Parents, practitioners, and policymakers are recognizing the importance of young people’s mental

health. Youth with better mental health are physically healthier, demonstrate more socially positive
behaviors and engage in fewer risky behaviors. Conversely, youth with mental health problems, such as
depression, are more likely to engage in health risk behaviors. Furthermore, youths’ mental health
problems pose a significant financial and social burden on families and society in terms of distress, cost of
treatment, and disability.

Most mental health problems diagnosed in adulthood begin in adolescence. Half of lifetime
diagnosable mental health disorders start by age 14; this number increases to three fourths by age 24.
The ability to manage mental health problems, including substance use issues and learning disorders, can
affect adult functioning in areas such as social relationships and participation in the workforce

Two topics we Will encounter

 One in five adolescents experience significant symptoms of emotional distress and nearly one in
ten are emotionally impaired;
 The most common disorders among adolescents include depression, anxiety disorders and
attention-deficit/ hyperactivity disorder and substance use disorder

 What is mental health and mental illness?

The 1999 Surgeon General’s Report on Mental Health defined mental health as “successful performance
of mental function, resulting in productive activities, fulfilling relationships with other people, and the
ability to change and to cope with adversity

Mental illness refers to diagnosable mental disorders that are characterized by alterations in thinking,
mood, or behavior (or a combination thereof) associated with distress and/or impaired functioning.”

Common disorders include mood disorders such as depression; anxiety disorders; behavioral problems
such as oppositional defiant disorder or conduct disorder; eating disorders such as anorexia nervosa and
bulimia; addictive disorders; and other disorders commonly seen in childhood and adolescence such as
autism, learning disorders and attention-deficit/hyperactivity disorder (AD/HD).

According to WHO (World Health Organization) mental health encompasses positive aspects of
well-being and healthy functioning as well as negative aspects of mental disorder and dysfunction. Ideally,
a comprehensive overview of adolescent mental health status would reflect both positive and negative
aspects. A comprehensive overview would also recognize that family, community and social contexts
influence mental health status. For example, exposure to violence can have adverse consequences for
mental health status.
  Specific Disorders

 Depression - feelings of severe despondency and dejection.

Depression is one of the most widely studied mental health conditions because of its large
burden on individuals, families, and society and its links to suicide. Depression is the most widely
reported disorder, with over a quarter of adolescents affected A Mental Health Profile of
Adolescents Page 5 by at least mild depressive symptoms.

One of the broadest indicators of depressive symptoms comes from the YRBSS. This study
asks: Have you ever felt so sad or hopeless almost every day, for two weeks in a row, that you
couldn’t do some of your usual activities? Results from the 2005 YRBSS indicate that 36.7% of
female and 20.4% of male high school students reported this level of sadness;

10 common symptoms of depression:

1. Feelings of helplessness and hopelessness. A bleak outlook—nothing will ever get better and
there’s nothing you can do to improve your situation.
2. Loss of interest in daily activities. You don’t care anymore about former hobbies, pastimes, social
activities, or sex. You’ve lost your ability to feel joy and pleasure.
3. Appetite or weight changes. Significant weight loss or weight gain—a change of more than 5% of
body weight in a month.
4. Sleep changes. Either insomnia, especially waking in the early hours of the morning, or
oversleeping.
5. Anger or irritability. Feeling agitated, restless, or even violent. Your tolerance level is low, your
temper short, and everything and everyone gets on your nerves.
6. Loss of energy. Feeling fatigued, sluggish, and physically drained. Your whole body may feel
heavy, and even small tasks are exhausting or take longer to complete.
7. Self-loathing. Strong feelings of worthlessness or guilt. You harshly criticize yourself for perceived
faults and mistakes.
8. Reckless behavior. You engage in escapist behavior such as substance abuse, compulsive
gambling, reckless driving, or dangerous sports.
9. Concentration problems. Trouble focusing, making decisions, or remembering things.
10. Unexplained aches and pains. An increase in physical complaints such as headaches, back pain,
aching muscles, and stomach pain.

 Anxiety Disorders - are a group of mental disorders characterized by significant feelings

of anxiety and fear. Anxiety is a worry about future events and fear is a reaction to current events.
These feelings may cause physical symptoms, such as a fast heart rate and shakiness.
 National prevalence data on specific anxiety disorders in adolescents are limited,
although regional studies suggest that the combined prevalence of anxiety disorders is among the
highest in childhood and adolescence. National data were located on Post Traumatic Stress
Disorder (PTSD): according to the 1995 National Survey of Adolescents (NSA), 3.7% of all males
and 6.3% of all females ages 12-17 were reported to have PTSD in 1995. Among these youth,
nearly half of the males (47.3%) also had symptoms of major depressive disorder, as did nearly
30% of the females.

Types of Anxiety Disorders

Anxiety disorder is an umbrella term that includes different conditions:

1. Panic disorder. You feel terror that strikes at random. During a panic attack, you may also sweat,
have chest pain, and feel palpitations(unusually strong or irregular heartbeats). Sometimes you
may feel like you’re choking or having a heart attack.
2. Social anxiety disorder. Also called social phobia, this is when you feel overwhelming worry and
self-consciousness about everyday social situations. You fixate about others judging you or on
being embarrassed or ridiculed.
3. Specific phobias. You feel intense fear of a specific object or situation, such as heights or flying.
The fear goes beyond what’s appropriate and may cause you to avoid ordinary situations.
4. Generalized anxiety disorder. You feel excessive, unrealistic worry and tension with little or no
reason.

 Substance Abuse Disorders - A substance use disorder (SUD), also known as a drug use
disorder, is a condition in which the use of one or more substances leads to a clinically significant
impairment or distress. In the DSM-5 substance use disorder replaced substance
abuse and substance dependence. it has been implicated in addictions
to alcohol, cannabinoids, cocaine, nicotine, phenylcyclidine, and substituted amphetamines as
well as addictions to natural rewards such as sex, exercise, and food.

 Conduct Disorder and Oppositional Defiant Disorder – a range of antisocial types

of behavior displayed in childhood or adolescence. is a childhood disorder that is defined by a
pattern of hostile, disobedient, and defiant behaviors directed at adults or other authority
figures. ODD is also characterized by children displaying angry and irritable moods, as well as
argumentative and vindictive behaviors.

Although complete evaluation of all DSM criteria for conduct disorder could not be located, the 1995
AddHealth study reported “proxy variables,” including stealing, damaging property, and threatening
others which were associated with conduct disorder diagnosis

Behavioral symptoms:

 Easily losing one’s temper / throwing repeated temper tantrums

 Arguing
  Fighting
 Refusing to follow rules
 Deliberately acting in a way that will annoy others
 Blaming others
 Blatant hostility towards others
 Being unwilling to compromise or negotiate
 Willingly destroying friendships
 Being spiteful and seeking revenge
 Blatant and repeated disobedience

Cognitive symptoms:

 Frequent frustration
 Difficulty concentrating
 Failure to “think before speaking”

Psychosocial symptoms:

 Difficulty making friends

 Loss of self-esteem
 Persistent negativity
 Consistent feelings of annoyance

 Learning Disabilities and Attention Deficit and Hyperactivity Disorder

(ADHD) - Attention deficit hyperactivity disorder (ADHD) affects children and teens and can
continue into adulthood. ADHD is the most commonly diagnosed mental disorder of children.
Children with ADHD may be hyperactive and unable control their impulses. Or they may have
trouble paying attention.

ADHD/Inattentive Type

1. Does not pay close attention to details, makes careless mistakes

2. Often has trouble keeping attention on tasks
3. Often does not seem to listen when spoken to directly
4. Often does not follow through on instructions and fails to finish work or chores (because of failure
to understand, not defiance)
5. Often has trouble organizing activities
6. Often avoids or dislikes things that take a lot of mental effort for a long period of time.
7. Often loses things needed for tasks and activities
8. Is often easily distracted
9. Is often forgetful in daily activities
ADHD Hyperactive/Impulsive Type

1. Often fidgets with hands and feet or squirms in seat

2. Often gets up from seat
3. Often excessively runs about our climbs when not appropriate
4. Often has trouble playing or doing leisure activities quietly
5. Is on the go as if driven by a motor
6. Often talks excessively
7. Often blurts out answers before questions have been finished
8. Often has trouble waiting his turn
9. Often interrupts or intrudes on others

 Causes
o Heredity
o Smoking, drinking and drug use during pregnancy
o Prematurity
o Exposed to Lead
o Nutritional Triggers

 Eating Disorders - any of a range of psychological disorders characterized by abnormal or

disturbed eating habits (such as anorexia nervosa).

National data related to eating disorders could not be located except for two questions in the
YRBSS. The first relates to bulimia symptoms and the second addresses use of diet products. In 2005,
4.5% of high school students took a laxative or vomited and 6.3% took diet pills, powders or liquids
without a doctor’s advice to lose weight or avoid gaining weight. More females purged than males,
with 6.2% of females and 2.8% of males saying they had taken laxatives or vomited to control weight.
This gender trend is similar for taking diet pills, powders or liquids with 8.1% of females and 4.6% of
males reporting this behavior

Type of Eating Disorders –

Anorexia (or anorexia nervosa) is a serious mental illness where people are of low weight due to
limiting their energy intake. It can affect anyone of any age, gender, or background. As well as restricting
the amount of food eaten, they may do lots of exercise to get rid of food eaten. Some people with
anorexia may experience cycles of bingeing (eating large amounts of food at once) and then purging.

Bulimia (or bulimia nervosa) is a serious mental illness. It can affect anyone of any age, gender, or
background. People with bulimia are caught in a cycle of eating large quantities of food (called
bingeing), and then trying to compensate for that overeating by vomiting, taking laxatives or diuretics,
fasting, or exercising excessively (called purging). Early intervention offers the best chance for a rapid
and sustained recovery from bulimia.
Binge eating disorder (BED) is a serious mental illness where people experience a loss of control and
eat large quantities of food on a regular basis. It can affect anyone of any age, gender, or background.

 Suicide - Suicide is the act of intentionally causing one's own death.

While not a mental health disorder, suicide is more common among adolescents with certain mental
health problems. In addition to depression, the presence of other mental health problems, such as
conduct disorders, eating disorders, and anxiety disorders, also increase the risk of suicide. Suicide is
the third leading cause of adolescent mortality.