Dr. Sachin Arora
Dr. Sachin Arora finished his MBBS from GMC, Nagpur and his degree in M.D.(Psychiatry) from Gauhati Medical College, Guwahati. He has bagged 9 years of experience and specializes in Addiction Psychiatry. He is the principal faculty of psychiatry at Delhi Academy of Medical Sciences (DAMS). He currently has a thriving practice in the capital city of Delhi.
With the increasing shift in people’s acceptance and awareness of mental health disorders and ailments, people have become more conscious of their psyche and are actively seeking professionals to deal with their internal struggles. Diseases that were internalized as a part of normal human behavior are being called out, researched, and intervened medically or through counseling. As a society, we’re relocating to a more secure, peaceful space, mentally and emotionally. As the older generations are developing more receptive to mental health issues, the status of adolescents and teenagers is impacted positively but there still exist several wrinkles that need smoothing over when it comes to this particular age group.
CLASSIFICATION
Diagnosis of psychiatric disorders in children and adolescents can be tricky because they aren’t as conscious as adults and hence unable to pinpoint and communicate the exact problem. For ease of diagnosis, the symptoms with which they present are categorized as:- Emotional symptoms- consisting of anxiety, obsessions, fears, moods, etc
- Behavioral disorders – pertaining to behaviors of defiance, aggression, anti-social behavior, and eating disorders
- Developmental delays- causing abnormalities of speech, attention, bladder/bowels, reading, writing, etc
- Relationship difficulties- with parents or friends
CAUSES
Psychological disorders occur due to the interplay of various factors in children, adolescents, and teenagers. These factors can be-- Genetic– genetic factors when aggravated and impacted upon by environmental ones are the underlying cause of various psychiatric ailments in this particular age group. The best example of this is attention deficit hyperactivity disorder (ADHD). ADHD has a heritability of around 65-70% meaning first-degree relatives of ADHD-stricken children are three-five times more likely to be at risk of suffering from ADHD too. Studies also demonstrate a 60% chance of ADHD in monozygotic twins, clearly pointing towards a genetic etiology.
- Physical diseases– most likely being brain injury but any other physical disease may also be at blame. Children having brain disorders are particularly at risk. Some studies claim that conduct disorders may arise as a result of minor brain trauma but the pieces of evidence supporting this claim are negligible and unconvincing.
- Family factors– it is paramount that children and adolescents be exposed to healthy, secure and stable family dynamics till the time they gain autonomy and control of their own lives. Familial issues impact adolescents negatively and get reflected into adulthood. Research claims half of adult psychological disorders are a direct extension from childhood and adolescence. A normal child’s development requires attention, love, care. Lack of any of these may predispose to abnormal psychological growth and disorders. Some examples are:
- Poor Parenting: neglect, abuse, or humiliation of a child can be consequent upon the development of abnormal behaviors. General inattentiveness and lack of care may evoke a feeling of abandonment in children and adolescents. It is crucial that parents realize they have a pivotal role to play in a child’s psychological development. Threats to any of the foundational requirements necessary for a child until they become an independent entity can lead to catastrophic results.
- Family conflict: a stable, loving family environment is essential. Conflicting family settings like arguments between parents can cause crippling emotional disorders.
- Prolonged absence or loss of a parent: can lead to a child/adolescent feeling unwanted and can predispose to emotional as well as conduct disorders
- Parental illness: of either the physical or mental variety can cause excessive worrying in a child especially if they’re not fully informed and included in the discussion or decisions surrounding it
- Care provided outside of the home: orphans, abandoned or given up children/adolescents who are raised in foster homes, under social services supervision, or any other institution are victims of psychiatric morbidity more than the normally raised ones. It cannot be made clear whether these problems arise due to circumstances before going into care or are a direct result of being raised in such institutions
- Social and cultural factors: these elements become increasingly influential as a child grows older and spends more and more time outside of the home. He/she is subjected to the attitudes and behaviors of teachers, other children, and people in the neighborhood. Impaired social factors are directly proportionate to the degree of psychological harm in children and adolescents. Some of them are:
- Influences at school
- Racism or discrimination
- Huge lifestyle changes (like new school)
- Peer group behaviors
- Poor social amenities and overcrowding
- Bullying at school
SYMPTOMS
Dr. Sachin Arora outlines some of the signs and symptoms to watch out for when assessing a child or adolescent exhibiting a potentially psychologically impaired status.- Frequent and fluctuating mood swings. Adolescents may remain agitated, grumpy, and cranky all the time. These may even be extreme.
- They recede in their shell, become withdrawn from friends, family, and the outside world. They begin avoiding social interactions and gatherings like it’s a plague.
- They may undergo a sudden and extreme change in body weight (either gain or loss)
- They may be tired or sleepy all the time
- Their academic performance may take a hit
- Their eating habits may show an unexplained change (loss of appetite or even food binging)
- They may resort to drug or alcohol abuse as a cry for attention
GENERAL OUTLINE OF TREATMENT
- ASSESSMENT:
- Diagnosis of psychiatric disorders, co-morbidities, and complications
- Risk assessment
- GENERAL MEASURES FOR ALL PATIENTS:
- Devise a clear treatment plan
- Assign a care coordinator
- Psychoeducation of both the child and the parent
- Make available self-help resources for the child as well as the parent
- Eliminate any stressors; teach problem-solving and relaxation techniques
- Regular monitoring of mental status
- PSYCHOLOGICAL TREATMENTS:
- Cognitive Behavioral Therapy (CBT)
- Group therapy
- Interpersonal therapy
- Family therapy
- Play and art therapy
- PHARMACOLOGICAL TREATMENTS
- Stimulants
- Anti-depressants
- Mood stabilizers
- Anti-psychotics
- Maintenance of a positive, cheerful environment at home
- Do not leave the child alone all the time, give them your time of the day, and shower them with patience. Sit with them, and make them feel wanted and adored.
- Disciplining them is important, but you should know where to draw the line
- Do not pressurize a child/adolescent to excel academically, know that they’re trying their best. Give them mini bursts of appreciation, and celebrate their small victories.
- Go on family vacations.
If you have a child or adolescent at home, beware of the aforementioned symptoms, actively look out for them, know when to intervene, and know when it’s time to seek a professional. It may aggravate the situation if you dismiss their behaviors as a cry for attention or trivialize when they voice their concerns to you. A child/adolescent has the most delicate, impressionable state of mind, and everything you say or do may have an effect on them.