mental health

• occurs in 2 stages- physical(wt, ht, muscles, organs, voice) & sexual( production of gonadotropin when puberty starts)
• puberty- body able to reproduce

• Girls
• start puberty @ 8-14y/o, they expirience 24-36 mo. puberty growth spurt around 9 yrs start period 12yrs 9mo. could start @ 10yrs or as late as 16yr, breast developmet, fat distribution, ends by 16-18yr

• Boys
• devolope slower, starts @ 10-12yr, testes enlarge, growth of pubic hair, penis grows in lenth & width, growth spurt @ 11-14yr, pubery lasts until 18yr, but they could father @ 12yr

• refers to the nonphysical realm of functioning
• teens have a period when they feel awkward, inadequate, & unworhty

• childrens thinkin is concrete, based on what is observed/expirienced @ present time
• young adolescents(10-13yr) have trouble thinking realistically bout future
• teens- thinking moves from present to concrete future & what is possible ( relationship, problem solving thru reasoning & logic)
• middle teen-14-17yr, abstract thinking(adaptable, flexible thinking(using concepts, generalization, problem solving), feeling of power & self-centeredness
• @17yr- abstract thinking becomes more realistic, are able to plan reachable actions, goals, & careers

• during adolescence rapid change & adjustment
• 10-13yr emotional stabilty replaced w/ worry about body changes leading 2 low self-esteem, body image, & self-concept, it becomes a confusing time.
• mood changes- inprdicatable, aggressive, withdrawn, depressed
• daydreaming- allows them 2 try new roles & they place themselves in "what if " situations
• intense emotions @ 14-17yr, a lonely/troubled time, question if/how they fit in the get self control by 18yr

younger teens seek personal identity & belonging w/ differant groups to find the differance btween self & parants it serves as a stepin stone od individual identity & seperating from family

middle teen- see themselves in differant way, groups determines new ways to dress, behaviors, & activities, they start to see themsleves as other do, they a usually self-centered, sex is important, by 18yr already had sex

17yr- shift from group 2 individual, caring 4 other, dateing is personal & intimate

• adolescents start 2 ? family values & beliefs, stop goin 2 church, or worship alone
• attracted to other religions that gives more acceptance & love @ this time they spiritual concerns needing understanding, patience

• emotional up/down
• Introspection- process of examing one's own thoughts, emotions, reactions, attitudes, opinions, values, & behaviors by looking @ inner self, ? who they are, how other see them, this process looking inward help define themselves, but also brings changes in mood

this is when they need feel secure & emotionaly supported

early adolescencs 11-14yr, want to stay dependant & also be indepentant, want freedom but req. emptional ties w/ family\

midadolescence 14-17yr, want all independance they detach from family (family can b overprotective 2 not not caring bout them), some deal w/ physical violance, sexual abuse, parents that do drugs, neglect, they deal w/ gangs, peer groups are usually run by adults & are positive 4 teens, star being interested in other sex until 2yr relationship is based on a sense of giving other than recieving

other external problems- air pollution, quality & quantity of foods, purity of water, exposure to drugs, violance, crimes, media

• Dx- in early childhood but last till adult
• they have low attention/focus span, impulsive, bad behavior, can't relate 2 others, they get unhappy
• TX- multidisciplinary approach w/ sm., structured, classes & firm, non-judgemental teachers needed, these kids need to be rewarded 4 good behaviors
• behavioral therapy good 4 kid & parents, parents taught to enforce limits w/o being harsh inconsistant, or angry
• Meds- stimulants, antidepressants, antipsychotics

w/o judgement get info on any hx of past/current substance abuse, b/c of drug interactions

• defience of authority & aggression to others, usually in boys w/ academic problems
• Factors- harsh parents w/ physical punishment
• symptoms- fighhting, tempertantrums, running away, destroying properties, stealing, setting fires, truancy, vandalism, & substance abuse, many have w/ violant hx also have anxiety, & depression
• Tx- stabalizing home enviroment, improve family interactions w/ therapy & disciplinary tech., teaching self control by emotional, behavior, cognitive therapy, inpatient tx when kids is a harm to self or others, these kids usually become antisocial as adults

they need caregivers that have patience, willing to set limits, & that they enforce those limits

they are usually a normal part of life, but when they interfere w/ ADL mental health care is needed

• Anxiety- when kid is overwhelmed/overstressed, they go into an emotional state that triggers physical changes as body tries to adapt
• physical & emotional symptoms can lead to panic disorders, phobias, OCD, Posttraumatic SD, substance abuse, & depression

• Mood disorders(affective disorders)- wide range of behaviors from depression 2 hyperactivity, when up/down are 4 long-term an emotional disorder suspected
• S/S- mood swings, acting out, antisocial, low performance in school, loss of energy, headache, stomach ache, eating/sleeping problems, problems w/ family, theft, vandalism,

Best prevention is early recog. if untreated leads 2 serious mental health disorders in adulthood

Obesity- wt that is 20% or more, b/c eating patterns of obese teens is not a immediate threat, chronic overeating not considered a mental disorder, many use food in troubled times, most affected are girls or athlete boys, mortality is 9%

Anorexia nervosa- refusal to eat, seen by 12yr, peaks @ 13-14yr & again @ 17-18yr, over cooperative, achievement-oriented, thinks she is overwt & start diets & get obsessed of wt, may b hx of eating or mood disorders in family, may restrict calories, exercise alot, vomit, use laxitives/diuretics, pills, even drugs, avoids friends & family, becomes irritable, anxious, & depressed, will deny problem, can be fatal

• Bulimia- binge eating them purging, occurs @ 17yr, harder to detect, start w/ big interest in diets, they eat 5,000-20,000 calories of high-carbs, then feelin guilt/depression, to control wt gain they thowup exersice, use drugs even starvation, may loss wt but remains w/i 2% norm., usually b/c of stressfull event
• Compl.- erosion of tooth enamel gastric dialation, pancreitis, electrolyte inbalance, most know they have problem but won't admit it
• Tx- 3 Goals
• 1.manage medical danger like metabolic disturbance, cardiac problems, & dehydration
• 2.to restore norm. nutrition & eating patterns
• 3.meet psychiatric tx needs 4 all involved
• force feeding not recommended b/c goalis 4 pt to choose to eat

Both disorders decrease by 30yr, nurse help with identifing stressor, & find better coping skills

• state in which one physically or psychologically req. drugs
• 4 adolescents temptation is 2 find out whats its like, way of coping w/ life, usually don't become addicted, but usually become sexually active

• 4 stages:
• 1.experimentation- try for the 1st time, to be lik peers
• 2.active seeking- want the feeling of being under the influence, friends will only be others that use drugs too
• 3.peoccupation- feel that can't be w/o dug, may start other drugs, used to prevent withdrawals, friends lost, gets violent
• 4.burnout- can't function w/o it,
• S/S- changes in moods, habits, personality, they disappear w/ friends & avoid family
• TX- finding other coping skills, behavioral & cognative therapies, provide safe enviroment b/c most are suicidal, prevention & early recog. best tool

• comb. of behavior patterns devoleped 4 coping, or for our identity
• TX- psychotherapy, meds
• disorders thought to be RT problems w/ serotonin, tx w/ SSRI like floxetine hydrocloride (prozac), found sucessfull
• Impulsivity- do harmful acts, inappropiate actions (overeating, casual sexual acts, thrill seeking, all or nothing concept
• introspection is low, anger, depression, low self-esteem, fear of being alone/abandoned), most try suicide

• characterized by distress & impaired ability to function
• gender indentity- discomfort of own gender
• may want hormonal therapy, surgery,
• Tx- medical & mental therapy
• sexual acting ouit is normal 4 teens, but could be harmful b/c society sees behavior as inappropiate
• could be solved w/ good communication skills

• schizophrenia- impaired ability 2 function b/c of not being in touch w/ reality, onset is usually in adolescencs, good child that start w/ wierd behaviors & acts, loss of contact w/ reality,
• S/S- hallucinations, delusions, feeling of paranoia, lack judgement, impulsive, lil insight, inappropriat, ritualistic, repetative behaviors, bad hygiene, not eating
• Tx- psychotherapy & meds like antipsychotics, antidepressants, & lithium
• Care focused on basic needs (ADL), safe environment, & developi skills 4 good living

itz life-long & the major problem w/ management is poor complience in taking RX meds, family encouraged to join a support group

• girls attempted 3x more, but boy more successful b/c they choose more lethal methods
• itz a call 4 help, or attention
• factors- abuse, neglect, instability w/i family, depression, illness, availability of guns, drugs/alcohol, comptition
• teens who attempt suicide fall into 3 groups:
• 1.depression
• 2.trying to influence others
• 3.teens w/ mental health problems
• teens could be trying to getback @ others, or to scare other , usually seen girls
• white males @ higher risk
• Tx- to protect them, build trust, help w/ coping skills

• 4 suicidal thoughts
• *survielance- safety, making good decisions, making sure they follow rules (Degree of problem determines amount of surveillance)
• *limiting settings, enforcing them, praise them
• *building self-esteemeye contact, active listening, call by 1st name, don't lecture
• *role modeling
• *skill developing- cognative, social, living skills