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Anxiety Disorder

Anxiety Disorder

Kids and Mental Disorders – ADHD

Children and mental disorders – when is too soon for diagnosis?

I spend a decent chunk of my time cruising chat boards and reading journals, news, social media posts and such about mental disorders.  My own “specialties” are Bipolar Disorder, Adult ADHD, Autism Spectrum DisorderBorderline Personality Disorder, Anxiety Disorder, Depression, Abuse Disorders, OCD… nevermind – I really “specialize” in them all, because I know most Attention Deficit Hyperactivity Disorderof these disorders within my social circle, and I know them on a professional level.

Anyway, I was on a Facebook page the other day for ADHD. (attention deficit hyperactivity disorder)  A woman posted a question about how to manage a kid with ADHD who wakes up and wreaks havoc within the house while everyone is trying to get ready for school and work.  Naturally he was disagreeable, confrontational, oppositional, had “meltdowns” – and it was all exhausting.  (pretty typical behavior for a truly ADHD kid)  A therapist once told me that the ADHD brain doesn’t “wake up” right away and cause all this trouble partly because their brain is not actually engaged yet.  The mom was asking for advice.

Comments on the page gave some really good answers. Some of them are common. Like plan your morning before you go to bed (get out clothes, get backpack ready, make lunch), let the kid make some choices – blah blah blah, stuff we have all heard.

Others were less common, but possibly better advice. Advices like; give the kid an extra 30 minutes to “wake up” in silence, give the child an incentive to get dressed NOW – like playing Minecraft after he is dressed.  I handle mine with the “don’t talk to him yet” option – waiting about 20-30 minutes before making him get busy.  His siblings aren’t allowed to bug him during this time either.  He can wrap himself in a blanket, stare at the wall or whatever – just don’t go back to sleep.

One lady suggested that the kid should be woken to take his meds an hour before he has to be out of bed. Then let him go back to sleep so that his medicines are working by the time he actually gets up.  I found that last piece of advice to be very helpful. My husband with adult ADHD takes his meds about 4 am and gets up at 6, ready to go rather than rude, obnoxious and unhelpful.

Mental Disorders - ADHDWhat troubled me was a comment from a woman who didn’t actually give advice, but chimed in to complain about how hard her four-year-old was to manage.  She said that he had been diagnosed with ADHD and was on meds, but also said that he had bipolar disorder, and still was a screaming banshee in the morning.  This gives me pause for concern.

I certainly can’t do anything about this particular kid, and I don’t really know the exact circumstances but I find the dual diagnosis with bipolar disorder very troubling for a four-year-old child.  Certainly, kids can exhibit ADHD symptoms at 4, and some will benefit from treatment.  But the medications weren’t working, and I am not so sure about the bipolar disorder.

Traditionally, until a few years ago, no one was willing to consider bipolar disorder as a pediatric concern.  Still today, though bipolar disorder obviously exists in childhood – most of the major issues don’t come out until adolescence.

The Diagnostic and Statistical Manual of Mental Disorders does not recognize the bipolar disorder in children under the age of 13

The National Institutes of Mental Health does acknowledge that bipolar disorder in children MAY exist but also warns that many children are misdiagnosed when the main problem is ADHDNIMH recommends that these children be labeled with Mood Dysregulation Syndrome until such time as a diagnosis can be relied upon.

The main problem in diagnosing young children with any mental disorder is that symptoms in children are vastly different from those in adults.  To complicate matters, symptoms of various Cerebrum Lobesdisorders in children are similar to one another.

Symptoms such as irritability, excessive mood swings, meltdowns, oppositional behavior, trouble in school, social inadequacies, explosive behavior, frequent frustration, and hyperactivity, etc. can point to a number of disorders.  Frankly the child may be ADHD, Bipolar, Depressed, Autism Spectrum… or even have food intolerance.

Because of our family history (not just mine), I watch my children very carefully.  I do analyze everything that happens, and I know that all of them probably have a disorder of one type or another.  Two may have ADHD, one is likely bipolar and one has Asperger’s or mild ASD.  I have sought treatment for some issues – but with others, I hesitate to run to a physician – likely a pediatrician who just doesn’t really know.

Our understanding of mental disorders is still evolving

I was personally diagnosed with the wrong disorder for over 15 years – and I was an adult.  How damaging would it have been if I had been labeled with a disorder that I did not have when I was only four years old?
The particular woman I described with the dual diagnosis child was beside herself.  Despite the fact that the four-year-old was receiving medical treatment for both disorders – it wasn’t working.  To me, this means that the treatment was with the wrong meds and for the wrong disorder(s).  In addition, her management skills weren’t the best.

As I said, I know that my children are likely to have disorders of their own but I don’t want to treat them for just any disorder.  I will want them to be treated for the right disease.  My advice to this parent, or any parent whose child had been put on medication that wasn’t working would be to seek a second opinion.

I am more emphatic about that advice if the doctor was willing to “add” a diagnosis to provide more medication; she should definitely seek another opinion.  Preferably the opinion of a pediatric Ritalin - ADHD Medicinepsychiatrist – or even a pediatric behavioral neurologist.  These specialists are few and far between, but it isn’t worth doing anything, but suffering through all the misery because the treatment isn’t working.

Medications are beneficial in the treatment of some types of mental disorders, but they do “change the brain”.  That is how they work – changing the brain can be harmful if you are changing it in the “wrong” directions.  Just seems like common sense.

Melissa Lind

Bipolar Disorder and Adolescents

Symptoms of bipolar disorder in children and adolescents may look like other disorders

Traditionally bipolar disorder has been thought to first show in early adulthood – and more often in females.  Bipolar disorder was considered to be quite rare as few as 20 years ago, to be more exact. The first emergence came in the early 20s, mainly in females. But, our knowledge about bipolar disorder has grown rapidly in the last 20 years.

Instead of the single manic-depressive diagnosis – which included diagnostic criteria of both depressive periods, alternating with manic periods – described as “euphoria”?

Those who did not have clearly rhythmic, alternating periods of a “happy” and frantic manic phase with a classic depression period were mishandled, misdiagnosed, mistreated, or dismissed.

Bipolar ChildrenIn addition, it wasn’t really known that bipolar disorder could start in adolescence or even childhood, or that there are different types of bipolar disorder.  Today, it still isn’t “officially” recognized in the “psychiatric bible” – the Diagnostic Statistical Manual of Mental Disorders (DSM), but at least more practitioners do know that it exists.

Today, we don’t exactly know what causes bipolar disorder (only that there is a genetic link of some kind, and often some past trauma). But, we can at least identify adolescent and childhood bipolar illness.  We also recognize a variety of different types of bipolar disorder (Such as mixed manic episodes, rapid cyclers, people without a depressive phase, hypomania, dysphoria rather than euphoria and cyclothymia). We also have a “catch-all” type – Bipolar NOS or “not-otherwise-specified”.

Adolescent or childhood bipolar disorder is official known as: “early onset bipolar disorder”.  In fact, childhood bipolar disorder can be more serious than a similar disease in adults and may have slightly different symptoms.

Symptoms of bipolar illness in children can often be more severe, and the cycling period may be more frequent.  Children also have more mixed episodes.  Children also have slightly different symptoms – so even the depression phase of the cycle may not be obvious.

Pediatric patients (children and adolescents) with bipolar disorder may have:

Bipolar Disorder in Children•    Abrupt mood swings
•    Periods of hyperactivity followed by lethargy
•    Intense temper tantrums
•    Frustration
•    Defiant behavior
•    Chronic irritability

These symptoms have to appear in more than one setting (school and home) and cause “distress”.

The problem is that many of these symptoms may look like other disorders.  They might be disorders such as ADHD, childhood depression, anxiety disorder, obsessive compulsive disorder, conduct disorder, premenstrual syndrome, oppositional defiant disorder and others. The danger might come from a misdiagnosis and improper treatment.

Bipolar disorder is treated with anti-manic agents (lithium), anti-convulsants (Depakote, lamotrigine) or atypical antipsychotics (Abilify, Risperdal).  In many cases, anti-depressant won’t be needed.  Treatment for other disorders like ADHD or depression may make bipolar disorder worse. Childhood bipolar disorder is something that desperately needs treatment as the distress caused to the patient, and the family can predispose the youngster to

•    Drug or alcohol abuse
•    Stealing
•    Involvement with law enforcement
•    Poor social integration
•    Poor academic performance
•    Suicidal tendencies
•    Premature sexual behavior

The Balanced Mind has a good self-check list of symptoms that can help a parent or a teen decide if bipolar disorder might be an issue.  Self-testing is not always accurate and should be discussed with a doctor, (preferably with test results in hand).  Not all doctors accept pediatric bipolar disorder. Parents may have to seek advice from more than one mental health professional and be aware that insurance may not cover the illness.

Melissa Lind

Generalized Anxiety Disorder and Women

Lots of women first develop generalized anxiety disorder during childhood

GAD and Women


Studies have shown that while 19 million Americans suffer from anxiety disorders each year, of that number, the majority of them are women.

Feeling anxious is quite normal — until and unless it starts interfering with one’s day-to-day life, or preventing one from reaching their goals. In fact, normal anxiety is a contributing factor to helping us get things accomplished — especially in women.

What most people don’t realize is that many women suffer from generalized anxiety disorder. Women are “natural born worriers” for the most part, but there are those women who suffer a bit more than others. Women who suffer from GAD worry about everything, and that fear brings about physical problems, such as headaches, muscle tension, an inability to relax, fatigue, lack of focus, and more.

Would you believe that many of these women first develop GAD during childhood?

It is true — and because of this, they never even realize that there is a problem. In fact, they often will assume that everyone worries as much as they do. It’s completely “normal” as far as they are concerned, because it has always been a part of their lives. Most of these women cope very well with the anxiety — simply because they are used to it.

Then there are those who have never suffered from GAD, and actually never have had worried more than anyone else about things. Suddenly, they are overwhelmed with anxious feelings. And because this is new, and they are not used to it, it becomes a huge thing to worry about — on top of whatever else they may be worrying about.

Often, for women, the cause of the anxiety in this situation is hormonal changes. Estrogen and progesterone levels change over time. In fact, a woman is likely to experience more anxiety during PMS, perimenopause, menopause, and even pregnancy. Estrogen affects the levels of serotonin that the brain is producing. This serotonin gives us our “sense of well-being.”

For lots of women, the anxiety passes as either time or medication puts the hormone levels back into check. Other women may discover that they have been suffering from GAD for most of their lives, with the change in hormone levels drastically elevating the condition.

In any case, there is treatment and help available. You can go through life without so much worry and anxiety.

Childhood Sexual Abuse and Mental Health

Mental Health and Childhood Sexual Abuse – Don’t Carry the Secret

Recently I saw something on Facebook that was very sad.  It was a video of a 50 plus year old man named Scott – also called “Spider,” who told the story of his life through written cards, in a fashion similar to Ben Breedlove’s “This is my story” about his heart condition. In the video, this tough looking man, confessed the trauma of his own sexual abuse and the damage it had done to him over the years – drug abuse, divorce, culminating in an arrest for beating his child’s sexual predator with a bat.

The story was naturally sad but is all too common.  In fact, statistics shows that 1 in 6 boys will be sexually molested by the age of 18 and worse for girls with 1 in 3.  The other sad fact is that many, many children who are sexually abused don’t tell anyone.  Either they are threatened or ashamed – or both.  They carry the secret for much of their lives.

Trauma, abuse, neglect – biology didn’t account for its infliction on children.  As children, our brains develop best in a loving,
supportive environment with plenty of nutritional food and quality exercise so that our bodies become the best they can be.  Childhood Trauma - Mental HhealthAround the world we see the damage that poor nutrition, neglect and physical abuse can do to children.  What is not so obvious is the damage wreaked by sexual abuse – it is a hidden traumaSexual abuse is hidden by the child, hidden from the adults, hidden from other children, and sometimes even hidden by the child’s memory.

Secrets are always dark.  Carrying secrets can ruin a relationship or ruin a career.  Carrying secrets imposes a burden of stress on your body – your heart doesn’t work as well, your adrenal system gets burned out, your sleep is affected.  Carrying a secret like that can change a child’s brain.

Studies have shown that abuse or childhood trauma actually causes physical changes to the developing brain.  It can make the child unable to grow to what they would have been.

So what does this have to do with mental health?

The effects of childhood trauma are hard to predict.  Mental health is hard to identify – particularly the cause.  In some cases, we can easily point to the parents and say “Mom and Grandma have clinical depression; it is no surprise that the daughter has depression.”  Schizophrenia has been shown to be driven by over 100 genes and a child with one schizophrenic person has a 13 percent chance of developing the disorder.  Some people are “born” alcoholics in that they are missing an enzyme that allows them to process alcohol properly and will nearly always become addicted if they drink.

In other cases – we can’t identify the cause.  You have some cases of mental disorders that develop in people with perfect childhoods.  You have people with horrible experiences who are remarkably healthy – rare, but true.  In many cases though, someone with a history of child abuse will develop some mental disorder – but the type is very hard to predict.

In “Spider’s” case, he became a drug addict, had an anger problem and felt that he had to prove he could “conquer” women (his own words), leading to the destruction of his family.  Likely he suffered from depression, anxiety disorder, and possibly Mental Health - Child AbusePost-Traumatic Stress Disorder.  Telling the “secret”, not carrying the weight may, just may have kept him from his self-destructive behavior.  Unfortunately, it may not have stopped his daughter from being a victim, but it might have allowed him better tools than a bat to deal with her problem.

In severe cases, extreme trauma can actually cause the personality to “split,” in “Dissociative Identity Disorder” (DID), which was previously called “Multiple Personality Disorder” (MPD).

(Photo-source: http://blogs.ocweekly.com/navelgazing/2014/08/scott_spider_spideralamode_facebook_molest.php)

Sexual abuse has another problem – that children are often disbelieved which worsens the trauma.  Unlike physical abuse, unlike neglect, unlike starvation – there are no “obvious” signs.  There are signs, but you have to know what they are.  Children who have been sexually abused do exhibit signs:

•    changes in behavior or personality type – a normally outgoing child becomes withdrawn, a normally gregarious child becomes angry and sullen
•    bed wetting and nightmares (oddly the bed-wetting may be punished)
•    refusal to go to school, church, sports or club activities or to a certain friend’s house
•    sudden clinginess or a sudden desire to be left alone

Too often, adults don’t ask.  Too often, children don’t tell.  Sadly, sometimes adults won’t listen.  If you know of a child that has
sudden behavioral changes – ask.  If you are an adult, believe.  If you are a victim, tell.  Even at a late date, telling can change your life and resolve some of your “issues.” I think in the end, “Spider’s” main message was “tell your kids to tell.”

What does this have to do with mental health?

Sexual abuse can contribute to:

PTSD, Depression, Bipolar Disorder, Anxiety Disorder, Intermittent Explosive Disorder, Obsessive Compulsive Disorder, Bulimia, Anorexia, Drug Addiction, Alcoholism, Attachment Disorder… and many more.

History of Child Abuse – Free PDF

Melissa Lind

Anxiety Often Interferes With Life

Anxiety can be as if one is suffering from a physical disability

Everyone deals with stress in their lives. Everyone also feels anxious from time to time, and this is perfectly normal. But the fear can become abnormal, and if this happens, it will start interfering in your life. Something like that can significantly reduce your quality of life, just as if you were suffering from a physical disability. In fact, anxiety can become a type of physical disability.

Anxious and Depressed GirlAnxiety will prevent you from doing things that you want to do. People who are socially anxious can see that anxiousness progress to the point where they do not want to leave their homes. They will start avoiding crowded places, or places or events where they might be required to socialize with other people. They may even start fearing the telephone.

Obviously, all of these things combined serve to lessen the quality of that person’s life — keeping them from socializing with old friends, failing to meet new friends, and failing to participate in particular experiences.

Anxiousness will also prevent you from fully enjoying vital aspects of your life, such as your children or grandchildren, hobbies, or your career. Those who suffer from an anxiety disorder can fill their minds with such enormous amounts of worry that there is little room to enjoy the things that are useful in their lives. They simply cannot stop worrying.

Stress can lead to physical and mental problems. Anxiousness in ChildrenDepression is a common result of anxiety, as are constant tension headaches. These other mental and physical conditions also play a role in lowering one’s quality of life.

People who often are anxious do not sleep well. When we’ve had enough sleep, we see the world around us in a more positive light. With the lack of sleep, however, things often appear to be “gloomier” than they really are.

Despite the fact that things aren’t as gloomy as we might think, the quality of life is lessened even more because our perception of what is going on around us is all that we really have to go by in life.

Anxiety does have an enormous impact on one’s overall life, and, therefore, if you are suffering from anxiety, you should seek treatment as soon as possible, so that your life — and your perception of your life — can get back on the right track.

Anxiety and depression often go hand-in-hand!

Panic Attacks and Anxiety

Suffering from anxiety disorder and have panic attacks?

Do you have anxiety?
Are you constantly worried?

We all probably know that anxiety is a normal part of life.  That horrible feeling of anxiousness is something that can happen to all of us from time to time — and with good reason. However, many people suffer from anxiety without any valid reason — regardless of how correct the reason for the anxiety seems to them.

Anxiety can cause a host of other mental health problems.
Child AnxietyFirst, when the brain is stressed, the body’s immune system fails to function properly. Things like this leads to illnesses. Second, anxiety can prevent one from living life to the fullest. And, finally, stress can lead to full-blown anxiety attacks, otherwise known as panic attacks.

A panic attack might feel like a heart attack. In fact, when one suffers their first panic attack, this is what they think that it is, in most cases. They will usually seek out medical emergency services. A lot of the symptoms are often the same as a heart attack. The person may feel chest pains, have trouble catching their breath, become dizzy, feel nauseous, and also feel completely out of control.

AnxiousLuckily, you won’t die from a panic attack — even though you can’t be convinced of that when it is happening. Even better news is that panic attacks can be prevented. Medication can be prescribed, relaxation techniques can be used, and counseling, in the form of Cognitive Behavioral Therapy (CBT) can be sought.

Your doctor will most likely prescribe an antidepressant for your anxiety. However, antidepressants take about three weeks to become effective, and during this time, you may discover that you are more anxious than you were before. Panic attacks may become more severe during this time.

For reasons mentioned, your doctor may also prescribe a benzodiazepine. The benzodiazepine will effectively take care of the anxious feelings, and help to prevent panic attacks. However, this is not a safe long-term drug, as antidepressants are. Therefore, after about three weeks, your doctor will most likely discontinue the benzodiazepine, and continue with the antidepressant. Naturally, CBT will also be recommended.

Panic attacks are very real — and very scary. If you suffer from panic attacks, know that there is treatment out there, and with that treatment, you can avoid future panic attacks.

Stress and Anxiety – Is There Any Relationship? (Free PDF)

Panic attacks and anxiety disorder sufferers