Behavior ProblemsChildhood, for all of its joys, can be a difficult time of life — so can Adolescence. The image of the unpredictable adolescent: happy one moment, sullen the next, is a cultural stereotype, with good reason. Hormonal changes, social pressures, and increased responsibilities at school can take a toll. While experts agree that most adolescents have reasonably happy lives and do well at home and in school, they also recognize that at least one in five children and adolescents has some type of mental health disorder. At least one in 10, or about 6 million children and adolescents, has a serious emotional disturbance. When untreated, mental health disorders in children and adolescents can lead to school failure, family conflicts, drug abuse, violence, and even suicide. Untreated mental health disorders can be very costly to families, communities, and the health care system Scientists believe that mental health disorders in children and adolescents are caused mostly by biology and environment. Examples of biological causes are genetics, chemical imbalances in the body, or damage to the central nervous system, such as a head injury. Many environmental factors also put young people at risk for developing mental health disorders. Examples include:

 

  • Exposure to environmental toxins, such as high levels of lead;
  • Exposure to violence, such as witnessing or being the victim of physical or sexual abuse, drive-by shootings, muggings, or other disasters;
  • Stress related to chronic poverty, discrimination, or other serious hardships; and
  • The loss of important people through death, divorce, or broken relationships.

Warning Signs A variety of signs may point to mental health disorders or serious emotional disturbances in children or adolescents. You might notice your child or adolescent is troubled by feeling

  • Sad and hopeless for no reason, and these feelings do not go away
  • Very angry most of the time and crying a lot or overreacting to things
  • Worthless or guilty
  • Anxious or worried
  • Unable to get over a loss or death of someone important
  • Extremely fearful or having unexplained fears
  • Constantly concerned about physical problems or physical appearance
  • Frightened that his or her mind either is controlled or is out of control

You might see negative changes in your child or adolescent’s behavior, such as

  • Behavior problems
  • School truancy
  • Running away
  • Stealing
  • Abusing others’ property
  • Hostile, angry attitude toward authority figures
  • Destruction of property
  • Not respecting curfew
  • Not complying with even simple requests
  • Substance Abuse
  • Using marijuana, LSD, crack
  • Using alcohol as a minor
  • Arriving home intoxicated
  • Possessing illegal drugs
  • Legal problems (arrests, probation, mandated treatment)
  • Exhibiting behavior problems listed above
  • Learning Problems
  • Chronic inability to attain passing grades in one or more subject areas
  • One or more grade levels behind peers
  • Inability to work within structure of school rules
  • Suspensions and/or expulsion from school
  • Dissatisfaction with services offered by school system

Effects on the Family Emotional problems in children and adolescents put tremendous stress on a marriage and a family. Parents often blame each other for the child’s problems. Other children in the family can experience anger, fear, or sadness because of the emotional or behavior problems or because of the parents’ focus on these problems. This dynamic is only compounded when the family is “blended,” with some children from previous marriages and some from the new union. Then, the step-parent often becomes the target of a lot of anger and frustration over the intolerable situation. Getting Help Family therapy can help each family member present his or her own view of the problem and of solutions that might solve it. One advantage of family therapy is that it makes the teen feel less like “the problem” and helps motivate him or her for therapy since it’s “all for one and one for all.” Family therapy also helps parents and siblings identify how they can help the teen turn the problem around. Siblings who may be affected by the problems can vent their anger or fear a in a constructive manner, and ask for what they need from parents, who may be preoccupied with helping the teen. Family therapy also can help parents become a high-performance parenting team, to form a “circle of wagons” around the teen. This is time and energy intensive, but it does work to help teens decrease the behaviors that are causing them trouble. Usually, family therapy occurs once a week for 50 minutes. During times of crisis, a more intensive schedule can be of benefit, for example after a teen has run away, to help the family stabilize the situation. While families can’t control the crisis, they can change how they react to the teen, thus stopping any “secondary gains” the teen may be getting from the crisis. Change at time of crisis may come easily, but maintaining the change when things are calming down can be dicey. The teen is trying to convince the parents that everything’s OK so that the interventions will stop, and then the teen can resume the negative behaviors. Hope Is Important Families with a child or adolescent who is struggling with emotional or behavioral problems are under extreme stress. It is important that parents’ needs and other areas of life aren’t neglected while the family addresses the problems. Taking time out as a couple, and doing upbeat activities with the other children, are ways to fight stress and take a step back. With your batteries recharged, you can be a more effective parent to all of your children. If your child or teen is struggling with problematic emotions and behaviors and you are unsure what to do, you are welcome to contact us to schedule a free phone consultation. Our clinicians are skilled and experienced in helping children and teens overcome these problems; and in helping families build strong, positive relationships.

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Glenn Dale, MD / McLean, VA / Internet

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