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The Reason Behind the Behavior

The Reason Behind the Behavior. Mental Illnesses in Our Youth. NAMI. Advocacy, support, education Over 1000 local and state affiliates Focus is on the severe, persistent brain disorders that can affect one's ability to think, feel, and relate to others and his environment. Major Topics.

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The Reason Behind the Behavior

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  1. The Reason Behind the Behavior Mental Illnesses in Our Youth

  2. NAMI • Advocacy, support, education • Over 1000 local and state affiliates • Focus is on the severe, persistent brain disorders that can affect one's ability to think, feel, and relate to others and his environment.

  3. Major Topics • Brain Research • Diagnosis • Warning Signs • Treatment • The Family • Interventions

  4. Childhood-onset brain disorders • Tend to be more severe and more mixed than adult-onset disorders • More difficult to diagnose and treat. • Interfere with development, learning

  5. Prevalence • 7 of 10 children – no diagnosable brain disorder • 25% - moderately severe disorder • 5% - marked impairment/SED • Less than 1 in 5 get help. • One-half of life-time cases begin by age 14 • Adults – 21% • (GSMS 1998, Surgeon General’s Report 1999, NIMH NCS-R 2005)

  6. Brain Research • Mental disorders - Neurobiological Brain Disorders (NBD) • Scientifically proven biologically-based • PET Scans, MRI findings, biochemical and genetic research substantiate scientific, biological basis of disorders • Involve some impairment of thought, perception, feeling and/or behavior

  7. Diagnosis • Psychiatrists base diagnosis of emotional, behavioral, and mental disorders on DSM-IV. • Diagnostic Statistical Manual, 4th edition, 1995 is the American Psychiatric Association’s classification of mental disorders. • Symptoms vary from person to person. • Result in reduced ability to cope with life. • Based on disability, duration of symptoms, symptoms of specific disorder.

  8. Benefits of Early Recognition • Faster, more complete recovery • Less severe brain disorder with improved prognosis • Individuals more able to recognize illness when less ill and more compliant with treatment/meds • Reduces risk of suicide, depression, substance abuse, unprovoked aggression • Less disruption to psychological, social and educational development

  9. Warning Signs: Elementary Difficulty going to sleep, reluctance to take part in activities normal for child’s age; Frequent, unexplainable temper tantrums; Hyperactive behavior/fidgeting; Steady, noticeable decline in school performance; Pattern of deliberate disobedience or aggression; Persistent nightmares; Pronounced difficulties with attention, concentration, organization; Increased irritability.

  10. Warning Signs • Feeling hopeless, overwhelmed, low self-esteem; • Sudden overwhelming fear for no apparent reason; • Severe mood swings affecting relationships with others; • Drastic change in personality or behavior; and • Extreme worries or fears that interfere with friendships, school work, or play.

  11. Warning Signs: Pre-teens, Teens Frequent outbursts of anger or inability to cope with problems and daily activities; Lack of close friends; Marked change in school performance, sleeping &/or eating habits Threats of self-harm or injury and toward others; Sexual acting-out; Threaten to run away; Strange thoughts, feelings, or unusual behaviors.

  12. Common denominators of extreme behavior • High anxiety/separation anxiety • Aggression, rage • Hyper-reactive • Dangerous impulsivity • Disorientation and attention issues • Social phobia • Substance abuse

  13. ADHD • Quick to arouse in AM • “Expert hunters” of long ago • Seek stimulus safety (lights, smells, touch) • Understimulated cognitive domain • “Frantic starts, endless running” like transmission in car.

  14. Major Depression IRRITABILITY Low energy Frequent physical complaints Low self-esteem Poor concentration Sensitive Grouchy anger Kindling effect Bipolar disorder Very depressed Marked impairment – work, school, social Slow to arouse in AM With mania – Flight of Ideas, distractible, grandiosity, goofiness, talkative, may be aggressive, rage Charming, gifted A Few Words about Mood Disorders

  15. Anxiety Disorders • Obsessions, compulsions, tics are “hard wired” in brain. • Sense of relief from compulsions • Panic attacks • Big need to feel safe

  16. Cognitive Distortions ALL-OR-NOTHING THINKING – No shades of gray. OVERGENERALIZATION One event is seen as part of a pattern of failure. MENTAL FILTER Only negative or fearful aspects of a situation are perceived. DISQUALIFYING THE POSITIVE Positive experiences discounted/rejected. MIND READING Assuming others are thinking badly of you

  17. More Cognitive Distortions • FORTUNE TELLING – Predicting that things will turn out badly. • MAGNIFICATION – Smallest mistake is projected into worst possible outcome. • LABELING AND MISLABELING – Overgeneralizing – “I am stupid.” “I am a loser.” • PERSONALIZATION– “If anything goes wrong, it must be my fault.” • LEARNED HELPLESSNESS – “Nothing ever works for me anyway, so why try?”

  18. Stigma • Old myths, shame, embarrassment • Destroys hope; silences success stories • Systematic discrimination • Nobody is to blame

  19. What Parents Need • To learn how child reacts in educational setting • Parent needs to report this info to doctor, therapist • May need to develop home-school behavior plan • Focus placed on strengths and needs, not on pathology, programs, available services • To know they are not to blame • To be asked what they need

  20. Skills for working with children • Flexibility, patience, ability to laugh at oneself/situations • Good conflict management skills • Receptive to change • Open communication

  21. Strategies • Reduce exposure to stress • Help improve coping skills • Provide structure, predictability each day • Use praise, encouragement • Most important – how adults respond to and work with them

  22. Strategies • Good working knowledge of symptoms • Good communication with home • Prepared with a variety of approaches to handle shifts in mood • Prepare for transition

  23. What Professionals Can Do • Be aware that behaviors that are unusual or interfere with learning may be symptoms of a disorder of child’s brain. • Speak in terms of “differences” not disabilities. • Remind parents they are not to blame. • Let parent, support staff know what warning signs are present. • Refer child to student support team - counselor, school psychologist.

  24. What Professionals Can Do • Be vigilant in observing behavior of children. • Divert attention - calming voice, little talking. • Cognitive behavioral intervention - Teach coping skills to child, self-talk strategy, learning to recognize signs of stress, what to do. • Take agitation, threats seriously. Be prepared to use interventions. • Front-end interventions are best.

  25. Problem with Executive Functions • Trouble setting priorities, planning • Difficulty with sequence, organization • Unaware of future, inflexible • Problem with carrying out goals, feedback • Inability to suppress, delay response • Production difficulties • unable to self-monitor

  26. How to help these children • Problem w/executive function? - Break up directions, check early on. • “This is the problem. This is what you need to do.” • “Instant replay” • Find out what they love.

  27. Memory Deficits - TS, OCD, ADD • Cannot control thoughts, worrying, stuck, stuck, stuck…. • Anxiety increases if interrupted. • Problem with working memory, strategy. • Writing, math difficulties may be production problems

  28. When feelings are intense … thinking is impaired!!

  29. Stress-related Issues • Routine important • Rules posted, few in number, positively stated • Teach organizational skills • Try to avoid sensory overload • Exercise!!! • Graceful Exit Plan

  30. Hope on the Horizon • Research - new treatments, “Decade of the Brain” • Advocacy groups fighting stigma • Families as equal partners in treatment • Full range of services to the child and family address all needs • Strength-based assessment

  31. Our Basic Message • Mental illnesses are no-fault brain disorders. • Getting the right diagnosis and proper medication is not easy but treatment works! • Early recognition of symptoms is vital. • Families need support. • Interventions work! • Thank you for all you do!

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