All Posts Tagged: ocd

Self Harm – Is Your Child Engaging in it?

Self harm or self-injury is the intentional wounding of one’s own body. Most often, people who self harm will cut themselves with a sharp object.

Self harming may also include:

  • severely scratching areas of their body with a fingernail or sharpened object
  • carving words or patterns into their skin
  • burning or branding themselves using lighters, cigarettes, lit matches, or other hot objects
  • biting themselves
  • excessively picking at their skin (dermatillomania) or wounds
  • hair pulling (trichotillomania)
  • head banging
  • punching or hitting themselves
  • excessive skin-piercing or tattooing may also be indicators of self harm

Generally, people who self-harm do so in private. Often, they follow a ritual. For example, they might have a favorite object that they use to cut themselves or they may listen to certain music while they self injure.

Self harmers will target any area of the body, but the legs, arms, or front of the body are the most commonly selected. These areas are not only easy to reach, they are also easy to cover up, allowing the person to hide their wounds away from judgmental eyes.

Additionally, self harm can include actions that don’t seem so obvious to others. Activities like excessive substance abuse or binge drinking, driving recklessly or having unsafe sex can all be signs of self harm.

Causes of Self Harm

There are many reasons that people engage in the unhealthy coping mechanism of self-injury.

Oftentimes, a self-mutilator may have trouble understanding or expressing their emotions. Those who self harm report feelings of worthlessness and rejection, loneliness or isolation, guilt, self-hatred, and anger.

When a self harmer attacks their own body, they are really seeking:

  • distraction from painful emotions
  • to release intolerable mental anguish
  • a sense of control over their feelings, their body, or their lives
  • a physical distraction from emotional pain or emotional “numbness”
  • to punish themselves for supposed faults

People who self injure often feel an intense yearning to injure themselves. Even though they know it’s destructive, this feeling grows stronger until they complete the act of mutilation.  Feeling the resulting pain releases their distress and anxiety. This relief is only temporary, though, until their shame, guilt, and emotional pain triggers them to injure themselves again.

Who is At Risk for Self Harm?

Self injury happens in all walks of life. It is not restricted to a certain race or age group, nor to a particular educational or socioeconomic background.

It does happen more often in:

  • people with a background of childhood trauma, such as verbal, physical, or sexual abuse
  • those who have difficulty expressing their emotions
  • those without a strong social support network or, conversely, in those who have friends who also self harm
  • people who also have obsessive compulsive disorder (OCD), post traumatic stress disorder (PTSD), eating disorders, borderline personality disorder, or those who engage in substance abuse

Although anyone may self harm, the behavior occurs most frequently in teens and young adults. Females tend to engage in cutting and other forms of self-mutilation at an earlier age than males, but adolescent boys have the highest incidence of non-suicidal self injury.

Self-Harming Symptoms

Physical signs of self harm may include:

  • unexplained scars, often on wrists, arms, chest, or thighs
  • covering up arms or legs with long pants or long-sleeved shirts, even in very hot weather
  • fresh bruises, scratches or cuts
  • telling others they are clumsy and have frequent “accidents” as a way to explain their injuries
  • keeping sharp objects (knives, razors, needles) either on their person or nearby
  • blood stains on tissues, towels, or bed sheets

Emotional signs of self harm may include:

  • making statements of feeling hopeless, worthless, or helpless
  • isolation and withdrawal
  • impulsivity
  • emotional unpredictability
  • problems with personal relationships

Help for Self Harm

The first step in getting help for self harm is to tell someone that you are injuring yourself. Make sure the person is someone you trust, like a parent, your significant other, or a close friend. If you feel uncomfortable telling someone close to you, tell a teacher, counselor, religious or spiritual advisor, or a mental health professional.

Professional treatment for self injury depends on the specific case and whether or not there are any related mental health concerns. For example, if the person is self harming but also has depression, treatment with address the underlying mood disorder as well.

Most commonly, self harm is treated with a psychotherapy modality, such as:

  • Cognitive behavioral therapy (CBT), which helps the person identify negative beliefs and inaccurate thoughts, so they can challenge them and learn to react more positively.
  • Psychodynamic psychotherapy, which helps identify the issues that trigger their self-harming impulses. This therapy will develop skills to better manage stress and regulate emotions.
  • Dialectical behavior therapy (DBT), which helps the person learn better ways to tolerate distress. They’ll also learn coping skills so they can control the urge to self harm.
  • Mindfulness-based therapies, which can teach them skills to effectively cope with the myriad of issues that cause distress on a regular basis.

Treatment for self injury may include group therapy or family therapy in addition to individual therapy.

Self care for self-harming includes:

  • Asking for help from someone whom you can call immediately if you feel the need to self injure.
  • Following your treatment plan by keeping your therapy appointments.
  • Taking any prescribed medicines as directed, for underlying mental health conditions.
  • Identifying the feelings or situations that trigger your need to self harm. When you feel an urge, document what happened before it started. What were you doing? Who was with you? What was said? How did you feel? After a while, you’ll see a pattern, which will help you avoid the trigger. This also allows you to make a plan for ways to soothe or distract yourself when it comes up.
  • Being kind to yourself – eat healthy foods, learn relaxation techniques, and become more physically active.
  • Avoiding websites that idealize self harm.

 If your loved one self-injures:

  • Offer support and don’t criticize or judge. Yelling and arguments may increase the risk that they will self harm.
  • Praise their efforts as they work toward healthier emotional expression.
  • Learn more about self-injuring so you can understand the behavior and be compassionate towards your loved one.
  • Know the plan that the person and their therapist made for preventing relapse, then help them follow these coping strategies if they encounter a trigger.
  • Find support for yourself by joining a local or online support group for those affected by self-injuring behaviors.
  • Let the person know they’re not alone and that you care.

Need More Information?

Are you concerned that your child is engaging in self harm? Don’t wait to seek help – speak to a compassionate child psychologist at The Children’s Center for Psychiatry, Psychology and Related Services in Delray Beach, Florida. Contact us for more information or call us at (561) 223-6568.

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Signs Your Child May be a Hypochondriac

Signs Your Child May be a Hypochondriac

A hypochondriac is someone who lives with the fear that they have a serious, but undiagnosed medical condition, even though diagnostic tests show there is nothing wrong with them. Hypochondriacs experience extreme anxiety from the bodily responses most people take for granted. For example, they may be convinced that something as simple as a sneeze is the sign they have a horrible disease.

Hypochondria accounts for about five percent of outpatient medical care annually. More than 200,000 people are diagnosed with hypochondria (also known as health anxiety or illness anxiety disorder) each year. While health anxiety generally begins in early adulthood, children can also experience hypochondria.

Hypochondriac Symptoms

True hypochondria is a mental health disorder. Hypochondria may show up in a child after they or someone they know has gone through an illness or a serious medical condition. Its symptoms can vary, depending on factors such as stress, age, and whether the person is already an extreme worrier.

In children, hypochondriac symptoms may include:

·         Regularly checking themselves for any sign of illness

·         Telling you about a new physical complaint almost every day

·         Fearing that anything from a runny nose to a gurgle in their gut is the sign of a serious illness

·         Frequently asking their parent to take them to the doctor

·         Asking to have their temperature taken daily (or more than once per day)

·         Talking excessively about their health

·         Happily wearing bandages like badges of honor, has one on almost constantly

·         May focus excessively on things most children typically don’t: a certain disease (example: cancer) or a certain body part (example: worrying about a brain tumor if they have a headache)

·         Having frequent pains or finds lumps that no one else can feel

·         Fearing being around people who are sick

Health anxiety can actually have its own symptoms because it’s possible for the child to have stomachaches, dizziness, or pain as a result of their overwhelming anxiety. In fact, illness anxiety can take over a hypochondriac’s life to the point that worrying and living in fear are so stressful, the child refuses to go to school or participate in outside activities.

You may be wondering what triggers hypochondria. Although there really isn’t an exact cause, we do know that people with illness anxiety are more likely to have a family member who is also a hypochondriac. The child with health anxiety may have gone through a serious illness and fear that their bad experience may be repeated. Or, they may already be suffering from a mental health condition and their hypochondria may be part of it.

Hypochondriac Treatment

Self-help for child hypochondria can include:

  • Letting your child know that sometimes focusing too much on being sick can cause anxiety that makes their bodily sensation worse
  • Trying to not talk about your own aches or pains in front of your child
  • Helping your child learn stress management and relaxation techniques
  • Encouraging older children to avoid online searches for the possible meanings behind their symptoms
  • Focusing on outside activities such as a hobby they enjoy
  • Working to help your child recognize that the physical signs they experience are not a symptom of something ominous, but are actually normal bodily sensations

Professional treatments for hypochondria include:

  • Cognitive Behavioral Therapy (CBT), which is very helpful for reducing patient fears. In this type of therapy, the child learns to recognize and understand the false beliefs that set off their anxiety. Research has shown that CBT successfully teaches hypochondriacs to identify what triggers their behavior and gives them coping skills to help them manage it.
  • Behavioral stress management or exposure therapy may be helpful
  • Psychotropic medications, such as anti-depressants, are sometimes used to treat health anxiety disorder

Get Help for Hypochondria and Health Anxiety Disorder

Being a hypochondriac negatively affects the lives of the child who suffers from it.  The child psychologists at the Children’s Center for Psychiatry, Psychology and Related Services in Delray Beach, Florida are experienced in helping those with illness anxiety. For more information, contact us or call us today at (561) 223-6568.

Reference: https://jamanetwork.com/journals/jama/fullarticle/198437

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PANDAS Disease Following a Strep Throat Infection

PANDAS Disease Following a Strep Throat Infection

PANDAS disease (short for Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections) isn’t a true disease. Instead, it is a rare disorder that can occur in children following a strep throat infection. With PANDAS strep, the child’s body sets up an immune response to the invading streptococcus bacteria, but ends up attacking the child’s own tissues in addition to the strep bacteria. The result is inflammation within the brain, and the dramatic onset of OCD (obsessive-compulsive disorder), tics, intense anxiety and other debilitating symptoms.

The hallmark of PANDAS is that these new symptoms and disorders appear or worsen very suddenly. In fact, parents say they come “out of the blue” or that their child changes “overnight.” Keep in mind that children who have been previously diagnosed with OCD or tics will always have their good days and their bad days, so an upswing in symptoms does not necessarily mean the child has PANDAS disease just because they’ve had a throat infection. With PANDAS disease, however, the child’s tics or OCD would flare up dramatically and continue to stay elevated anywhere from several weeks to several months.

PANDAS Symptoms

The National Institute of Mental Health (NIMH) reports that the diagnosis of PANDAS syndrome is strictly a clinical diagnosis. There are no lab tests that can diagnose the PANDAS disorder. Additionally, the diagnosis of PANDAS is controversial, so some clinicians either don’t understand it or may overlook the syndrome.

Currently, the only way to determine whether a child has PANDAS disease is to look at the clinical features of the illness, so health care providers use diagnostic criteria to make a PANDAS diagnosis.

NIMH’s diagnostic criteria for PANDAS:

  • Presence of obsessive-compulsive disorder and/or a tic disorder
  • Pediatric onset of symptoms (age 3 years to puberty)
  • Episodic course of symptom severity (see information below)
  • Association with group A Beta-hemolytic streptococcal infection (a positive throat culture for strep or history of scarlet fever)
  • Association with neurological abnormalities (physical hyperactivity, or unusual, jerky movements that are not in the child’s control)
  • Very abrupt onset or worsening of symptoms

If the symptoms have been present for more than a week, blood tests may be done to document a preceding streptococcal infection.

Additionally, the NIMH reports that children with PANDAS often experience one or more of the following symptoms in conjunction with their OCD and/or tics:

  • ADHD symptoms (hyperactivity, inattention, fidgety)
  • Separation anxiety (child is “clingy” and has difficulty separating from his/her caregivers; for example, the child may not want to be in a different room in the house from his or her parents)
  • Mood changes, such as irritability, sadness, emotional lability (tendency to laugh or cry unexpectedly at what might seem the wrong moment)
  • Trouble sleeping, night-time bed-wetting, day-time frequent urination or both
  • Changes in motor skills (e.g. changes in handwriting)
  • Joint pains

PANDAS Disease Risk Factors

The risk factors for PANDAS syndrome are:

  • A family history of rheumatic fever
  • The child’s mother has a personal history of an autoimmune disease
  • The child has a history of recurrent group A streptococcal infections
  • PANDAS is more common in males
  • It is more common in prepubescent children

PANDAS Syndrome Treatment

Treatment for PANDAS disorder is medication to treat the strep throat infection (*Tip: Sterilize or replace toothbrushes during and following the antibiotics treatment, to make sure that the child isn’t re-infected with strep.). Treatment also includes medications to control the neuropsychological symptoms and Cognitive Behavioral Therapy (CBT) to help with the child’s OCD or ADHD symptoms.

Research does not indicate long-term penicillin use to try to prevent recurrence of PANDAS disorder. Current information suggests the syndrome is caused by the antibodies produced by the child’s body in response to the streptococcus bacteria, not by the actual bacteria itself. Research also does not support the removal of the child’s tonsils strictly to prevent recurrence of PANDAS disease.

Have Questions about PANDAS Disease?

If you are concerned your child may have PANDAS syndrome after a strep throat infection, we can help. Our Children’s Center focuses specifically on offering a variety of clinical, therapeutic, educational and supportive services to children ages two through twenty two in a warm and welcoming environment.

To learn more, contact the Children’s Center for Psychiatry Psychology and Related Services in Delray Beach, Florida or call us today at (561) 223-6568.

 

 

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Children’s Mental Health – Psychiatric Help for Children

While we tend to think of childhood as a carefree time of life, the fact is that many children suffer from mental conditions and disorders, just the same as adults. Among other things, children’s mental health concerns can include emotional, behavioral, and mental disorders such as eating disorders, learning and developmental disabilities, Attention Deficit Hyperactive Disorder (ADHA), and autism. And, similar to adults, children can be impacted by conditions like anxiety, depression, Obsessive Compulsive Disorder (OCD) and Post-traumatic Stress Disorder (PTSD). Additionally, as children grow and mature into young adults, they can develop other problems associated with adolescence, such as underage drinking and substance abuse.

Left untreated, any of these conditions or disorders can result in difficulties with making friends, and behavior issues in school and at home. What is most troubling, however, is that research has shown that a majority of adult mental disorders start early in life. This makes it critical that children’s mental health conditions be caught promptly and treated appropriately.

Symptoms of Child Psychological Disorders

Child psychological disorders and conditions can affect any ethnic group, and income level, and those living in any region of the country. In fact, the Centers for Disease Control (CDC) cites a study from a National Research Council and Institute for Medicine report that estimates about 1 in 5 children across the United States will experience a mental disorder in any given year.

Symptoms often change as a child grows and matures, so the signs of a problem may be difficult to spot in the early stages. Often, parents are the first to recognize that there is an issue with their children’s emotions or behavior, however problems may also be brought to your attention by your child’s educators or another adult who knows your child well. Some general signs to look for include:

  • Marked decline in school performance
  • Strong worries or anxiety that causes problems at home or at school
  • Random, frequent physical aches and pains, such as headaches or an upset stomach
  • Difficulty sleeping, nightmares
  • Marked changes in eating habits
  • Feeling hopeless
  • Having low or no energy
  • Aggressive behavior, disobedience, and/or confrontations with or defiance of authority figures
  • Temper tantrums or outbursts of anger
  • Thoughts of suicide or thoughts of harming themselves or others

Psychiatric Help for Children

  • Please get immediate assistance if you think your child may be in danger of harming themselves or someone else.  Call a crisis line or the National Suicide Prevention Line at 1.800.273.TALK (8255).

Getting psychiatric help for children, in the form of early diagnosis and receiving the correct treatment, is essential for your child’s well being, both now and throughout their life.

If your child’s problems persist across a variety of settings (for example: home, school, and with peers), some of the steps to get help include:

  • Talk to your child about how they are feeling. Find out if they would like to discuss a problem with you or another adult. Actively listen to their responses and concerns.
  • Talk to your child’s pediatrician, school counselor or school nurse, or a mental health professional if you see behaviors or problems in your child or teen that worry you.
  • Seek evaluation from a specialist who deals with children’s mental health concerns.
  • Ask the specialist if they have experience with treating the problem or behavior you see in your child.
  • Don’t delay in seeking help – early treatment generally gives better results.

Children can be treated in a variety of settings that range from one-on-one (or with a parent) sessions with a mental health professional to a group setting with a therapist and the child’s peers. Talk therapy can help change behaviors and may be used in combination with other treatments. Cognitive Behavioral Therapy (CBT) has been shown to be very effective in helping children learn coping strategies so they can change unhealthy behavior patterns and distorted thinking. Additionally, medications may be recommended for disorders such as ADHD or may be given for other types of severe or difficult cases.

Need More Information on Children’s Mental Health?

If you have questions or need more information about psychiatric help for children, we can help. For more information, contact The Children’s Center for Psychiatry, Psychology, & Related Services in Delray Beach, Florida or call us today at 561-223-6568.

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