Mental health problems in adolescence Flashcards
What are the 9 key symptoms characteristic of depression, self-harm and suicide?
Pervasive depressed mood Loss of interest/enjoyment Feeling of tiredness Poor concentration Thoughts of guilt, self-blame and hopelessness Changes in sleep Changes in appetite and weight Irritability Unexplained psychosomatic symptoms e.g. chest pain
What are 3 common comorbidities with depression in adolescents?
Difficulties with relationships
Low self esteem
Other mental health problems, primarily anxiety and behavioural issues (the latter can actually mask underlying emotional problems e.g. aggression)
What are possible interventions for depression?
Management of underlying problem
CBT - challenging ingrained beliefs, can involve keeping a journal to spot patterns where beliefs not actually supported by evidence; behavioural aspect has varying importance, mostly effective for things like angry behaviour
Different psychotherapies - e.g. interpersonal psychotherapy
Family interventions
Antidepressants (often in conjunction with psychological treatment options)
What are the key features of self-harming behaviour?
Can be categorised in a number of ways - attempted suicide, non-accidental, self-injury, para-suicide
Can exist in absence of diagnosable mental health problem
Statistically higher in females during adolescence
Majority of self harm is through overdose but cutting is increasingly prevalent
The concern with self harm is that increasing amounts of the behaviour increases risk of suicide attempts at some point later in life
What are 6 options for management of self-harm?
Reduce “maintaining factors” e.g. family issues
Restrict access to materials e.g. drugs or sharp things (restricting the reflexive access should encourage the individual to find alternative coping strategies)
Safety plan established with carers/teachers/important adults
Close monitoring and follow-up
Treatment of underlying disorder e.g. depression
Crisis intervention - containment of immediate issue before move to more therapeutic phase once stabilised
What is the peak age for suicide
Mid-20s
What are the 6 key features of PTSD?
Repetitive images/thoughts
Regular fears and fears of recurrence
Nightmares
Upset by triggers
Emotional numbing and detachment/avoidance behaviours (may be subconscious)
Dose-effect i.e. linear relationship between severity and proximity of event and severity of subsequent symptoms
What are these symptoms of PTSD like?
Generally anxiety-related but strongly linked to specific trauma
Key difference from depression is that depressive symptoms are associated with here/now adversities while PTSD relates to an issue in the past
How can PTSD be treated?
Specific trauma-based CBT or narrative therapies in which they are encouraged to write their story in verbal or non-verbal creative means
Complex/multiple traumatic events e.g. abuse come with associated problems e.g. domestic violence and are thus more difficult to treat
What is psychosis in young life like?
Very rare, and onset generally after 16
Bipolar affective disorder (starts later, can be well controlled with medication), schizophrenia and drug-induced psychosis
Onset is insidious and initially difficult to detect - may initially present simply as confusion but will get progressively worse until the presentation of the more florid symptoms including hallucinations, delusions and negative symptoms such as social withdrawal and fatigue
How do interventions for psychosis differ from those for depression?
Pharmacological interventions are more commonly a first-line option
But drugs alone aren’t sufficient - still need social, family and other supportive activities in place
Education and employment also need to be considered
