Are you concerned about the psychological wellbeing of your child or teen?  Here are some common mental health issues affecting children and adolescents:  

• Depression
• Anxiety Disorders
• Tourette’s Syndrome
• ADHD
• Eating Disorders
• Bipolar Disorder
• Autism and Other Pervasive Developmental Disorders
• Conduct Disorder
• Schizophrenia 

Children or teens can experience the same disorders as adults, although the symptoms may present themselves a little differently.  These illnesses may have occurred as a result of genetic factors, constitutional predisposition, environmental factors, including emotional or physical abuse, neglect, loss of a loved one, frequent relocation, substance abuse, traumatic experiences, exposure to violence, harmful stress, discrimination, and poverty.  It is important to remember, however, that any youth can exhibit signs of these disorders, regardless of the environment around them.  

Can children be depressed or anxious?

Is your child or teen withdrawn, sad, or unlike him or herself?  Is your child irritable?  Does your child mope around and neglect to do things he once enjoyed?  Is your child doing poorly in school and neglecting to do his schoolwork?  Does your child appear to frequently be tired?

Is your child anxious, fearful, or constantly worried?  It is quite common for anxiety and depression to be felt in children and teens.  Anxiety is also a common disorder in children and teens, and comes in the form of generalized anxiety disorder, obsessive compulsive disorder (OCD), panic disorder, post-traumatic stress disorder (PTSD), phobias, separation anxiety, and selective mutism (the failure to speak in specific social situations.) 

For more detailed information, see the “Therapy for Children” and “Problems in Adolescents” below and the sections on “Anxiety” and “Depression” in this website.

Is adolescence always characterized by explosiveness, moodiness, uncooperativeness, rebellion, school problems, or drug and alcohol problems?

There is a myth that when your child becomes a teenager, your family faces many difficulties.  While many teenagers are defiant or act out, many teens are hardworking, studious, responsible, cooperative and an absolute joy.  Your teenage child is dealing with their changing body and a world that grows more complex each day.  Some teenagers adapt to these changes, by taking them in stride and flourishing, while other teenagers may feel that nobody understands them, their world, or their feelings. Teenagers who have trouble adapting to the changes they encounter often feel alone, angry, and confused about the complex issues they face involving drinking and drugs, their body, sexual behavior, their peers, and above all, their identity.

As a parent, you are probably angry and frustrated when your adolescent child is disrespectful to you. Your long-standing rules and methods of discipline may no longer work. You probably feel helpless and scared about the choices your teenager is making.  If this is the case, your child’s adolescence phase is creating a lot of difficulties for you and your family. Some areas of conflict might be:

• disputes over your adolescent's curfew
• your adolescent spending time with the family versus peers
• your adolescent’s choice of friends
• school and work performance
• cars and driving privileges    
• clothing, hair styles and makeup
• dating and sexuality
• self-destructive behaviors such as smoking, drinking and using drugs. 

Working through the challenges of adolescence is difficult for everybody involved, but it is especially difficult for your teenager. In general, families are successful at raising teenagers to become responsible and independent. Don’t give up. You are probably doing a better job than you think!  

However, there are a number of warning signs indicating that things are not going well. Your family should seek outside help if your adolescent is aggressive or violent, promiscuous, abuses drugs or alcohol, runs away, is truant at school, or even breaks the law. Therapy is also advised if your adolescent shows signs of depression, cutting, suicidal ideation or verbalizations, anxiety, panic, slipping grades, or withdrawal from peers or family.  

For more detailed information about issues facing adolescents and their families and treatment for adolescents, see “Psychotherapy for Children” and “Problems in Adolescents” below and the sections on this website on “Depression,” “Anxiety,” “Substance Abuse,” “Conduct Disorder,” “ADHD,” and “Family Therapy.”  

Attention deficit hyperactivity disorder (ADHD)

Is your child easily distracted?  Is he or she more active than other children? Is you child impulsive, disorganized, or do they call out of turn?   If these characteristics are descriptive of your child’s behavior, attention deficit hyperactivity disorder (ADHD) might be the cause.  ADHD is the most commonly diagnosed psychiatric disorder in children.

Symptoms of the disorder include inappropriate levels of:

• Concentration
• Activity
• Attention
• Distractibility
• Impulsivity
• Impaired functioning in interpersonal relationships at home and school 

If left untreated, ADHD may have long-term effects on academic performance, career success, possible substance abuse, and social or emotional development.  Along with intensive psychotherapy, medication is a widely used treatment for the disorder.

For more detailed information, see the sections below, titled “Therapy for Children” and “Problems in Adolescents” and the sections in “ADHD” on this website.

Does my child have an eating disorder?

Has food become a main concern in your child’s life?  Does your child fear that he or she is overweight when they are actually underweight? Whether your child is eating too little, too much, or purging after meals, your child can be facing a serious and dangerous illness.

An eating disorder causes extreme changes in eating behavior, such as acute and unhealthy cutback of food intake, or severe overeating.  Your child might feel extremely concerned with his or her body shape or weight and have constant anxiety over their food intake.  Or, your child might be preoccupied by food or your child might be preoccupied with food and constantly overeating or eating unhealthy food.

Eating disorders are far too common and tend to appear in adolescence.  Children and teens are under a lot of pressure to keep their bodies in perfect condition.  Sports, dance, and other activities also pressure children to be far more concerned about their weight than they should be.  Although eating disorders are far more common in young women, young men are also afflicted.  Your child might also turn to food as a matter of control.  As children grow, their lives become more complicated and they might use food to feel that they have some control over their lives.  Some individuals eat when they're stressed or upset, and others stop eating. As a parent, you must be aware of what and how your child eats so you can stop potential eating disorders before they happen.

Today’s teenagers are bombarded with images on television, in movies, and in magazines of exaggerated thinness and the need for body perfection.  These images provide great psychological pressure to teenagers of today who try to emulate actors, actresses, models, movie stars, and rock stars.  Whether it is Vogue or a tabloid, they are constantly exposed to the importance of body image.

For more detailed information, see the “Therapy for Children” and “Problems in Adolescents” below and the sections on “Eating Disorders” on this website.

Does my child have bipolar disorder?

Does your child have mood swings?  Does your child seem depressed at times and irritable at other times?  Does your child have elated moods characterized by rapid talking?  Does your child have fantasies of grandiosity?  Does your child sometimes have out of control behavior?  Does your child sometimes have runaway behavior?  Does your child abuse drugs?  Do you suspect that your child is sexually active?  If your child is manifesting any of these behaviors, he or she may have bipolar disorder. There are two types of bipolar— bipolar disorder type I and bipolar disorder type II, the latter being less severe.  Your child might be experiencing a cycling of mood changes from extreme highs to extreme lows.  The highs are considered “mania” and include symptoms such as:

• Distractibility
• Impulsivity
• Abnormal or excessive elation
• Unusual irritability
• Decreased need for sleep
• Grandiose notions
• Increased talking
• Racing thoughts
• Increased sexual desire
• Markedly increased energy
• Poor judgment
• Inappropriate social behavior  

The lows are considered “depression” and are characterized by the common symptoms of major depression, including: 

• Persistent sad, anxious, or "empty" mood
• Feelings of hopelessness, pessimism 
• Feelings of guilt, worthlessness, helplessness
• Loss of interest or pleasure in hobbies and activities that were once enjoyed, including sex
• Decreased energy, fatigue, being "slowed down"
• Difficulty concentrating, remembering, making decisions
• Insomnia, early-morning awakening, or oversleeping
• Appetite and/or weight loss or overeating and weight gain
• Thoughts of death or suicide; suicide attempts
• Restlessness, irritability
• Persistent physical symptoms that do not respond to treatment, such as headaches, digestive disorders, and chronic pain  

Symptoms of bipolar disorder can interfere with successful school performance, peer interactions, family relationships, and everyday activities.  Although the disorder typically remains undiagnosed until early adulthood, evidence can be found in children and adolescents. Common characteristics of the disorder in children include continually mixed cycles of symptoms that can co-exist with other disorders and are difficult to distinguish between them, such as attention deficit hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD).  It is very difficult to discern between attention deficit hyperactivity disorder (ADHD), oppositional defiant disorder (ODD) and bipolar disorder (BP). Therapy is very beneficial, but medication can also be very helpful.  Mood stabilizers that are used in adults can be effective in conjunction with psychotherapy. 

For more detailed information, see the sections titled below, “Therapy for Children” and “Problems in Adolescents” and the sections on “Bipolar Disorder” on this website.

Does my child have Autistic Spectrum Disorder?

Autism and other developmental disorders are growing at exponential rates in the United States.  If your child is affected by an autistic spectrum disorder, they may have difficulty communicating, responding appropriately to the outside world, and forming relationships.  Usually, autism can be diagnosed by age 3, but symptoms, along with severity, may vary.  There is a wide range in the spectrum of autistic disorders, with some children able to function at a high level while others are extremely developmentally delayed.  Early diagnosis is important to bring about the best results in treatment.  To improve the behavior and functioning of autistic children, psychosocial and pharmacological methods are used (usually simultaneously).  It has been concluded through research that genetic factors can be underlying the disorder, and, particularly due to the recent influx of autism in children, much biological research is being done to develop future treatments. 

The child with autistic spectrum disorder requires special schooling and early intervention. This includes ABA therapy, occupational therapy, speech therapy and physical therapy. ABA therapy is helpful for the child with an Autistic Spectrum Disorder. Special training is needed in this modality Family therapy can help the parents and siblings adjust to the child with an autistic spectrum disorder. For more detailed information, see the “Therapy for Children” and “Family Therapy” sections below.

Does my child have oppositional defiant disorder (ODD)?

The DSM-IV diagnoses conduct disorder as a repetitive and persistent pattern of behavior in which the basic rights of others or major age-appropriate societal norms or rules are violated, as manifested by the presence of three (or more) of the following criteria in the past 12 months, with at least one criterion present in the past 6 months:  

• Aggression to people and animals
• Destruction of property
• Deceitfulness or theft
• Serious violation of rules 

After the age of 18, conduct disorder may turn into antisocial personality disorder.  For more information on antisocial personality, refer to the “Personality Disorders” section of our website. It is important for someone with an oppositional defiant disorder to start individual and family psychotherapy and/or medication as soon as possible from a licensed psychologist, clinical social worker, psychotherapist, counselor, psychiatric nurse practitioner or psychiatrist.  In a confidential, supportive, non-judgmental atmosphere, psychotherapy or counseling with a licensed psychologist or psychotherapist can help the individual gain awareness, achieve positive behavioral change, and improve overall functioning. Medication can be prescribed by a psychiatric nurse practitioner or psychiatrist. The sooner treatment is begun, the sooner the oppositional defiant disorder can go into remission.

Does my child have schizophrenia?

Does your child seem disconnected from reality? If this is the cure,  He or she might be suffering from schizophrenia, a severe and chronic disorder. 

Symptoms of schizophrenia include: 

• Delusions
• Social withdrawal
• Hallucinations
• Disordered thinking

Although schizophrenia is quite rare in children and usually doesn’t emerge until early adulthood, research has found that cognitive and social impairments may provide evidence of possible schizophrenia in late adolescence.  Research has also shown that due to early life disturbances interfering with born development, a combination of genetic and environmental factors lead to the symptoms of schizophrenia. In addition to intensive therapy, medications may also be useful. 

Does my child have Tourette’s Syndrome?

Does your child seem unable to control bodily movement or sounds? If this is the case, he or she may have Tourette’s Syndrome (TS). 

Tourette’s Syndrome usually emerges before adolescence and includes the following symptoms: 

• Repeated, involuntary movements
• Uncontrollable vocal sounds
• Tics

TS could be caused by various factors, including a neurological abnormality, and occasionally, the symptoms of TS can be related to those of OCD. TS is a neurological condition characterized by too much dopamine in the brain stem.  Although Tourette’s Syndrome does not impair intellectual functioning, it does affect the child in certain intellectually related situations such as timed tests. Medications can be helpful, but only if the individual can tolerate the sedative side effects.  Individuals with Tourette’s Syndrome can usually live well-functioning lives in both scholastic situations and at home.

Parents should make certain that the school provides the child with the proper accommodations. This includes making discussions and providing the child’s classmates with explanations regarding your child’s condition as well as with teachers and all school personal. Proper school accommodations also involve special provisions for test taking which includes a separate room and untimed testing.

Psychotherapy cannot help reduce the tics or movements, however, it can help the child better adjust to the condition and improve self-esteem and self-confidence. Family therapy can help the family members, both parents and siblings accept and adjust to this condition and be supportive and understanding of the child with Tourette’s.

Is adolescence always characterized by explosiveness, moodiness, uncooperativeness, rebellion, school problems, or drug and alcohol problems?

The idea that when your child becomes a teenager, your family faces many difficulties is considered a myth.  While many adolescents are defiant or act out, many teens are hardworking, studious, responsible, and cooperative.  Your adolescent child is dealing with their changing body and their world is becoming increasingly more complex.  Some adolescents adapt to these changes but taking them in stride and flourishing.  Other adolescents feel like nobody understands them, their world, or their feelings. Adolescents who have trouble adapting to their rapidly changing lives may feel alone, angry, and confused about the complex issues they face involving drinking and drugs, their body, sexual behavior, their peers, and especially their identity.

As a parent, it can be increasingly frustrating or it may cause you to feel angry when your adolescence shows lack of respect for you long-standing rules and methods of discipline. You probably feel helpless and scared about the choices your adolescent is making.

Naturally, adolescence creates a lot of difficulties for your family. Some areas of conflict might be: 

• disputes over your adolescents curfew
• spending time with the family versus with peers
• your adolescent’s choice of friends
• school and work performance
• cars and driving privileges   
• clothing, hair styles and makeup
• dating and sexuality
• self-destructive behaviors such as smoking, drinking and using drugs.

Working through the challenges of adolescence is difficult for everybody involved, but is hardest for your teenager. In general, families are successful at raising teenagers to become responsible and independent. Don’t give up. You are probably doing a better job than you think!

However, there are a number of warning signs that things are not going well. Your family should seek outside help if your adolescent is aggressive, violent, promiscuous, abuses drugs or alcohol, runs away, is truant at school, or breaks the law. Therapy is also advised if your adolescent shows signs of depression, cutting, suicidal ideation or verbalizations, anxiety, panic, slipping grades, or withdrawal from others.

Psychotherapy for children and adolescents

Psychotherapy for children is very similar to psychotherapy for adults, because they use the same psychological principles to help the patient. However, your child’s therapy is tailored to work for their age level. Since kids enjoy to play, the therapist help your child through play, by using special toys, games, and activities to help your child work through his or her difficulties. Your child’s therapist is specially trained to work with children and will match the therapy with your child’s needs. Sometimes you may be involved with your child’s therapy as well.  You might meet with the therapist to discuss events and changes that your child might not be aware of or be able to express to the therapist. You are the most important person in helping your child resolve his or her problems. As the parent, it is important to support your child's work with the therapist making sure that appointments are kept and offering encouragement as needed. It is also important for parents to respect the confidentiality of their child's sessions and not to press him of her for details on what is or is not talked about in the sessions. This helps to maintain trust, which is central to the therapy. The goal of therapy with children is to help the child solve problems in a constructive way, in an effort improve functioning at home, at school, and with peers, and to develop a positive self-image.

It is important for the child and family to seek psychotherapy and/or medication as soon as possible from a licensed psychologist, clinical social worker, psychotherapist, counselor, psychiatric nurse practitioner or psychiatrist.  In a confidential, supportive, non-judgmental atmosphere, psychotherapy or counseling with a psychologist or psychotherapist can help the child gain awareness, achieve positive behavioral change, and improve overall functioning. Medication can be prescribed by a psychiatric nurse practitioner or psychiatrist. The sooner treatment begins, the sooner the child’s situation can improve.

If you think your child or adolescent can benefit from psychotherapy or counseling and you would like more information about psychotherapy with children or adolescents, want to discuss your specific needs, or make an appointment, call our office today to speak to someone.  We have licensed psychologists, psychotherapists, psychiatrists, counselors, clinical social workers, and psychiatric nurse practitioners, qualified and experienced in effectively treating children, adolescents and families, and we can help suggest the therapist that best meets your needs. Our telephone number is 212-996-3939 or 212-996-2929