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Kevin Leehey M.D. Child, Adolescent, and Adult Psychiatry Board Certified
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  1. Kevin Leehey M.D.Child, Adolescent, and Adult PsychiatryBoard Certified 296-4280 leeheymd.com

  2. Community of Concern Workshop • Depression and Self Destructive Behaviors Kevin Leehey, M.D. 296-4280

  3. Overview • What causes depression, anxiety, and self harm? • What is Depression ? • What is Anxiety ? • What is stress? • What is self destructive behavior ? • How do I help my teen ? Kevin Leehey, M.D. 296-4280

  4. Causes • Genetics • Life events, losses, environment, disappointments • “Stress” - personal, family, peers, societal pressures • Alcohol and other drugs • Health problems • ADD, ADHD, Learning Disorders • “Nature vs Nurture” - genes or experiences Kevin Leehey, M.D. 296-4280

  5. Types of Depression • Major • Dysthymic disorder • Depression NOS • Bipolar Depression • Existential or adolescent angst • Personal and Family History PH, FH Kevin Leehey, M.D. 296-4280

  6. Major Depression : for diagnosis 5 of below for at least 2 weeks • Sad, mad, down most of every day • Anhedonia - loss of interest, withdrawal • Fatigue, loss of energy • Sleep change - up or down • Appetite change - up or down • Feel worthless, hopeless, guilt, negative • Agitation or slowed movements and thoughts • Decreased concentration and ability to think, or decide • Recurrent thoughts of death or suicide Kevin Leehey, M.D. 296-4280

  7. Especially common in depressed teens : • Irritable, cranky, negative • Withdrawal, isolation • Change or avoid friends • Drop in school performance • Quit or fail to follow through with activities, jobs, etc. • Substance abuse • Anxiety, worry about the future, hopeless, no longer trying, loss of motivation Kevin Leehey, M.D. 296-4280

  8. Other Forms of Depression • Dysthymia • Depresson NOS • Existential, “angst” • Bipolar Depression • PH and FH Kevin Leehey, M.D. 296-4280

  9. Mania: while not one’s usual self for at least a week, a marked change • Elevated, expansive, irritable, temper • Inflated self esteem, grandiosity • Markedly decreased need for eating or sleeping • Pressured speech • Racing thoughts • Flight of ideas • Loss of judgement, spend, sex, illegal, pleasure seek, substance abuse, gamble, unwise business ventures • Agitation • Distractible • Psychosis can occur Kevin Leehey, M.D. 296-4280

  10. Anxiety • Excessive worry, fear, nervous • Generalized Anxiety Disorder, GAD • Panic, “anxiety attack” • Separation anxiety, school anxiety • Social anxiety • Obsessive Compulsive Disorder, OCD • O/C style, perfectionism • Over-sensitive,over-reactive, control • PH and Family history Kevin Leehey, M.D. 296-4280

  11. Stress • Forces from the outside (or inside) that impinge, affect, or impact us. • Mild to moderate stress can promote growth. Severe, sudden, or chronic stress cause biologic damage resulting in physical and emotional damage, disease. • Trying to do too much too fast, pressure to grow up, achieve, excel • Positive coping • Negative coping Kevin Leehey, M.D. 296-4280

  12. Co- and Extra-curricular Activities • studies show : • 10-20 hours a week is best for most teens • Kids who do <10 hours and kids who do >20 hours do less well in school • Sports, clubs, music, job, youth groups, 4H, horses, volunteer, martial arts, etc. • learn a skill, develop a hobby, make new friends, build self esteem, manage time, get experience, build a resume, find a mentor, have positive fun Kevin Leehey, M.D. 296-4280

  13. Self Destructive Behavior • Any behavior that hurts you • Substances • Eating disorders • Piercings ? Tattoos? • The “choking game” • Self harm, self mutilation • Suicide Kevin Leehey, M.D. 296-4280

  14. Self Harm • Cut, scratch, burn, mutilate • Trendy, myspace, “community”, “emo” • Arms and more • Mild to severe • To release feelings physically; to convert emotional pain into physical • Usually not suicide intent Kevin Leehey, M.D. 296-4280

  15. Suicide • “accidental”, uncertain intent, ambivalent, passive, nihilism • Ideation, plan, intent, act • #2 to 3 cause of death age 15-24 • Firearms 80% in boys; 50% girls • Overdoses, hanging, “accidents” • Arizona in worst 5 • “survivors”, the suffering of those left Kevin Leehey, M.D. 296-4280

  16. Suicide - cont’d • 1) Depressed, angry, substances • 2) “the last person you’d ever expect” • 3) Eating Disorders especially Bulimia • 4) Psychosis or severe mental illness • Disciplinary Crisis • Connectedness, support system • Lethality of method and intent • Rate dropped 25 % in last decade • Prevention, treatment Kevin Leehey, M.D. 296-4280

  17. How do I help my Teen? • Model healthy living and coping • Reasonable expectations • Be present, involved, and caring • Avoid over-control and intrusion • Focus on developing the life skills your teen will need for happy independence • Encourage but limit electronics • Use the Community of Concern Kevin Leehey, M.D. 296-4280

  18. How do I help? - cont’d • Teach or provide “teacher” of healthy coping skills, stress mgmt, values, spirituality, self esteem, goals • The “relaxation response” • Motor vehicles, firearms, substances • Parenting books • Therapy and counseling • Medication Kevin Leehey, M.D. 296-4280

  19. Therapy and Counseling • Individual therapy- Cognitive Behavioral (CBT), Behavior Management, Interpersonal, Psychodynamic, Psycho-education • Family therapy- Family system, Structural, Parenting, Psycho-education • Intensive Outpatient Programs • Residential Treatment • Inpatient Hospitalization Kevin Leehey, M.D. 296-4280

  20. Medication • Safety - carefully prescribed and monitored the safety record is excellent • The more “biologic” signs that are present the more likely medicine will help and is needed • The more severe the anxiety or depression • The stronger the family and personal history • If therapy is not enough, not effective, refused, or if medication is preferred Kevin Leehey, M.D. 296-4280

  21. Medication - cont’d • 25% best with therapy alone, 25% best with medicine alone, 50% best with combination for Major Depression or severe Anxiety • SRI’s, buproprion, SNRI’s, etc. • Bipolar disorder usually requires medicine • Omega 3 (and 6) FA’s, supplements, vitamins, diet, exercise, other Kevin Leehey, M.D. 296-4280

  22. Good night and good luck! • Kevin Leehey M.D. • 296-4280 • leeheymd.com Kevin Leehey, M.D. 296-4280