Mental Illnesses

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Mental illnesses common at adolescence

Although psychiatric disturbances are only a little more in adolescence than in the middle years of childhood, the pattern of disorder is markedly different, being closer to that of adults. As mentioned by Graham and Rutter (1885), about two-fifths of adolescents with psychiatric conditions showed emotional disorders of some kind. Most of these were anxiety states, depression or some kind of relative disorders.

Anxiety disorders

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Dealing with normal adolescent
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The generalized anxiety disorder was 3.7% & separation anxiety was 1% in adolescents (Kaplon & Sadock 1998). Incidence of panic disorder was found to be 0.6% animal phobias get replaced by social phobia and agoraphobia. Similarly school refusal shows an increase in frequency but reason is not only a separation anxiety but more likely to form part of widespread emotional disturbance. Clear-cut hysterical reactions and obsessive-compulsive disorders become more common during adolescence (Graham & Rutter 1985)

Identity disorders

The disturbance due to severe subjective distress over an inability to reconcile aspects of the self into a relatively coherent and acceptable sense of self is manifested by uncertainty about a variety of issues relating to identity such as goals, career choice, friendship, sexual behavior, moral values and group loyalties. It is not actually a mental disorder but it is some times manifest in the contest of such mental disorders as mood disorders, psychotic disorder or borderline personality disorder (Gelder 1983).

Depression

There is a major increase in the frequency of depressive conditions of all types. Either depression will show typical clinical depression or may reflect in poor academic performance, sexual promiscuity, truancy or running away (Kapplan & Sadock, 1998). Studies show that the higher incidence of depressions in females begins in adolescence, when roles and expectations change dramatically. Along with other stressors, hormonal changes may be associated more often with depressions in females. Studies also indicate that individual with certain characteristic-pessimistic thinking, low self esteem, a sense of having control over life events and proneness to excessive worrying are more likely to develop depression. Some experts have suggested that the traditional upbringing of girls might foster these traits and that may be a factor in the higher rate of depression. Study by Riedon and Koff (1997) indicated that the more subjective and personal measures of weight related body image discontent-weight dissatisfaction and weight concerns were associated with increased depressive symptoms.

Suicide

Increasing rates of adolescent suicide are a significant health concern and the third leading cause of death for this age group (Rosewater & Burr, 1998). Pre and post examination tension exposed students to a world of fear and remorse plus lack of psychological support in the family and society pushes the children to suicide. Another common cause of suicide at this age is broken love affair.

Asthenia

Unexplained fatigue or even asthenia are frequently encountered in gynecological practice during this transition period, involving major hormonal and morphological changes-particularly during adolescence which are able to radically alter the subject’s self image. The term fatigue can have very different meanings in the adolescent girls. In addition to true tiredness, it can also mean ‘I Feel Ill’, “I am dissatisfied or sad’ while true fatigue or asthenia is described in terms of ‘I feel awful’ ‘I have a headache’ or ‘I am unable to concentrate’. Perception of symptoms related to fatigue is interpreted in very different ways by adolescent girls and this interpretation often differs from that of adult.

Anorexia nervosa

Anorexia nervosa is mainly observed in young women in the 15 to 24 year age range. The incidence is 1 to 2% in the general population of female adolescents. Diagnosis is clinical and confirmed by an analysis of the underlying conflicts, which involve difficult in accepting the female identity and assuming self-sufficiency outside the family. Anorexia nervosa is not a truly structured psychopathological disorder but rather a loss of stable organization of self with a highly vulnerable narcissistic element and precarious neurotic defenses. Till very recently, anorexia nervosa was a rare disorder in our country but socio cultural differences in the value attached to sliminess may perhaps account for the probable recent increase in the incidence.

Schizophrenia is another common disorder at this age but incidence is equal in both boys and girls.

Coping Strategies

Understanding the manner in which adolescents cope with stress is very important. Adolescents more often utilize avoidant coping strategies. (listening to music, playing sports, sleeping etc.) than approach oriented coping strategies (trying to directly solve the problem, seeking help and guidance from someone about the problems) to deal with negative affective influences. According to Reuter & Conger (1998) the development of either effective or disruptive adolescent problem solving behavior is reciprocally associated with the child rearing strategies of parents.

Recommendation

To minimize the impact of adolescence on mental health, it is better to follow some guide-lines.Parents and teachers training in understanding psychology of adolescence.

Sex education in middle school. Group therapy sessions for adolescents to understand the physical and emotional changes they are undergoing and teaching them to use healthy coping mechanisms

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