely via exercise and self-induced starvation. Women are more often affected by anorexia nervosa, but men can also struggle with eating disorders and associated body image issues.

While eating disorders are most often diagnosed among teens and young adults, they can occur (or persist) later in life too. Because teens are learning to take care of themselves and taking concepts such as nutrition and healthy living into their own hands, it’s important for parents and educators to differentiate between healthy lifestyle changes and potential symptoms of an eating disorder.

A Key Characteristic of Anorexia Nervosa

There are several signs and symptoms for anorexia nervosa, the most important being self-induced starvation, physical symptoms of extreme malnutrition, and a fear of gaining weight, particularly fat. However, it often comes back to a central point: The need to always lose more weight.

Teens who struggle with anorexia nervosa constantly perceive themselves as fat in some way, and often suffer from symptoms of body dysmorphia, a compulsive mental health issue wherein someone constantly perceives flaws within themselves even when these flaws aren’t present. More than any other symptom, teens with anorexia nervosa will insist that they need to lose more weight even while they’re unhealthily underweight.

Other Warning Signs of Anorexia

Teens with anorexia nervosa will go through extreme lengths to avoid eating food or making up for meals with excessive and intense exercise. While there is certainly a benefit to intense exercise, the level of exercise that is characteristic for someone with anorexia is destructive and harmful, particularly in the absence of much needed nutrition and critical recovery.

At the very least, a growing teen body needs plenty of sleep and plenty of food. This is doubly important when undergoing training. If your teen is obsessed with sports alongside unrealistic calorie restrictions, they may be struggling with anorexia. Other important signs and symptoms include:

    • Denying hunger
    • Eating in secret to avoid being judged
    • Developing certain rituals during meals (centered around reducing intake, such as excessive chewing)
    • Extreme dietary rulesets (completely avoiding one type of food or nutrient)

Aside from behavioral symptoms, anorexia can lead to the development of serious physical symptoms because of malnutrition and intense physical stress. These symptoms include:

    • Amenorrhea, or the absence of menstruation
    • Signs of osteoporosis, or brittle bones
    • Abnormally dry and flaking skin
    • Acne
    • Hair loss
    • The development of very fine facial and body hair, known as lanugo
    • Frequent fainting spells
    • Low blood pressure

These are not surefire signs of anorexia, and any one of these symptoms should prompt a visit to a doctor. But in the absence of a different medical condition, they may be caused by malnutrition and stress because of an eating disorder – especially in combination with the aforementioned behavioral signs.

What Causes Anorexia?

The causes of anorexia are complex, consisting of both environmental triggers and potential heritable traits that overlap with symptoms of obsessive-compulsive disorder (eating disorders and OCD can cooccur), anxiety, and depression. Psychiatric causes, including abuse and exposure to certain media, also play a large role. Other identified causes range from genetics to bacterial infection.

Given that eating disorders are more common in developed or Western countries, and are rising in prevalence in developing or non-Western countries, one theory is that the growing rate of eating disorders among teens is at least partially a result of Western beauty standards, media, and advertising (from TV to Instagram).

In the age of fitness models and influencer culture, teens are more inundated with unrealistic bodies and beauty standards than ever and may adopt unhealthy diets or exercise regimens not understanding what goes on behind the scenes. They may not be aware of how dangerous it is to remain at a certain low bodyfat outside of competition or aren’t aware of the use of things like fake weights, imperceptible image manipulation, and performance-enhancing drugs.

However, whether these environmental factors simply trigger an innate potential for anorexia or contribute to its development is still unclear. Research into eating disorders has shed a lot of light on just how complex they are, as well as revealing the many internal and external factors that play a role in their origin.

Signs of Anorexia in Boys

When eating disorders are brought up in the context of boys and men, other body image issues – such as muscle dysmorphia – are more commonly talked about. Indeed, “bigorexia” is a more common issue among boys than girls. However, that doesn’t mean anorexia nervosa does not exist in men. An estimated 20 percent of anorexics are male, presenting with all the same symptoms – starvation, a heavily distorted body image, and extremely restrictive dietary habits.

Again, symptoms of anorexia in boys overlap with symptoms of anxiety, depression, and obsessive-compulsive behavior. It’s a disorder that claims lives across gender lines, and while women are more heavily affected than men, the cases of boys with anorexia are rising, or at least becoming more known to clinicians and researchers.

How Anorexia Is Treated?

Some cases are far more severe than others. Because anorexia nervosa can sometimes go untreated until hospitalization occurs (because many teens refuse treatment), one of the most important steps to treating anorexia is first ensuring an anorexic teen’s survival. Teens with anorexia are carefully monitored to ensure that their hydration and electrolyte levels are improved, that their heart health hasn’t deteriorated too much, and they may require a feeding tube if they can’t keep down solid food. In extreme cases, hospitalization plays a vital role in the long road towards recovery and improvement.

Because the causes for anorexia may be neurological as well, treatment differs from individual to individual depending on how effective certain approaches are deemed to be. Teens with anorexia will usually work with a therapist to overcome and deny delusions of fatness and accept that they need help to work towards a healthier bodyweight. Different types of behavioral therapy such as CBT may help teens with anorexia confront their own thought patterns and avoid re-engaging in self-induced starvation.

Sadly, anorexia has the highest mortality rate of any mental disorder, in large part because of the risk of cardiovascular failure and the effects of starvation. Treating this disorder can be difficult, and requires a holistic approach addressing a teen’s psychological and physical symptoms. Family members often work with specialists to provide critical support, and a registered dietitian will help a teen learn to rethink their eating habits and slowly return to a healthier weight.

Categories
Mental Health

How Does Nature vs Nurture Affect Teenage Brain Development?

The age-old battle between nature vs nurture is something we still haven’t resolved – in particular because the answer is never clearly one or the other, and it always depends on the exact question. While we have learned that brains continue to develop and change after our early years, we haven’t exactly managed to differentiate between how our genes affect these changes in their entirety.

Individual studies on large segments of different teen and child populations have let us better grasp the complexity of how our genes affect brain development, but that development is also heavily impacted by countless environmental factors from financial hardship to peer influence, and the genes we have managed to identify and isolate often control or affect far more than just a single aspect of a teen’s brain and body.

Are Teen Brains Born or Made?

On the most basic level, we can say based on what we have learned that nature vs nurture intertwine and work together to create who we eventually are – and that even after puberty, we continue to learn and evolve in response to the world around us, on the principle of neuroplasticity. Genes play a role in the likelihood of a teen developing in a certain direction. For example, high rates of schizophrenia among a teen’s next of kin would indicate an increased chance of associated symptoms.

But a teen’s environment still plays a significant role in whether these symptoms do or don’t develop, and when. Some factors are protective while others heighten that risk. Some genes are a bit more stubborn. There are markers that help indicate the timing of puberty, which can have an assortment of effects on a teen’s emotional and cognitive development. Environmental factors such as stress and diet still play a role here as well, but just like a teen’s body weight and height, certain physiological aspects are written into our genetic code and are only very minimally affected by our surroundings.

This is also where endocrinology intersects with neurobiology and psychiatry, giving us a little bit of insight into how impossibly complex individual behaviors can be as they’re influenced by a number of internal and external factors. We also have stubborn genes that affect brain development. For example, one trait that was highly heritable was mathematical skill and working memory. Certain anatomical parts of the brain are highly heritable, while others are far more susceptible to environmental impact.

For example, twin methodology studies have proven a genetic link particularly to certain risk factors such as early alcohol use, but that research also indicates environmental factors have a greater influence overall. We cannot predetermine a teen’s behavioral development. Genes might give us some insight on probability and risk, but countless other factors ultimately remain at least equally important if not more so.

Heritability and Environment

We can estimate the heritability of certain traits, behaviors, and mental health issues – but these estimates vary greatly from individual to individual and may not help provide much useful information for parents or laypersons. The heritability of certain traits such as altruism or risk-taking, for example, are estimated to be between 5 percent and 20 percent. That’s anywhere from one in twenty and one in five that an adolescent’s behavior will coincide with their parents.

Researchers can also identify specific genes associated with these behaviors – for example, the gene CADM2 was linked to earlier age at first intercourse, greater number of children, higher number of sexual partners, and more risk-taking behavior. The MSRA gene, in contrast, predicted more neurotic personality traits and later age at first intercourse. In another example, adults with a certain type of FAAH gene had a different brain structure that reduced their likelihood of developing anxiety symptoms after the age of 12.

Research such as this can help us get closer to understanding the interplay between genes and the environment, and provide valuable information to help researchers better analyze public health data – but for individuals, it’s important not to forget that genes cannot ever totally account for a teen’s development, and their influence is limited towards tipping the scales in one direction or another, rather than predetermining behavior.

In response to the need for research clarifying how genetics and environmental factors individually impact the development of certain behaviors, neurodevelopmental conditions, and mental health issues, the NIH launched the Adolescent Brain Cognitive Development (ABCD) study in 2015, a study slated to follow nearly 12,000 children across the country ages 9-10 for a decade. The study is the first of its kind, trying to accurately map behavioral and neurological changes throughout adolescence and early adulthood.

Preliminary results are already offering insight into the development of conduct disorders and antisocial behavior. When taking environmental factors into account, it helps to concretely establish what counts as an environmental factor. While internal factors may include endocrinology and neurobiology, from highly heritable brain anatomy to a teen’s brain volume, external factors include:

    • Stress
    • Diet
    • Trauma
    • Parent relationships
    • Victimization
    • Peer influences
    • Media and advertising
    • Economic distress
    • And more

Some environmental factors are identified as risk factors. Others are identified as protective factors. But it’s more complicated than that. For example, a strained child-parent relationship may be a risk factor for risk-taking behavior and drug use. However, this correlation does not necessarily mean that children who don’t like their parents take drugs as a result. The parent-child strain might be a result of other related factors, ranging from socioeconomic struggles to a history of abuse.

This particular example also brings to light how complicated it can be to trace certain behavior to genes versus environmental factors, as children of addicted parents are more likely to be addicts themselves – not necessarily because of their neurology, but perhaps more so because of their early experiences with addiction and drug use. Whether these factors exacerbate existing neurological issues, cause mental health issues to develop, or simply trigger them and feed them, is up for debate and depends highly on the circumstances surrounding each individual case.

How Nature vs Nurture Both Play a Role in Treatment

Teens develop mental health issues and conduct problems for a wide variety of reasons, and even among teens with one specific condition – such as major depressive disorder – it is impossible to blame a single consistent factor. Genetics and environment go hand-in-hand, both in cause and treatment. A holistic approach is important because the factors that influence behavior and mental health are so complex.

A course of treatment that is purely pharmacological or relies only on therapy might be missing another important contributing factor. Understanding how a teen’s nature vs nurture both contribute to their behavior can help healthcare providers prescribe more accurate and effective treatments.

Categories
Bipolar Disorder

How to Spot the Signs of Bipolar Disorder in Teens

Bipolar disorder is one of several mental health conditions known as mood disorders. These conditions are characterized by problems with mood regulation, usually involving low mood (depression). While it’s normal to feel blue sometimes, a person with a mood disorder will feel a sudden and drastic dip in emotion.

For bipolar disorder in teens, symptoms of low mood are also paired with periods of mania, wherein the individual experiences irrational happiness and elevated mood, high irritability, high energy levels, restlessness, and a heavily inflated self-esteem. These two states cycle off one another, usually once or twice a year.

While bipolar is more often diagnosed in adults, it may be underdiagnosed in teens. This is a condition that is not as well understood as some other mood disorders such as major depressive disorder, but we have come to learn much about it over the last few decades.

Understanding Bipolar Disorder

Previously known as manic depressive disorder, bipolar disorder is a condition characterized primarily by symptoms of mania alongside periods of depression. We generally understand that it occurs in the brain and is partially hereditary, but researchers are still identifying how and why it occurs.

Many functions in the brain are related to mood regulation, and any one of them may play a contributing role in the development of a bipolar disorder. Some teens experience full-blown mania and depression, with symptoms ranging from excessively risky behavior and delusions of grandeur to suicidal tendencies, while others experience milder symptoms, known as hypomania.

External factors may also play a role – stress, trauma, and even diet can contribute to mood changes. Bipolar disorder is a lifelong condition, and can be generally split into two types:

Bipolar 1

Bipolar 1, also referred to as bipolar I disorder, refers to any type of bipolar disorder with “full” mania, usually referring to the severity of the manic symptoms. Symptoms of depression in patients with bipolar 1 may range from mild to severe, and some cases of unipolar mania (mania without depression) are often also categorized under bipolar 1 (at an estimated rate of 1-3 percent among bipolar 1 patients).

Bipolar 2

Bipolar 2, also referred to as bipolar II disorder, refers to cases of bipolar disorder with severe depression but mild mania (hypomania).

Other key forms of bipolar disorder include cyclothymia, which refers to milder symptoms of mania and depression, as well as rapid cycling bipolar disorder, wherein episodes of mania and depression occur more than four times in a single year. Anyone with bipolar disorder may also have “mixed” episodes, wherein an overwhelmingly depressive episode may have some periods of mania, and an overwhelmingly manic episode may feature depressive thoughts.

Identifying bipolar disorder in teens can be a challenge. The symptoms are more obvious in adults, as most people generally learn to regulate their mood and emotions over the years, while teens are expected to be more impulsive and whimsical. This can mean that a teen’s chaotic tendencies and sulking mood may mask symptoms of a mood disorder like bipolar.

While there are no physical tests to determine a positive diagnosis for a mood disorder, certain hallmark symptoms can help set bipolar disorder apart from “normal” teen behavior. If a teen is suspected to be struggling with a mental health condition, they can work with a licensed psychiatrist to determine whether an accurate diagnosis can be made, and whether treatment is needed.

Early Symptoms and Warning Signs of Bipolar Disorder in Teens

Teens can get moody and irritable, and there will be moments when they sulk or become sad over matters adults might not find as important. But normal adolescent behavior can be distinguished from symptoms of bipolar disorder in teens by the severity and pattern of these mood changes and behaviors. Symptoms of depression and mania are unprovoked, often severe, and debilitating. During episodes of depression, teens may exhibit signs of:

    • Suicidal ideation and self-harm.
    • Wanting to die (not necessarily suicidal).
    • Extremely low self-esteem and frequent self-deprecation.
    • Long periods of sadness.
    • Despair and helplessness.
    • Feeling lonely or unwanted.
    • Trouble sleeping, or sleeping in.
    • Sudden changes in appetite, and rapid weight gain/loss.
    • No longer showing interest in old hobbies.
    • Unexplained aches, mostly headaches and stomach aches.

During episodes of mania, teens may exhibit signs of:

    • Extremely inflated ego and sense of self.
    • Heightened irritability.
    • Short or no sleep, unrealistically high energy levels.
    • Speaking much faster than usual, switching topics and interests frequently.
    • Delusional thinking (believing things to be true when they aren’t).
    • Lowered inhibition, much more risk taking than usual.
    • Racing thoughts, unable to slow down.
    • Anxious energy (feeling uncomfortable with one’s own overactivity).
    • Other signs of psychosis (a break from reality) including mild hallucinations.

Cases of cyclothymia may be harder to recognize, but if your teen is suddenly acting strange and experiencing unprovoked signs of low mood or excitability, talk to them and ask them about how they have been feeling. Their emotions and mood might be tied to stress at school, the loss of a friendship, or a budding relationship suddenly breaking off.

But if symptoms persist or worsen or are unrelated to what’s going on in their life, it may be worth talking to your teen about visiting a mental health provider – especially if symptoms are interfering with school and everyday life. Only a licensed psychiatrist can make a professional diagnosis of your teen’s condition, should anything be wrong.

Bipolar Disorder and Co-Occurring Issues

Bipolar disorder in teens can be difficult to spot and diagnose, as it may co-occur with the use of mood- and perception-altering substances, as well as other co-occurring mental health conditions. Some common co-occurring mental health issues include:

    • Anxiety disorders
    • Conduct disorders
    • Personality disorders
    • Developmental disorders (ADHD)

What Does Teen Bipolar Disorder Treatment Look Like?

While there is no cure, bipolar disorder can be managed via a combination of therapy and medication. Mood stabilizers, including lithium, can be used to help teens reduce the severity of their symptoms and lead healthier lives.

Therapy is critically important as the other half of the equation, helping teens recognize their symptoms and identify aberrant thoughts, and manage stressors and situations that might aggravate their mental health.

Support is also an important part of long-term treatment. Friends and family play a role in helping a teen when they can’t help themselves and learning more about their loved one’s condition so they can differentiate between an episode and normal behavior and call the right people in emergency situations.

Depending on the severity of the condition, treating bipolar disorder in teens can be incredibly challenging. But with the right support and diligent treatment, the worst can be avoided, and a teen’s quality of life can be dramatically improved.

Exit mobile version