Glossery of Syptoms and Mental Illness Affecting Teenagers
Being a teenager is not easy. Adolescents feel all kinds of
pressures -- to do well in school, to be popular with peers, to
gain the approval of parents, to make the team, to be cool. In
addition, many teenagers have other special problems. For
example, they may worry about a parent being out of work or the
family's financial problems.
Adolescents may be hurt or confused by their parents' divorce,
or they may have to learn how to live with a parent's alcoholism
or mental illness. Despite these pressures, it is important to
remember that most teenagers develop into healthy adults.
Unfortunately, some teenagers develop serious emotional problems
requiring professional help. This glossary of brief definitions
was developed to help teenagers, parents, teachers, and others
learn more about the major mental illnesses, symptoms, and
mental health issues which affect teenagers. Please remember:
All the problems described in the glossary are treatable and
some can be prevented. In every case, the sooner a teenager gets
help, the better.
ALCOHOL AND DRUG ABUSE
Use and abuse of drugs and alcohol by teens is very common and
can have serious consequences. In the 15-24 year age range, 50%
of deaths (from accidents, homicides, suicides) involve alcohol
or drug abuse. Drugs and alcohol also contribute to physical and
sexual aggression such as assault or rape. Possible stages of
teenage experience with alcohol and drugs include abstinence
(non-use), experimentation, regular use (both recreational and
compensatory for other problems), abuse, and dependency.
Repeated and regular recreational use can lead to other problems
like anxiety and depression. Some teenagers regularly use drugs
or alcohol to compensate for anxiety, depression, or a lack of
positive social skills. Teen use of tobacco and alcohol should
not be minimized because they can be "gateway drugs" for other
drugs (marijuana, cocaine, hallucinogens, inhalants, and
heroin). The combination of teenagers' curiosity, risk taking
behavior, and social pressure make it very difficult to say no.
This leads most teenagers to the questions: "Will it hurt to try
A teenager with a family history of alcohol or drug abuse and a
lack of pro-social skills can move rapidly from experimentation
to patterns of serious abuse or dependency. Some other teenagers
with no family history of abuse who experiment may also progress
to abuse or dependency. Therefore, there is a good chance that
"one" will hurt you. Teenagers with a family history of alcohol
or drug abuse are particularly advised to abstain and not
experiment. No one can predict for sure who will abuse or become
dependent on drugs except to say the non-user never will.
Warning signs of teenage drug or alcohol abuse may include:
a drop in school performance,
a change in groups of friends,
delinquent behavior, and
deterioration in family relationships.
There may also be physical signs such as red eyes, a persistent
cough, and change in eating and sleeping habits. Alcohol or drug
dependency may include blackouts, withdrawal symptoms, and
further problems in functioning at home, school, or work.
Anorexia Nervosa occurs when an adolescent refuses to maintain
body weight at or above a minimal normal weight for age and
height. The weight loss is usually self-imposed and is usually
less than 85% of expected weight. The condition occurs most
frequently in females, however, it can occur in males.
Generally, the teenager has an intense fear of gaining weight or
becoming fat even though underweight. Self evaluation of body
weight and shape may be distorted and there may be denial of the
potential health hazards caused by the low body weight.
Physical symptoms can include:
absence of regular menstrual cycles
low pulse rate, and
low blood pressure
Behavioral changes commonly occur such as:
Without treatment, this disorder can become chronic and with
severe starvation, some teenagers may die.
Anxiety is the fearful anticipation of further danger or
problems accompanied by an intense unpleasant feeling
(dysphoria) or physical symptoms. Anxiety is not uncommon in
children and adolescents. Anxiety in children may present as:
Separation Anxiety Disorder: Excessive anxiety concerning
separation from home or from those to whom the child is
attached. The youngster may develop excessive worrying to the
point of being reluctant or refusing to go to school, being
alone, or sleeping alone. Repeated nightmares and complaints of
physical symptoms (such as headaches, stomach aches, nausea, or
vomiting) may occur.
Generalized Anxiety Disorder: Excessive anxiety and worry about
events or activities such as school. The child or adolescent has
difficulty controlling worries. There may also be restlessness,
fatigue, difficulty concentrating, irritability, muscle tension,
and sleep difficulties. Panic Disorder: The presence of
recurrent, unexpected panic attacks and persistent worries about
having attacks. Panic Attack refers to the sudden onset of
intense apprehension, fearfulness, or terror, often associated
with feelings of impending doom.
There may also be shortness of breath, palpitations, chest pain
or discomfort, choking or smothering sensations, and fear of
"going crazy" or losing control. Phobias: Persistent, irrational
fears of a specific object, activity, or situation (such as
flying, heights, animals, receiving an injection, seeing blood).
These intense fears cause the child or adolescent to avoid the
object, activity, or situation.
ATTENTION DEFICIT/ HYPERACTIVITY DISORDER (ADHD)
ADHD is usually first diagnosed during the elementary school
years. In some cases, symptoms continue into adolescence. A
teenager with Attention Deficit/Hyperactivity Disorder has
problems with paying attention and concentration and/or with
hyperactive and impulsive behavior. Despite good intentions, a
teenager may be unable to listen well, organize work, and follow
directions. Cooperating in sports and games may be difficult.
Acting before thinking can cause problems with parents,
teachers, and friends. These teens may be restless, fidgety, and
unable to sit still.
Attention Deficit/Hyperactivity Disorder occurs more commonly in
boys and symptoms are always present before the age of seven.
Problems related to ADHD appear in multiple areas of a
youngster's life and can be very upsetting to the teen, his/her
family, and people at school. Symptoms of ADHD frequently become
less severe during the late teen years and in young adulthood.
BIPOLAR DISORDER (MANIC DEPRESSION)
Bipolar Disorder is a type of mood disorder with marked changes
in mood between extreme elation or happiness and severe
depression. The periods of elation are termed mania. During this
phase, the teenager has an expansive or irritable mood, can
become hyperactive and agitated, can get by with very little or
no sleep, becomes excessively involved in multiple projects and
activities, and has impaired judgment.
A teenager may indulge in risk taking behaviors, such as sexual
promiscuity and anti-social behaviors. Some teenagers in a manic
phase may develop psychotic symptoms (grandiose delusions and
hallucinations). For a description of the depressive phase see
depression. Bipolar disorder generally occurs before the age of
30 years and may first develop during adolescence.
BULIMIA NERVOSA (BULIMIA)
Bulimia Nervosa occurs when an adolescent has repeated episodes
of binge eating and purging. Binges are characterized by eating
large quantities of food in a discrete period of time. The teen
also has feelings of being unable to stop eating and loss of
control over the amount of food being eaten. Usually, after
binge eating, they attempt to prevent weight gain by
self-induced vomiting, laxative use, diuretics, enemas,
medications, fasting, or excessive exercise. These teen's
self-esteem is strongly affected by weight and body shape.
Serious medical problems can occur with Bulimia Nervosa (e.g.
esophageal or gastric rupture, cardiac arrhythmias, kidney
failure, and seizures). Other psychological problems such as
depression, intense moods, and low self-esteem are common. Early
diagnosis and treatment can improve outcome and decrease the
risk of worsening depression, shame, and harmful weight
Teenager's with conduct disorder have a repetitive and
persistent pattern of behavior in which they violate the rights
of others, or violate norms or rules that are appropriate to
their age. Their conduct is more serious than the ordinary
mischief and pranks of children and adolescents.
Severe difficulties at home, in school, and in the community are
common, and frequently there is very early sexual activity.
Self-esteem is usually low, although the adolescent may project
an image of "toughness." Teenagers with this disorder have also
been described as "delinquent" or "anti-social." Some teenagers
with conduct disorder may also have symptoms of other
psychiatric disorders (see ADHD, depression, alcohol and drug
Though the term "depression" can describe a normal human
emotion, it also can refer to a psychiatric disorder. Depressive
illness in children and adolescents includes a cluster of
symptoms which have been present for at least two weeks.
In addition to feelings of sadness and/or irritability, a
depressive illness includes several of the following:
Change of appetite with either significant weight loss (when not
dieting) or weight gain
Change in sleeping patterns (such as trouble falling asleep,
waking up in the middle of the night, early morning awakening,
or sleeping too much)
Loss of interest in activities formerly enjoyed
Loss of energy, fatigue, feeling slowed down for no
reason, "burned out" Feelings of guilt and self blame for things
that are not one's fault
Inability to concentrate and indecisiveness
Feelings of hopelessness and helplessness
Recurring thought of death and suicide, wishing to die, or
attempting suicide Children and adolescents with depression may
also have symptoms of irritability, grumpiness, and boredom.
They may have vague, non-specific physical complaints
(stomachaches, headaches, etc.). There is an increased incidence
of depressive illness in the children of parents with
Learning Disorders occur when the child or adolescent's reading,
math, or writing skills are substantially below that expected
for age, schooling, and level of intelligence. Approximately 5%
of students in public schools in the United States are
identified as having a learning disorder.
Students with learning disorders may become so frustrated with
their performance in school that by adolescence they may feel
like failures and want to drop out of school or may develop
behavioral problems. Special testing is always required to make
the diagnosis of a learning disorder and to develop appropriate
remedial interventions. Learning disorders should be identified
as early as possible during school years.
OBSESSIVE- COMPULSIVE DISORDER (OCD)
Teenagers with OCD have obsessions and/or compulsions. An
obsession refers to recurrent and persistent thoughts, impulses,
or images that are intrusive and cause severe anxiety or
distress. Compulsions refer to repetitive behaviors and rituals
(like hand washing, hoarding, ordering, checking) or mental acts
(like counting, repeating words silently, avoiding). The
obsessions and compulsions also significantly interfere with the
teen's normal routine, academic functioning, usual social
activities, or relationships.
Physical abuse occurs when a person responsible for a child or
adolescent's welfare causes physical injury or harm to the
child. Examples of abusive treatment of children include:
hitting with an object, kicking, burning, scalding, punching,
and threatening or attacking with weapons. Children and
adolescents who have been abused may suffer from depression,
anxiety, low selfesteem, inability to build trusting
relationships, alcohol and drug abuse, learning impairments, and
POST- TRAUMATIC STRESS DISORDER (PTSD)
PTSD can occur when a teenager experiences a shocking,
unexpected event that is outside the range of usual human
experience. The trauma is usually so extreme that it can
overwhelm their coping mechanisms and create intense feelings of
fear and helplessness.
The traumatic event may be experienced by the individual
directly (e.g. physical or sexual abuse, assault, rape,
kidnaping, threatened death), by observation (witness of trauma
to another person), or by learning about a trauma affecting a
close relative or friend. Whether teens develop PTSD depends on
a combination of their previous history, the severity of the
traumatic event, and the amount of exposure.
Recurrent, intrusive, and distressing memories of the event
Recurrent, distressing dreams of the event.
Acting or feeling as if the traumatic event were recurring
Intense psychological distress when exposed to reminders of the
traumatic event and consequent avoidance of those stimuli.
Numbing of general responsiveness (detachment, estrangement from
others, decreased interest in significant activities) Persistent
symptoms of increased arousal (irritability, sleep disturbances,
poor concentration, hyper-vigilance, anxiety).