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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

Borderline Personality Disorder or Traumatic Stress Disorder

Borderline Personality Disorder – What if it is a traumatic stress disorder?

When most people think of Borderline Personality Disorder – they think of bad behavior.  It is someone that is very difficult to deal with, someone that you have to be on guard against, Borderline Disordersomeone who will try their best to manipulate you.
But, while that may be the outcome, just like most psychiatric disorders, it isn’t exactly their fault.

One of the problems with BPD is that since it is a “personality disorder“, there is often no recognized medical treatment.

We simply expect that the patient should self-monitor and control their behavior.  Therapy may help this, but how many of us (psychiatric patients, in general) really want to go to therapy.

Many of us have already spent hundreds of hours with a therapist – who may or may not help.  In addition, the best therapists are likely people who can “see through the bullshit” and refuse to be manipulated.  This obviously goes against the nature of someone with Borderline Personality Disorder.

In fact, the stigma is so bad that some therapists won’t even work with Borderline patients.

Co Morbid DisordersOne theory may help.  Some therapists have developed an automatic assumption that a Borderline patient is also a trauma victim.  While this co-morbid condition may not always be true, it can help some therapists feel more comfortable treating the patient.

Due to many soldiers returning from impossible battlefields in the Middle East, Post Traumatic Stress Disorder is fairly well recognized.  Remember; I am not saying that it is easily treatable, but to some extent, the stigma is less.

When therapists look at Borderline patients as truly a PTSD patient, they may be more willing to treat the disorder. And they will attempt to get to the underlying causes of abandonment, impulsive and destructive issues, loss of control and poor self-image.

While PTSD is well defined by the professional psychiatric community, a longer-term disorder currently known as complex traumatic disorder is not.  Most examples of CTSD still involve soldiers, or they may involve women who had difficult pregnancies or who were violently sexually abused, repeatedly.

However, what if you don’t fit any of those recognized categories?

There are more ways to treat traumatic stress disorders such as Cognitive Behavioral Therapy or a newer one, Dialectical Behavior TherapyDBT focuses on four major areas:

•    Regulation of emotionsPost-Traumatic Stress Disorder
•    Tolerance for distress
•    Interpersonal effectiveness
•    Mindfulness

Unlike CBT, there is no “processing” component – making it work well as an initial treatment, starting before the patient has developed coping skills.  It builds up the feeling of emotional safety so that coping skills may develop.

Differentiating between “plain” Borderline patients – and those whose behavior is brought on by traumatic experience may help to eliminate some of the stigma still associated with BPD.  It may also offer actual, more effective treatment than CBT or other approaches.

Melissa Lind

Anxiety Treatment Method – Mental Imaging

Use of mental imaging as an anxiety treatment method

While there are many wonderful medications that aid in the treatment of anxiety symptoms, there are other methods for controlling anxiety as well. Mental imaging is one such treatment.

Mental ImagingMental imaging is used in many instances and professions. Professional sports players, speakers, and actors use mental imaging. For the purpose of anxiety, mental imaging works as a relaxation technique. It can be used to negate negative thoughts, and replace those negative thoughts with positive images that help one to face or get through a situation that makes them feel anxious.

To practice mental imaging, you must predetermine what your image will be. Will you see yourself handling a tough situation? Will you see yourself doing something that you didn’t think you could do? Again, you need to have your mental image ready to go before you need it.

The hardest part of mental imaging remembers to use it when you need it. This is not always easy to do when you are feeling anxious, and worries are clouding your mind. You may also need mental imaging aids at the beginning, such as cassette tapes to get you into the state of mental imaging. You may need to close your eyes to practice mental imaging in the beginning as well.

Mental imaging can also be used outside of anxious situations — when you are calm — to help build confidence in yourself.

In fact, people who suffer from anxiety disorders who practice mental imaging outside of anxious situations find that the anxiety episodes that they do have are fewer and far between — and that they don’t last as long.

While mental imaging is very easy, and can be done by anyone, it should not be used to replace medical treatment for anxiety. You still need treatment from a doctor, and you can discuss mental imaging with your doctor.

Mental Imaging and Anxiety

Untreated Anxiety

Untreated anxiety is an extremely real problem.

According to the NIMH, or National Institute of Mental Health, more than 19 million Americans suffer from anxiety disorders. Unfortunately, a study conducted by the Anxiety Disorders Association of America (ADAA), done in 1999, found that only about one-third of those people seek treatment. Of those who do seek treatment, the stress may be grossly misdiagnosed, and, therefore, not treated properly.

Untreated AnxietyUntreated anxiety is absolutely a real problem — and that question just grows as long as it is left untreated. Anxiety can eventually dominate your life, preventing you from living your life to the fullest potential. Long-term anxiety can even lead to depression or increased anxieties, which in turn will most likely progress to anxiety, or panic attacks.

Anxiety is stress, but it is extreme stress. When the brain is stressed, the immune system does not function properly, and this makes you more subject to illnesses, and will also make it difficult to get over illnesses that you do have. Common problems associated with anxiety include increased blood pressure, digestive problems, stomach problems, and sleep disorders. You may also experience stress related aches and pains, diarrhea, and dizziness.

These are not temporary problems. As long as the anxiety remains untreated, these problems will not only persist — they will expand into even worse mental health problems. Nobody dies from anxiety attacks, but they can certainly die from health problems that are brought on by the stress of anxiety.

Many people don’t seek treatment for anxiety because they feel as it is “normal” and that no treatment is needed. In most cases, anxiety is normal. We all feel anxious when things aren’t going well or when truly awful things happen.

However, no matter what the cause of the anxiety, if it is a long term, and left untreated, the problems that are coming are even worse than the ones that you are experiencing today. Do yourself, your mind and your body a favor — seek treatment!

Generalized Anxiety Disorder – GAD

GAD – More than a Worrywart.

Everybody worries from time to time, but a person worrying extends to interrupt daily life and cause debilitating anxiety, those persons may have Generalized Anxiety Disorder, or, in short – GAD. While people with GAD may start out by worrying about everyday things, this disorder can easily take over people’s life and be the cause other medical problems. If one thinks they have GAD, one should see a doctor immediately and talk about various treatment options.

General Anxiety DisorderPeople with GAD worry about everyday things like money, health, relationships, and jobs. It is normal to worry about these things, even on a daily basis. However, if a person has GAD, worries are constant and excessive, and in many cases, irrational. People diagnosed with Generalized Anxiety Disorder are often distracted and consumed with fear. These things are something that is difficult to think about, and it is difficult to do anything else but think of all that worries. To be worried is a part of life for everyone – from the moment one awakes to the moment one falls asleep, but that worries have no real foundation in reality.

Numerous of symptoms occur as a result of GAD. Such as; squeamishness, muscle tension, sleeping problems, exhaustion, breathing difficulties, changes in appetite, sweating or hot flashes, headache and restlessness. Medical professionals do not yet know what causes GAD. Treatment and diagnosis can, therefore, sometimes be difficult. If some of these symptoms are experiencing and one find they are worrying often, one should seek for medical help with what could be Generalized Anxiety Disorder.Anxious

It is essential to be extremely specific about the symptoms since treatment for GAD begins with ruling out other anxiety disorders. Treatment that works well can than include both therapy and medication. Every person worries in a different way, so every person needs different treatment, as well. To find the best form of medical treatment for his or hers GAD situations one should always work together with a doctor. Work with one`s own body`s wants and needs.

No matter why people have developed GAD, they can get help. Most people suffering from GAD do not know that they can be helped.

If people find themself constantly consumed with worries, they should talk to a doctor immediately to find out how medical treatment can help.
One may feel as though there is always something to worry about – from having enough money to pay for bills to getting that job promotion. In a normal life, one may think about these things at least once or twice a day.
A doctor can help achieve this, even if one has GAD.

More about GAD here (Video): Generalized Anxiety Disorder (GAD) and how it affects my life