Mental, Emotional, and Behavior Disorders
in Children and Adolescents
Mental, Emotional, Behavior Problems Are Real
Young people can have mental, emotional, and behavior problems
that are real, painful, and costly. These problems, often called “disorders,”
are a source of stress for the child as well as the family, school, community,
and larger society.
The number of families who are affected by mental, emotional,
and behavior disorders in young people is staggering. It is estimated that as
many as one in five children or adolescents may have a mental health problem
that can be identified and treated. At least 1 in 10---or as many as 6 million
young people---may have a “serious emotional disturbance.” This term refers to
a mental health problem that severely disrupts a person’s ability to function
socially, academically, and emotionally.
Mental health disorders in children and adolescents are caused
by biology, environment, or a mix of both. Examples of biological factors are
genetics, chemical imbalances in the body, and damage to the central nervous
system, such as a head injury. Many factors in a young person’s environment can
affect his or her mental health, such as exposure to violence, extreme stress,
and loss of an important person.
Caring families and communities working together can help
children and adolescents with mental disorders. A broad range of services often
is necessary to meet the needs of these young people and families.
The Disorders
Following are descriptions of some of the mental, emotional, and
behavior problems that can occur during childhood and adolescence. All of these
disorders can have serious impact on a child’s overall health. Some disorders
are more common than others, and conditions can range from mild to severe.
Often, a child has more than one disorder.
Anxiety disorders are
among the most common of childhood disorders. They affect an estimated
* phobia --- an unrealistic and overwhelming fear of some object or
situation;
* generalized anxiety
disorder --- a pattern of excessive, unrealistic worry not attributable to any
recent experience;
* panic disorder ---
terrifying panic attacks that include physical symptoms such as rapid heartbeat
and dizziness;
* obsessive-compulsive
disorder --- being trapped in a pattern of repeated thoughts and behaviors such
as counting or hand washing; and
* post-traumatic stress
disorder --- a pattern of flashbacks and other symptoms that occurs in children
who have experienced a psychologically distressing event such as physical or
sexual abuse, being a victim or witness of violence, or exposure to some other
traumatic event such as a bombing or hurricane.
Major depression is
recognized more and more in young people. Years ago, may people believed that
major depression did not occur in childhood. But we now know that the disorder
can occur at any age. Studies show that up to 6 out of every 100 children may
have depression. The disorder is marked by changes in:
* emotion --- the child
often feels sad, cries, looks tearful, feels worthless;
* motivation ---
schoolwork declines, the child shows no interest in play;
* physical well-being ---
there may be changes in appetite or sleep patterns and vague physical
complaints; and
* thoughts --- the child
believes that he or she is ugly, that he or she is unable to do anything right,
or that the world or life is hopeless.
Some adolescents, or even
elementary school children with depression, may not place any value on their
own lives, which may lead to suicide.
Bipolar disorder (manic-depressive illness)
in children and adolescents is marked by exaggerated mood swings between
extreme lows (depression) and highs (excitedness or manic phases). Periods of
moderate mood occur in between. During a manic phase, the child or adolescent
may talk nonstop, need very little sleep, and show unusually poor judgement.
Bipolar mood swings can recur throughout life. Adults with bipolar disorder, as
common as 1 in 100 adults, often experienced their first symptoms during
teenage years.
Attention-deficit/hyperactivity
disorder occurs in up to 5 of every 100 children. A young person with
attention-deficit/hyperactivity disorder is unable to focus attention and is
often impulsive and easily distracted.
Most children with this disorder have great difficulty remaining still,
taking turns, and keeping quiet. Symptoms must be evident in at least two
settings (for instance, at home and at school) for
attention-deficit/hyperactivity disorder to be diagnosed.
Learning disorders
affect the ability of children and adolescents to receive or express
information. These problems can show up as difficulties with spoken and written
language, coordination, attention, or self-control. Such difficulties can make
it harder for a child to learn to read, write, or do math. Approximately 5 of
every 100 children in public schools are identified as having a learning
disorder.
Conduct disorder
causes children and adolescents to act out their feelings or impulses toward
others in destructive ways. Young people with conduct disorder repeatedly
violate the basic rights of others and the rules of society. The offenses that
these children and adolescents commit often get more serious over time.
Examples include lying, theft, aggression, truancy, fire setting, and
vandalism. Children and adolescents with conduct disorder usually have little
care or concern for others. Current research has yielded varying estimates of
the number of young people with this disorder; most estimates range from 4 to
10 of every 100 children and adolescents.
Eating disorders can
be life threatening. A young person with anorexia nervosa, for example, cannot
be persuaded to maintain a minimally normal body weight. This child or
adolescent is intensely afraid of gaining weight and doesn’t believe that he or
she is underweight. Anorexia affects 1 in every 100 to 200 adolescent girls and
a much smaller number of boys.
Youngsters with bulimia nervosa feel compelled to binge (eat
huge amounts of food at a time). Afterward, to prevent weight gain, they rid
their bodies of the food by vomiting, abusing laxatives, taking enemas, or
exercising obsessively. Reported rates vary from 1 to 3 out of 100 young
people.
Autism spectrum disorder
or autism appears before a child’s third birthday. Children with autism have
problems interacting and communicating with others. They behave inappropriately,
often repeating behaviors over long periods. For example, some children bang
their heads, rock, or spin objects. The impairments range from mild to severe.
Children with autistic disorder may have a very limited awareness of others and
are at increased risk for other mental disorders. Studies suggest that autism
spectrum disorder affects 7 to 14 of every 10,000 children.
Schizophrenia can be
a devastating mental disorder. Young
people with schizophrenia have psychotic periods when they may have
hallucinations (sense things that do not exist, such as hearing voices),
withdraw from others, and lose contact with reality. Other symptoms include delusional or
disordered thoughts and an inabilility to experience pleasure. Schizophrenia is even more rare than autism
in children under 12, but occurs in about 3 out of every 1000 adolescents.
Treatment, Support Services, and Research: Sources of Hope
Many of the symptoms and much of the distress associated with
childhood and adolescent mental, and behavior problems may be alleviated with
timely and appropriate treatment and support services.
A child or adolescent in need of treatment or services and his
or her family may need a plan of care based on the severity and duration of
symptoms. Optimally, this plan is developed with the family, service providers,
and a service coordinator, who is referred to as a case manager.
Whenever possible, the child or adolescent is involved in
decisions.
Tying together all the various supports and services in a plan
of care for a particular child and family is commonly referred to as a “system
of care.” A system of care is designed
to improve the child’s ability to function in all areas of life---at home, at
school, and in the community. For a fact
sheet on systems of care, call 1.800.789.2647.
Researchers are working to
produce new knowledge and understanding about mental, emotional, and behavior
disorders. Studies are also exploring
ways to prevent and treat mental, emotional, and behavior problems, including
the range of services that may be required.
Many of these studies are funded by Federal agencies within the
Department of Health and Human Services, which include:
* the National Institutes of Health:
-the National Institute of
Mental Health
- the
National Institute of Child Health and Human Development
- the
National Institute for Drug Abuse
- the
National Institute on Alcoholism and Alcohol Abuse.
* the Substance Abuse and Mental Health Services Administration:
-
the Center for Mental Health Services
-
the Center for Substance Abuse Prevention
-
the Center for Substance Abuse Treatment.
* the Administration for Children and Families
* the Health Resources and Services
Administration.
Related activities are
taking place within:
* the Department of
Education
* the Department of
Justice.
There is now more reason
than ever for youngsters with these problems and their families to lead normal,
happy lives.
Important Messages About
Children’s and Adolescents’ Mental Health:
* Every child’s mental health is important.
* Many children have mental health problems.
* These problems are real and painful and can be severe.
* Mental health problems can be recognized and treated.
* Caring families and communities working together can
help.
* Information
is available; cal1.800.789.2647.
For free information about
children’s and adolescents’ mental health---including publications, references,
and referrals to local and national resources and organizations---call
1.800.789.2647; TTY 301.443.9006 or go to www.mentalhealth.org.
For more
information about Mental Illnesses -
Contact:
The Alliance for the Mentally Ill
NAMI of Greater Chicago
1536 West Chicago Ave, Chicago, IL 60622
Phone: 312-563-0445