module one · teen stress, health and add 1 module one table of contents moody: teen stress,...

Teen Stress, Health and ADD 1

Module One

Table of Contents Moody: Teen Stress, Anxiety, and Depression

Catherine Hart Weber, Ph.D.. .................................................................................................................................. 2

Walking the Thin Line: Health, Diets, and Eating Disorders Marian Eberly, MSW .................................................................................................................................................. 11

Teen ADD/ADHD and Other Disorders in Adolescence Glen Havens, M.D. ........................................................................................................................................................ 18

Teen Stress, Health and ADD


Course Description Stress, anxiety, and depression are prevalent issues that must be addressed among teens today. Christian counselors have a very important part in supporting teens and their families through turbulent times, bringing hope and healing into challenging and desperate situations. This lesson will provide an overview of risk factors, practical strategies, and interventions that counselors can integrate into their ministries and counseling, in order to be more effective with teenagers today.

Learning Objectives: By the end of this lesson, students:

1. Will be able to develop an understanding of current issues on teen stress and depression, while understanding the causes and effects of stress and how it is damaging to teens.

2. Will be able to learn about the link between stress, anxiety, depression,

and other related disorders.

3. Will be able to discover effective interventions and strategies for integrating into their work in helping teens and their families through turbulent times.

MOODY: TEEN STRESS, ANXIETY, AND

DEPRESSION Catherine Hart Weber, Ph.D.


Introduction

There are some shifting dynamics in the teen scene currently that is

increasing teen stress, anxiety and depression. It seems that with all

of the world’s advances, teens should have it better than any other

generation. In some ways they do, and they are better off for it. Yet,

in other ways, people are still seeing an increase in stress, anxiety

and depression as well as other related disorders that are showing

consequences into adulthood. Fortunately, experts are also learning

more now about how to tackle these challenges and hopefully reach

today’s young people so they can be better equipped to deal with

and recover from stress and other related challenges such as anxiety

and depression.

I. Taming Teen Stress Hormones

A. Current Teen Scene

Risk factors impacting today

Teen stats


B. What Stresses Teens Out?

From surveys, research, and book Stressed or Depressed

Internal Stressors

External Stressors

C. Each Teen Responds to Stress Differently Depending On:

D. Symptoms of Teen Stress

E. When Stress Becomes Damaging: When stress is too much, too long, too intense.

1. How much?

2. How long?

3. How intense?

No recovery and poor coping skills.


F. Negative Effects of Stress

Stress hormone damage.

Co-morbidity. Link between:

G. Maladaptive Patterns to Stress and Related Problems

H. Taming Stress Hormones Treatment protocol considerations.

Stress recovery. Active. Passive.

Reducing the stress response 1. Recuperation.

2. Relaxation.

I. Learning to ‘Deal with It’, Express It, and Take Action

- Stress management and recovery skills include:


II. Beating Back Depression in Teens

A. Teen Depression Linked to Stress and Anxiety Teen depression statistics

Depression is starting earlier. Usually starts with:

Teen depression is often: misdiagnosed, untreated, long

lasting. Consequences include:

B. Most Common Causes for Teen Depression

Types of depression 1. Reactive Depression

2. Endogenous (Unipolar, bipolar)

C. What Teen Depression Looks Like Compared to Adult Depression

Signs and symptoms to look for:


1. Mild

2. Moderate

3. Severe

D. Critical Issues Associated with Depression (Co-Morbidity)

Anxiety

Other related conditions along with stress and depression:

E. Comprehensive Treatment Plan

Creating a ‘safe place’.

Intake and diagnosis

Referrals


Anti-depressants

Other considerations

F. Increasing Therapeutic Effectiveness Integrating proven and new theoretical models. Breaking

the 65% barrier of traditional treatments.

Factors to consider for teens getting better and living well.

III. Fostering Teen Resiliency

A. Bounce-Back-Adapt-Ability

Biblical principles

Definition of resiliency

Resiliency factors – Equipping for life


B. Meaningful Connections

Teens are in the most trouble when:

Despite all the new scientific research, experts say that the most beneficial thing for teenagers is:

Teens are hardwired for connection and need:

Examples of the positive effects of connections in case studies, stories, and nature:

C. Build Teen’s Strengths

Positive Psychology researcher Dr. Martin Seligman states:

“The way to prevent disconnection is to build our teens…

“I want to suggest that the best buffers we have against substance abuse, depression and violence in our children have to do with…

D. VIA Character Strengths

E. Confidence and Competence


Ways to build confidence and competence:

Authentic self-worth. Doing well in life.

F. Spiritual Resilience

Study of 3,300 teens found that teens who attend services, read the Bible, and pray feel optimism and hope for the future

What it means to be a Hope Giver:

Sleeping with Bread illustrates Victor Frankl principles:


Course Description Adolescents are faced with constant messages denoting that “thin” is the new ideal, and acceptance is determined by weight and shape. These messages often lead to dieting, which can easily spiral out of control and develop into an eating disorder. This lesson will provide information about risk factors in developing an eating disorder and ways to help prevent these problems in teens. This lesson explores how body image issues and media influences contribute to the development of eating problems.


1. Will be able to develop an understanding of the definition of anorexia and bulimia, and identify the risk factors for developing an eating disorder.

2. Will be able to identify the signs and symptoms of eating disorders, and

protective factors in the prevention of an eating disorder.

3. Will be able to identify the biblical perspective of beauty, body, and self-acceptance.

WALKING THE THIN LINE: HEALTH,

DIETS, AND EATING DISORDERS Marian Eberly, MSW


Introduction

“The thin ideal” has become the norm in westernized society as the acceptable body type.

Unless one is thin they often believe they are not acceptable of good enough. Adolescents

are particularly prone to believing these misconceptions. The slippery slope of dieting can

lead teens into serious problems, such as the development of an eating disorder. Eating

disorders are both preventable and treatable. The path to healing includes obtaining a solid

Biblical understanding of one’s worth and value. God’s Word is not silent in the area of a

person’s value and worth and speaks to this issue straightforwardly, warning of the

potential dangers of becoming confused about one’s identity.

I. Definitions

A. Anorexia Nervosa: Anorexia is a disorder defined as abnormally low body weight (typically 85% of the individual’s ideal weight or less), intense fear of being or becoming fat, body image distortions such as unfounded complaints of being fat, refusal to move toward or maintain an adequate weight, loss of a menstrual period in post menarche girls, or failure to start menstruation at all by puberty.

B. Bulimia Nervosa: Bulimia is an eating disorder that always involves binge eating (consuming large amounts of calories over a relatively short time followed by some form of compensatory behavior to prevent weight gain). People tend to associate bulimia with self-induced vomiting, however some bulimics do not force themselves to vomit after eating, but use other means of purging away those unwanted calories such as using excessive exercise, laxative, diuretic or diet pill abuse.

C. What is one’s personal definition of body image? Body Image: an inner view of one’s outer self (Thompson, 1996)

D. Prevalence: Eating disorders affect 1 in 10 adolescent girls. The National Institute of Mental health (NIMH) states that 0.5-3% of women will develop


anorexia at some time in their life, while 1-4.5% of women will develop bulimia. Bulimia is more common than anorexia.

II. Development of Eating Disorders

A. How does a person develop an eating disorder?

Genetics: Recent research has revealed that there is a genetic component to the development of anorexia and bulimia of about 40% heritability.

The inherited trait is more likely to be a trait for obsession or perfectionism, which, given the appropriate environmental stressors, can lead to the development of an eating disorder.

Environment, society, and culture:

Each plays a large role in the development of an eating disorder. Elementary

school girls are 9 times more likely to develop an eating disorder. This behavior is influenced by the rampant belief that thin is better… Children as young as 8 years old are becoming very concerned with body image and weight. Some statistics show that 50-75% of school age girls consider themselves to be on diets. It is not uncommon for children as young as 8 years old to be on diets.

III. How Does a Young Adolescent or Child Present with an Eating Disorder?

A. Classic Self-Starvation Behavior and Weight Loss (Restricting Food Intake)

B. Severe Anxiety Related to Stress in the Home, School, etc.

C. Symptoms of Depression: Withdrawal from Others and Fun Activities, Low

Mood, Excessive Sleeping D. Obsessive Thoughts Related to a Fear of Eating and a Fear of Getting Fat


E. A Desire to Eat the Food, but Cannot Do as Their Parent’s Request

F. Does Not Necessarily Seem to Be a Defiant Behavior

G. Most Do Have Body Image Concerns and Obsessions, but Not All Do

IV. Typical Signs of an Eating Disorder in Adolescents:

Weight loss: Extreme thinness or loss of 15 or more lbs in 2-3 months, is exhilarated by weight loss

Intense fear of being overweight: Preoccupied with thinness, wants to be thinner than peers, complains of being overweight, when not, obsessed with clothing size, scales, and mirrors

Preoccupation with dieting & food: Uses diet products, talks constantly about food, calories and fat grams, reads a lot about nutrition, dieting, and exercise

Eating little: Skips meals, eats very little, is finicky about food, appears to eat when not— e.g., pushes food around on a plate but mostly does not eat it

Unusual eating habits: Eats one thing at a time, eats the same thing every day, cuts food into tiny pieces, fears touching certain foods, sudden vegetarianism, refuses to eat with others

Bathroom breaks: Disappears into the bathroom during or after meals—may suggest vomiting to purge calories

Taking up smoking: To suppress the appetite, especially for someone who would not be expected to smoke

Caffeine use: Excessive drinking of diet caffeinated beverages or large amounts of coffee daily

Evidence of binge-eating: A lot of empty food packages(often found in hidden places) may suggest bingeing

Empty laxative packages: Herbal or otherwise, may suggest purging Onset of hyperactivity: Constantly fidgets, lots of exercise Loss of menstrual period: Irregular, minimal, or absent menses may possibly be an

indication of dangerous weight loss Intolerance of cold: Constantly cold due to loss of body fat, shivering, blue skin or

fingers Baggy or full-covering clothes: Wears baggy clothes or long sleeves, pants when

normally this individual would not—used to hide excessive thinness, may indicate body image problems


Skin & hair problems: Pasty-looking skin, very thin and dry hair, hair loss, and fine baby–like hair growth on the face and arms (called lanugo) —all indicate malnourishment

Swollen salivary glands: Distended, “chipmunk cheeks” from excessive vomiting/purging

Broken blood vessels in the eyes Change in mood: Anxiety, depression, irritability, increased obsessions and

compulsions Social withdrawal: Isolates from peers and family; unwilling to eat with other

people Perfectionism & low self-esteem: Expects too much of self and sees self as not good

enough V. Body Image and the Media’s Impact on Culture

A. It becomes critical then to combat these cultural pressures, norms and lies by renewing one’s mind with the truth. The Scripture is clear to warn us of those who are quick to benefit from other’s dissatisfaction, and promise something better. “Do not be tossed around by waves, by the trickery of men, by the craftiness of deceitful scheming” (Eph 4:14)

B. Three Areas Affect the Development of Body Image: Perception: This refers to changes that occur in the brain that produce a deficit

in how one views physical shape

Development: The emotional effects of early maturational experiences such as teasing, name calling or other unspoken expectations of body shape and weight related to acceptance/rejection

Socio-cultural : Accepted ideals prominent in western culture, and the influence of gender and mass media


VI. Prevention

A. Protective Factors: Faith has been found to be a protective factor in the prevention of body image

disturbance because one understands their value and worth come from God.

Parental attitudes toward dieting and prejudicial attitudes toward overweight people.

Providing basic nutrition education is a good starting place for a person struggling with these issues of dieting and body dissatisfaction. Proper nutritional education clarifies the myths and misconceptions about dieting and weight gain/loss.

VII. Hope for the Future

A. Research has shown that those who receive help for an eating disorder, especially in the early stages, are much more likely to recover fully.(APA guidelines for eating disorder treatment)

B. For those teens who consider themselves “damaged goods”, the truth can bring necessary perspective and healing. God considers us “worthy” – worthy enough to pour his own life into. As this mystery unfolds in a person’s life, it brings greater self-acceptance “May the Lord bring you into an ever deeper understanding of the Love of God” (2Thessalonians 3:5)

Bibliography/Reading List Eberly, M.(2004) Body Image: A Biblical Perspective. Remuda Review: The Christian Journal of Eating Disorders. Vol. 3, Issue 4.

Kole, S. (2001) Seeing yourself through God’s eyes. Artesia, CA: Shannon Publishers.

Newman, D. (2002) Loving your Body: Embracing our true beauty in Christ. Wheaton, IL: Tyndale House Publishers


Soul Care Notes Ephesians 4:14 2 Thessalonians 3:5 Luke 16:15 I Peter 3:3-4 I Samuel 16:7 2 Corinthians 6:16


Course Description ADD/ADHD and other disorders are commonly misunderstood when it comes to treating adolescents. Many are over and under diagnosed. They are over treated and under treated. How does a parent know if his/her adolescent has a disorder or is just undisciplined or unmotivated? This course will define various disorders typically diagnosed in adolescence and summarize treatment options.


1. Will be able to state three core symptoms of Attention Deficit (Regulation)/Hyperactivity Disorder.

2. Will be able to recognize symptoms related to disorders often found

in adolescents.

3. Will be able to advise parents on how to cope with their teen’s diagnosis and obtain the best treatment.

TEEN ADD/ADHD and Other Disorders

in Adolescence Glen Havens, M.D.


Introduction: Attention Deficit/Hyperactivity Disorder is a neurologically based medical problem that is present in 5 to 7% of the general population. The validity of the diagnosis has often been questioned by the lay public, and medication in particular has been criticized in terms of overuse and misuse. Unfortunately, many who suffer from this disorder remain undiagnosed and untreated. Through neuroimaging, it is now possible to see that the brain is actually not functioning properly. As the understanding of the brain has become more and more sophisticated, treatment protocols have been tailored to the individual. Much can be done, although much remains to be learned. Attention deficit is a regulation problem as opposed to a true deficit. The main issue is one of “over-focusing” on a particular subject of interest.

I. A Closely Grouped Spectrum of Adolescent Disorders

A. Attention Regulation—ADD/ADHD B. Obsessive Compulsive Disorder C. Tourette’s Syndrome D. Bipolar Disorder—( aka: Manic Depression) E. Autism/Asperger’s Syndromes

II. Areas Affected by Attention Regulation A. Distractibility—(internal/external)

B. Impulsivity


C. Hyperactivity—(changes the most with age)

III. Autistic Spectrum Disorders A. Autism

B. Asperger’s Syndrome/Disorder—higher functioning form of Autism

C. Pervasive Developmental Disorder Not Otherwise Specified (PDD-NOS)

D. Childhood Disintegrative Disorder (CDD)

IV. Areas Affected by Autism Spectrum Disorders A. Social Interactions

B. Communication Skills

C. Repetitive and Stereotypical Behaviors

V. Neural Imaging


A. Structure of Brain—(CT Scan; MRI) 1. In many attention regulation problems, the frontal lobe of the brain

is underactive.

VI. Problematic Areas for Teens A. Depression

1. Does not look like “sadness” 80% of the time

2. Disproportionate anger and reactivity

3. Change in sleeping patterns

4. Change in appetite

5. Tearfulness

6. Using coping mechanisms (i.e. cutting)

7. Suicidal thoughts—Proper question for assessment, “Does life seem

like it’s just not worth living anymore?”

B. Anxiety

C. Learning Disability 1. Written expression disabilities

2. Math disabilities

3. Executive Dysfunction—(medication will not address this issue)


D. Violence

VII. Advice to Parents A. Know your own child

B. Trust your gut

C. Get help, but educate yourself

D. Treat the symptom, not the diagnosis

E. Don’t be afraid to get help

F. Get yourself “into neutral”

G. Structure is internalized as love

H. Educate your child and the people who work with your child

“Train up a child in the way he should go; even when he is OLD he will not depart from it.”

~Proverbs 22:6

module one · teen stress, health and add 1 module one table of contents moody: teen stress,...

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