Month: November 2020

Categories
Mental Health

The Mental Fitness Benefits of Sports and Physical Activity

Exercise and physical activity are often touted as beneficial for overall mental fitness, health, and wellbeing. Still, when people think about exercising for health, they foresee early morning jogs, aerobics classes, and gym memberships. Physical activity encompasses nearly any form of movement and exertion, however, and both children and adults stand to benefit from regular exercise – whether it’s a team sport or an individual one, whether it takes place in the great outdoors or an air-conditioned fitness center, and whether it’s competitive or a purely casual experience.

The key to incorporating exercise as a useful tool for improving mental fitness and health, providing a healthy kind of stress relief, and building physical fitness (which has a marked effect on mental fitness) is to find a physical activity or sport you like. Even kids who aren’t “natural athletes” and dislike sports may have just had bad experiences that they don’t want to repeat but aren’t aware of the sheer breadth of activities they could partake in one-person competitive sports to informal group activities that are fun and engaging.

Physical Activity, Physiological Changes, and Mental Fitness Impact

In part due to how staying in shape plays a role in our survival, physical activity leads to the release of endorphins and other neurotransmitters that generally make us feel good, both during and after exercise. Some people experience this release more strongly than others. There are genetic differences in both aptitudes to specific activities and how much any given person is likely to enjoy exercising.

But a lot of the love behind the exercise is also generated through experience, due to its habit-forming nature, as regular exercise correlates with improved self-esteem, better and more stable mood, and a profound impact on the symptoms and effects of long-term psychiatric conditions including:

In other words, the more regularly you exercise, the more likely you are to continue doing it.

Beyond Movement and Exercise

Actual physical movement elicits an endocrine response that makes us feel good – or at least, better than usual. This doesn’t mean exercise isn’t uncomfortable. There’s also the issue of muscle pain and recovery that can be quite jarring for some beginners.

But there is a direct physiological link between moving regularly and feeling better, both physically and psychologically, in the long-term. However, the benefits of sports and exercise go beyond the immediate impact of keeping fit. There are complex social elements in many activities that play a role in how much we enjoy them and impact whether we commit to them and how they fit into our lives.

Some teens are naturally competitive and are drawn to sports that they are good at, wherein they have an aptitude they can strive to improve upon to reach greater heights further. Other teens relish the camaraderie and interpersonal bonds forged in the middle of a challenging match between team members or rivals. Sports and physical activities are a great way to make new friends through shared hobbies and find things to talk about with other people.

Sports and physical activity also demand that teens develop physical fitness and improve upon it and hone their techniques. Teens are tasked with getting better, overcoming challenges, moving past failures, and working harder for successes. This kind of personal growth – challenging oneself and overcoming such difficulties – can provide an immense boost to confidence and mental fitness.

The Importance of a Personalized and Balanced Approach

It is not every teen’s dream to be a football captain, nor is it every teen’s dream to win in competitions, achieve physical excellence, or lead an unequivocally healthy lifestyle. Teens are young people, each with their goals and aspirations, each in a stage of their lives where these dreams and aspirations are volatile and temporary.

Whether an individual or as a team, physical exercise and sport is an opportunity for teens to experience positive peer interactions, cultivate healthier habits, and potentially discover hobbies that will continue to lead them towards future interests and serve as coping mechanisms. There are countless activities and sports for teens to try and develop an interest in.

Some teens hate track and cannot stand the weight room but love to dance or develop a swimming passion. Maybe they are born wrestlers or volleyball players. Perhaps they do not have a particular aptitude for any given sport but love to lift weights. Maybe they have the most fun on bars and rings and show some gymnastic aptitude.

Or perhaps it is the outdoors that call to them the most, and they are in their best element while hiking, rock climbing, or canoeing. Physical activity can be an immense boon on physical and mental fitness, both in the short term and in the long time, but both teens and parents have to put in the work to figure out what they enjoy doing.

There is often bound to be some skew to physical activity that your teen is particularly interested or talented in. Of course, talent doesn’t always imply interest – while it’s easier to enjoy doing something when you’re good at it, some teens fall in love with sports they have no aptitude for and develop skill through sheer determination.

Regardless of what your teen ends up having the most fun with, a balanced approach is still essential. Obsession with a sport or exercising, in general, can hint at a potential for other developing issues down the line, including:

    • Body image problems and eating disorders in both boys and girls.
    • Performance-enhancing substance use (which comes with a host of risks, especially for developing bodies).
    • The chances of injury (from the physical and mental fitness impact of long-term pain to the medication and difficulties for physical recovery).
    • The psychological effects of competition and failure.
    • The potential for emotional and physical abuse, especially in team sports.

It might take time and a little experience for some teens (exceptionally competitive ones) to eventually find a balanced approach to their passion. Parents and educators will have to temper the overeager and learn not to fuel behavior that might end up destroying a teen’s health.

Categories
Eating Disorders

Eating Disorders in Teens: How to Talk About It

Eating disorders refer to several mental health conditions revolving around the bingeing and purging of food, obsessions with weight, highly restrictive diets, and other requirements (including the compulsive ingestion of non-food items, known as pica). While eating disorders can, on the surface, sometimes be masked as a “healthy” concern for bodyweight, they are intensely physically and psychologically destructive and continue to have the highest mortality rate among all psychiatric conditions currently recognized by the Diagnostic and Statistical Manual of Mental Disorders.

Characterizing Eating Disorders in Teens

Eating disorders can have a long list of potential symptoms. While there are five major characterized eating disorders (anorexia nervosa, bulimia nervosa, binge eating disorder, rumination disorder, and pica), there are also several behaviors that can be classified as “other specified feeding or eating disorders” (OSFED), as well as “avoidant/restrictive food intake disorders” (ARFID), which are separate but related to eating disorders.

Anorexia Nervosa

Intense fear of weight gain characterizes anorexia, specific “fear foods,” incredibly low daily caloric intake, low body weight, and severe body image issues, to the point that the patient doesn’t recognize their low body weight as being unhealthy or too low. At its worst, teens with anorexia may have various physical symptoms caused by their malnutrition and low body weight, including:

    • Loss of menstrual cycle
    • Dizziness
    • Brittle or thinning bones
    • Dangerous heart health issues
    • Lanugo-like body hair
    • Dental damage due to frequent purges

There is some overlap with obsessive-compulsive disorder (OCD). Teens with anorexia tend to set extreme rules for themselves surrounding food intake and body weight and may punish themselves for breaking these rules (through starvation and excessive exercise).

Bulimia Nervosa

Bulimia is characterized by frequent binge-eating behavior coupled with subsequent purging behavior. It is cyclical, in the sense that teens with bulimia will often obsess over certain foods and be obsessed with eating, binge heartily, then experience extreme guilt, leading to a purge. Purging behavior includes vomiting, taking laxatives, fasting, or excessive exercise.

Teens with bulimia are not usually underweight, but they may still be at risk of malnutrition and other physical ailments because of their frequent binging and purging, including swollen lymph nodes, a weakened immune system, and damage to the throat and teeth caused by stomach acid.

Binge Eating Disorder

Binge eating disorder is characterized by frequent binging and subsequent low mood, but not purging. Teens diagnosed with binge eating disorder will often feel incredibly guilty and self-conscious, reinforcing binging as a coping mechanism, starting a cycle. Unlike teens with anorexia or bulimia, teens with binge eating disorder may be overweight or obese.

Seek Guidance From Parents or Therapists

Eating disorders are severe, and many teens diagnosed with an eating disorder have a warped sense of what is and is not suitable for physical appearance and food. They may be sensitive to specific phrases and sentiments, such as seeing others comment about their health and appearance or seeing them pick up new diets or commit to new kinds of eating.

Start helping your friend by asking their parents or therapist how you can help by learning what sentences and actions to avoid or learning what you should do to model a healthier relationship with food. By better understanding your friend’s diagnosis, you will have an easier time knowing how your behavior and words might affect them emotionally.

Family Support and Care Is Vital

Family and friends can play a significant role in eating disorders in teens through the Maudsley approach. This family-based therapy emphasizes the importance of continuing to provide support outside of inpatient or hospital treatments. The Maudsley approach helps families play a role in the treatment of their teens by coordinating with a therapist providing individual or group therapy and by setting the foundation for healthful living through:

    • Weight restoration.
    • Modeling healthy eating habits.
    • Noting and tracking both physical and mental health improvements.
    • Slowly helping teens take control over their eating habits as they close in on a healthy weight and have made significant progress.

Family therapy may also play an essential role in helping families better understand their teen’s behavior and problems surrounding food and teaching them how to encourage better eating without placing pressure on the teen themselves and blaming them for their behavior. It emphasizes that the disorder is an external actor playing a role in their teen’s behavior and that the focus is on overcoming that disorder together. Therapists will ensure that parents do not criticize their teen’s behavior or make it “their fault.”

Help and Treatment for Eating Disorders in Teens

It is important not to encourage the behavior associated with your friend’s condition, such as skipping meals, exercising way past the point of physical recovery, avoiding certain foods, or obsessing over body image and thinness. Empathy and compassion are essential, recognizing that a friend’s self-image issues may continue to be a sensitive topic for them even after treatment.

They might not be ready to discuss certain things without triggering anxieties and worries about body image or food. Teens struggling with eating disorders often have a long and arduous treatment process ahead of them, one in which both their physical and mental health must be taken into consideration. Many teens with conditions such as anorexia nervosa are treated at the height of their malnourishment and near starvation.

Despite such consequences, many teens diagnosed with an eating disorder do not realize that they are actively harming themselves and harbor extreme and deep-seated fears regarding certain foods and weight gain. Long-term support from friends and family is essential to the proper treatment of eating disorders in teens. By assisting in the critical refeeding process, modeling healthy eating behaviors, working on beneficial coping mechanisms together, and keeping an eye on potential signs of relapse, a teen’s loved ones continue to play an important role long after the initial treatment process.

Categories
Depression

What Is Situational Depression? What Parents Should Know

Situational depression is another term for a type of adjustment disorder wherein a person develops short-term depressive symptoms, usually in response to overwhelming stress. Adjustment disorders are characterized by behaviors and symptoms that require treatment in response to stressors within everyday human experience and are not necessarily exceptional or “traumatic,” such as a breakup, divorcing parents, struggling at school, or losing a loved one due to natural causes.

What is and is not traumatic remains relative. Still, the main distinction between something like an adjustment disorder and post-traumatic stress disorder, for example, is the magnitude and intensity of the causal experience(s). Situational depression, and by extension, other adjustment disorders are especially relevant now. Research shows us that anxiety and depression symptoms are still climbing among teens, and we’ve seen a spike in mental health concerns this year.

A recent poll shows that teens most often cited thoughts about the future, increasing loneliness, concerns about the world, and the inability to hang out with friends as primary causes of anxiety and depressive thinking. Between the ongoing pandemic and continued political polarization, the world has become a scarier place for many teens.

Understanding the difference between mood disorders, like major depressive disorder and bipolar disorder, and adjustment disorders, like situational depression, is essential. These conditions progress differently, may be treated differently, and have different and distinct causes.

Situational Depression Is Not a “Mood Disorder”

Mood disorders are a family of psychiatric conditions related to mood regulation, closely tied to symptoms of depression (exceptionally low mood) and mania (exceptionally high mood). Major depressive disorder (MDD) is the most common mood disorder and is also known as clinical depression.

When someone is diagnosed with MDD, they struggle with the condition that affects how their brain regulates their mood in the long-term. The causes behind this kind of depression can include external factors such as childhood trauma – which can leave a lasting impact on the brain, and internal factors such as a hereditary predisposition towards poor mood regulation.

Environmental factors and stressors can exacerbate or improve symptoms. Still, someone diagnosed with major depressive disorder is not just going through a rough patch or feeling blue solely due to extraneous circumstances.

The same goes for most other mood disorders, such as premenstrual dysphoric disorder (linked to neurological and endocrinological causes) and bipolar disorder. While an adjustment disorder is more severe than just “feeling low” for a short time, it is not usually a long-term disorder like most mood disorders.

Most cases of situational depression are no longer than six months. Whereas the onset of a mood disorder may be stressful, a mood disorder’s causes are more complex than any single stressor. On the other hand, adjustment disorders can be linked back to an identifiable causal event or experience.

Can You Have Situational Depression and a Mood Disorder?

A teen might first be diagnosed with situational depression because their symptoms began after a coincidental stressful event, but further sessions and therapy may show it to be a mood disorder or different condition instead if the typical treatment program doesn’t help reduce symptoms, or if other criteria are met.

Most of the time, situational depression can be addressed with a swift therapeutic response, essentially helping a teen cope with the stressors around them, address their behavior and thinking, and help family members better understand their teen’s behavior and provide support.

This does not mean that situational depression is somehow less important or severe than a mood disorder like MDD. A teen with situational depression can still develop suicidal tendencies, consider self-harm, or become increasingly antagonistic towards friends and family.

The distinction is essential to help separate treatment courses for teens with an underlying mood disorder and teens struggling with an adjustment disorder and give parents a better understanding of why teens may respond differently to stressors and why some teens may be depressed for a few months while others struggle with depression for years.

Situational Depression Is Short-Term But Serious

The symptoms of situational depression, or “adjustment disorder with depressive symptoms,” are like those of other depressive disorders. They include:

    • Low mood or sadness
    • Lack of motivation
    • Losing interest in old hobbies/not developing new ones
    • Withdrawing from opportunities for social interaction
    • Feelings of hopelessness
    • Constant fatigue and restlessness
    • Inexplicable pains and aches (especially headaches and stomach aches)
    • Sudden changes in appetite and weight
    • Signs of substance use
    • Self-harm
    • Frequently talking about suicide

It is important never to rely on self-diagnosis when it comes to any medical or psychiatric condition. Be sure to get a proper diagnosis from a mental health professional if you suspect you or a loved one are struggling with a form of depression, regardless of what kind of depression it might be.

Therapy, Support, and Empathy

Situational depression is treated primarily through therapy. Teens discuss their fears and worries, thoughts and feelings, and learn to separate depressive symptoms from other, more rational thinking. While situational depression is rooted in a stressful cause, depressive thoughts are inherently irrational. They can cause someone to feel hopeless even in something hopeful or feel alone, even when surrounded by family.

Therapists can help teens develop coping tools to identify and combat depressive thoughts and slowly spend more time with therapeutic activities and coping mechanisms (such as exercise, creative endeavors, or spending time with friends) while avoiding things that may help reduce mood. Teen group therapy and family therapy can help teens respond better to a group dynamic. They learn more about situational depression and other adjustment disorders and useful coping tools with loved ones.

Family and friends play a significant role in helping teens cope with their symptoms by offering support and empathy. Empathic responses can include assisting a teen in talking themselves out of a depressive episode, showing love and understanding for their perceived suffering rather than minimizing it, not belittling them for their mood, and more. Family therapy can also help heal ruptures and address family communication issues that might contribute to a teen’s depression.

Medication and Treatment Options

Antidepressant medication may still help teens with situational depression by addressing potential underlying or accompanying symptoms. On their own, adjustment disorders are not caused by brain changes, so medication usually will not affect them. Therapy remains key to a swift treatment for situational depression. However, in teens with other conditions, antidepressants may help address lower than normal levels of necessary brain chemicals like serotonin and norepinephrine by affecting how the brain adjusts its endogenous neurotransmitter levels.

Categories
Personality Disorder

Teen Drama vs. Histrionic Personality Disorder

Teens can be dramatic, and they are often preoccupied with themselves. But at what point is such behavior normal and understandable, and at what point does it become a disorder? Disorders do not characterize or differentiate annoying from acceptable behavior, and part of the process of going through adolescence includes mood swings, identity changes, irritability, and a tendency towards hyperbole.

But certain behaviors fall outside the scope of “normal,” hinting at a developing problem that may be better managed in later life if addressed and treated early. Histrionic personality disorder, for example, is a lifelong mental health condition characterized by excessive dramatization, constant attention-seeking, and inappropriate behavior. Its onset tends to coincide with early adolescence. Despite similarities to normal teen behavior, specific characteristics tend to be blown out of proportion in teens with histrionic personality disorder.

What Is Histrionic Personality Disorder (HPD)?

Histrionic personality disorder (HPD) is one of ten major personality disorders identified and characterized in the Diagnostic and Statistical Manual of Mental Disorders (5th edition), under a cluster of personality disorders centered around dramatic and attention-seeking behavior (cluster B). At its root, it is defined by overly dramatic and theatrical (i.e., histrionic) behavior. This disorder’s history is long and varied.

Its early meaning has little to do with modern psychiatry, dating back to when male doctors blamed “unmanageable” female behaviors on “hysteria.” For a time, HPD was known as hysterical personality. We have since learned that the causes and contributing factors in most personality disorders are varied and complex, from environmental agents to genetics and early childhood experiences, and have nothing to do with uteri or most other believed causes of hysteria.

Where teens might exaggerate for the sake of calling attention to themselves or experiment with boundaries, a teen with histrionic personality disorder will consistently engage in outrageous and inappropriate behavior to remain in the center of attention at all times, and they may be visibly upset if they aren’t the center of attention. Some characteristic behaviors for teens with a potential histrionic personality disorder include:

    • Intentionally provocative or seductive behavior.
    • Rapidly shifting and changing emotions.
    • Overtly shallow expressions (i.e., acting).
    • Consistently alters and uses physical appearance to draw attention.
    • Jumps from relationship to relationship, quickly consider relationships to be more intimate than they are.
    • Extreme self-dramatization, exaggerated storytelling and expressions, and a shallow style of speech.
    • May resort to extreme statements to draw attention, including repeatedly threatening suicide and very rash decision-making.
    • Very susceptible to suggestion, easily influenced by others.
    • Symptoms are consistent across settings, i.e., displays the same behavioral issues at home, at work, and elsewhere.

A teen with HPD may not necessarily be consistently disruptive. Many grow up to remain “high-functioning” in the sense that they can hold a job and get through life. Yet, their behavior remains odd and can negatively impact relationships, friendships, and more. To be diagnosed according to the DSM-5, a teen would have to display at least five or more of the following signs:

    1. Discomfort when not the center of attention.
    2. Seductive behavior.
    3. Shifting emotions.
    4. Using appearance to draw attention.
    5. Vague, impressionistic speech.
    6. Exaggerated emotions.
    7. Suggestible.
    8. Considers relationships more intimate than they are.

It is also important to note that identifying and diagnosing a personality disorder is not a simple process. Individual cases rarely fit neatly into textbook definitions, and only a trained mental health professional can make a diagnosis and prescribe treatment if needed. There may also be co-occurring mental health issues such as irritability or “affective dysregulation,” which can complicate the diagnosis with depression and anxiety symptoms.

Part of the process also involves ruling out any other potential explanations or causes for a teen’s symptoms. Teens with histrionic personality disorder may be very reluctant to consider anything “wrong” with their behavior and may sometimes dissociate from their actions or words as a defense mechanism.

Histrionic Personality Disorder vs. Other Personality Disorders

The main characteristic that sets histrionic personality disorder apart from other personality disorders in its cluster focuses on overly dramatized speech and behavior and the need to remain the center of attention. Other similar personality disorders include:

Borderline Personality Disorder (BPD)

Borderline personality disorder is characterized by unstable and rapidly changing moods and self-image.

Antisocial Personality Disorder (ASPD)

Antisocial personality disorder is characterized by a lack of empathy and constant manipulation of others.

Narcissistic Personality Disorder (NPD)

Narcissistic personality disorder is characterized by self-grandeur, often accompanied by the need to put others down.

What Causes Histrionic Personality Disorder?

The causes of histrionic personality disorder are varied, depending on the teen’s circumstances and history. Genetics seem to play at least some role, as does gender – while the prevalence for histrionic personality disorder is less than two percent in the general population, it is four times more common in women than men.

While identities and behaviors evolve, temperament is mostly determined early on and may play a role in how the disorder develops. Upbringing may also be necessary – children who were only awarded affection and attention in specific ways after performing certain tasks may learn to behave that way into their teen years.

Can Histrionic Personality Disorder Be Treated?

Yes, although it cannot be “cured.” Like most personality disorders, histrionic personality disorder can be treated and managed through therapy, specifically by helping teens differentiate between maladaptive thinking and their other thoughts, identifying the condition before it translates into behavior and action. It can take time for a patient to learn the difference.

Various approaches may be utilized to get to that point, including group therapy, dialectical behavior therapy (DBT), cognitive-behavioral therapy (CBT), and family therapy. In cases where histrionic personality disorder is also accompanied by severe mood issues or an anxiety disorder, medication can help alleviate significant symptoms to make therapy more effective. There may be evidence that some personality disorders – particularly ones in the same cluster as HPD – generally improve with age, especially with treatment.

Categories
Therapy

How Group Therapy Empowers Teens

Individual talk therapy is when a patient and their therapist can discuss and overcome unwanted and negative thoughts and behaviors through self-reflection and insight-oriented work. Talk therapy is complicated and challenging, and it nearly always requires a willing and cooperative patient. To that end, it can be challenging to apply individual talk therapy to teens without a thoroughly established relationship and plenty of rapport, as many teens tend to favor a contrarian attitude and are unlikely to be cooperative.

Helping a teen in a one-on-one setting requires a specialized and experienced therapy that knows how a teen’s mind operates and responds and can best relate to them. When a therapist can finally get on the same page as their teen patient, the progress they can make together can be incredible. But often, finding an alternative approach is productive in the early stages of treatment. This is where group therapy becomes a powerful tool when treating adolescents for multiple essential reasons.

Offers Peer Support and Encouragement, Helps Teens Feel Less Alone or Isolated

The first thing group therapy teaches a teen is that they’re not alone with their thoughts and struggles. Teens are inexperienced and naturally self-centered (this is not a bad thing). They are preoccupied with the rapid and complicated changes they are experiencing on a nigh-daily basis. When they realize that they are “different,” one of the significant issues they face is the crippling isolation experienced by feeling cut off from their peers due to their condition and the treatment process. It is fun to be unique, but it is lonely and terrifying to be “weird.”

Group therapy can help teens realize that they’re not alone at all and that while there might not be too many people out there who can completely relate to their experiences, there are still enough people out there to fill a room and talk about it. It also helps them remember that struggling with a mental health disorder does not make someone less of a person or somehow alien. People are people, and even with a variety of different problems, there is always some way in which different people can relate to one another and make each other feel a little more “normal.”

Addresses Unique Teen-Specific Substance Use and Mental Health Issues

Teens aren’t just self-centered; they’re also famously and painfully self-aware. With that comes a great deal of social anxiety, particularly among teens who feel shy and nervous around strangers and struggle with serious communication issues. These issues and fears are easily masked in a one-on-one session. Still, for teens with social anxiety and communication problems, group therapy becomes a safe space to practice critical social skills and overcome many fears amplified by inexperience or victimization.

Often, teens resort to absorbing other identities into themselves to figure out who they are. It is part of the process of becoming an adult and might involve suddenly gaining ultimately new friends, looks, and interests overnight. However, there are cases when this kind of behavior is maybe contributing to an inner conflict stemming from guilt or shame over one’s immutable characteristics or flaws.

Teen insecurity is nothing new. It’s a natural part of being in that “awkward” stage, but learning to overcome them – not by transforming into someone else, but by developing the self-confidence to be oneself – is an essential part of growing up. A safe and healthy group therapy environment can help empower teens to identify with what makes them unique and stand out, rather than seeking solely to blend in with others or adapt to whatever is most popular.

Provides a Platform for Peer-to-Peer Connections and Discussions

A group therapy setting is not just a place to listen to others talk, but it is also a place to be heard. It can feel validating and empowering to finally sit among other teens who are capable of reacting empathically and with understanding, who have likely gone through similar experiences or, in the very least, know what it can feel like to be alone or ostracized because of specific symptoms or behaviors. Being heard is something we all yearn for, whether we are children, adolescents, or adults.

And the best way to feel like you truly belong somewhere is to tell your story and feel like it resonates with those around you. Getting the chance to talk about one’s anxieties and struggles can also help confirm to the speaker that these are real issues they need to address, and not just quirks or things to be belittled for. Teens can begin to contextualize and even better understand their thoughts and behaviors and compare their experiences to those around them and gain insight into how others have dealt with their problems.

Offers a Safe, Structured Place for Teens to Experience Positive Social Interactions

Consequently, group therapy also becomes a place where positive experiences and learning experiences are shared and discussed, and it becomes a place where those teens who have had more experience with therapy can help guide others through the early stages of the treatment process and become part of their path towards understanding their condition. These relationships go both ways – while newcomers feel welcomed and understood, those who have had more time in therapy can reap the benefits of helping others through their own experiences.

Helps Teens Develop Social Skills and Effective Coping Tools

Through group therapy sessions, teens are encouraged to practice their social skills, engage with their peers empathically, learn to reflect on their own experiences by way of reviewing or recontextualizing what happened to others, and gain a chance to help one another by giving advice, sharing stories, and being there for each other.

Group therapy becomes a place where teens with various issues learn to identify similarities and work out their differences, making a lot of progress in developing stronger self-esteem, a more concrete identity, communication skills, and relationship skills.

The Bottom Line

Group therapy may be ideal for teens because it’s a setting where they can interact with and help their peers, work on their social skills, and develop a stronger sense of self amid a group. These improvements and skills can carry over into individual therapy and day-to-day life outside of treatment. Through other people’s experiences and stories, teens can also better understand their thoughts and behaviors. It is still hard work – all therapy is – but it may help many teens in ways unique to adolescence.

Categories
PTSD Trauma

Recognizing Trauma and Stressor Related Disorders in Teens

Trauma and stressor related disorders, sometimes commonly referred to as post-traumatic stress disorder (PTSD), can be characterized by aberrant symptoms following a period or event of extreme stress, with various recurring reactions, behaviors, thoughts, and other symptoms ranging from restlessness jitters to panic attacks, extreme irritability, and more.

PTSD symptoms differ from age group to age group. The condition can occur at any point in a person’s lifetime. The only prerequisite for PTSD is trauma – while there is a genetic component in how likely PTSD is to occur after a harrowing event, anyone can be affected by PTSD.

When a teen develops PTSD or trauma and stressor related disorders, their stress response system is no longer functioning the way it should. This can lead to several issues during everyday situations, such as being hyperaware and constantly on-edge, or dissociating from life and reacting seemingly cold or emotionless.

While PTSD used to be considered a type of anxiety disorder, it has since been recategorized as a trauma disorder due to trauma and stressor related disorders having their phenotype characteristics, including dissociative symptoms and extreme irritability.

However, teens with PTSD are also more likely to struggle with comorbidity in the form of depression and anxiety. They may be more susceptible to co-occurring substance use disorders and high-risk behaviors such as self-harm. Recognizing trauma and stressor related disorders in teens is essential because specific symptoms can be mistaken for “normal” teen behavior.

What Does PTSD in Children and Teens Look Like?

Children and teens can react differently to trauma than some adults do. In younger school-aged children, PTSD symptoms may include reliving or re-engaging in traumatic experiences through play (either with toys or virtually). It is thought that younger children have a more challenging time recalling the order of traumatic events.

Teens are more likely than children and adults to react aggressively after trauma and are more likely to develop impulsive behaviors as part of their PTSD. From here, signs and symptoms vary wildly. Some of the signs of PTSD in children and teens include:

    • Avoidance of certain situations or events
    • Nightmares and flashbacks in older children
    • More impulsive behavior
    • Frequent nervousness, restlessness, being on-edge
    • Acting numb or distant
    • Trouble focusing on tasks and academics

The DMV-5 utilizes eight sets of criteria with their symptoms to define and diagnose PTSD in individuals, further providing information about how the disorder might manifest. These criterion sets include:

    1. A significant stressor/traumatic event(s)
    2. Intrusive symptoms (unwanted thoughts, flashbacks, and nightmares)
    3. Avoidance symptoms
    4. Adverse changes in mood and memory (i.e., trouble remembering things)
    5. Changes in arousal and reaction (greater aggression, easily startling, hypervigilance)
    6. Duration (symptoms lasting more than four weeks)
    7. Functional significance (symptoms must create distress and impact social life, school life, work, etc.)
    8. Excluding other reasons (symptoms cannot be explained by medication, other illnesses, substance use)

Some of these signs may be more obvious than others. It is also understood that there are dissociative variants of PTSD (where the primary characteristic is a “disconnection” from reality) or other trauma and stressor related disorders.

Defining Other Trauma and Stressor Related Disorders

A traumatic experience is one that leaves a lasting negative impression. Ultimately, many of us experience traumatic events in our lives. Losing a loved one, witnessing a natural catastrophe or accident, or being the victim of a crime can leave a lasting and significant impact. However, each person processes trauma in different ways.

In some cases, the damage can be so severe that it lingers for months and bleeds into every waking moment. Flashbacks, avoidance symptoms, and hypervigilance are just some of how the mind tries to cope with an event or horror that has left an impression too great to overcome without help and therapy. Some of the other ways in which trauma can leave a lasting impact include:

Acute Stress Disorder

Acute stress disorder (ASD) shares many of the same symptoms as PTSD. Still, its onset is almost immediately after a traumatic event, lasting for at least two days and less than a month. Sometimes, ASD develops into PTSD if symptoms persist past a month.

Adjustment Disorders

Adjustment disorders are defined as adverse changes in thought or behavior in a teen following a traumatic event, usually below the threshold for a PTSD diagnosis.

Reactive Attachment Disorder

Reactive attachment disorder (RAD) is characterized by withdrawn behavior. It is typically caused by extreme neglect or social deprivation. A teen with RAD may display limited or lacking emotional responses and low empathy or remorse.

Disinhibited Social Engagement Disorder

Disinhibited social engagement disorder (DSED) is characterized by a lack of inhibition when interacting with strangers. Children and teens with DSED may be overly friendly or welcoming towards people they don’t know, for no apparent reason. It’s a different form of response to extreme neglect and social deprivation.

Other Dissociative Disorders

Dissociative disorders, such as dissociative identity disorder (DID), dissociative amnesia, and depersonalization disorder, are often the result of an extreme stressor or traumatic experience, causing a person to separate themselves from the experience of reality itself.

Grief-Related Trauma

The loss of a loved one causes bereavement disorders. While it’s normal to be in pain when we lose someone we love, specific symptoms – such as intense grief over a year after the death, significant impairment due to distress, preoccupation with the deceased, etc. – may indicate a disorder.

Treating Trauma and Stressor Related Disorders in Teens

Treatments for trauma and stressor related disorders depend on the severity of the condition and the types of symptoms present. Talk therapy is an integral part of the treatment process, and therapists may leverage specific techniques to help teens better process their emotions and regulate responses or gradually approach and confront particular events. Trauma-specific treatments meant to address stressors include:

Eye Movement Desensitization and Reprocessing (EMDR)

This approach to treatment utilizes guided eye movements to change how a person reacts in response to triggers.

Exposure Therapy

Although it sounds drastic, exposure therapy encompasses several different therapy types to overcome their fear or trauma in a safe environment.

Cognitive Therapy

This type of talk therapy aims to help patients become aware of the relationship between their thoughts, behaviors, and mood and recognize patterns in thinking and behavior associated with their PTSD. Identifying these patterns can help in slowly altering them over time.

Treating PTSD in teens is difficult at any age, under any circumstances. Trauma is powerful, and it takes time and support to overcome these emotional and physical responses slowly. However, with consistent therapy and help from friends and family, long-term treatment can significantly reduce symptoms.

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