Mood Disorders, Bipolar Disorder and Teenage Depression
Ironwood Adolescent Residential Treatment Center
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programs for teens 13-18.
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I. What are Mood
Disorders?
"But when the melancholy fit shall fall
Sudden from heaven like a weeping cloud,
That fosters the droop-headed flowers all,
And hides the green hill in an April shroud;
Then glut thy sorrow on a morning rose."
John Keats, Ode on Melancholy
We have all felt sad, or melancholy, from time to time. But
there is a point where the ache of sadness becomes chronic
and insufferable, a mountain of pain to its victim. Mood disorders,
predominantly Depression and Bi-polar syndromes, are said
to strike one in seven of the population.
How Prevalent are Mood Disorders in Children
and Adolescents?
7-14% of children will experience an episode
of major depression before the age of 15. 20-30% of adult
bipolar patients report having their first episode before
the age of 20.
Out of 100,000 adolescents, two to three thousand
will have mood disorders out of which 8-10 will commit suicide.
-Adapted from an article of the same name
in the
NARSAD Research Newsletter, Winter 1996.
The two principal classifications for mood
disorders are bi-polar (also known as manic-depression) and
depression alone. Bi-polarity is characterized by wild mood
swings ranging from deep sadness and depression to euphoric
and manic type behavior. Depression is defined as a deep overriding
sadness and feelings of despair. These feelings are all pervasive
and don't disappear in time.
Children and adults who suffer from mood disorders
cannot cope well in society. When depressed, they experience
a loss of interest and lack of enjoyment in life. For a person
with bi-polar disorder, the manic swings can create a disruptive
influence on all aspects of their life and the lives of everyone
around them.
Bi-polar disorder is classified in two categories:
Bi-polar I and Bi-Polar II. Bipolar I Disorder is considered
the classic form of manic depression, with full Manic Episodes
and Major Depressive Episodes. Bipolar II Disorder involves
Major Depressive Episodes and Hypomanic (non-full-blown Mania)
Episodes. Since a significant portion of those suffering with
manic depression do not have full manic episodes, the classification
was divided into Bipolar I and Bipolar II. However, Bipolar
II is often a first step to Bipolar I.
Bi-polar disorder appears to run in
families, and there is some evidence that a biological vulnerability
towards bi-polarity could be inherited. However, not everyone
with this genetic vulnerability has the illness. Major depression
also seems to appear generationally, but it too can occur
in persons with no family history of the disease. An important
factor that the research has uncovered is that major depressive
disorder is associated with a neuro-chemical imbalance in
the brain.
II.
What are the symptoms of a mood disorder
Depression
symptoms include:
· Sadness |
· Difficulty sleeping |
· Fatigue |
· Hopelessness |
·
Despair |
·
Sense of inferiority |
·
Dejection |
·
Exaggerated guilt |
·
Changes in appetite |
·
Feelings of incompetence |
·
Loss of interest |
·
Inability to function effectively |
Bi-polar symptoms include all of the
above, with these additional indications of the manic phase
of the disorder:
· Increased strength and energy,
decreased sleep |
· Extreme irritability |
· Rapid, unpredictable emotional
changes |
· Racing thoughts,
flights of ideas |
· Increased interest in activities,
overspending |
· Grandiosity, inflated self-esteem |
· Increased sexual drive |
· Poor judgment |
Depression
Checklist
III. How are Depression and Bi-polar Disorders
Diagnosed?
Depression and Bi-Polar Inventories
Inventories or checklists are diagnostic tools
used by doctors to help them diagnose depression. One of these
diagnostics is called the Beck's Depression Inventory, a series
of questions that is presented to the patient to help the
doctor's assess the extent of the patient's problem, and if
a diagnosis of depression is warranted. There are a number
of such inventories that are used besides the Beck's Inventory:
Goldberg Depression Inventory, Goldberg Mania Inventory, and
the Young Mania Scale, being the most commonly used diagnostics.
Doctors interview the patient and the patient's caregivers
to help them assess the extent of the illness. Assessment
includes a full medical history and physical examination.
V. How are Mood Disorders Treated?
Treatment of Mood Disorders includes:
Medication.
Psychotherapy.
Combined treatment of medication and psychotherapy.
The treatment is geared to treat the more
severe symptoms. The choice of treatment is based on a variety
of factors, among them the history of the illness and the
severity of the episodes. The severity of the illness is assessed
using some of these general definitions:
A. Severe depression is present when a person has nearly all
of the symptoms of depression, and the depression almost always
keepthem from doing their regular day-to-day activities.
B. Moderate depression is present when a person has many symptoms
of depression that often keep them from doing things that
theyneed to do.
C. Mild depression is present when a person has some of the
symptoms of depression, and it takes extra effort to do the
things they need to do.
The severity of Bi-polar disorder is assessed by clinical
history and descriptions of the latest episodes: both Depression
and Mania.
Medications
The following medications are used to treat
Depression and Bi-polarity:
· Anafranil** |
· Asendin |
· Aventyl |
· Desyrel |
· Effexor |
·Elavil |
· Ludiomil |
· Luvox (SSRI) |
· Marplan (MAOI) |
· Nardil (MAOI) |
· Norpramin |
· Pamelor |
· Parnate (MAOI) |
· Paxil (SSRI) |
· Pertofrane |
· Prozac (SSRI) |
· Remeron |
· Serzone |
· Sinequan |
· Surmontin |
· Tofranil** |
· Vivactil |
· Wellbutrin |
· Zoloft (SSRI) |
Medications Specific to Bi-Polar Disorder
· Lithium |
· Wellbutrin |
· Depakote |
·
Zoloft |
·
Prozac |
|
More
information about specific medications
Outpatient Facilities
A. Outpatient facilities have therapeutic staff on-hand to
offer therapy and support to patients on a part-time basis.
This can be helpful in the treatment of depression and Bi-polar.
Professionals to Seek Out
- See your physician
or pediatrician
- Consult with your clergy to assist in spiritual
and practical guidance
- Consult with an educational consultant
to help
you find the right program for your child.
- Consult with a therapist or counselor.
- Consult with an Educational Advocate to
help you
with your current school situation
- Consult with an Educational Consultant
to find the
right program for your child.
Find
out more about Educational Consultants
Programs
- Inpatient: hospitalization
- Outpatient
- Day
Treatment
- Residential
Programs
a. Emotional
Growth School
Emotional Growth schools are highly structured environments
that stress academics and teach coping skills through the
use of conflict resolution. Children learn they can make choices
and learn to accept responsibility through the use of modeling
behavior and outdoor therapy. The length of stay is between
9 and 18 months, at which time they either return to the mainstream
or attend a boarding school, if possible. Parents are involved
with the school staff and the children throughout the child's
attendance at the school.
Find
out more about Outdoor Therapy
b. Therapeutic
Residential Boarding School
These schools are usually fully accredited schools with emotional
growth programs. They stress holistic education: growth of
the person through holding children responsible for their
actions. There is no rehabilitation or physicians on staff.
c. Therapeutic
Wilderness Program
A Therapeutic Wilderness program does not necessarily have
academics; their goal can be to introduce the children to
a different role. These programs use Outdoor Therapy to help
build low self-esteem. They make obtainable goals for them
to reach. The programs vary but they are about 6 to 8 weeks
long. It is a very structured program with a goal of teaching
the children coping skills and raising their self0esteem.
Children go from this program to mainstream back into their
public school or attend a small structured boarding school.
Find out
more about Therapeutic Wilderness Programs
d. Residential
Treatment School
A Residential Treatment Program or School provides a full
professional staff that includes therapists, psychologists,
and psychiatrists. They also have a small academic program.
Many of the children in the program have been recommended
there by mental health agencies that make the placements.
It is a highly structured environment whose emphasis is on
treatment and learning coping skills and independent living.
Chemical dependence education and rehabilitation is also provided.
Outdoor therapy is sometimes used to facilitate building social
skills and self-esteem. Recovery programs are also available.
Residential Treatment schools are secure schools.
Find
out more about Residential Treatment Schools
Which program
is right for my child?
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