Mental health issues in teenagers can be addressed efficiently with either a clinical psychologist, or a psychiatrist in cases where prescription medicines are required.
While mental health issues achieve a clear manifestation during teen years, Mary John, clinical psychologist, said that today, these problems are seen to manifest even among preteens. Children as young as five or six years can also exhibit symptoms of mental distress.
Misdiagnosis in a 5-year-old
Background
Anil (not his real name) was diagnosed as an autistic child as by the age of five, he had begun displaying the typical symptoms of autism — no eye contact, a refusal to listen to instructions, temper tantrums and non-compliance with instructions from any person of authority. He was in KG2 when these behaviour patterns began to emerge. However, when his parents brought him to John, she soon realised it was not a case of autism at all.
Teen mental health issues growing in the UAE
“The child has been misdiagnosed as autistic but was in fact suffering from acute parental neglect as both his parents held high-profile jobs and were not able to create any family time for him,” said John.
The mother, employed in the health care sector, kept demanding schedules which left her with little energy to attend to her son’s emotional needs by the end of the day.
The guilt of neglect pushed the parents to pacify their son with needless and excessive gifts even as they chose to overlook his tantrums. This made the child believe that it was acceptable to behave badly and still be rewarded. With no role models and no attempts to keep him disciplined, the five-year-old was a poster boy for aggression.
John’s diagnosis: Severe aggression
Therapy
The mother was asked to take two months’ leave from her job and spend the time with her son, to learn his every need, behaviour and response.
The parents were asked to stop giving their son unnecessary gifts and instead schedule playtime hours with the child on a daily basis that also involved the participation of his older sister. This ensured the family was linked as a unit in the time they spent with each other.
Basic behaviour therapy was applied where it was made clear to the child that bad behaviour would attract punitive measures and good behaviour would be rewarded.
Both parents were asked to unify their approach when interacting with their son and collaborate in creating a partnership of parenting so the child was witnessing unity and not disunity in authority. The boy realised that he was dealing with one authority and it helped him focus on it.
Outcome
Within three weeks of following this practice, the parents witnessed a turnaround in their five-year-old son. He began listening to them, following their instructions and his performance at school improved.
The therapy is currently ongoing.
15-year-old with a severe eating disorder
Background
The mother of a 15-year old girl with a severe eating disorder brought her in for an evaluation. The girl was skinny and refused to eat anything, weighed in at 36kg, suffered from sleeping disorders and would be up all night either watching television or on social media. As a result, she had trouble waking up most mornings in time for school and often skipped classes. On other days, she would have fainting spells in school and her mother would be urgently summoned to school to pick up her daughter.
The mother, who was in her second marriage, was an extremely pretty woman, and also an individual with high anxiety levels. Her mother’s attractive looks led her daughter to develop a complex and she came off unfavourably in her own eyes. In fact, she felt downright ugly compared to her mother, her evaluation revealed.
Adding to the teenager’s problem was the bullying at school wherein she was called names by her peers, with one girl saying she looked “retarded, had bad teeth and no friends”. Upon complaining to her mother, the mother retaliated that it was all the girl’s fault as she did not have the coping skills to deal with her peers, and blamed her daughter’s poor communication for her predicament.
This further eroded the girl’s self-esteem and heightened her negative self-image.
John’s diagnosis: Severe depression
Therapy
Cognitive behaviour therapy was employed to deal with the teen’s mind. The therapy involves converting extreme negative thoughts of an individual into neutral thoughts. So, if the teenager felt she was a bad student, had no friends, the psychotherapist helped her break down the thoughts into smaller units and rated them on a scale of 1-10. Each emotion attached to each thought was also addressed.
John explained: “For example, if she said she was not a good student, I pointed out she wasn’t a bad student, had never failed any class, did moderately well despite the challenges. Each thought was first made neutral and then gradually turned positive.
“I would take each thought and convert it into a rational, realistic thought.”
Separate sessions were held with the mother to help her deal with her own anxiety that was affecting the child. The mother was gradually made to accept her daughter for who she was, as she was.
Relaxation techniques were practised with the girl to help her deal with her sleep disorders and anxiety; her dreams and her relationships were addressed.
Supportive psychotherapy sessions were held with mother and daughter to deal with credibility issues between the two.
Separately, John met the head teacher at school and, without revealing too much of the girl’s personal issues, requested her to be seated with a peer she could feel more comfortable with.
The teenager was also taught other useful techniques in therapy such as who is in control of the situation, the benefits of the ‘pause and reflect’ as well as ‘truth and consequences’ approaches to a situation.
Outcome
Six months of therapy, once a week, has led to significant improvement in the teenager’s social skills. Today, she is in a better relationship with her mother, has resumed eating and her weight has climbed to 46kg.
Therapy is ongoing and is likely to continue for another year, with sessions now spaced out once a fortnight and then once a month.
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