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Emotional Well-Being FAQ

Is my child depressed?
While a physician, psychologist, or counselor should make a final judgment about whether a child is depressed, here are some signs you can look for:

  • Depressed or irritable mood most of the day, nearly every day
  • Loss of interest or pleasure in several activities s/he used to enjoy (not simply outgrowing past interests)
  • Significant decrease in appetite or significant weight loss
  • Difficulty falling or staying asleep
  • Agitated or restless behavior, or the opposite–lethargy, significant decreases in activity level
  • Saying negative things about him- or herself, especially feelings of worthlessness or inappropriate guilt
  • Diminished ability to concentrate or focus on schoolwork
  • Frequent thoughts of death or dying, and especially threats to harm or kill him- or herself
  • Sudden decline in school motivation and performance

Most kids and teens have days when they feel down or out-of-sorts. The symptoms above should cause concern when they persist, or when your child/teen doesn’t seem able to “bounce back” as well as s/he used to.

What is bipolar disorder?
Bipolar disorder (also known as manic-depression) is a condition that involves extreme disturbances in a person’s mood, energy, and ability to think clearly. In many individuals with bipolar disorder, their mood swings from high (mania) to low (depression) and then back again, often with normal moods in between. These cyclical mood changes can be severe, ranging from highly energetic, euphoric states to persistent states of hopelessness and despair. Such shifts in mood often seriously interfere with a person’s normal day-to-day functioning. Mania typically occurs in episodes and can include racing thoughts, inflated self-esteem, talkativeness, distractibility, and the ability to go with little or no sleep for days without feeling tired. Although manic states are often associated with intense elation and euphoria, these feelings can quickly shift to extreme anger and hostility. The symptoms associated with the depressive phase of bipolar disorder are generally similar to the signs of clinical depression (sometimes referred to as unipolar depression). Individuals with bipolar disorder may experience depressive symptoms before, during, and/or following manic states within the same episode, though this can vary considerably from person to person.

Does bipolar disorder occur in children or adolescents?
Bipolar disorder is characterized by disturbances in a person’s mood, energy, and overall ability to function. Generally, bipolar disorder involves episodes of mania (unusually high energy, extreme irritability, decreased need for sleep, high risk behavior) which alternate with episodes of depression.

Twenty years old is the average age of onset for bipolar disorder. Consequently, about half of people with the disorder develop symptoms during their adolescent or childhood years. About 1% of all children and adolescents experience bipolar disorder. Family history plays a role in a child’s risk for developing the disorder. Children who have a bipolar parent or sibling are 4 to 6 times more likely to develop bipolar disorder than children without a bipolar family member.

The clinical features of childhood bipolar disorder differ somewhat from adult bipolar disorder. Children and adolescents are likely to have more rapid mood changes and disturbances in perception (e.g., hallucinations) than are adults with the disorder. It is important to note that many of the symptoms associated with child and adolescent bipolar disorder (e.g., irritability, emotional reactivity, high risk behavior) are associated with other disorders and also occur at some level in youth with no mental health problems. For this reason, a careful professional evaluation is recommended before diagnosing a child with bipolar disorder. A thorough evaluation involves gathering information about the child’s development, family history, behavioral concerns, and academic functioning. The use of standardized questionnaires and psychological tests is often recommended.

What constitutes an eating disorder?
An eating disorder is characterized by serious disturbances in an individual’s eating habits, and usually involves abnormal obsessions with food and body weight. The health complications that can result from having an eating disorder are often serious and have the potential to be life-threatening. The two most common types of eating disorders are Anorexia Nervosa and Bulimia Nervosa:

  • Anorexia: Individuals suffering from anorexia refuse to maintain a normal, healthy body weight and may severely restrict their calorie intake and/or exercise excessively and compulsively. Some may also engage in binge eating and purging behaviors. Although these individuals are below ideal body weight for their height and age, and despite comments from family and friends that they are too thin, they often experience an intense fear of gaining weight and a significantly distorted perception of their own size.
  • Bulimia: This type of eating disorder is characterized by a cycle of binge eating (consuming a large number of calories within a short period), followed by purging (an effort to compensate or “undo” the binge by getting rid of the food). Purging often involves self-induced vomiting, laxatives, diuretics, fasting, or excessive exercise. For individuals suffering from bulimia, this addictive cycle can quickly become almost uncontrollable.

What is obsessive-compulsive disorder (OCD)?
Obsessive-compulsive disorder (OCD) is a type of anxiety disorder that is characterized by having persistent, distressing thoughts or impulses (obsessions) and/or repetitive behaviors or rituals (compulsions). Compulsions are performed in response to an obsession as a way to prevent or control the upsetting thoughts or impulses and to decrease the anxiety that they cause. Individuals with OCD commonly have multiple obsessions and compulsions that are often associated with one another. For example, hand washing and cleaning rituals are usually associated with germs and contamination obsessions. Other common rituals involve repeatedly checking, counting, or touching things in a specific order or sequence. Although individuals with OCD can often recognize that their obsessions or compulsions are excessive or illogical, the compelling and urgent need they feel to perform their particular routines persists.

What is Post-traumatic stress disorder (PTSD)?
Post-traumatic stress disorder (PTSD) is characterized by persistent anxiety following exposure to an overwhelming traumatic event, such as a natural disaster, major accident, kidnapping, war and violence, or sexual abuse. Common symptoms of PTSD include:

  • Experiencing vivid flashbacks or distressing nightmares that either relate to, or sometimes replicate, the traumatic event
  • Avoiding reminders of the traumatic event, withdrawing or disengaging from loved ones, or feeling emotionally numb
  • Increased arousal, such as being more jumpy or nervous, having difficulty sleeping, or trouble concentrating

Although witnessing a traumatic event is usually very distressing for the persons directly exposed, especially in the immediate aftermath, it does not necessarily mean that every person will develop symptoms of PTSD that persist over time. Reactions to trauma typically vary over time and may depend on a number of different factors such as the level of trauma exposure, availability of social support, coping skills, and other pre-existing individual characteristics. In addition, recent research looking at gender differences suggests that women tend to be more vulnerable to developing post-traumatic stress symptoms than men and may actually take longer periods of time to recover.