Orchard Wellness Blog

Autism Spectrum Disorder

Tue, 02 Aug 2022 17:17:38 GMT

What is autism spectrum disorder?

Autism spectrum disorder (ASD) is a neurological and developmental disorder that affects how people interact with others, communicate, learn, and behave. Although autism can be diagnosed at any age, it is described as a “developmental disorder” because symptoms generally appear in the first two years of life.

According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), a guide created by the American Psychiatric Association that health care providers use to diagnose mental disorders, people with ASD often have:

Difficulty with communication and interaction with other people
Restricted interests and repetitive behaviors
Symptoms that affect their ability to function in school, work, and other areas of life

Autism is known as a “spectrum” disorder because there is wide variation in the type and severity of symptoms people experience.

People of all genders, races, ethnicities, and economic backgrounds can be diagnosed with ASD. Although ASD can be a lifelong disorder, treatments and services can improve a person’s symptoms and daily functioning. The American Academy of Pediatrics recommends that all children receive screening for autism. Caregivers should talk to their child’s health care provider about ASD screening or evaluation.

What are the signs and symptoms of ASD?

The list below gives some examples of common types of behaviors in people diagnosed with ASD. Not all people with ASD will have all behaviors, but most will have several of the behaviors listed below.

Social communication and social interaction behaviors may include:

Making little or inconsistent eye contact
Appearing not to look at or listen to people who are talking
Infrequently sharing interest, emotion, or enjoyment of objects or activities (including infrequently pointing at or showing things to others)
Not responding or being slow to respond to one’s name or to other verbal bids for attention
Having difficulties with the back and forth of conversation
Often talking at length about a favorite subject without noticing that others are not interested or without giving others a chance to respond
Displaying facial expressions, movements, and gestures that do not match what is being said
Having an unusual tone of voice that may sound sing-song or flat and robot-like
Having trouble understanding another person’s point of view or being unable to predict or understand other people’s actions
Difficulties adjusting behavior to different social situations
Difficulties sharing in imaginative play or in making friends

Restrictive/repetitive behaviors may include:

Repeating certain behaviors or having unusual behaviors, such as repeating words or phrases (a behavior called echolalia)
Having a lasting intense interest in specific topics, such as numbers, details, or facts
Showing overly focused interests, such as with moving objects or with parts of objects
Becoming upset by slight changes in a routine and having difficulty with transitions
Being more sensitive or less sensitive than other people to sensory input, such as light, sound, clothing, or temperature

People with ASD also may experience sleep problems and irritability.

People on the autism spectrum also may have many strengths, including:

Being able to learn things in detail and remember information for long periods of time
Being strong visual and auditory learners
Excelling in math, science, music, or art

What are the causes and risk factors for ASD?

Researchers don’t know the primary causes of ASD, but studies suggest that a person’s genes can act together with aspects of their environment to affect development in ways that lead to ASD. Some factors that are associated with an increased likelihood of developing ASD include:

Having a sibling with ASD
Having older parents
Having certain genetic conditions (such as Down syndrome or Fragile X syndrome)
Having a very low birth weight

Not everyone who has these risk factors develops ASD.

How is ASD diagnosed?

Health care providers diagnose ASD by evaluating a person’s behavior and development. ASD can usually be reliably diagnosed by the age of 2. It is important to seek an evaluation as soon as possible. The earlier ASD is diagnosed, the sooner treatments and services can begin.

Diagnosis in Young Children

Diagnosis in young children is often a two-stage process.

Stage 1: General Developmental Screening During Well-Child Checkups

Every child should receive well-child checkups with a pediatrician or an early childhood health care provider. The American Academy of Pediatrics recommends that all children receive screening for developmental delays at their 9-, 18-, and 24- or 30-month well-child visits, with specific autism screenings at the 18- and 24-month well-child visits. A child may receive additional screenings if they are at high risk for ASD or developmental problems.

Considering caregivers’ experiences and concerns is an important part of the screening process for young children. The health care provider may ask questions about the child’s behaviors and evaluate those answers in combination with information from ASD screening tools and clinical observations of the child. To learn more about ASD screening tools, visit the Centers for Disease Control and Prevention (CDC) website .

If a child shows developmental differences in behavior or functioning during this screening process, the health care provider may refer the child for additional evaluation.

Stage 2: Additional Diagnostic Evaluation

It is important to accurately detect and diagnose children with ASD as early as possible, as this will shed light on their unique strengths and challenges. Early detection also can help caregivers determine which services, educational programs, and behavioral therapies are most likely to be helpful for their child.

A team of health care providers who have experience diagnosing ASD will conduct the diagnostic evaluation. This team may include child neurologists, developmental behavioral pediatricians, speech-language pathologists, child psychologists and psychiatrists, educational specialists, and occupational therapists.

The diagnostic evaluation is likely to include:

Medical and neurological examinations
Assessment of the child’s cognitive abilities
Assessment of the child’s speech and language abilities
Observation of the child’s behavior
An in-depth conversation with the child’s caregivers about the child’s behavior and development
Assessment of age-appropriate skills needed to complete daily activities independently, such as eating, dressing, and toileting
Questions about the child’s family history

Because ASD is a complex disorder that sometimes occurs with other illnesses or learning disorders, the comprehensive evaluation may include blood tests and a hearing test. The outcome of this evaluation may result in a formal diagnosis and recommendations for treatment.

Diagnosis in Older Children and Adolescents

Caregivers and teachers are often the first to recognize ASD symptoms in older children and adolescents who attend school. The school’s special education team may perform an initial evaluation and then recommend that a child undergo additional evaluation with their primary health care provider or a health care provider who specializes in ASD.

A child’s caregivers may talk with these health care providers about the child’s social difficulties, including problems with subtle communication. These subtle communication differences may include problems understanding tone of voice, facial expressions, or body language. Older children and adolescents may have trouble understanding figures of speech, humor, or sarcasm. They also may have trouble forming friendships with peers.

Diagnosis in Adults

Diagnosing ASD in adults is often more difficult than diagnosing ASD in children. In adults, some ASD symptoms can overlap with symptoms of other mental health disorders, such as an anxiety disorder or attention-deficit/hyperactivity disorder (ADHD).

Adults who notice signs and symptoms of ASD should talk with a health care provider and ask for a referral for an ASD evaluation. Although evaluation for ASD in adults is still being refined, adults can be referred to a neuropsychologist, psychologist, or psychiatrist who has experience with ASD. The expert will ask about:

Social interaction and communication challenges
Sensory issues
Repetitive behaviors
Restricted interests

The evaluation also may include a conversation with caregivers and other family members to learn about the person’s early developmental history, which can help ensure an accurate diagnosis.

Obtaining a correct diagnosis of ASD as an adult can help people understand past challenges, identify personal strengths, and find the right kind of help. Studies are underway to determine the types of services and supports that are most helpful for improving the functioning and community integration of autistic transition-age youth and adults.

What treatment options are available for ASD?

Treatment for ASD should begin as soon as possible after diagnosis. Early treatment for ASD is important because proper care and services can reduce individuals’ difficulties while helping them learn new skills and build on their strengths.

People with ASD may face a wide range of issues, which means there is no single best treatment for ASD. Working closely with a health care provider is an important part of finding the right combination of treatments and services.

Medication

A health care provider may prescribe medication to treat specific symptoms. With medication, a person with ASD may have fewer problems with:

Irritability
Aggression
Repetitive behavior
Hyperactivity
Attention
Anxiety and depression

Behavioral, Psychological, and Educational Interventions

People with ASD may be referred to health care providers who specialize in providing behavioral, psychological, educational, or skill-building interventions. These programs are typically highly structured and intensive, and they may involve caregivers, siblings, and other family members. These programs may help people with ASD:

Learn social, communication, and language skills
Reduce behaviors that interfere with daily functioning
Increase or build on strengths
Learn life skills for living independently

Other Resources

Many services, programs, and other resources are available to help people with ASD. Here are some tips for finding these additional resources:

Contact a health care provider, local health department, school, or autism advocacy group to learn about special programs or local resources.
Find an autism support group. Sharing information and experiences can help people with ASD and their caregivers learn about treatment options and ASD-related programs.
Record conversations and meetings with health care providers and teachers. This information helps when it’s time to decide which programs and services are appropriate.
Keep copies of health care reports and evaluations. This information may help people with ASD qualify for special programs.

Where can I find resources about ASD?

For more information about ASD, visit:

Generalized Anxiety Disorder: When Worry Gets Out of Control

Tue, 02 Aug 2022 17:11:09 GMT

Do you often find yourself worrying about everyday issues for no obvious reason? Are you always waiting for disaster to strike or excessively worried about things such as health, money, family, work, or school?

What is generalized anxiety disorder?

Occasional anxiety is a normal part of life. Many people may worry about things such as health, money, or family problems. But people with GAD feel extremely worried or nervous more frequently about these and other things—even when there is little or no reason to worry about them. GAD usually involves a persistent feeling of anxiety or dread that interferes with how you live your life. It is not the same as occasionally worrying about things or experiencing anxiety due to stressful life events. People living with GAD experience frequent anxiety for months, if not years.

GAD develops slowly. It often starts around age 30, although it can occur in childhood. The disorder is more common in women than in men.

What are the signs and symptoms of generalized anxiety disorder?

People with GAD may:

Worry excessively about everyday things
Have trouble controlling their worries or feelings of nervousness
Know that they worry much more than they should
Feel restless and have trouble relaxing
Have a hard time concentrating
Startle easily
Have trouble falling asleep or staying asleep
Tire easily or feel tired all the time
Have headaches, muscle aches, stomachaches, or unexplained pains
Have a hard time swallowing
Tremble or twitch
Feel irritable or "on edge"
Sweat a lot, feel lightheaded, or feel out of breath
Have to go to the bathroom frequently

Children and teens with GAD often worry excessively about:

Their performance in activities such as school or sports
Catastrophes, such as earthquakes or war
The health of others, such as family members

Adults with GAD are often highly nervous about everyday circumstances, such as:

Job security or performance
Health
Finances
The health and well-being of their children or other family members
Being late
Completing household chores and other responsibilities

Both children and adults with GAD may experience physical symptoms such as pain, fatigue, or shortness of breath that make it hard to function and that interfere with daily life.

Symptoms may fluctuate over time and are often worse during times of stress—for example—with a physical illness, during school exams, or during a family or relationship conflict.

What causes generalized anxiety disorder?

Risk for GAD can run in families. Several parts of the brain and biological processes play a key role in fear and anxiety. By learning more about how the brain and body function in people with anxiety disorders, researchers may be able to develop better treatments. Researchers have also found that external causes, such as experiencing a traumatic event or being in a stressful environment, may put you at higher risk for developing GAD.

How is generalized anxiety disorder treated?

If you think you’re experiencing symptoms of GAD, talk to a health care provider. After discussing your history, a health care provider may conduct a physical exam to ensure that an unrelated physical problem is not causing your symptoms. A health care provider may refer you to a mental health professional, such as a psychiatrist, psychologist, or clinical social worker. The first step to effective treatment is to get a diagnosis, usually from a mental health professional.

GAD is generally treated with psychotherapy (sometimes called “talk therapy”), medication, or both. Speak with a health care provider about the best treatment for you.

Psychotherapy

Psychoanalytic/psychodynamic treatment for anxiety and panic disorders is an evidence-supported treatment that attempts to uncover the unconscious psychological meaning of anxiety; the treatment often focuses on internal and interpersonal conflicts that include separation/autonomy and anger expression/management.

Cognitive behavioral therapy (CBT), is another evidence-supported type of psychotherapy, is commonly used to treat GAD. CBT teaches you different ways of thinking, behaving, and reacting to situations that help you feel less anxious and worried. CBT has been well studied and is the gold standard for psychotherapy.

Another treatment option for GAD is acceptance and commitment therapy (ACT). ACT takes a different approach than CBT to negative thoughts and uses strategies such as mindfulness and goal setting to reduce your discomfort and anxiety. Compared to CBT, ACT is a newer form of psychotherapy treatment, so less data are available on its effectiveness. However, different therapies work for different types of people, so it can be helpful to discuss what form of therapy may be right for you with a mental health professional.

Medication

Health care providers may prescribe medication to treat GAD. Different types of medication can be effective, including:

Antidepressants, such as selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs)
Anti-anxiety medications, such as benzodiazepines

SSRI and SNRI antidepressants are commonly used to treat depression, but they also can help treat the symptoms of GAD. They may take several weeks to start working. These medications also may cause side effects, such as headaches, nausea, or difficulty sleeping. These side effects are usually not severe for most people, especially if the dose starts off low and is increased slowly over time. Talk to your health care provider about any side effects that you may experience.

Benzodiazepines, which are anti-anxiety sedative medications, also can be used to manage severe forms of GAD. These medications can be very effective in rapidly decreasing anxiety, but some people build up a tolerance to them and need higher and higher doses to get the same effect. Some people even become dependent on them. Therefore, a health care provider may prescribe them only for brief periods of time if you need them.

Buspirone is another anti-anxiety medication that can be helpful in treating GAD. Unlike benzodiazepines, buspirone is not a sedative and has less potential to be addictive. Buspirone needs to be taken for 3–4 weeks for it to be fully effective.

Both psychotherapy and medication can take some time to work. Many people try more than one medication before finding the best one for them. A health care provider can work with you to find the best medication, dose, and duration of treatment for you.

For basic information about these and other mental health medications, visit NIMH’s Mental Health Medications webpage . Visit the U.S. Food and Drug Administration (FDA) website for the latest warnings, patient medication guides, and information on newly approved medications.

Support Groups

Some people with anxiety disorders might benefit from joining a self-help or support group and sharing their problems and achievements with others. Support groups are available both in person and online. However, any advice you receive from a support group member should be used cautiously and does not replace treatment recommendations from a health care provider.

Healthy Habits

Practicing a healthy lifestyle also can help combat anxiety, although this alone cannot replace treatment. Researchers have found that implementing certain healthy choices in daily life—such as reducing caffeine intake and getting enough sleep—can reduce anxiety symptoms when paired with standard care—such as psychotherapy and medication.

Stress management techniques, such as exercise, mindfulness, and meditation, also can reduce anxiety symptoms and enhance the effects of psychotherapy. You can learn more about how these techniques benefit your treatment by talking with a health care provider.

Disruptive Mood Dysregulation Disorder: The Basics

Tue, 02 Aug 2022 16:23:24 GMT

Disruptive mood dysregulation disorder (DMDD) is a condition in which children or adolescents experience ongoing irritability, anger, and frequent, intense temper outbursts.

What is disruptive mood dysregulation disorder?

Disruptive mood dysregulation disorder (DMDD) is a condition in which children or adolescents experience ongoing irritability, anger, and frequent, intense temper outbursts. The symptoms of DMDD go beyond a “bad mood.” DMDD symptoms are severe. Youth who have DMDD experience significant problems at home, at school, and often with peers. They also tend to have high rates of health care service use, hospitalization, and school suspension, and they are more likely to develop other mood disorders.

DMDD can be treated. If you are concerned that your child may have DMDD, schedule an appointment with a mental health professional for a consolation and assessment.

Did You Know?

DMDD is a newly classified disorder, first appearing in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) in 2013. The DSM is used for the assessment and diagnosis of mental disorders; it does not include specific guidelines for the treatment of any disorder.

What are the signs and symptoms of DMDD?

Children or adolescents with DMDD experience:

Severe temper outbursts (verbal or behavioral), on average, three or more times per week
Outbursts and tantrums that have been ongoing for at least 12 months
Chronically irritable or angry mood most of the day, nearly every day
Trouble functioning due to irritability in more than one place (at home, at school, and with peers)

Youth with DMDD are diagnosed between the ages of 6 and 10. To be diagnosed with DMDD, a child must have experienced symptoms steadily for 12 or more months.

What is the difference between typical irritability and severe irritability?

All children can become irritable sometimes. It’s a normal reaction to frustration. Children experiencing severe irritability (as observed in DMDD) have difficulty tolerating frustration and have outbursts that are out of proportion for the situation at hand. These outbursts occur more often and are more severe than what you would typically expect for children of this age.

For example, a parent tells the child to stop playing a game and do their homework. Any child might be frustrated or annoyed. But a child with DMDD may become extremely upset and emotional and have an intense temper outburst with yelling or hitting. A child with DMDD experiences these intense temper outbursts a few times a week.

Over time, as children grow and develop, the symptoms of DMDD may change. For example, an adolescent or young adult with DMDD may experience fewer tantrums, but they begin to exhibit symptoms of depression or anxiety. For these reasons, treatment may change over time, too.

Children with DMDD may have trouble in school and experience difficulty maintaining healthy relationships with family or peers. They also may have a hard time in social settings or participating in activities such as team sports. If you think your child has DMDD, it is essential to seek a diagnosis and treatment.

How is DMDD diagnosed?

If you think your child may be experiencing symptoms of DMDD, talk to your child’s health care provider. Describe your child’s behavior, and report what you have observed and learned from talking with others, such as a teacher or school counselor. An evaluation by your child’s health care provider can help clarify problems that may be underlying your child’s behavior, and the provider may recommend the next steps.

You also can ask your health care provider for a referral to a mental health professional who has experience working with children and adolescents. DMDD symptoms also can occur at the same time as other disorders associated with irritability, such as attention-deficit/hyperactivity disorder (ADHD) or anxiety disorders . An accurate diagnosis is vital for effective treatment.

For more information about diagnosis and treatment of children and tips for talking to your health care provider, check out NIMH’s fact sheets, Children and Mental Health and Tips for Talking With Your Health Care Provider . If you need help identifying a provider in your area, call the Substance Abuse and Mental Health Services Administration (SAMHSA) Treatment Referral Helpline at 1-800-662-HELP (4357).

How is DMDD treated?

DMDD is a newly classified disorder, and few DMDD-specific treatment studies have been conducted to date. Current treatments are primarily based on research focused on other childhood disorders associated with irritability (such as anxiety and ADHD). Fortunately, many of these treatments also work for DMDD. NIMH is currently funding studies focused on further improving these treatments and identifying new treatments specifically for DMDD. It is important for parents or caregivers to work closely with their child’s doctor to make treatment decisions that are best for their child.

Treatment for DMDD generally includes certain types of psychotherapy (“talk therapy”) and sometimes medications. In many cases, psychotherapy is considered first, with medication added later. However, at times, providers recommend that children receive both psychotherapy and medication at the start of their treatment.

Psychotherapies

Psychodynamic therapy has been shown to be especially effective for internalizing disorders such as depression and anxiety, as well as in the treatment of emerging personality disorders and in the treatment of children who have experience of adversity. This approach also promotes emotional integration/regulation, and, interestingly, children and teens who engage in psychodynamic psychotherapy tend to demonstrate continued improvement beyond the end of therapy (the so-called “sleeper effect”).

Cognitive behavioral therapy (CBT) and/or Acceptance and Commitment Therapy (ACT) is used to help children and adolescents learn how to cope with thoughts and feelings that contribute to their feeling depressed or anxious. CBT for anxiety often includes exposing the child to situations that make them anxious so that they can learn to respond to those situations better. Clinicians can use similar techniques to teach children to increase their ability to tolerate frustration without having an outburst. This therapy also teaches coping skills for controlling anger and ways to identify and re-label the distorted perceptions that contribute to outbursts.

Researchers also are studying the use of dialectical behavior therapy for children (DBT-C) with DMDD. This type of therapy may help children learn to regulate their emotions and avoid extreme or prolonged outbursts. In DBT-C, the clinician helps children learn skills that can help with regulating their moods and emotions.

It can be effective to combine therapy for the child or adolescent with parent training. Parent training teaches parents or caregivers more effective ways to respond to irritable behavior, such as anticipating events that might lead a child to have a temper outburst and working ahead to avert it. Training also focuses on the importance of predictability, being consistent with children, and rewarding positive behavior.

Medications

Currently, there are no medications approved by the U.S. Food and Drug Administration (FDA) specifically for treating children or adolescents with DMDD. However, health care providers may prescribe certain medications —such as stimulants, antidepressants, and atypical antipsychotics—to help relieve your child’s DMDD symptoms. All medications have side effects. Monitor and report your child’s side effects and review the medications frequently with your child’s health care provider. Visit the FDA website for the most up-to-date information on medications, side effects, and warnings.

Stimulants are often used in the treatment of ADHD, and research suggests that stimulant medications also may decrease irritability in youth.
Antidepressants are sometimes used to treat irritability and mood problems that children with DMDD may experience. One study suggests that citalopram (a serotonin reuptake inhibitor antidepressant), when combined with the stimulant methylphenidate, can decrease irritability in youth with DMDD. Please note: Antidepressants may increase suicidal thoughts and behaviors in youth, who should be monitored closely by their health care provider.
Certain atypical antipsychotic medications are used to treat children with irritability, severe outbursts, or aggression. FDA has approved these medications for the treatment of irritability associated with autism, and they are sometimes used to treat DMDD, too. However, due to the side effects associated with these medications, they are often used only when other approaches have not been successful.

Tips for Parents and Caregivers

Being a parent or caregiver for a child or adolescent with DMDD can be stressful and overwhelming. While working on creating a better environment for the child, you may want to consider the following:

Learn as much as you can about the disorder. Talk to your child’s health care provider or mental health professional. Ask questions about risks, benefits, and treatment options.
Talk to your child’s teacher, counselor, or school psychologist. Together, you may come up with strategies, plans, and accommodations that can help your child thrive in school. For more information, check out NIMH’s Children and Mental Health fact sheet .
Find ways to manage your stress. Take practical steps to manage your own stress to avoid the risk of negative health effects. For tips, see NIMH’s 5 Things You Should Know About Stress .
Seek additional support and professional help. Parents and caregivers may be able to find resources and encouragement through their local chapter of the National Alliance on Mental Illness , the National Federation of Families for Children’s Mental Health , Mental Health America , and other organizations. (Please Note: These resources are provided for informational purposes only. They are not comprehensive and do not constitute an endorsement by NIMH.)
Communicate regularly and effectively with your child’s health care provider. Find tips to help you prepare for your child’s visit . For additional resources, including questions to ask your doctor, visit the Agency for Healthcare Research and Quality website .

Depression in Women: What to Know

Tue, 02 Aug 2022 03:04:44 GMT

Life is full of ups and downs, but when you feel sad, empty, or hopeless most of the time for at least 2 weeks or those feelings keep you from your regular activities, you may have depression.

Depression is a serious mental health condition. In the past year, women were almost twice as likely as men to have symptoms of depression. 1 Depression is not a normal part of being a woman. Most women, even those with the most severe depression, will likely improve with treatment.

What is depression?

Depression is a mental condition when someone feels sad (including crying often), empty, or hopeless most of the time (or loses interest in or takes no pleasure in daily activities) for at least 2 weeks. Depression affects a person’s ability to work, go to school, or have relationships with friends and family. Depression is one of the most common mental health conditions in the United States. 2 It is an illness that involves the body, mood, and thoughts. It can affect the way you eat and sleep, the way you feel about yourself, and the way you think about things.

It is different from feeling “blue” or “down” or just sad for a few hours or a couple of days. Depression is also different from grief over losing a loved one or experiencing sadness after a trauma or difficult event. It is not a condition that can be willed or wished away. People who have depression cannot just “pull themselves” out of it.

Are there different types of depression?

Yes. Different kinds of depression include:

Major depressive disorder. Also called major depression, this is a combination of symptoms that affects a person’s ability to sleep, work, study, eat, and enjoy hobbies and everyday activities.
Dysthymic disorder. Also called dysthymia , this kind of depression lasts for 2 years or more. The symptoms are less severe than those of major depression but can prevent you from living normally or feeling well.

Other types of depression have slightly different symptoms and may start after a certain event. These types of depression include:

Psychotic depression, when a severe depressive illness happens with some form of psychosis, such as a break with reality, hallucinations , and delusions
Postpartum depression , which is diagnosed if a new mother has a major depressive episode after delivery. Depression can also begin during pregnancy, called prenatal depression.
Seasonal affective disorder (SAD), which is a depression during the winter months, when there is less natural sunlight
Bipolar depression, which is the depressive phase of bipolar illness and requires different treatment than major depression

Who gets depression?

Women are twice as likely as men to be diagnosed with depression. 1 It is more than twice as common for African-American, Hispanic, and white women to have depression compared to Asian-American women. Depression is also more common in women whose families live below the federal poverty line. 3

What causes depression?

There is no single cause of depression. Also, different types of depression may have different causes. There are many reasons why a woman may have depression:

Family history. Women with a family history of depression may be more at risk. But depression can also happen in women who don’t have a family history of depression.
Brain changes. The brains of people with depression look and function differently from those of people who don’t have depression.
Chemistry. In someone who has depression, parts of the brain that manage mood, thoughts, sleep, appetite, and behavior may not have the right balance of chemicals.
Hormone levels. Changes in the female hormones estrogen and progesterone during the menstrual cycle, pregnancy, postpartum period, perimenopause, or menopause may all raise a woman’s risk for depression. Having a miscarriage can also put a woman at higher risk for depression.
Stress. Serious and stressful life events, or the combination of several stressful events, such as trauma, loss of a loved one, a bad relationship, work responsibilities, caring for children and aging parents, abuse, and poverty, may trigger depression in some people.
Medical problems. Dealing with a serious health problem, such as stroke , heart attack, or cancer, can lead to depression. Research shows that people who have a serious illness and depression are more likely to have more serious types of both conditions. 4 Some medical illnesses, like Parkinson’s disease, hypothyroidism , and stroke, can cause changes in the brain that can trigger depression.
Pain. Women who feel emotional or physical pain for long periods are much more likely to develop depression. 5 The pain can come from a chronic (long-term) health problem, accident, or trauma such as sexual assault or abuse.

What are the symptoms of depression?

Not all people with depression have the same symptoms. Some people might have only a few symptoms, while others may have many. How often symptoms happen, how long they last, and how severe they are may be different for each person.

If you have any of the following symptoms for at least 2 weeks, talk to a doctor or nurse or mental health professional:

Feeling sad, “down,” or empty, including crying often
Feeling hopeless, helpless, worthless, or useless
Loss of interest in hobbies and activities that you once enjoyed
Decreased energy
Difficulty staying focused, remembering, or making decisions
Sleeplessness, early morning awakening, or oversleeping and not wanting to get up
Lack of appetite, leading to weight loss, or eating to feel better, leading to weight gain
Thoughts of hurting yourself
Thoughts of death or suicide
Feeling easily annoyed, bothered, or angered
Constant physical symptoms that do not get better with treatment, such as headaches, upset stomach, and pain that doesn’t go away

How is depression linked to other health problems?

Depression is linked to many health problems in women, including: 6

Heart disease . People with heart disease are about twice as likely to have depression as people who don’t have heart disease. 7
Obesity . Studies show that 43% of adults with depression have obesity. Women, especially white women, with depression are more likely to have obesity than women without depression are. 8 Women with depression are also more likely than men with depression to have obesity. 8
Cancer . Up to 1 in 4 people with cancer may also experience depression. More women with cancer than men with cancer experience depression. 9

How is depression diagnosed?

Make an appointment with a mental health professional. Certain medicines and some health problems (such as viruses or a thyroid disorder) can cause the same symptoms as depression. Sometimes depressive symptoms can be part of another mental health condition.

Diagnosis of depression includes a mental health professional asking questions about your life, emotions, struggles, and symptoms. The doctor, nurse, or mental health professional may order lab tests on a sample of your blood or urine and do a regular checkup to rule out other problems that could be causing your symptoms.

How is depression treated?

Your doctor or mental health professional may treat depression with therapy, medicine, or a combination of the two. Your doctor or nurse may refer you to a mental health specialist for therapy.

Some people with milder forms of depression get better after a few months of therapy. People with moderate to severe depression might need therapy and a type of medicine called an antidepressant. Antidepressants change the levels of certain chemicals in your brain. It may take several weeks for antidepressants to work. There are different types of antidepressant medicines, and some work better than others for certain people. Some people get better only with both treatments — therapy and antidepressants. Learn what you can do if these treatments don't help.

Having depression can make some people more likely to turn to drugs or alcohol to cope. But drugs or alcohol can make your mental health condition worse and can affect how antidepressants work. Talk to your therapist or doctor or nurse about any alcohol or drug use.

What if the treatments I try for depression don’t work?

Give treatments time to work. It may take several weeks for the antidepressants to start working. Do not suddenly stop taking medicine for depression without talking to your doctor or nurse first.

If you have major depressive disorder and have tried at least 2 types of antidepressants but your symptoms are not getting better, you may have treatment-resistant depression. If you have this type of depression, you may be able to try a treatment called esketamine. Esketamine is a nasal spray that has been approved by the Food and Drug Administration (FDA) for treatment-resistant depression when taken together with an antidepressant. 10 Do not take esketamine if you are pregnant or breastfeeding. Talk to your doctor or nurse about the benefits and risks of esketamine. Learn more about esketamine from the FDA .

If you have severe depression, you can also ask your doctor or nurse if electroconvulsive therapy (ECT) and other brain stimulation therapies are treatment options. 11 Learn more about ECT from the National Institutes of Mental Health .

I think I may have depression. How can I get help?

Talk to someone like a doctor, nurse, psychiatrist, mental health professional, or social worker about your symptoms. You can also find no-cost or low-cost help in your state by using the mental health services locator on the top left side (desktop view) or bottom (mobile view) of this page.

What if I have thoughts of hurting myself?

If you are thinking about hurting or even killing yourself, get help now. Call 911 or the National Suicide Prevention Lifeline at 1-800-273-TALK (8255).

You might feel like your pain is too overwhelming to bear, but those feelings don’t last forever. People do make it through suicidal thoughts. Many thoughts of suicide are impulses that go away after a short period of time. 12

Can I take St. John’s wort to treat depression?

Taking St. John’s wort for depression has not been approved by the Food and Drug Administration (FDA). Studies show mixed results about the plant’s ability to treat depression. 13

It may be dangerous to take St. John’s wort if you also take other medicines. St. John’s wort can make many medicines not work at all or may cause dangerous or life-threatening side effects. The medicines used to treat heart disease, HIV, depression, seizures, certain cancers, and organ transplant rejection may not work or may have dangerous side effects if taken with St. John’s wort. St. John’s wort may also make birth control pills not work, which increases the chance you will get pregnant when you don’t want to. 14 It is crucial that you tell your doctor or nurse if you take St. John’s wort.

Depression is a serious mental condition that can be successfully treated with therapy and FDA-approved medicines. FDA-approved medicines and natural treatments can have side effects. It’s best to talk to a doctor or nurse about treatment for depression.

Does exercise help treat depression?

For some people, yes. Researchers think that exercise may work better than no treatment at all to treat depression. 15 They also think that regular exercise can lower your risk of getting depression and help many depression symptoms get better. 16 Researchers do not know whether exercise works as well as therapy or medicine to treat depression. 15 People with depression often find it very difficult to exercise, even though they know it will help make them feel better. Walking is a good way to begin exercising if you haven’t exercised recently.

Are there other natural or complementary treatments for depression?

Researchers are studying natural and complementary treatments (add-on treatments to medicine or therapy) for depression. Currently, none of the natural or complementary treatments are proven to work as well as medicine and therapy for depression. However, natural or complementary treatments that have little or no risk, like exercise, meditation, or relaxation training, may help improve your depression symptoms and usually will not make them worse.

Will treatment for depression affect my chances of getting pregnant?

Maybe. Some medicines, such as some types of antidepressants, may make it more difficult for you to get pregnant, but more research is needed. 17 Talk to your doctor about other treatments for depression that don’t involve medicine if you are trying to get pregnant. For example, a type of talk therapy called cognitive behavioral therapy (CBT) helps women with depression. 18 This type of therapy has little to no risk for women trying to get pregnant. During CBT, you work with a mental health professional to explore why you are depressed and train yourself to replace negative thoughts with positive ones. Certain mental health care professionals specialize in depression related to infertility.

Women who are already taking an antidepressant and who are trying to get pregnant should talk to their doctor or nurse about the risks and benefits of stopping the medicine. Learn more about taking medicines during pregnancy in our Pregnancy section.

Did we answer your question about depression?

For more information about depression, call the OWH Helpline at 1-800-994-9662 or check out these resources from the following organizations:

Depression — Information from HelpGuide.org.
Depression — Information from the Depression and Bipolar Support Alliance.
Depression in Women: 5 Things You Should Know — Brochure from the National Institute of Mental Health.
Older Adults and Depression — Booklet from the National Institute of Mental Health.
Postpartum Disorders — Information from Mental Health America.
St. John’s Wort and Depression: In Depth — Information from the National Center for Complementary and Integrative Health.

Sources

Substance Abuse and Mental Health Services Administration Center for Behavioral Health Statistics and Quality (SAMHSA). (2018). 2017 National Survey on Drug Use and Health: Detailed Tables. Table 8.56A (PDF, 36.1 MB).
SAMHSA Center for Behavioral Health Statistics and Quality. (2016). Key substance use and mental health indicators in the United States: Results from the 2015 National Survey on Drug Use and Health (PDF, 2.3 MB). HHS Publication No. SMA 16-4984, NSDUH Series H-51. Rockville, MD: SAMHSA.
Brody, D.J., Pratt, L.A., Hughes, J. (2018). Prevalence of depression among adults aged 20 and over: United States, 2013–2016 . NCHS Data Brief, no 303. Hyattsville, MD: National Center for Health Statistics.
Kang, H.-J., Kim, S.-Y., Bae, K.-Y., Kim, S.-W., Chin, I.-S., Yoon, J.-S., et al. (2015). Comorbidity of Depression with Physical Disorders: Research and Clinical Implications . Chonnam Medical Journal; 51(1): 8–18.
Trivedi, M.H. (2004). The Link Between Depression and Physical Symptoms . The Primary Care Companion to the Journal of Clinical Psychiatry; 6(Suppl 1): 12–16.
Chapman, D.P., Perry, G.S., Strine, T.W. (2005). The Vital Link Between Chronic Disease and Depressive Disorders . Preventing Chronic Disease; 2(1): A14.
Lichtman, J.H., Bigger, J.T., Blumenthal, J.A., Frasure-Smith, N., Kaufmann, P.G., Lespérance, F., et al. (2008). Depression and Coronary Heart Disease . Circulation; 118: 1768–1775.
Pratt, L.A., Brody, D.J. (2014). Depression and Obesity in the U.S. Adult Household Population, 2005–2010 . NCHS Data Brief No. 167. Hyattsville, MD: National Center for Health Statistics.
Linden, W., Vodermaier, A., Mackenzie, R., Greig, D. (2012). Anxiety and depression after cancer diagnosis: prevalence rates by cancer type, gender, and age . Journal of Affective Disorders; 141(2–3): 343–351.
U.S. Food and Drug Administration. (2019). FDA approves first treatment for post-partum depression .
National Institute of Mental Health. (2018). Depression: Treatment and therapies .
Cáceda, R., Durand, D., Cortes, E., Prendes-Alvarez, S., Moskovciak, T., Harvey, P.D., et al. (2014). Impulsive choice and psychological pain in acutely suicidal depressed patients . Psychosomatic Medicine; 76(6): 445–451.
National Center for Complementary and Integrative Health (NCCIH). (2016). St. John's Wort and Depression: In Depth .
NCCIH. (2016). Fact Sheet: St. John's Wort .
Cooney, G.M., Dwan, K., Greig, C.A., Lawlor, D.A., Rimer, J., Waugh, F.R., et al. (2013). Exercise for depression . Cochrane Database of Systematic Reviews; 9.
U.S. Department of Health and Human Services. (2018). Physical Activity Guidelines for Americans, 2nd edition (PDF, 14.2 MB).
Casilla-Lennon, M.M., Meltzer-Brody, S., Steiner, A.Z. (2016). The effect of antidepressants on fertility . American Journal of Obstetrics and Gynecology; 215(3): 314.e1–314.e5.
Driessen, E., Hollon, S.D. (2010). Cognitive Behavioral Therapy for Mood Disorders: Efficacy, Moderators and Mediators . Psychiatric Clinics of North America; 33(3): 537–555.
Substance Abuse and Mental Health Services Administration Center for Behavioral Health Statistics and Quality (SAMHSA). (2018). 2017 National Survey on Drug Use and Health: Detailed Tables. Table 8.56A (PDF, 36.1 MB).
SAMHSA Center for Behavioral Health Statistics and Quality. (2016). Key substance use and mental health indicators in the United States: Results from the 2015 National Survey on Drug Use and Health (PDF, 2.3 MB). HHS Publication No. SMA 16-4984, NSDUH Series H-51. Rockville, MD: SAMHSA.
Brody, D.J., Pratt, L.A., Hughes, J. (2018). Prevalence of depression among adults aged 20 and over: United States, 2013–2016 . NCHS Data Brief, no 303. Hyattsville, MD: National Center for Health Statistics.
Kang, H.-J., Kim, S.-Y., Bae, K.-Y., Kim, S.-W., Chin, I.-S., Yoon, J.-S., et al. (2015). Comorbidity of Depression with Physical Disorders: Research and Clinical Implications . Chonnam Medical Journal; 51(1): 8–18.
Trivedi, M.H. (2004). The Link Between Depression and Physical Symptoms . The Primary Care Companion to the Journal of Clinical Psychiatry; 6(Suppl 1): 12–16.
Chapman, D.P., Perry, G.S., Strine, T.W. (2005). The Vital Link Between Chronic Disease and Depressive Disorders . Preventing Chronic Disease; 2(1): A14.
Lichtman, J.H., Bigger, J.T., Blumenthal, J.A., Frasure-Smith, N., Kaufmann, P.G., Lespérance, F., et al. (2008). Depression and Coronary Heart Disease . Circulation; 118: 1768–1775.
Pratt, L.A., Brody, D.J. (2014). Depression and Obesity in the U.S. Adult Household Population, 2005–2010 . NCHS Data Brief No. 167. Hyattsville, MD: National Center for Health Statistics.
Linden, W., Vodermaier, A., Mackenzie, R., Greig, D. (2012). Anxiety and depression after cancer diagnosis: prevalence rates by cancer type, gender, and age . Journal of Affective Disorders; 141(2–3): 343–351.
U.S. Food and Drug Administration. (2019). FDA approves first treatment for post-partum depression .
National Institute of Mental Health. (2018). Depression: Treatment and therapies .
Cáceda, R., Durand, D., Cortes, E., Prendes-Alvarez, S., Moskovciak, T., Harvey, P.D., et al. (2014). Impulsive choice and psychological pain in acutely suicidal depressed patients . Psychosomatic Medicine; 76(6): 445–451.
National Center for Complementary and Integrative Health (NCCIH). (2016). St. John's Wort and Depression: In Depth .
NCCIH. (2016). Fact Sheet: St. John's Wort .
Cooney, G.M., Dwan, K., Greig, C.A., Lawlor, D.A., Rimer, J., Waugh, F.R., et al. (2013). Exercise for depression . Cochrane Database of Systematic Reviews; 9.
U.S. Department of Health and Human Services. (2018). Physical Activity Guidelines for Americans, 2nd edition (PDF, 14.2 MB).
Casilla-Lennon, M.M., Meltzer-Brody, S., Steiner, A.Z. (2016). The effect of antidepressants on fertility . American Journal of Obstetrics and Gynecology; 215(3): 314.e1–314.e5.
Driessen, E., Hollon, S.D. (2010). Cognitive Behavioral Therapy for Mood Disorders: Efficacy, Moderators and Mediators . Psychiatric Clinics of North America; 33(3): 537–555.

Men & Depression

Tue, 02 Aug 2022 02:48:40 GMT

Men and women both experience depression but their symptoms can be very different

Introduction

Men and women both experience depression but their symptoms can be very different. Because men who are depressed may appear to be angry or aggressive instead of sad, their families, friends, and even their doctors may not always recognize the anger or aggression as depression symptoms. In addition, men are less likely than women to recognize, talk about, and seek treatment for depression. Yet depression affects a large number of men.

What is depression?

Everyone feels sad or irritable and has trouble sleeping once in a while. But these feelings and troubles usually pass after a couple of days. Depression is a common but serious mood disorder that may cause severe symptoms. Depression affects the ability to feel, think, and handle daily activities. Also known as major depressive disorder or clinical depression, a man must have symptoms for at least two weeks to be diagnosed with depression.

Both men and women get depression but their willingness to talk about their feelings may be very different. This is one of the reasons that depression symptoms for men and women may be very different as well.

For example, some men with depression hide their emotions and may seem to be angry, irritable, or aggressive while many women seem sad or express sadness. Men with depression may feel very tired and lose interest in work, family, or hobbies. They may be more likely to have difficulty sleeping than women who have depression. Sometimes mental health symptoms appear to be physical issues. For example, a racing heart, tightening chest, ongoing headaches, or digestive issues can be signs of a mental health problem. Many men are more likely to see their doctor about physical symptoms than emotional symptoms.

Some men may turn to drugs or alcohol to try to cope with their emotional symptoms. Also, while women with depression are more likely to attempt suicide, men are more likely to die by suicide because they tend to use more lethal methods.

Depression can affect any man at any age. With the right treatment, most men with depression can get better and gain back their interest in work, family, and hobbies.

"My daily routine was shot. I didn't have the energy to do anything. I got up because the dog had to be walked and my wife needed to go to work. The day would go by and I didn't know where it went. I wanted to get back to normal. I just wanted to be myself again."
—Jimmy, Firefighter

What are the signs and symptoms of depression in men?

Different men have different symptoms, but some common depression symptoms include:

Anger, irritability, or aggressiveness
Feeling anxious, restless, or “on the edge”
Loss of interest in work, family, or once-pleasurable activities
Problems with sexual desire and performance
Feeling sad, "empty," flat, or hopeless
Not being able to concentrate or remember details
Feeling very tired, not being able to sleep, or sleeping too much
Overeating or not wanting to eat at all
Thoughts of suicide or suicide attempts
Physical aches or pains, headaches, cramps, or digestive problems
Inability to meet the responsibilities of work, caring for family, or other important activities
Engaging in high-risk activities
A need for alcohol or drugs
Withdrawing from family and friends or becoming isolated

Not every man who is depressed experiences every symptom. Some men experience only a few symptoms while others may experience many.

What are the different types of depression?

The most common types of depression are:

Major depression—depressive symptoms that interfere with a man's ability to work, sleep, study, eat, and enjoy most aspects of life. An episode of major depression may occur only once in a person's lifetime. But it is common for a person to have several episodes. Special forms (subtypes) of major depression include:
Psychotic depression—severe depression associated with delusions (false, fixed beliefs) or hallucinations (hearing or seeing things that are not really there). These psychotic symptoms are depression-themed. For example, a man may believe he is sick or poor when he is not, or he may hear voices that are not real that say that he is worthless.
Seasonal affective disorder—characterized by depression symptoms that appear every year during the winter months when there is less natural sunlight.
Persistent depressive disorder (also called dysthymia)—depressive symptoms that last a long time (2 years or longer) but are less severe than those of major depression.
Minor depression—similar to major depression and persistent depressive disorder, but symptoms are less severe and may not last as long.
Bipolar Disorder is different from depression. It is included in this list because a person with bipolar disorder experiences episodes of extreme low moods (depression). But a person with bipolar disorder also experiences extreme high moods (called “mania”).

What causes depression in men?

Depression is one of the most common mental disorders in the U.S. Current research suggests that depression is caused by a combination of risk factors including:

Genetic factors—men with a family history of depression may be more likely to develop it than those whose family members do not have the illness.
Environmental Stress—financial problems, loss of a loved one, a difficult relationship, major life changes, work problems, or any stressful situation may trigger depression in some men.
Illness—depression can occur with other serious medical illnesses, such as diabetes, cancer, heart disease, or Parkinson’s disease. Depression can make these conditions worse and vice versa. Sometimes, medications taken for these illnesses may cause side effects that trigger or worsen depression.

How is depression treated?

Men often avoid addressing their feelings and, in many cases, friends and family members are the first to recognize that their loved one is depressed. It is important that friends and family support their loved one and encourage him to visit a doctor or mental health professional for an evaluation. A health professional can do an exam or lab tests to rule out other conditions that may have symptoms that are like those of depression. He or she also can tell if certain medications are affecting the depression.

The doctor needs to get a complete history of symptoms, such as when they started, how long they have lasted, how bad they are, whether they have occurred before, and if so, how they were treated. It is important that the man seeking help be open and honest about any efforts at “self-medication” with alcohol, non-prescribed drugs, gambling, or high-risk activities. A complete history should include information about a family history of depression or other mental disorders.

After a diagnosis, depression is usually treated with medications or psychotherapy , or a combination of the two. The increasingly-popular “collaborative care” approach combines physical and behavioral health care. Collaborative care involves a team of health care providers and managers, including a primary care doctor and specialists.

Medication

Medications called antidepressants can work well to treat depression, but they can take several weeks to be effective. Often with medication, symptoms such as sleep, appetite, and concentration problems improve before mood lifts, so it is important to give medication a chance before deciding whether it is effective or not.

Antidepressants can have side effects including:

Headache
Nausea or feeling sick to your stomach
Difficulty sleeping and nervousness
Agitation or restlessness
Sexual problems

Most side effects lessen over time but it is important to talk with your doctor about any side effects that you may have. Starting antidepressant medication at a low dose and gradually increasing to a full therapeutic dose may help minimize adverse effects.

It's important to know that although antidepressants can be safe and effective for many people, they may present serious risks to some, especially children, teens, and young adults. A "black box" warning—the most serious type of warning that a prescription drug can have—has been added to the labels of antidepressant medications to warn people that antidepressants may cause some young people to have suicidal thoughts or may increase the risk for suicide attempts. This is especially true for those who become agitated when they first start taking the medication and before it begins to work. Anyone taking antidepressants should be monitored closely, especially when they first start taking them.

For most people, though, the risks of untreated depression far outweigh those of taking antidepressant medications under a doctor's supervision. Careful monitoring by a health professional will also minimize any potential risks.

For reasons that are not well-understood, many people respond better to some antidepressants than to others. If a man does not respond to one medication, his doctor may suggest trying another. Sometimes, a medication may be only partially effective. In that case, another medication might be added to help make the antidepressant more effective.

If you begin taking antidepressants, do not stop taking them without the help of a doctor. Sometimes people taking antidepressants feel better and then stop taking the medication on their own, and the depression returns. When it is time to stop the medication, usually after a course of 6 to 12 months, the doctor will help you slowly and safely decrease your dose. Stopping them abruptly can cause withdrawal symptoms.

Some people who relapse back into depression after stopping an antidepressant benefit from staying on medication for additional months or years.

Psychotherapy

Several types of psychotherapy or “talk therapy” can help treat depression. Some therapies are just as effective as medications for certain types of depression. Therapy helps by teaching new ways of thinking and behaving, and changing habits that may be contributing to the depression. Therapy can also help men understand and work through difficult situations or relationships that may be causing their depression or making it worse.

Psychodynamic therapy, cognitive behavioral therapy (CBT), interpersonal therapy (IPT), and problem-solving therapy are examples of evidence-supported talk therapy treatments for depression.

Treatment for depression should be personalized. Some men, might try therapy first and add antidepressant medication later if it is needed. Others might start treatment with both medication and psychotherapy.

How can I help a loved one who is depressed?

It’s important to remember that a person with depression cannot simply "snap out of it." It is also important to know that he may not recognize his symptoms and may not want to get professional treatment.

If you think someone is experiencing depression, you can support him by helping him find a doctor or mental health professional and then helping him make an appointment. Even men who have trouble recognizing that they are depressed may agree to seek help for physical symptoms, such as feeling tired or run down. They may be willing to talk with their regular health professional about a new difficulty they are having at work or losing interest in doing things they usually enjoy. Talking with a primary care provider may be a good first step toward learning about and treating possible depression.

Other ways to help include:

Offering him support, understanding, patience, and encouragement
Listening carefully and talking with him
Never ignoring comments about suicide, and alerting his therapist or doctor
Helping him increase his level of physical and social activity by inviting him out for hikes, games, and other events. If he says, “no,” keep trying, but don't push him to take on too much too soon.
Encouraging him to report any concerns about medications to his health care provider
Ensuring that he gets to his doctor's appointments
Reminding him that with time and treatment, the depression will lift

How can I help myself if I am depressed?

than later can relieve symptoms quicker and reduce the length of time treatment is needed.

Other things that may help include:

Spending time with other people and talking with a friend or relative about your feelings
Increasing your level of physical activity. Regular exercise can help people with mild to moderate depression and may be one part of a treatment plan for those with severe depression. Talk with your health care professional about what kind of exercise is right for you.
Breaking up large tasks into small ones, and tackling what you can as you can. Don't try to do too many things at once
Delaying important decisions until you feel better. Discuss decisions with others who know you well.
Keeping stable daily routines. For example, eating and going to bed at the same time every day.
Avoiding alcohol

As you continue treatment, gradually you will start to feel better. Remember that if you are taking an antidepressant, it may take several weeks for it to start working. Try to do things that you used to enjoy before you had depression. Go easy on yourself.

The Teen Brain: 7 Things to Know

Mon, 01 Aug 2022 22:42:50 GMT

Did you know that big and important changes are happening in the brain

during adolescence? Here are 7 things to know about the teen brain

Helping Children and Adolescents Cope With Traumatic Events

Mon, 01 Aug 2022 18:51:44 GMT

Every year, children and adolescents experience disasters and other traumatic events. Family, friends, and trusted adults play an essential role in helping youth cope with these experiences.

How do children and adolescents respond to traumatic events?

It is typical for children and adolescents to have a range of reactions after experiencing or witnessing a traumatic event, such as a natural disaster, an act of violence, or a serious accident.

Regardless of age, children and adolescents may:

Report having physical problems such as stomachaches or headaches.
Have nightmares or other sleep problems, including refusing to go to bed.
Have trouble concentrating.
Lose interest in activities they normally enjoy.
Have feelings of guilt for not preventing injuries or deaths.
Have thoughts of revenge.

Young children (age 5 and younger) may:

Cling to caregivers and/or cry and be tearful.
Have tantrums, or be irritable or disruptive.
Suddenly return to behaviors such as bed-wetting and thumb-sucking.
Show increased fearfulness (for example, fear of the dark, monsters, or being alone).
Incorporate aspects of the traumatic event into imaginary play.

Older children (age 6 and older) and adolescents may:

Have problems in school.
Withdraw or become isolated from family and friends.
Avoid reminders of the event.
Use drugs, alcohol, or tobacco.
Be disruptive, disrespectful, or destructive.
Be angry or resentful.

Many of these reactions are normal and will lessen with time. If these symptoms last for more than a month, the family should reach out to a health care provider.

What can adults do to help?

How adults respond to trauma can strongly influence how children and adolescents react to trauma. When caregivers and family members take steps to support their own ability to cope, they can provide better care for others.

Caregivers and family members can help by creating a safe and supportive environment, remaining as calm as possible, and reducing stressors. Children and adolescents need to know that their family members love them and will do their best to take care of them.

Do:

Ensure children and adolescents are safe and that their basic needs are addressed.
Allow them to be sad or cry.
Let them talk, write, or draw pictures about the event and their feelings.
Limit their exposure to repetitive news reports about traumatic events.
Let them sleep in your room (for a short time) or sleep with a light on if they are having trouble sleeping.
Try to stick to routines, such as reading bedtime stories, eating dinner together, and playing games.
Help them feel in control by letting them make some decisions for themselves, such as choosing their meals or picking out their clothes.
Pay attention to sudden changes in behaviors, speech, language use, or strong emotions.
Contact a health care provider if new problems develop, particularly if any of the following symptoms occur for more than a few weeks:
Having flashbacks (reliving the event)
Having a racing heart and sweating
Being easily startled
Being emotionally numb
Being very sad or depressed

Don’t:

Expect children and adolescents to be brave or tough.
Make them discuss the event before they are ready.
Get angry if they show strong emotions.
Get upset if they begin bed-wetting, acting out, or thumb-sucking.
Make promises you can’t keep (such as “You will be OK tomorrow” or “You will go home soon.”)

Bipolar Disorder in Teens and Young Adults: Know the Signs

Mon, 01 Aug 2022 18:40:31 GMT

Bipolar disorder is a mental disorder that causes unusual shifts in mood, marked by episodes of mania and depression.

New Title

Teen Depression: More Than Just Moodiness

Mon, 01 Aug 2022 16:35:20 GMT

More than just moodiness

Being a teenager can be tough, but it shouldn’t feel hopeless. If you have been feeling sad most of the time for a few weeks or longer and you’re not able to concentrate or do the things you used to enjoy, talk to a trusted adult about depression .

Do I have depression?

Do you often feel sad, anxious, worthless, or even “empty”?
Have you lost interest in activities you used to enjoy?
Do you get easily frustrated, irritable, or angry?
Do you find yourself withdrawing from friends and family?
Are your grades dropping?
Have your eating or sleeping habits changed?
Have you experienced any fatigue or memory loss?
Have you thought about suicide or harming yourself?

Depression looks different for everyone. You might have many of the symptoms listed above or just a few.

How do I get help for depression?

You’re not alone, and help is available. You can feel better. To get help:

Talk to a trusted adult (such as your parent or guardian, teacher, or school counselor) about how you’ve been feeling.
Ask your doctor about options for professional help. Depression can be treated with psychotherapy (also called “talk therapy”), medication, or a combination of medication and talk therapy.
Try to spend time with friends or family, even if you don’t feel like you want to.
Stay active and exercise, even if it’s just going for a walk. Physical activity releases chemicals, such as endorphins, in your brain that can help you feel better.
Try to keep a regular sleep schedule.
Eat healthy foods.

For immediate help, call the National Suicide Prevention Lifeline : 1-800-273-TALK (8255).

Children and Mental Health: Is This Just a Stage?

Mon, 01 Aug 2022 16:25:01 GMT

Mental Health in Childhood

Raising a child can be challenging. Even under the best circumstances, their behaviors and emotions can change frequently and rapidly. All children are sad, anxious, irritable, or aggressive at times, or they occasionally find it challenging to sit still, pay attention, or interact with others. In most cases, these are just typical developmental phases. However, such behaviors may indicate a more serious problem in some children.

Mental disorders can begin in childhood. Examples include anxiety disorders, attention-deficit/hyperactivity disorder (ADHD), autism spectrum disorder, depression and other mood disorders, eating disorders, and post-traumatic stress disorder (PTSD). Without treatment, these mental health conditions can prevent children from reaching their full potential. Many adults who seek mental health treatment reflect on the impact of mental disorders on their childhood and wish they had received help sooner.

When to Seek Help

How can you tell the difference between challenging behaviors and emotions that are a normal part of growing up and those that are cause for concern? In general, consider seeking help if your child’s behavior persists for a few weeks or longer; causes distress for your child or your family; or interferes with your child’s functioning at school, at home, or with friends. If your child’s behavior is unsafe, or if your child talks about wanting to hurt themselves or someone else, seek help immediately.

Young children may benefit from an evaluation and treatment if they:

Have frequent tantrums or are intensely irritable much of the time
Often talk about fears or worries
Complain about frequent stomachaches or headaches with no known medical cause
Are in constant motion and cannot sit quietly (except when they are watching videos or playing video games)
Sleep too much or too little, have frequent nightmares, or seem sleepy during the day
Are not interested in playing with other children or have difficulty making friends
Struggle academically or have experienced a recent decline in grades
Repeat actions or check things many times out of fear that something bad may happen

Older children and adolescents may benefit from an evaluation and treatment if they:

Have lost interest in things that they used to enjoy
Have low energy
Sleep too much or too little or seem sleepy throughout the day
Are spending more and more time alone and avoid social activities with friends or family
Diet or exercise excessively, or fear gaining weight
Engage in self-harm behaviors (such as cutting or burning their skin)
Smoke, drink, or use drugs
Engage in risky or destructive behavior alone or with friends
Have thoughts of suicide
Have periods of highly elevated energy and activity and require much less sleep than usual
Say that they think someone is trying to control their mind or that they hear things that other people cannot hear

Get Immediate Help

If you, your child, or someone you know is in immediate distress or is thinking about hurting themselves, call the National Suicide Prevention Lifeline toll-free at 1-800-273-TALK (8255). You also can text the Crisis Text Line (HELLO to 741741) or use the Lifeline Chat on the National Suicide Prevention Lifeline website.

First Steps for Parents

If you are concerned about your child’s mental health, you can start by talking with others who frequently interact with your child. For example, ask their teacher about your child’s behavior in school, at daycare, or on the playground.

You can talk with your child’s pediatrician or health care provider and describe the child’s behavior, as well as what you have observed and learned from talking with others. You also can ask the health care provider for a referral to a mental health professional who has experience and expertise in treating children. (See Choosing a Mental Health Professional for additional information.)

Choosing a Mental Health Professional

When looking for a mental health professional for your child, you may want to begin by asking your child’s pediatrician for a referral. If you need help identifying a provider in your area, you can call the Substance Abuse and Mental Health Services Administration (SAMHSA) Treatment Referral Helpline at 1-800-662-HELP (4357). You also can search SAMHSA’s online Behavioral Health Treatment Services Locator , which lists facilities and programs that provide mental health services. It’s especially important to look for a mental health professional with training and experience treating children, particularly your child's specific problems.

Asking questions and providing information to your child’s health care provider can improve your child’s care. Talking with the health care provider builds trust and leads to better results, quality, safety, and satisfaction. Here are some questions you can ask when meeting with prospective treatment providers:

Do you use treatment approaches that are supported by research?
Do you involve parents in the treatment? If so, how are parents involved?
Will there be “homework” between sessions?
How will progress be evaluated?
How soon can we expect to see progress?
How long should treatment last?

To find ideas for starting the conversation with your health care provider, visit the Agency for Healthcare Research and Quality website and read NIMH’s Tips for Talking With Your Health Care Provider . Additional information about finding a qualified mental health professional is available on NIMH's Help for Mental Illnesses webpage and through other organizations listed in More Information and Resources .

Assessing Your Child’s Behavior

An evaluation by a mental health professional can help clarify problems underlying your child’s behavior and provide reassurance or recommendations for the next steps. An evaluation offers an opportunity to learn about your child’s strengths and weaknesses and to determine which interventions might be most helpful.

A comprehensive evaluation of a child’s mental health includes the following:

An interview with the parents to discuss the child’s developmental history, temperament, relationships with friends and family, medical history, interests, abilities, and any prior treatment. It is important for the mental health professional to get a picture of the child’s current situation—for example, a recent change in schools, an illness in the family, or another change that affects the child’s daily life.
Information gathering from the child’s school, such as standardized tests and reports on behavior, capabilities, and difficulties.
If needed, an interview with the child and the mental health professional’s testing and behavioral observations.

Treatment Options

The mental health professional will review the evaluation results to help determine if a child’s behavior is related to changes or stresses at home or school or if it’s the result of a disorder for which they would recommend treatment. Treatment recommendations may include:

Psychotherapy (“talk therapy”). There are many different approaches to psychotherapy, including structured psychotherapies directed at specific conditions. For more information about types of psychotherapies, visit NIMH’s psychotherapies webpage . Effective psychotherapy for children always includes:
Parent involvement in the treatment
Teaching the child skills to practice at home or school (between-session "homework assignments")
Measures of progress (such as rating scales and improvements on “homework assignments”) that are tracked over time.
Medications. As with adults, the type of medicines used for children depends on the diagnosis and may include antidepressants, stimulants, mood stabilizers, or other medications. For general information on specific classes of medications, visit NIMH’s mental health medications webpage . Medications are often used in combination with psychotherapy. If multiple health care providers or specialists are involved, treatment information should be shared and coordinated to achieve the best results.
Family counseling. Including family members in treatment can help them to understand how a child's challenges may affect relationships with parents and siblings.
Support for parents. Individual or group sessions for parents that include training and the opportunity to talk with other parents can provide new strategies for supporting a child and managing difficult behavior in a positive way. The therapist also can coach parents on how to communicate and work with schools on accommodations.

To find information about treatment options for specific disorders, visit NIMH’s Mental Health Information webpage . Researchers continue to explore new treatment options for childhood mental disorders: Participating in a Research Study for Children provides information on participating in clinical research.

Working With the School

Children who have behavioral or emotional challenges that interfere with success in school may benefit from plans or accommodations provided under laws that prevent discrimination against children with disabilities. Your child’s health care providers can help you communicate with the school.

A first step may be to ask the school whether accommodations such as an individualized education program may be appropriate for your child. Accommodations might include measures such as providing a child with a tape recorder for taking notes, allowing more time for tests, or adjusting seating in the classroom to reduce distraction. There are many sources of information on what schools can and, in some cases, must provide for children who would benefit from accommodations and how parents can request evaluation and services for their child:

There are Parent Training and Information Centers and Community Parent Resource Centers located throughout the United States. The Center for Parent Information and Resources lists centers in each state.
The U.S. Department of Education has detailed information on laws that establish mechanisms for providing children with accommodations tailored to their individual needs and aimed at helping them succeed in school. The Department also has a website on the Individuals with Disabilities Education Act , and its Office for Civil Rights has information on other federal laws that prohibit discrimination based on disability in public programs, such as schools.
Many of the organizations in More Information and Resources also offer information on working with schools as well as more general information on disorders affecting children.

NIH.gov

Attention-Deficit/Hyperactivity Disorder in Children and Teens

Mon, 01 Aug 2022 16:13:11 GMT

ADHD: What You Need to Know

Have you noticed that your child or teen finds it hard to pay attention? Do they often move around during times when they shouldn’t, act impulsively, or interrupt others? If such issues are ongoing and seem to be impacting your child’s daily life, they may have attention-deficit/hyperactivity disorder (ADHD).

ADHD can impact the social relationships and school performance of children and teens, but effective treatments are available to manage the symptoms of ADHD. Learn about ADHD, how it’s diagnosed, and how to find support.

What is ADHD?

ADHD is a developmental disorder associated with an ongoing pattern of inattention, hyperactivity, and/or impulsivity. Symptoms of ADHD can interfere with daily activities and relationships. ADHD begins in childhood and can continue into the teen years and adulthood.

What are the symptoms of ADHD?

People with ADHD experience an ongoing pattern of the following types of symptoms:

Inattention—having difficulty paying attention
Hyperactivity—having too much energy or moving and talking too much
Impulsivity—acting without thinking or having difficulty with self-control

Some people with ADHD mainly have symptoms of inattention. Others mostly have symptoms of hyperactivity-impulsivity. Some people have both types of symptoms.

Signs of inattention may include:

Not paying close attention to details or making seemingly careless mistakes in schoolwork or during other activities
Difficulty sustaining attention in play and tasks, including conversations, tests, or lengthy assignments
Trouble listening closely when spoken to directly
Finding it hard to follow through on instructions or to finish schoolwork or chores, or starting tasks but losing focus and getting easily sidetracked
Difficulty organizing tasks and activities, such as doing tasks in sequence, keeping materials and belongings in order, managing time, and meeting deadlines
Avoiding tasks that require sustained mental effort, such as homework
Losing things necessary for tasks or activities, such as school supplies, books, eyeglasses, and cell phones
Being easily distracted by unrelated thoughts or stimuli
Being forgetful during daily activities, such as chores, errands, and keeping appointments

Signs of hyperactivity and impulsivity may include:

Fidgeting and squirming while seated
Getting up and moving around when expected to stay seated, such as in a classroom
Running, dashing around, or climbing at inappropriate times or, in teens, often feeling restless
Being unable to play or engage in hobbies quietly
Being constantly in motion or on the go and/or acting as if driven by a motor
Talking excessively
Answering questions before they are fully asked or finishing other people’s sentences
Having difficulty waiting one’s turn, such as when standing in line
Interrupting or intruding on others, for example, in conversations, games, or activities

How is ADHD diagnosed in children and teens?

To be diagnosed with ADHD, symptoms must have been present before the age of 12. Children up to age 16 are diagnosed with ADHD if they have had at least six persistent symptoms of inattention and/or six persistent symptoms of hyperactivity-impulsivity present for at least 6 months. Symptoms must be present in two or more settings (for example, at home or school or with friends or relatives) and interfere with the quality of social or school functioning.

Parents who think their child may have ADHD should talk to their health care provider. Primary care providers sometimes diagnose and treat ADHD. They may also refer individuals to a mental health professional, such as a psychiatrist or clinical psychologist, who can do a thorough evaluation and make an ADHD diagnosis. Stress, sleep disorders, anxiety, depression, and other physical conditions or illnesses can cause similar symptoms to those of ADHD. Therefore, a thorough evaluation is necessary to determine the cause of the symptoms.

During an evaluation, the health care provider or mental health professional may:

Examine the child’s mental health and medical history.
Ask permission to talk with family members, teachers, and other adults who know the child well and see them in different settings to learn about the child’s behavior and experiences at home and school.
Use standardized behavior rating scales or ADHD symptom checklists to determine whether a child or teen meets the criteria for a diagnosis of ADHD.
Administer psychological tests that look at working memory, executive functioning (abilities such as planning and decision-making), visual and spatial skills, or reasoning skills. Such tests can help detect psychological or cognitive strengths and challenges as well as identify or rule out possible learning disabilities.

Does ADHD look the same in all children and teens?

ADHD symptoms can change over time as a child grows and moves into the preteen and teenage years. In young children with ADHD, hyperactivity and impulsivity are the most common symptoms. As academic and social demands increase, symptoms of inattention become more prominent and begin to interfere with academic performance and peer relationships. In adolescence, hyperactivity often becomes less severe and may appear as restlessness or fidgeting. Symptoms of inattention and impulsivity typically continue and may cause worsening academic, organizational, and relationship challenges. Teens with ADHD also are more likely to engage in impulsive, risky behaviors, including substance use and unsafe sexual activity.

Inattention, restlessness, and impulsivity continue into adulthood for many individuals with ADHD, but in some cases, they may become less severe and less impairing over time.

What causes ADHD?

Researchers are not sure what causes ADHD, although many studies suggest that genes play a large role. Like many other disorders, ADHD probably results from a combination of factors. In addition to genetics, researchers are looking at possible environmental factors that might raise the risk of developing ADHD and are studying how brain injuries, nutrition, and social environments might play a role in ADHD.

What are the treatments for ADHD in children and teens?

Although there is no cure for ADHD, currently available treatments may help reduce symptoms and improve functioning. ADHD is commonly treated with medication, education or training, therapy, or a combination of treatments.

Medication

Stimulants are the most common type of medication used to treat ADHD. Research shows these medications can be highly effective. Like all medications, they can have side effects and require an individual’s health care provider to monitor how they may be reacting to the medication. Nonstimulant medications are also available. Health care providers may sometimes prescribe antidepressants to treat children with ADHD, although the Food and Drug Administration (FDA) has not approved these medications specifically for treating ADHD. Sometimes an individual must try several different medications or dosages before finding what works for them.

For general information about stimulants and other medications used to treat mental disorders, see NIMH's Mental Health Medications webpage . The FDA website has the latest medication approvals, warnings, and patient information guides.

Psychotherapy and Psychosocial Interventions

Several psychosocial interventions have been shown to help children and their families manage symptoms and improve everyday functioning.

Behavioral therapy aims to help a person change their behavior. It might involve practical assistance, such as help organizing tasks or completing schoolwork, learning social skills, or monitoring one’s own behavior and receiving praise or rewards for acting in a desired way.
Cognitive behavioral therapy helps a person to become more aware of attention and concentration challenges and to work on skills to improve focus.
Family and marital therapy can help family members learn how to handle disruptive behaviors, encourage behavior changes, and improve interactions with children.

All types of therapy for children and teens with ADHD require parents to play an active role. Psychotherapy that includes only individual treatment sessions with the child (without parent involvement) is not effective for managing ADHD symptoms and behavior. This type of treatment is more likely to be effective for treating symptoms of anxiety or depression that may occur along with ADHD.

Parent Education and Support

Mental health professionals can educate the parents of a child with ADHD about the disorder and how it affects a family. They also can help parents and children develop new skills, attitudes, and ways of relating to each other. Examples include parenting skills training, stress management techniques for parents, and support groups that help parents and families connect with others who have similar concerns.

School-Based Programs

Children and adolescents with ADHD typically benefit from classroom-based behavioral interventions and/or academic accommodations. Interventions may include behavior management plans or teaching organizational or study skills. Accommodations may include preferential seating in the classroom, reduced classwork load, or extended time on tests and exams. The school may provide accommodations through what is called a 504 Plan or, for children who qualify for special education services, an Individualized Education Plan (IEP).

To learn more about special education services and the Individuals with Disabilities Education Act (IDEA), visit the U.S. Department of Education's IDEA website .

Stress vs. Anxiety

Mon, 01 Aug 2022 13:44:55 GMT

Feeling overwhelmed? Learn whether it’s stress or anxiety, and what you can do to cope.

Is it stress or anxiety?

Life can be stressful—you may feel stressed about performance at school, traumatic events (such as a pandemic, a natural disaster, or an act of violence), or a life change. Everyone feels stress from time to time.

What is stress? Stress is the physical or mental response to an external cause, such as having a lot of homework or having an illness. A stressor may be a one-time or short-term occurrence, or it can happen repeatedly over a long time.

What is anxiety? Anxiety is your body's reaction to stress and can occur even if there is no current threat.

If that anxiety doesn’t go away and begins to interfere with your life, it could affect your health. You could experience problems with sleeping, or with your immune, digestive, cardiovascular, and reproductive systems. You also may be at higher risk for developing a mental illness such as an anxiety disorder or depression. Read more about anxiety disorders .

So, how do you know when to seek help?

Stress vs. Anxiety

Both Stress and Anxiety Generally is a response to an external cause, such as taking a big test or arguing with a friend.
Goes away once the situation is resolved.
Can be positive or negative. For example, it may inspire you to meet a deadline, or it may cause you to lose sleep.

Both stress and anxiety can affect your mind and body. You may experience symptoms such as:

Excessive worry
Uneasiness
Tension
Headaches or body pain
High blood pressure
Loss of sleep
Generally is internal, meaning it's your reaction to stress.
Usually involves a persistent feeling of apprehension or dread that doesn't go away, and that interferes with how you live your life.
Is constant, even if there is no immediate threat.

It’s important to manage your stress.

Everyone experiences stress, and sometimes that stress can feel overwhelming. You may be at risk for an anxiety disorder if it feels like you can’t manage the stress and if the symptoms of your stress:

Interfere with your everyday life.
Cause you to avoid doing things.
Seem to be always present.

Coping With Stress and Anxiety

Learning what causes or triggers your stress and what coping techniques work for you can help reduce your anxiety and improve your daily life. It may take trial and error to discover what works best for you. Here are some activities you can try when you start to feel overwhelmed:

Keep a journal.
Download an app that provides relaxation exercises (such as deep breathing or visualization) or tips for practicing mindfulness, which is a psychological process of actively paying attention to the present moment.
Exercise, and make sure you are eating healthy, regular meals.
Stick to a sleep routine, and make sure you are getting enough sleep.
Avoid drinking excess caffeine such as soft drinks or coffee.
Identify and challenge your negative and unhelpful thoughts.
Reach out to your friends or family members who help you cope in a positive way.

NIH Publication No. 20-MH-8125

Psychological Testing Q & A

Tue, 27 Jul 2021 17:04:02 GMT

What is psychological testing?

Psychological testing is a process of understanding how a person thinks, learns, and feels. It is helpful in gaining a more complete understanding of how a person interacts with and interprets the world. After an initial clinical interview, the scope of testing will be determined and a specific battery of tests will be administered.

Testing can identify the presence of a variety of conditions, including but not limited to

ADHD
Learning disabilities
Mood disorders
Anxiety disorders
Degenerative cognitive problems.
Developmental delays
Personality disorders

What should my child or I expect from psychological testing?

Clinical psychologists at Orchard Wellness are skilled at providing a range of neuropsychological, psycho-educational, and psychodiagnostic. Each evaluation utilizes qualitative and quantitative testing to produce a thorough appraisal with recommendations for treatment and referrals. Assessments are individualized for each client based on a developmental and psychosocial history, medication history and medical and psychiatric histories. Testing focuses on the specific, relevant problems that need to be investigated, such as psychological problems, treatment resistance or failure, difficulties in school or work, cognitive processing issues, failure to launch, and treatment dilemmas.

Can anyone carry out psychological testing?

Not just anyone should provide psychological testing. Orchard Wellness uses highly qualified doctoral-level professionals to administer the tests, score the results, and interpret the outcomes. You should only undergo psychological testing with experienced clinical psychologists who specialize in this type of service.

What kinds of psychological tests are there?

Orchard Wellness uses a variety of cognitive, academic achievement, personality, and neuropsychological tests. Personality tests help analyze all the aspects that make up your personality, including:

Thoughts
Emotions
Attitudes
Behavioral traits

Psycho-Educational Assessment Services

Psycho-Educational Assessments address concerns related to a student’s (Pre-K to Graduate level) academic performance and/or behavior both in the school setting and outside of school (i.e. homework completion, studying difficulties). Additionally, it can include testing for Giftedness and Intellectual Functioning. A psychoeducational assessment is helpful to identify the source of the learning difficulties whether it be related to Attention-Deficit/Hyperactivity Disorder (ADHD), Specific Learning Disorder, Trauma History, Anxiety, and/or Mood Disorder.

Testing for Psycho-Education Assessment typically includes (but is not limited to) the following comprehensive types of assessments:

-Clinical/Background Interview

-Cognitive Assessment (Intellectual Functioning)

-Academic Achievement

-Executive Functioning

-Psychological/Behavioral Functioning

-Family/Caregiver/School Input

By completing a comprehensive group of measures it allows the doctor to help you put the pieces of the puzzle together to get the best picture of what is going on for the student.

After testing is completed, you will receive an easy to read written report that outlines the assessment findings, diagnosis(es) if any, and recommendations. Examples of recommendations include (but are not limited to) treatment recommendations, referrals for medication management, school accommodation recommendations (IEP or 504 recommendations), standardized testing accommodations, and entrance exam accommodation recommendations.

Psychological tests are part of a comprehensive psychological assessment and should never be used on their own to make a diagnosis. Your expert provider at Orchard Wellness takes a detailed history from you and looks at your medical records and any other relevant records first. They then decide which psychological tests are most useful for your case.

Psycho-Diagnostic Assessment Services

Psycho-Diagnostic Assessments help provide clients of all ages a deeper understanding of their emotional, cognitive, personality, social, and behavioral functioning. This type of assessment can be helpful for individuals who:

-Experience distress/discomfort in social interactions

-Have a history of different doctors giving different diagnoses

-Difficulties with activities related to daily living and functioning

-Acting out behaviors

-Interpersonal difficulties in relationships

-Anger

-Mood fluctuations

-Anxiety

After completing a comprehensive battery of measures, the psychologist will review your results along with your medical and personal history and will schedule a comprehensive feedback session with you and others, such as outside therapists.

After testing is completed, you will receive an easy to read written report that outlines the assessment findings, diagnosis(es) if any, and recommendations.

For more information or to schedule a free consultation, contact info@orchard-wellness.com