Adolescent Mental Health Struggles Impact in the Classroom

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Adolescent Mental Health Struggles Impact in
the Classroom

• Christina K. Nolan, NCC, LCPC
• National-Louis University, Asst. Professor
• Illinois School Counselor Association (ISCA)
• President

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Children/Adolescent Struggles

• DEPRESSION
• ANXIETY
• EATING DISORDERS
• ADHD
• SELF-INJURY
• SUBSTANCE ABUSE

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Symptoms of Depression

• Depressed or irritable mood
• Decreased interest or pleasure in activities
• Change in appetite, weight or appearance
• Sleeping more or less than usual
• Feeling restless or slowed down
• Fatigue or loss of energy
• Feelings of guilt or worthlessness
• Decreased concentration
• Sense of hopelessness
• Substance Abuse
• Recurrent thoughts of death or suicide

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Impact of Depression on the Learner Classroom
Performance

• Change in student performance
• Organization/Higher Order Thinking Affected
• Lack of concentration
• Neurotransmitters out of balance serotonin
  norepinephrine
• Could be medication related
• Social Functioning
• Apathy - it doesnt matter, I cant
• Disconnected from peers/teachers
• Group Work difficulty

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Teacher Tips/Depression

• Express support of student
• Be respectful in discussing your concerns
• Share concrete observations of the students
  behavior in your classroom to help the student
  move toward referral to their counselor
• Recognize that student will not get better
  overnight medications and therapy take time
• Assignments
• Possible extended time
• Offer notes to be copied for an agreed upon time
• Assist student in breaking assignments down into
  manageable time chunks

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SUICIDE

• There is NO confidentiality if a student
  expresses thoughts or feelings of hopelessness in
  either written or verbal communication.
  Immediately refer to a counselor or dean. (Do not
  leave student)
• A suicide assessment will be conducted
• Intent
• Means
• Plan

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Suicide Warning Signs

• )
• Ideation Expressed in talking or writing
  thoughts of killing oneself, death, dying
• Substance Abuse Increased SUBSTANCE (alcohol
  or drug) use
• Purposelessness No reason for living no sense
  of PURPOSE in life
• Anxiety Agitation, unable to sleep or sleeping
  all the time
• Trapped Feeling TRAPPED - like theres no way
  out
• Hopelessness Its never going to be OK
• Withdrawal WITHDRAWING from friends, family
  and society
• Anger Rage, uncontrolled ANGER, seeking
  revenge
• Recklessness Acting RECKLESS or engaging in
  risky activities, seemingly without thinking

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Suicide Signals in Schools

• Cleaning out their locker
• Expressing hopelessness in their writings
• Art work that depicts death, hopelessness
• Giving away belongings to friends
• Saying goodbye
• Saying they cant do it anymore, nothing matters,
  it will never get better

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Anxiety Disorders

• Panic Disorder
• Phobias
• Specific
• Social
• Agoraphobia (infrequent)
• Obsessive-Compulsive Disorder
• Posttraumatic Stress Disorder
• Generalized Anxiety Disorder

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Symptoms of Anxiety Disorders

• Overwhelming feelings of panic and fear (Social?
  GAD? Phobia specific?)
• Presentations, oral reports in class, reading out
  loud, tests
• School Avoidance
• Uncontrollable obsessive thoughts (OCD?)
• I cant do this
• The teacher doesnt like me
• The class will laugh at me
• Ill mess up
• Painful, intrusive memories recurring nightmares
  (PTSD?)
• Associated with traumatic events
• Date rape
• Family events
• Bullying
• Nausea, sweating, muscle tension, and other
  uncomfortable physical reactions
• Physician intervention

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Teacher Tips/Anxiety

• Create a safe environment
• Be aware of classroom dynamics
• Privately ask student if they have a preference
  for when they do class presentations (First?
  Last?)
• Give reading assignments in advance so student
  might rehearse.

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Eating Disorders

• Anorexia nervosa
• Characterized by self-starvation
• excessive weight loss
• Bulimia Nervosa
• Characterized by a secretive cycle of bingeing
  and purging
• Binge Eating Disorder
• Characterized by frequent episodes of
  uncontrolled overeating

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Signs of Anorexia Nervosa

• Dramatic weight loss
• Preoccupation with weight, food, calories, etc.
• Denial of hunger
• Food rituals
• Avoidance of mealtimes, situations
• Withdrawal from friends

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Symptoms of Bulimia Nervosa

• Unusual swelling of the cheeks or jaw area
• Discoloration or staining of teeth
• Calluses on the back of the hands and knuckles
  from self-induced vomiting
• Excessive, rigid exercise regimen
• Evidence of purging behaviors, signs/smells of
  vomiting, presence of wrappers or packages of
  laxatives or diuretics, frequent trips to the
  bathroom

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Implications for the Classroom

• Physical Complications affect cognitive
  performance
• Severe dehydration
• Abnormally slow heart rate, low blood pressure.
  Risk for heart failure.
• Fainting, fatigue, weakness
• Growth of a downy layer of hair
• Dry hair and skin

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Teacher Tips for Concerns about Anorexia
Nervosa/Bulimia Nervosa/Binge Eating

• If you have concerns about a student please
  consult with counselor
• Maintain supportive relationship
• See handout Prevention Guidelines Strategies
  for Everyone

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Attention Deficit (really should be called
inconsistency or attention variability)
Hyperactivity Disorder (ADHD)

• Essential feature is a persistent pattern of
  inattention and/or hyperactivity that is more
  frequent and severe than is typically observed in
  individuals at a comparable level of development
• Must have been present before age 7 years
• Must be present in at least two settings
• Clear evidence of interference with
  developmentally appropriate social, academic, or
  occupational functioning

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ADHD

• Everyday is as new as yesterday

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Cognitive Deficits found in Individuals with ADHD
(Barkley, Russell, National Institute of Mental
Health)

• Difficulty with creation of past events as they
  relate to the future
• Difficulty with using speech to control behavior,
  talk to oneself
• Difficulty with separation of emotion from
  information
• Difficulty with breaking information into parts,
  analyze and the recombine
• Difficulty with internalizing emotion, using
  emotion to motivate behavior

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Teacher Tips/ADHD

• For multi-step projects, introduce one step or
  concept at a time. Help students create a
  timeline for the completion of each step.
• Use your physical presence to keep student
  engaged i.e. walk around the classroom.
• Have a routine or a system for cueing
  transitions.
• Create a buddy system so that students can check
  in with each other, or supply a copy of the daily
  notes.
• Post the daily and weekly agenda in a clearly
  visible spot.
• Use as many modalities as possible
• plan each lesson as if you have at least one
  blind student and one deaf student in the class

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Self-Injury

• The deliberate mutilation of the body or a body
  part, not with the intent to commit suicide but
  as a way of managing emotions that seem too
  painful for words to express. It can include
  cutting the skin, burning the skin, or bruising
  oneself through a premeditated action. It can
  mean scratching the skin until it bleeds or
  interfering with the healing of wounds
• Conterio Lader

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Teacher Tips/Self Injury

• Individuals use self-injury as a coping mechanism
  to help themselves feel better, more alive.
• Self-injury reduces the individuals internal
  tension.
• Making this a crisis only exacerbates the
  problem.
• Refer this student to a counselor

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Substance AbuseRisk Factor Checklist

• Genetic
• Children of substance abuser
• Constitutional
• Early first use (before age 15)
• Chronic pain or disability
• Physiological factors
• Psychological
• Physical, sexual, emotional abuse
• Attempted suicide
• Mental health problems
• Depression
• Anxiety
• ADHD

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Substance Abuse Risk Factors Continued

• Sociocultural
• Family
• Parental drug use and positive attitudes toward
  use
• Parental divorce/separation
• Family management problems
• Low expectations of childrens success
• Peer
• Friends who use drugs
• Favorable attitudes toward drug use
• Early antisocial/delinquent behavior and peer
  rejection
• School
• Lack of enforcement of school policies
• Little commitment to school
• School failure/dropout
• Transitions to new school levels

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Teacher TipsSubstance Abuse/Dependence

• Refer any student who appears intoxicated to Dean
• Dean, counselor and nurse will help create a plan
  for the student and their family to have an
  assessment and work with substance abuse mental
  health personnel