Saturday, March 05, 2005

ADD ADHD Advances Blog

ADD ADHD Advances Blog

ADHD Blog

ADHD Blog

Some Common Mental Health Terms

Some Common Mental Health Terms

Recently, I was having a discussion with a well-educated mother concerning her son’s condition. As the discussion continued it became more and more clear that even though she was freely using a number of mental health terms, she really had no idea of their actual meaning.

For this reason I have decided to define some of the words commonly used in mental health, so that you will have some idea what is being discussed when they are discussing your child. This is not an exhaustive list and it is in no particular order.

If there is something term or condition that you would like to know more about, please
contact me

ADHD- Attention Deficit Hyperactivity Disorder

ADHD is a brain-based neurological neurochemical disorder of brain function, which symptomatically manifests itself in a number of subtypes.

There are five primary areas in which the person’s inability to control himself is manifest.

  • Difficulty sustaining attention
  • Impulse control or inhibition
  • Excessive activity
  • Following rules and instructions
  • Excessive variability in their responses to situations, particularly doing work

There are four subtypes of ADHD (some researchers now claim there are six):


  • Type A- Inattentive Subtype
  • Type B- Hyperactive Impulsive Subtype
  • Type C- Combined Subtype
  • Type D-Nonspecific Subtype

ADD- Attention Deficit Disorder


This term was coined in the early 1980’s. At this time researcher began to switch their focus from hyperactivity to deficits in sustained attention and impulse control. The name of this disorder was officially changed to ADHD in the late 1980’s and the term ADD was officially discarded. The term ADD is still used by lay authors and the general public and usually refers to the inattentive subtype of ADHD.


Affective Disorders

These are disorders of mood. Examples include Major Depressive Disorder, Dysthymia, Depressive Disorder, and Bipolar Disorder.

Anxiety

Anxiety is the fear or anticipation danger from a threat that is not apparent or imminent. It is accompanied by intense unpleasant feelings or physical symptoms. There are four common forms of anxiety disorders in children:

  1. Separation Anxiety Disorder: Excessive anxiety concerning separation from home or from those to whom the child is attached. The child may worry about harm befalling a family member to the point where the child refuses to go to school or to sleep alone.

  2. Generalized Anxiety Disorder: Excessive anxiety and worry about events or activities such as school to the point where this worry interferes with daily functioning. There also may be restlessness, fatigue, difficulty concentrating, irritability, muscle tension, and sleep difficulties.

  3. Panic Disorder: The presence of recurrent, unexpected panic attacks characterized by the sudden onset of intense apprehension, fearfulness, or terror, often associated with feelings of impending doom. There may be shortness of breath, palpitations, chest pain or discomfort, choking or smothering sensations, and fear of "going crazy" or losing control.

  4. Phobias: Persistent, irrational fears that are focused on a specific object, activity, or situation.

Bipolar Disorder

Bipolar Disorder is a mood disorder characterized by mood swings between extreme elation, called mania, and severe depression. Thought originally to be a condition affecting adults, it is now clear that this condition is common in teens. There is a growing body of evidence that bipolar disorder may start early in childhood. For more information see the articles on Bipolar Disorder and Mood stabilizers.

Psychotic Disorders

Psychotic disorders include severe mental disorders, which are characterized by extreme impairment of a person's ability to think clearly, respond emotionally, communicate effectively, and behave appropriately. Typically the psychotic patient loses touch with reality. The psychotic patient may suffer from delusions and hallucinations.

Delusions are false and unusual beliefs firmly held by the patient, which are not based in reality. Examples are delusions of paranoia (others are plotting against them), grandiose delusions (exaggerated ideas of one's importance or identity), and somatic delusions (a healthy person believing that he/she has a terminal illness).


Hallucinations are the experience of a sensory perception (seeing, hearing, feeling, and smelling) in the absence of an outside stimulus. For example, the person may see things or hear voices. Common disorders where psychosis may be present include Major Depression, Bipolar Disorder, and Schizophrenia.


Depression

Depression can describe a normal human emotion or refer to a psychiatric disorder. The difference is a matter of degree. In addition to sadness or irritability present for at least two weeks, a depressive illness includes several of the following:

  • Change of appetite with significant weight loss or weight gain
  • Change in sleeping patterns
  • Loss of interest in activities formerly enjoyed
  • Loss of energy
  • Feelings of guilt for things that are not one's fault
  • Inability to concentrate
  • Feelings of hopelessness
  • Thoughts of death and suicide, wishing to die, or attempting suicide

Schizophrenia

This psychotic disorder characterized by severe problems with a person’s thoughts, feelings, behavior, and use of words and language. The symptoms include delusions and hallucinations. These delusions in schizophrenia are often paranoid and persecutory in nature. Hallucinations are usually auditory and may include hearing voices. This disorder usually develops before 30 years of age. There seems to be some genetic component.


Tourette's Syndrome

Tourette's Syndrome is characterized by multiple motor tics and at least one vocal tic. A tic is a sudden, rapid purposeless muscle movement. Motor tics may be simple movements such as eye blinking, or more complex movements such as touching and squatting. Vocal tics can include sounds such as grunts, barks, sniffs, snorts, coughs, and obscenities. People with Tourette's Syndrome often have ADHD or Obsessive Compulsive Disorder.

Obsessive Compulsive Disorder (OCD)

This condition is characterized by obsessions and compulsions, which interfere with the person’s ability to function normally. Obsession refers to recurrent and persistent thoughts, impulses, or images that are intrusive and cause severe anxiety or distress. Compulsions refer to repetitive behaviors and rituals (like hand washing, hoarding, ordering, checking) or mental acts (like counting, repeating words silently, avoiding). The person is aware that his behavior is abnormal but is unable to control himself. There is a growing body of evidence that this is a physiologically based disorder. For more information see the article on Obsessive Compulsive Disorder (OCD).


Learning Disorders

This group of disorders describes a situation in which a child’s reading, math, or writing skills are substantially below that expected for age, schooling, and level of intelligence. 5% of children have learning disorders.


Oppositional Defiant Disorder (ODD)

Oppositional defiant disorder (ODD) is a psychiatric behavior disorder that is characterized by aggressiveness and a tendency to purposefully bother and irritate others. These behaviors cause significant difficulties with family and friends and at school or work.

Oppositional defiant children show a consistent pattern of refusing to follow commands or requests by adults. These children repeatedly lose their temper, argue with adults, and refuse to comply with rules and directions. They are easily annoyed and blame others for their mistakes. Children with ODD show a pattern of stubbornness and frequently test limits, even in early childhood. We have an online Oppositional defiant disorder test. We also have an Oppositional defiant disorder child behavior program.

Conduct Disorder

Teens with conduct disorder have a persistent pattern of behavior in which they violate the rights of others, or violate norms or rules that are appropriate to their age. Their behavior is characterized by aggression toward people or animals, destruction of property, deceitfulness, lying, or stealing.


Neurotic Disorder

This is a mental disorder characterized by a distressing symptom or group of symptoms that the person is considers unacceptable and alien to his personality. The person is aware that his symptoms are abnormal, but is unable to control them. Examples are phobias, anxiety disorders, or Obsessive Compulsive Disorder.


Phobia

Phobias are persistent, irrational fears of specific objects, activities, or situations resulting in a compelling desire to avoid it. This often leads either to avoidance of the phobic stimulus or to enduring it with dread.


Phobias are generally divided into three categories:
  1. Social phobias - fears involving other people (performance anxiety)
  2. Specific phobias - fear of a single specific panic thing, like dogs or flying
  3. Agoraphobia - a generalised fear of leaving a familiar 'safe' area

Phobias vary in severity among individuals and may range from an extreme dislike of something to a fully-fledged panic attack. It is possible for a sufferer to become phobic about virtually anything.

Co-morbidity

Co-morbidity is the simultaneous occurrence of two or more disorders. The association may reflect a causal relationship between the disorders, reflect an underlying vulnerability to both disorders, or be completely coincidental.

Windigo

This is for the Canadians.

This is a syndrome found only in Canadians involving delusions of being possessed by a cannibalistic monster called a windigo characterized by attacks of agitation, depression and sadistic fears and impulses. (I am not making this up)


Anthony Kane, MD

ADD ADHD Advances


Anthony Kane, MD is a physician and international lecturer. Get ADD ADHD Child Behavior and Treatment Help for your child, including child behavior advice and information on the latest ADHD treatment, and help with Oppositional Defiant Disorder (ODD). Share your views at the ADD ADHD Blog. Sign up for the free ADD ADHD Advances online journal

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Thursday, March 03, 2005

ADD ADHD

ADD ADHD

Death from Ritalin


Death from Ritalin

Here is a letter I received recently.

Hi- I am concerned over the threat of death from taking Ritalin. I recently heard a report that over 150 children have died from taking this drug. These children were between the ages of 7 to 14. My daughter is only seven. Should I be concerned?

First of all, I understand your concern about the report of deaths due to Ritalin. The statistic that I heard was that 186 children died between 1990 and 2000. Though these deaths are not to be ignored, I would like to put the number in perspective.

There were 186 Ritalin related deaths in a ten-year period. In contrast there are 11 million prescriptions for Ritalin a year. If you divide the number of children who died from Ritalin by the number of annual prescriptions, that is 186/11,000,000= .000017. That means .0017% of children who take Ritalin are at risk for death.

Now I realize that this is not really an exact calculation. The real way to determine the exact death rate is to divide 186 by the number of people who took Ritalin during the last decade. I couldn't find any data on this. The point is that whatever the death rate is, it is very small. It is probably more likely for a child to die from a Tylenol overdose than to die from Ritalin use.

If you have an ADD ADHD child and Ritalin is helping, then I feel that benefits she gets from taking a drug like Ritalin far outweigh the risk of death from the drug. The bottom line is that no parent wants her child on Ritalin or some similar drug. However, if the child needs it, you as a parent should not worry that your child will be the one child in 60,000 that has a serious problem.

Anthony Kane, MD

ADD ADHD Advances

You can post your comments on this article at http://adhd-add.blogspot.com

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Monday, February 28, 2005

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