When disruptive behavior drives a wedge between parents and children

Writer: Rachel Ehmke

Clinical Expert: Dave Anderson, PhD

What You'll Learn

- What is oppositional defiant disorder (ODD)?

- How can parents help kids with ODD?

- What does treatment look like for ODD?

- Quick Read

- Full Article

- What is Oppositional Defiant Disorder (ODD)?

- Parenting under fire

- ADHD and other risk factors

- Why treatment is important

- What treatment for ODD looks like

Oppositional defiant disorder (ODD) is diagnosed in kids who are unusually angry, throw tantrums, don’t follow rules, or purposefully harm others. While all kids do these things from time to time, children with ODD show extreme versions of these behaviors for at least six months. Often, parents feel overwhelmed by their child’s behavior and aren’t sure how to help them. 

The behaviors that come with ODD can push parents to react in extreme ways without meaning to. Sometimes, you might yell at your child because you’re frustrated that they won’t cooperate. Or you might give in to whatever they want because you want them to stop having a tantrum. These reactions can reinforce the child’s behavior over time. They might learn that yelling is okay and that tantrums get them what they want. 

If your child has ODD, it’s important to get treatment as a family. In what’s called parent training you learn to set and enforce healthy boundaries with kids and teach them how to handle emotions like anger and frustration. A therapist can help you find the right strategy to improve kids’ behavior and stick to the plan at home. Some kids with ODD can also take medication that helps decrease their aggression. 

Kids may grow out of ODD, but without treatment many will continue to have behavior problems. Getting treatment early can put kids on a better track for the future and make life easier for the whole family. 

When parents start googling behavior issues, one phrase tends to jump out:oppositional defiant disorder (ODD). It’s easy to see why. “The words ‘oppositional’ and ‘defiant’ show up in parents’ vocabulary fairly frequently,” says David Anderson, PhD, a clinical psychologist at the Child Mind Institute. “It’s one of the more aptly named diagnoses that exists.”

Whether your child has oppositional defiant disorder (or ODD) or not, learning about the disorder can be helpful. That’s because the behavior management strategies used in treatment are evidence-based techniques that all parents will benefit from knowing.

What is Oppositional Defiant Disorder (ODD)?

It is normal for children to be oppositional and defiant at least some of the time. In fact, it’s a sign of healthy development. So when does a child have oppositional defiant disorder? The diagnosis should not be given, for example, to a toddler who has just discovered that their new favorite word is “no.”

ODD is typically diagnosed around early elementary school ages and stops being diagnosed around adolescence. Kids who have ODD have a well-established pattern of behavior problems. Symptoms include:

- Being unusually angry and irritable

- Frequently losing their temper

- Being easily annoyed

- Arguing with authority figures

- Refusing to follow rules

- Deliberately annoying people

- Blaming others for mistakes

- Being vindictive

All children can have these symptoms from time to time. What distinguishes ODD from normal oppositional behavior is how severe it is, and how long it has been going on for. A child with ODD will have had extreme behavior issues for at least six months.

Another hallmark of ODD is the toll it takes on family relationships. Regular daily frustrations — ignored commands, arguments, explosive outbursts — build up over time, and these negative interactions damage the parent-child bond and reinforce hostile patterns of behavior.

Parenting under fire

“Kids who have behavioral issues push parents towards the extremes,” says Dr. Anderson. “They push parents to become permissive and they push parents to become hyper-coercive in the hope that a larger amount of control will get the kid to listen.”

Neither of these extremes make for ideal parenting. It is never a parent’s intention to reinforce bad behavior, and we often don’t realize when we’re doing it. Here are two common scenarios:

- You tell your child to stop playing a game and get ready for bed. They ignore your first two requests. By the third time you ask, you’re so mad that you yell.

- You tell your child to stop playing a game and get ready for bed. They throw a tantrum because they want to keep playing. You don’t want them to be so worked up before bedtime, so you back down and say they can play for another 10 minutes — but then they have to go to bed.

In the first scenario, your child learns that yelling is an acceptable way to get a message across. More subtly, they might also be learning that they can continue ignoring those first few requests — when you escalate the situation is when they know you’re serious.

In the second scenario, your child has learned that throwing a tantrum might give them something that they want, so they’ll be more likely to do it again in the future.

Both of these scenarios can set families up for future conflicts, and the more they are repeated, the more they become familiar patterns of behavior that are harder to break out of. Your child doesn’t have to have ODD for these scenarios to happen, but repeated negative interactions like these make diagnosing a behavior disorder much more likely.

And just like parents aren’t necessarily to blame, neither are the kids, says Dr. Anderson. “Through no conscious effort of the child, they learn through hundreds of trials that this is a way to continue getting what they want.”

This also explains why kids who have ODD might act out more at home. Dr. Anderson notes, “Kids who have ODD are likely to be more oppositional with people they know well, partly because the pathways are so well worn. Whereas in a place like school, where a kid has less control in general over their environment, the types of behaviors that are common to ODD may not pay off as much.”

ADHD and other risk factors

There is a very high overlap in kids who have ADHD who are also diagnosed with ODD. Depending on the study, the overlap could be 30 to 50 percent of kids with ADHD also have ODD.

Dr. Anderson explains the connection like this: “Kids with ADHD are biologically loaded to be distractible, to be impulsive, to have difficulty staying in one place for a little while. So kids with ADHD start off doing things that parents perceive as off limits. And then when those kids get negative feedback they start to become even more negatively oriented towards adults.” These repeated patterns of negative interactions can lead to developing ODD.

But another pathway into developing ODD has more to do with a child’s temperament and might be apparent early on. Children who had a lot of difficulty soothing themselves as toddlers and continue to struggle with an age-appropriate ability to control their emotions in the face of disappointment or frustration can sometimes develop ODD. The adults in their environment might be more inclined to accommodate their demands in order to keep the family functioning as harmoniously as possible.

Kids who have experienced a lot of life stress and trauma are also more likely to develop ODD.

Why treatment is important

It’s important to get treatment to improve the parent-child relationship, which is crucial to the health and happiness of the entire household. It is also important for your child’s future. Some children will grow out of oppositional defiant disorder, but others will continue to have behavior issues, which could lead to peer rejection and difficulty forming healthy relationships, not to mention continued family discord.

They’ll also be less likely to achieve their potential. If something doesn’t go their way, they might think it’s anyone’s fault but theirs. Dr. Anderson says they might also “retreat to the places where they know they can get what they want. That might mean that they try even less, push even more on the people who are closest to them, who they actually care about the most, causing even more frayed relationships.”

A small percentage of kids with ODD go on to develop something called conduct disorder, which is a more severe behavior disorder that includes criminal acts like stealing, setting fires and hurting people. Getting treatment sooner rather than later improves a child’s trajectory.

#James Donaldson notes:Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.  #http://bit.ly/JamesMentalHealthArticleFind out more about the work I do on my 501c3 non-profit foundationwebsite www.yourgiftoflife.org Order your copy of James Donaldson's latest book,#CelebratingYourGiftofLife: From The Verge of Suicide to a Life of Purpose and Joy

Click Here For More Information About James Donaldson

Click here to follow James Donaldson's Blog

What treatment for ODD looks like

Parents play a key role in treatment for oppositional defiant disorder. This might be surprising, since children are the ones given the diagnosis, but in ODD the parent-child relationship needs to be repaired, which means both parties need to make changes to get back on track.

All programs have certain goals in common, like helping parents find the middle ground between being too authoritative and too permissive. A behavioral therapist helps parents learn how to train their child’s behavior through setting clear expectations, praising kids when they follow through, and using effective consequences when they don’t. Parents also learn to use these strategies consistently — one reason why behavior management strategies sometimes don’t work is because parents try different, conflicting techniques, or don’t stick to one program long enough to see gains. Parents and children will also learn problem solving skills they can rely on when they run into issues.

Parent training programs might include sessions with parents and children working together, or just parents alone. Some different programs include:

- Parent-Child Interaction Therapy (PCIT)

- Parent Management Training (PMT)

- Defiant Teens

- Positive Parenting Program (Triple P)

- The Incredible Years

Clinicians might also recommend social skills training to help improve your child’s peer relationships or cognitive behavioral therapy if they are struggling with anxiety or depression.

There is no FDA-approved medication for ODD, but medications are sometimes used as an adjunct tobehavioral therapy. Anti-psychotic medications like Abilify (aripiprazole) and Risperdal (risperidone), which have been shown to reduce aggression and irritability, are frequently used in cases where a child is at risk of being removed from the school or home. Stimulant medication may be used if a child has excessive impulsivity, including those who have an ADHD diagnosis. Antidepressants (SSRIs) may be helpful if a child has underlying depression or anxiety.

Regardless of the treatment plan your therapist recommends, parents will need to provide a lot of encouragement. “Make no mistake, kids do not often just suddenly wake up with the insight that they wish their behavior was better and then ask all the adults in their life how they can change,” warns Dr. Anderson. “They’ll stick with whatever behavior is working for them, even if it’s not working that well.”

But once the family dynamic begins to change, and kids (and parents) begin to feel more confident in their ability to get along, everyone will be a lot happier.

Frequently Asked Questions

What is ODD in a child?

Oppositional defiant disorder (ODD) is a behavior disorder in children that causes extreme anger and irritability. Kids with ODD often argue with authority figures and refuse to follow rules. What sets ODD apart from normal misbehavior is the severity and duration. In ODD, extreme behavior issues last for at least six months. https://standingabovethecrowd.com/?p=16430

James Donaldson on Mental Health - What Is Oppositional Defiant Disorder (ODD)?

When disruptive behavior drives a wedge between parents and children

Writer: Rachel Ehmke

Clinical Expert: Dave Anderson, PhD

What You'll Learn

- What is oppositional defiant disorder (ODD)?
- How can parents help kids with ODD?
- What does treatment look like for ODD?
- Quick Read
- Full Article
- What is Oppositional Defiant Disorder (ODD)?
- Parenting under fire
- ADHD and other risk factors
- Why treatment is important
- What treatment for ODD looks like

Oppositional defiant disorder (ODD) is diagnosed in kids who are unusually angry, throw tantrums, don’t follow rules, or purposefully harm others. While all kids do these things from time to time, children with ODD show extreme versions of these behaviors for at least six months. Often, parents feel overwhelmed by their child’s behavior and aren’t sure how to help them. 

The behaviors that come with ODD can push parents to react in extreme ways without meaning to. Sometimes, you might yell at your child because you’re frustrated that they won’t cooperate. Or you might give in to whatever they want because you want them to stop having a tantrum. These reactions can reinforce the child’s behavior over time. They might learn that yelling is okay and that tantrums get them what they want. 

If your child has ODD, it’s important to get treatment as a family. In what’s called parent training you learn to set and enforce healthy boundaries with kids and teach them how to handle emotions like anger and frustration. A therapist can help you find the right strategy to improve kids’ behavior and stick to the plan at home. Some kids with ODD can also take medication that helps decrease their aggression. 

Kids may grow out of ODD, but without treatment many will continue to have behavior problems. Getting treatment early can put kids on a better track for the future and make life easier for the whole family. 

When parents start googling behavior issues, one phrase tends to jump out:oppositional defiant disorder (ODD). It’s easy to see why. “The words ‘oppositional’ and ‘defiant’ show up in parents’ vocabulary fairly frequently,” says David Anderson, PhD, a clinical psychologist at the Child Mind Institute. “It’s one of the more aptly named diagnoses that exists.”

Whether your child has oppositional defiant disorder (or ODD) or not, learning about the disorder can be helpful. That’s because the behavior management strategies used in treatment are evidence-based techniques that all parents will benefit from knowing.

What is Oppositional Defiant Disorder (ODD)?

It is normal for children to be oppositional and defiant at least some of the time. In fact, it’s a sign of healthy development. So when does a child have oppositional defiant disorder? The diagnosis should not be given, for example, to a toddler who has just discovered that their new favorite word is “no.”

ODD is typically diagnosed around early elementary school ages and stops being diagnosed around adolescence. Kids who have ODD have a well-established pattern of behavior problems. Symptoms include:

- Being unusually angry and irritable
- Frequently losing their temper
- Being easily annoyed
- Arguing with authority figures
- Refusing to follow rules
- Deliberately annoying people
- Blaming others for mistakes
- Being vindictive

All children can have these symptoms from time to time. What distinguishes ODD from normal oppositional behavior is how severe it is, and how long it has been going on for. A child with ODD will have had extreme behavior issues for at least six months.

Another hallmark of ODD is the toll it takes on family relationships. Regular daily frustrations — ignored commands, arguments, explosive outbursts — build up over time, and these negative interactions damage the parent-child bond and reinforce hostile patterns of behavior.

Parenting under fire

“Kids who have behavioral issues push parents towards the extremes,” says Dr. Anderson. “They push parents to become permissive and they push parents to become hyper-coercive in the hope that a larger amount of control will get the kid to listen.”

Neither of these extremes make for ideal parenting. It is never a parent’s intention to reinforce bad behavior, and we often don’t realize when we’re doing it. Here are two common scenarios:

- You tell your child to stop playing a game and get ready for bed. They ignore your first two requests. By the third time you ask, you’re so mad that you yell.
- You tell your child to stop playing a game and get ready for bed. They throw a tantrum because they want to keep playing. You don’t want them to be so worked up before bedtime, so you back down and say they can play for another 10 minutes — but then they have to go to bed.

In the first scenario, your child learns that yelling is an acceptable way to get a message across. More subtly, they might also be learning that they can continue ignoring those first few requests — when you escalate the situation is when they know you’re serious.

In the second scenario, your child has learned that throwing a tantrum might give them something that they want, so they’ll be more likely to do it again in the future.

Both of these scenarios can set families up for future conflicts, and the more they are repeated, the more they become familiar patterns of behavior that are harder to break out of. Your child doesn’t have to have ODD for these scenarios to happen, but repeated negative interactions like these make diagnosing a behavior disorder much more likely.

And just like parents aren’t necessarily to blame, neither are the kids, says Dr. Anderson. “Through no conscious effort of the child, they learn through hundreds of trials that this is a way to continue getting what they want.”

This also explains why kids who have ODD might act out more at home. Dr. Anderson notes, “Kids who have ODD are likely to be more oppositional with people they know well, partly because the pathways are so well worn. Whereas in a place like school, where a kid has less control in general over their environment, the types of behaviors that are common to ODD may not pay off as much.”

ADHD and other risk factors

There is a very high overlap in kids who have ADHD who are also diagnosed with ODD. Depending on the study, the overlap could be 30 to 50 percent of kids with ADHD also have ODD.

Dr. Anderson explains the connection like this: “Kids with ADHD are biologically loaded to be distractible, to be impulsive, to have difficulty staying in one place for a little while. So kids with ADHD start off doing things that parents perceive as off limits. And then when those kids get negative feedback they start to become even more negatively oriented towards adults.” These repeated patterns of negative interactions can lead to developing ODD.

But another pathway into developing ODD has more to do with a child’s temperament and might be apparent early on. Children who had a lot of difficulty soothing themselves as toddlers and continue to struggle with an age-appropriate ability to control their emotions in the face of disappointment or frustration can sometimes develop ODD. The adults in their environment might be more inclined to accommodate their demands in order to keep the family functioning as harmoniously as possible.

Kids who have experienced a lot of life stress and trauma are also more likely to develop ODD.

Why treatment is important

It’s important to get treatment to improve the parent-child relationship, which is crucial to the health and happiness of the entire household. It is also important for your child’s future. Some children will grow out of oppositional defiant disorder, but others will continue to have behavior issues, which could lead to peer rejection and difficulty forming healthy relationships, not to mention continued family discord.

They’ll also be less likely to achieve their potential. If something doesn’t go their way, they might think it’s anyone’s fault but theirs. Dr. Anderson says they might also “retreat to the places where they know they can get what they want. That might mean that they try even less, push even more on the people who are closest to them, who they actually care about the most, causing even more frayed relationships.”

A small percentage of kids with ODD go on to develop something called conduct disorder, which is a more severe behavior disorder that includes criminal acts like stealing, setting fires and hurting people. Getting treatment sooner rather than later improves a child’s trajectory.

#James Donaldson notes:
Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.
Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.
Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.  #http://bit.ly/JamesMentalHealthArticle
Find out more about the work I do on my 501c3 non-profit foundation
website www.yourgiftoflife.org Order your copy of James Donaldson's latest book,
#CelebratingYourGiftofLife: From The Verge of Suicide to a Life of Purpose and Joy

Click Here For More Information About James Donaldson

Click here to follow James Donaldson's Blog

What treatment for ODD looks like

Parents play a key role in treatment for oppositional defiant disorder. This might be surprising, since children are the ones given the diagnosis, but in ODD the parent-child relationship needs to be repaired, which means both parties need to make changes to get back on track.

All programs have certain goals in common, like helping parents find the middle ground between being too authoritative and too permissive. A behavioral therapist helps parents learn how to train their child’s behavior through setting clear expectations, praising kids when they follow through, and using effective consequences when they don’t. Parents also learn to use these strategies consistently — one reason why behavior management strategies sometimes don’t work is because parents try different, conflicting techniques, or don’t stick to one program long enough to see gains. Parents and children will also learn problem solving skills they can rely on when they run into issues.

Parent training programs might include sessions with parents and children working together, or just parents alone. Some different programs include:

- Parent-Child Interaction Therapy (PCIT)
- Parent Management Training (PMT)
- Defiant Teens
- Positive Parenting Program (Triple P)
- The Incredible Years

Clinicians might also recommend social skills training to help improve your child’s peer relationships or cognitive behavioral therapy if they are struggling with anxiety or depression.

There is no FDA-approved medication for ODD, but medications are sometimes used as an adjunct tobehavioral therapy. Anti-psychotic medications like Abilify (aripiprazole) and Risperdal (risperidone), which have been shown to reduce aggression and irritability, are frequently used in cases where a child is at risk of being removed from the school or home. Stimulant medication may be used if a child has excessive impulsivity, including those who have an ADHD diagnosis. Antidepressants (SSRIs) may be helpful if a child has underlying depression or anxiety.

Regardless of the treatment plan your therapist recommends, parents will need to provide a lot of encouragement. “Make no mistake, kids do not often just suddenly wake up with the insight that they wish their behavior was better and then ask all the adults in their life how they can change,” warns Dr. Anderson. “They’ll stick with whatever behavior is working for them, even if it’s not working that well.”

But once the family dynamic begins to change, and kids (and parents) begin to feel more confident in their ability to get along, everyone will be a lot happier.

Frequently Asked Questions

What is ODD in a child?

Oppositional defiant disorder (ODD) is a behavior disorder in children that causes extreme anger and irritability. Kids with ODD often argue with authority figures and refuse to follow rules. What sets ODD apart from normal misbehavior is the severity and duration. In ODD, extreme behavior issues last for at least six months.

https://standingabovethecrowd.com/james-donaldson-on-mental-health-what-is-oppositional-defiant-disorder-odd/

James Donaldson on Mental Health - Poor sleep, distress and disadvantage linked to suicidal thoughts in teens

Photo by cottonbro studio on Pexels.com

by University of the Sunshine Coast

edited by Gaby Clark, reviewed by Robert Egan

Poor sleep, psychological distress, socioeconomic disadvantage and bad eating habits are strongly linked to greater risk of suicidal thoughts among adolescents, according to new research from the University of the Sunshine Coast. Credit: University of the Sunshine Coast

Poor sleep, psychological distress, socioeconomic disadvantage and bad eating habits are strongly linked to greater risk of suicidal thoughts among adolescents, according to new research from the University of the Sunshine Coast.

A longitudinal study conducted by UniSC's Thompson Institute tracked 159 young people aged 12–17 over several years to examine how lifestyle factors and social circumstances might influence suicidal ideation. The research is published in the journal BMJ Open.

Lead author of the research, Ph.D. candidate Maddison Crethar, said adolescents who reported having poor sleep were 2.6 times more likely to experience suicidal thoughts, than those who slept well.

"Poor sleep emerged as quite a significant risk factor. There's been little research to date that's explored this link over an extended period of adolescence," she said.

By far the most significant risk factor identified was socioeconomic disadvantage.

Adolescents from disadvantaged backgrounds up to 8.7 times more likely to experience suicidal thoughts than those with a higher socioeconomic status, which supports previous research in this space.

"Socioeconomic disadvantage is complex, involving access to resources, health services and financial pressures, and more research is needed to understand how these factors interact to increase suicide risk," Crethar said.

Those reporting higher psychological distress were 5.7 times more likely to experience suicidal ideation, while poor eating habits were also statistically significant.

Crethar said the findings highlighted the complex mix of biological factors (sleep and nutrition), psychological factors (distress) and social factors (socioeconomic) that can impact young people's mental health.

#James Donaldson notes:
Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.
Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.
Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.  #http://bit.ly/JamesMentalHealthArticle
Find out more about the work I do on my 501c3 non-profit foundation
website www.yourgiftoflife.org Order your copy of James Donaldson's latest book,
#CelebratingYourGiftofLife: From The Verge of Suicide to a Life of Purpose and Joy

Click Here For More Information About James Donaldson

Click here to follow James Donaldson's Blog

"Suicide is the leading cause of death among Australian adolescents. It's crucial we understand the risk factors that contribute to suicidal ideation and how they relate," she said.

"We can't say any of these factors by themselves are causal—even if there's clearly some relationship there. Some of the relationships could also be a two-way street. For example, suicidal thoughts might contribute to poorer sleep, eating and psychological distress.

"But through research like this, we can try to create a better risk profile that can be tailored to an individual's experiences, environment and circumstances."

UniSC Professor of Youth Mental Health and Neuroscience Daniel Hermens said the study reiterated the role parents, educators and health professionals can play in suicide prevention.

"This research reinforces the importance of awareness around risk factors associated with suicidal ideation and conversations about them," Professor Hermens said.

"Parents and schools can help by encouraging healthy sleep routines and being open to talking about mental health. Asking a young person if they are struggling or having thoughts of suicide does not increase risk—it can be the first step to getting help.

"We need to break down stigma and make these conversations normal."

Photo by cottonbro studio on Pexels.com https://standingabovethecrowd.com/james-donaldson-on-mental-health-poor-sleep-distress-and-disadvantage-linked-to-suicidal-thoughts-in-teens/

Photo by cottonbro studio on Pexels.com

by University of the Sunshine Coast

edited by Gaby Clark, reviewed by Robert Egan

Poor sleep, psychological distress, socioeconomic disadvantage and bad eating habits are strongly linked to greater risk of suicidal thoughts among adolescents, according to new research from the University of the Sunshine Coast. Credit: University of the Sunshine Coast

Poor sleep, psychological distress, socioeconomic disadvantage and bad eating habits are strongly linked to greater risk of suicidal thoughts among adolescents, according to new research from the University of the Sunshine Coast.

A longitudinal study conducted by UniSC's Thompson Institute tracked 159 young people aged 12–17 over several years to examine how lifestyle factors and social circumstances might influence suicidal ideation. The research is published in the journal BMJ Open.

Lead author of the research, Ph.D. candidate Maddison Crethar, said adolescents who reported having poor sleep were 2.6 times more likely to experience suicidal thoughts, than those who slept well.

"Poor sleep emerged as quite a significant risk factor. There's been little research to date that's explored this link over an extended period of adolescence," she said.

By far the most significant risk factor identified was socioeconomic disadvantage.

Adolescents from disadvantaged backgrounds up to 8.7 times more likely to experience suicidal thoughts than those with a higher socioeconomic status, which supports previous research in this space.

"Socioeconomic disadvantage is complex, involving access to resources, health services and financial pressures, and more research is needed to understand how these factors interact to increase suicide risk," Crethar said.

Those reporting higher psychological distress were 5.7 times more likely to experience suicidal ideation, while poor eating habits were also statistically significant.

Crethar said the findings highlighted the complex mix of biological factors (sleep and nutrition), psychological factors (distress) and social factors (socioeconomic) that can impact young people's mental health.

#James Donaldson notes:Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.  #http://bit.ly/JamesMentalHealthArticleFind out more about the work I do on my 501c3 non-profit foundationwebsite www.yourgiftoflife.org Order your copy of James Donaldson's latest book,#CelebratingYourGiftofLife: From The Verge of Suicide to a Life of Purpose and Joy

Click Here For More Information About James Donaldson

Click here to follow James Donaldson's Blog

"Suicide is the leading cause of death among Australian adolescents. It's crucial we understand the risk factors that contribute to suicidal ideation and how they relate," she said.

"We can't say any of these factors by themselves are causal—even if there's clearly some relationship there. Some of the relationships could also be a two-way street. For example, suicidal thoughts might contribute to poorer sleep, eating and psychological distress.

"But through research like this, we can try to create a better risk profile that can be tailored to an individual's experiences, environment and circumstances."

UniSC Professor of Youth Mental Health and Neuroscience Daniel Hermens said the study reiterated the role parents, educators and health professionals can play in suicide prevention.

"This research reinforces the importance of awareness around risk factors associated with suicidal ideation and conversations about them," Professor Hermens said.

"Parents and schools can help by encouraging healthy sleep routines and being open to talking about mental health. Asking a young person if they are struggling or having thoughts of suicide does not increase risk—it can be the first step to getting help.

"We need to break down stigma and make these conversations normal."

Photo by cottonbro studio on Pexels.com https://standingabovethecrowd.com/?p=16428

James Donaldson on Mental Health - Kids With Multiple Diagnoses

Why many children have more than one mental health or learning disorder

Photo by samer daboul on Pexels.com

Writer: Caroline Miller

Clinical Experts: Paul Mitrani, MD, PhD , Megan Ice, PhD

Key Takeaways

- Many children have more than one mental health or learning disorder, not because they are “sicker,” but because their symptoms can’t be fully explained by a single diagnosis.
- Co-occurring disorders are common because many conditions share underlying brain systems, and one disorder can often lead to another over time.
- Treatment usually begins with focusing on the disorder causing the most impairment, and monitoring the impact on the other, adapting medication or therapy as needed.
- Why are multiple diagnoses common in kids?
- What are common co-occurring disorders?
- How do you treat co-occurring disorders?
- Treating multiple disorders with medication
- Therapy and co-occurring disorders

When you have a child diagnosed with a mental health or learning disorder, it’s not unusual to find out that they also meet the criteria for another diagnosis. Your teen with ADHD might also have anxiety. Your first grader with autism might also have ADHD.

Sometimes multiple diagnoses — also known as “co-occurring” or “comorbid” disorders — are made at the same time. A child who is struggling might be evaluated and diagnosed with anxiety and depression, for example. But often a child is first diagnosed with one thing and anotherdiagnosis is added later.

“Families can feel overwhelmed hearing that their child has multiple diagnoses,” notes Megan Ice, PhD, a clinical psychologist at the Child Mind Institute. “There can be the perception that the more diagnoses, the sicker the child is.”

But that’s not necessarily the case. When a child has multiple diagnoses, it means they have symptoms that can’t all be attributed to or treated by one diagnosis. “By identifying multiple diagnoses, we’re able to open up paths for the treatments that will be effective for more of the symptoms,” Dr. Ice explains.

Why are multiple diagnoses common in kids?

In one widely cited study of 10,000 adolescents, 40 percent of those who had one mental health disorder met the criteria for another. But there are a variety of reasons why mental health and learning disorders so often occur together.

Multiple diagnoses, same brain system

Some disorders are linked to the same brain systems. “If you’re diagnosed with one anxiety disorder, like selective mutism, the likelihood is high that you’re going to have another anxiety disorder, like specific phobia, generalized anxiety disorder, or social anxiety,” says Paul Mitrani, MD, PhD, a child and adolescent psychiatrist at the Child Mind Institute. “It makes sense because it’s the same brain system that’s affected, just presenting in several different ways. So that that’s very common.”

Several different disorders can be linked to the same neurotransmitters — chemicals like dopamine and serotonin that are used to send messages in the brain. For instance, the serotonin system is involved in both anxiety and depression. “When the pathways related to serotonin in the brain are not working as well,” says Dr. Mitrani, “you’re at a higher risk for anxiety, as well as depression and OCD. ”

#James Donaldson notes:
Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.
Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.
Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.  #http://bit.ly/JamesMentalHealthArticle
Find out more about the work I do on my 501c3 non-profit foundation
website www.yourgiftoflife.org Order your copy of James Donaldson's latest book,
#CelebratingYourGiftofLife: From The Verge of Suicide to a Life of Purpose and Joy

Click Here For More Information About James Donaldson

Click here to follow James Donaldson's Blog

One disorder can lead to another

But it’s also common for a child’s struggles with one disorder to lead to another. For instance, a child with ADHD whose impulsivity leads to a lot of conflict with their parents can develop a behavior disorder. Kids with autism might develop anxiety because the world feels unpredictable and overwhelming. Or children with learning disorders who are struggling in school may develop anxiety or depression.

“It can be really hard to have ADHD or autism, or to struggle with learning, so it makes sense that you might have difficulty regulating your emotions and behavior or that you might develop anxiety or depression,” notes Dr. Ice.

Different diagnoses from different clinicians

Sometimes, children with several diagnoses have been seen, over the years, by different clinicians, who may have evaluated them differently and added a diagnosis without withdrawing an earlier one.

“The more interactions somebody has with the mental health system, the increased likelihood that they’ll have multiple diagnoses because of different providers seeing and hearing different things at different times,” notes Dr. Ice. A child can end up with a list of diagnoses that they’ve had in the past, but they don’t meet the criteria for anymore, she adds.

What are common co-occurring disorders?

A study of adolescents with co-occurring disorders found that slightly more than half (61 percent) had two disorders from one larger class of disorders, such as mood, anxiety, attention, or behavior disorders. Another quarter (25 percent) had disorders from two different classes, and 11 percent were affected by three different classes of disorders.

Some of the common combinations include:

- ADHD + Anxiety: Difficulty focusing, restlessness, and irritability can appear in both disorders, which can result in misdiagnosis — but many children also have both. Academic struggles, social difficulties, and consistent negative feedback can cause chronic stress, leading to anxiety over time.
- ADHD + Oppositional Defiant Disorder (ODD): Kids with ADHD may be easily frustrated and have difficulty complying or following instructions from parents and other adults, which can lead tooppositional or defiant behavior.
- ADHD + Depression: As the academic and social impact of ADHD builds up over time, kids can develop low self-esteem and depression.
- Anxiety + Depression: It’s very common for kids who experience chronic worries to develop sadness, a loss of interest in things they enjoy, and other symptoms of depression.
- Autism + ADHD: A study of more than 4,000 children with autism found that 40 percent also had ADHD. Sometimes ADHD symptoms are recognized first, and autism is diagnosed later — or vice versa. Autism and ADHD both run in families and havegenetic factors in common.
- Anxiety + OCD: OCD is an anxiety disorder, but it can appear with other anxiety types, like generalized anxiety or social anxiety.Kids may struggle with intense fears and compulsive rituals as well as general worry or panic.
- Trauma-Related Disorders + ADHD, Anxiety, Depression, or ODD: Trauma can impact a child’s mood, behavior, attention, and emotional regulation, leading to symptoms in all those areas. A trauma-informed approach is essential for accurate diagnosis and effective treatment. Trauma-informed assessments can help identify the root cause of symptoms.
- Learning Disorders + Anxiety or Depression: Children who have an extra hard time with learning often struggle with frustration and low self-esteem, which can cause them to develop anxiety or depression.
- Tic disorders + ADHD or OCD: More than three-quarters of children with Tourette’s disorder have at least one other disorder, with ADHD and anxiety being the most common.

How do you treat co-occurring disorders?

When a child has more than one disorder, how do you decide what to treat first? Whichever one seems primary, says Dr. Ice. “What is the thing that’s actually leading to the most problems? What is interfering with the child’s functioning the most — we want to figure out a plan for treating that first.”

If a child with ADHD is not paying attention in class, is hyperactive, and is getting into a lot of trouble, these difficulties could result in anxiety. “So, you treat the ADHD first, then you reassess to see if the anxiety gets better,” says Dr. Mitrani. “If it gets better, then you probably don’t need to use a medication or intervene for the anxiety. But if it doesn’t get better? Then we need to figure out how to treat the anxiety.”

Sometimes you can work on more than one disorder at the same time. A child with a learning disorder who becomes depressed should get support for their learning issues as well as treatment for depression.

But if you’re starting treatment with medication, Dr. Mitrani stresses, medicines should always be introduced one at a time. “You don’t start with two medicines at the same time because if something gets better or worse, you won’t know what the cause is,” he explains. For instance, for a child who has ADHD and anxiety, “if you start a stimulant and antidepressant at the same time and all of a sudden the child’s not sleeping, what’s causing that?”

Treating multiple disorders with medication

When treatment involves medication, the prescribing doctor needs to consider how medication for one might exacerbate or affect symptoms for another. For instance, stimulant medication for ADHD can worsen anxiety. “If a child has both, we may start with treatment for ADHD, but if the stimulant makes the anxiety worse, then we have to reassess and think about other options,” says Dr. Mitrani.

Medications for one disorder can also affect how another medication for a co-occuring disorder is metabolized — limiting its effectiveness or increasing the side effects. “Anytime you combine medications, you want to make sure there are no interactions that can worsen or compound side effects,” says Dr. Mitrani.

One of the risks when children have several mental health disorders is that they will be prescribed multiple medications without clarity on what each is intended to do and whether it is working. “The risk is that in layering medicine on medicine, you lose track of the underlying problems, and how well each medication is being tolerated,” said Dr. Mitrani.

“You can use any of these medicines in combination,” he notes, “but they need to be combined carefully to get an accurate picture of their effectiveness and manage side effects, especially when you’re dealing with meds that have more concerning side effects, like antipsychotics.”

Therapy and co-occurring disorders

One disorder could also make it more difficult for a child to participate successfully in therapy for another disorder. For instance, if a child has social anxiety and depression, the social anxiety could interfere with their ability to engage in therapy for depression that includes participation in a group, such as DBT (dialectical behavior therapy). If a child has ADHD and anxiety, the ADHD can interfere with their ability to follow through with a step-by-step treatment for anxiety like exposure and response prevention (ERP).

Kids with several mental health challenges may require more tailored treatment. “This involves adapting typical treatment for one of the diagnoses to include what is beneficial for the other diagnosis as well,” says Dr. Ice. For instance, the standardcognitive behavior therapy treatment for anxiety, Coping Cat, has been customized for autistic kids with anxiety, resulting in a treatment called BIACA (Behavioral Interventions for Anxiety in Children with Autism).

Dr. Mitrani stresses the importance of making sure to educate parents on all their options. “What’s possible with medicine? What’s possible with therapy? Where is parent work important? Where is working with the schools important? Since medications can come with concerning side effects, we want to make sure we’re setting specific goals for treatment interventions, carefully monitoring those interventions for effectiveness, and adjust things or bring in other approaches as needed.”

Frequently Asked Questions

What does it mean if my child has multiple diagnoses?

When a child is diagnosed with multiple mental health disorders, it means they have symptoms that can’t all be explained by one condition. Identifying each diagnosis helps clinicians choose treatments that address more of your child’s challenges — it doesn’t mean your child is “sicker.”

Is it common for kids to have more than one diagnosis?

Can one treatment plan address multiple diagnoses?

Photo by samer daboul on Pexels.com https://standingabovethecrowd.com/james-donaldson-on-mental-health-kids-with-multiple-diagnoses/

Why many children have more than one mental health or learning disorder

Photo by samer daboul on Pexels.com

Writer: Caroline Miller

Clinical Experts: Paul Mitrani, MD, PhD , Megan Ice, PhD

Key Takeaways

- Many children have more than one mental health or learning disorder, not because they are “sicker,” but because their symptoms can’t be fully explained by a single diagnosis.

- Co-occurring disorders are common because many conditions share underlying brain systems, and one disorder can often lead to another over time.

- Treatment usually begins with focusing on the disorder causing the most impairment, and monitoring the impact on the other, adapting medication or therapy as needed.

- Why are multiple diagnoses common in kids?

- What are common co-occurring disorders?

- How do you treat co-occurring disorders?

- Treating multiple disorders with medication

- Therapy and co-occurring disorders

When you have a child diagnosed with a mental health or learning disorder, it’s not unusual to find out that they also meet the criteria for another diagnosis. Your teen with ADHD might also have anxiety. Your first grader with autism might also have ADHD.

Sometimes multiple diagnoses — also known as “co-occurring” or “comorbid” disorders — are made at the same time. A child who is struggling might be evaluated and diagnosed with anxiety and depression, for example. But often a child is first diagnosed with one thing and anotherdiagnosis is added later.

“Families can feel overwhelmed hearing that their child has multiple diagnoses,” notes Megan Ice, PhD, a clinical psychologist at the Child Mind Institute. “There can be the perception that the more diagnoses, the sicker the child is.”

But that’s not necessarily the case. When a child has multiple diagnoses, it means they have symptoms that can’t all be attributed to or treated by one diagnosis. “By identifying multiple diagnoses, we’re able to open up paths for the treatments that will be effective for more of the symptoms,” Dr. Ice explains.

Why are multiple diagnoses common in kids?

In one widely cited study of 10,000 adolescents, 40 percent of those who had one mental health disorder met the criteria for another. But there are a variety of reasons why mental health and learning disorders so often occur together.

Multiple diagnoses, same brain system

Some disorders are linked to the same brain systems. “If you’re diagnosed with one anxiety disorder, like selective mutism, the likelihood is high that you’re going to have another anxiety disorder, like specific phobia, generalized anxiety disorder, or social anxiety,” says Paul Mitrani, MD, PhD, a child and adolescent psychiatrist at the Child Mind Institute. “It makes sense because it’s the same brain system that’s affected, just presenting in several different ways. So that that’s very common.”

Several different disorders can be linked to the same neurotransmitters — chemicals like dopamine and serotonin that are used to send messages in the brain. For instance, the serotonin system is involved in both anxiety and depression. “When the pathways related to serotonin in the brain are not working as well,” says Dr. Mitrani, “you’re at a higher risk for anxiety, as well as depression and OCD. ”

#James Donaldson notes:Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.  #http://bit.ly/JamesMentalHealthArticleFind out more about the work I do on my 501c3 non-profit foundationwebsite www.yourgiftoflife.org Order your copy of James Donaldson's latest book,#CelebratingYourGiftofLife: From The Verge of Suicide to a Life of Purpose and Joy

Click Here For More Information About James Donaldson

Click here to follow James Donaldson's Blog

One disorder can lead to another

But it’s also common for a child’s struggles with one disorder to lead to another. For instance, a child with ADHD whose impulsivity leads to a lot of conflict with their parents can develop a behavior disorder. Kids with autism might develop anxiety because the world feels unpredictable and overwhelming. Or children with learning disorders who are struggling in school may develop anxiety or depression.

“It can be really hard to have ADHD or autism, or to struggle with learning, so it makes sense that you might have difficulty regulating your emotions and behavior or that you might develop anxiety or depression,” notes Dr. Ice.

Different diagnoses from different clinicians

Sometimes, children with several diagnoses have been seen, over the years, by different clinicians, who may have evaluated them differently and added a diagnosis without withdrawing an earlier one.

“The more interactions somebody has with the mental health system, the increased likelihood that they’ll have multiple diagnoses because of different providers seeing and hearing different things at different times,” notes Dr. Ice. A child can end up with a list of diagnoses that they’ve had in the past, but they don’t meet the criteria for anymore, she adds.

What are common co-occurring disorders?

A study of adolescents with co-occurring disorders found that slightly more than half (61 percent) had two disorders from one larger class of disorders, such as mood, anxiety, attention, or behavior disorders. Another quarter (25 percent) had disorders from two different classes, and 11 percent were affected by three different classes of disorders.

Some of the common combinations include:

- ADHD + Anxiety: Difficulty focusing, restlessness, and irritability can appear in both disorders, which can result in misdiagnosis — but many children also have both. Academic struggles, social difficulties, and consistent negative feedback can cause chronic stress, leading to anxiety over time.

- ADHD + Oppositional Defiant Disorder (ODD): Kids with ADHD may be easily frustrated and have difficulty complying or following instructions from parents and other adults, which can lead tooppositional or defiant behavior.

- ADHD + Depression: As the academic and social impact of ADHD builds up over time, kids can develop low self-esteem and depression.

- Anxiety + Depression: It’s very common for kids who experience chronic worries to develop sadness, a loss of interest in things they enjoy, and other symptoms of depression.

- Autism + ADHD: A study of more than 4,000 children with autism found that 40 percent also had ADHD. Sometimes ADHD symptoms are recognized first, and autism is diagnosed later — or vice versa. Autism and ADHD both run in families and havegenetic factors in common.

- Anxiety + OCD: OCD is an anxiety disorder, but it can appear with other anxiety types, like generalized anxiety or social anxiety.Kids may struggle with intense fears and compulsive rituals as well as general worry or panic.

- Trauma-Related Disorders + ADHD, Anxiety, Depression, or ODD: Trauma can impact a child’s mood, behavior, attention, and emotional regulation, leading to symptoms in all those areas. A trauma-informed approach is essential for accurate diagnosis and effective treatment. Trauma-informed assessments can help identify the root cause of symptoms.

- Learning Disorders + Anxiety or Depression: Children who have an extra hard time with learning often struggle with frustration and low self-esteem, which can cause them to develop anxiety or depression.

- Tic disorders + ADHD or OCD: More than three-quarters of children with Tourette’s disorder have at least one other disorder, with ADHD and anxiety being the most common.

How do you treat co-occurring disorders?

When a child has more than one disorder, how do you decide what to treat first? Whichever one seems primary, says Dr. Ice. “What is the thing that’s actually leading to the most problems? What is interfering with the child’s functioning the most — we want to figure out a plan for treating that first.”

If a child with ADHD is not paying attention in class, is hyperactive, and is getting into a lot of trouble, these difficulties could result in anxiety. “So, you treat the ADHD first, then you reassess to see if the anxiety gets better,” says Dr. Mitrani. “If it gets better, then you probably don’t need to use a medication or intervene for the anxiety. But if it doesn’t get better? Then we need to figure out how to treat the anxiety.”

Sometimes you can work on more than one disorder at the same time. A child with a learning disorder who becomes depressed should get support for their learning issues as well as treatment for depression.

But if you’re starting treatment with medication, Dr. Mitrani stresses, medicines should always be introduced one at a time. “You don’t start with two medicines at the same time because if something gets better or worse, you won’t know what the cause is,” he explains. For instance, for a child who has ADHD and anxiety, “if you start a stimulant and antidepressant at the same time and all of a sudden the child’s not sleeping, what’s causing that?”

Treating multiple disorders with medication

When treatment involves medication, the prescribing doctor needs to consider how medication for one might exacerbate or affect symptoms for another. For instance, stimulant medication for ADHD can worsen anxiety. “If a child has both, we may start with treatment for ADHD, but if the stimulant makes the anxiety worse, then we have to reassess and think about other options,” says Dr. Mitrani.

Medications for one disorder can also affect how another medication for a co-occuring disorder is metabolized — limiting its effectiveness or increasing the side effects. “Anytime you combine medications, you want to make sure there are no interactions that can worsen or compound side effects,” says Dr. Mitrani.

One of the risks when children have several mental health disorders is that they will be prescribed multiple medications without clarity on what each is intended to do and whether it is working. “The risk is that in layering medicine on medicine, you lose track of the underlying problems, and how well each medication is being tolerated,” said Dr. Mitrani.

“You can use any of these medicines in combination,” he notes, “but they need to be combined carefully to get an accurate picture of their effectiveness and manage side effects, especially when you’re dealing with meds that have more concerning side effects, like antipsychotics.”

Therapy and co-occurring disorders

One disorder could also make it more difficult for a child to participate successfully in therapy for another disorder. For instance, if a child has social anxiety and depression, the social anxiety could interfere with their ability to engage in therapy for depression that includes participation in a group, such as DBT (dialectical behavior therapy). If a child has ADHD and anxiety, the ADHD can interfere with their ability to follow through with a step-by-step treatment for anxiety like exposure and response prevention (ERP).

Kids with several mental health challenges may require more tailored treatment. “This involves adapting typical treatment for one of the diagnoses to include what is beneficial for the other diagnosis as well,” says Dr. Ice. For instance, the standardcognitive behavior therapy treatment for anxiety, Coping Cat, has been customized for autistic kids with anxiety, resulting in a treatment called BIACA (Behavioral Interventions for Anxiety in Children with Autism).

Dr. Mitrani stresses the importance of making sure to educate parents on all their options. “What’s possible with medicine? What’s possible with therapy? Where is parent work important? Where is working with the schools important? Since medications can come with concerning side effects, we want to make sure we’re setting specific goals for treatment interventions, carefully monitoring those interventions for effectiveness, and adjust things or bring in other approaches as needed.”

Frequently Asked Questions

What does it mean if my child has multiple diagnoses?

When a child is diagnosed with multiple mental health disorders, it means they have symptoms that can’t all be explained by one condition. Identifying each diagnosis helps clinicians choose treatments that address more of your child’s challenges — it doesn’t mean your child is “sicker.”

Is it common for kids to have more than one diagnosis?

Can one treatment plan address multiple diagnoses?

Photo by samer daboul on Pexels.com https://standingabovethecrowd.com/?p=16425

James Donaldson on Mental Health - Learning Disabilities and Depression

Why kids with LDs often develop depression, and need emotional support, too

Writer: Molly Hagan

Clinical Experts: Laura Phillips, PsyD, ABPdN , Helene Omansky, LCSW

https://www.youtube.com/watch?v=4uIAhuvwFIk

What You'll Learn

- Why are kids with LDs more likely to be depressed?
- How does school affect a child's self-esteem?
- How can parents and teachers emotionally support kids with learning disabilities?
- Quick Read
- Full Article
- School and self-worth
- Academic challenges get tougher
- Comparisons with peers
- Hiding the signs
- A vicious cycle — how depression impacts learning
- Classroom safety
- Combining academic and emotional supports
- Learning Disabilities and Depression
- How Depression Affects Kids in School

Quick Read

Research shows that children with learning disabilities run a higher risk of developing depression than other kids — and that this risk increases as they get older.

Depression comes from feelings of hopelessness and low self-worth. And the struggles kids have at school play a big role in how good or bad they feel about themselves. These challenges include more difficult work in the classroom as kids get older but also social problems.

When kids turn 8 or 9, they begin to compare themselves to their friends and peers. Kids with LDs might feel embarrassed by their learning challenges and want to hide them. Some kids will act out. Others, including many girls, will withdraw at school, and from friends  — which makes it much harder for parents and teachers to know that they have a learning disorder in the first place.

Dealing with undiagnosed learning disabilities can make kids anxious and depressed. And depression and anxiety, in turn, can affect the brain, making it harder to remember things and concentrate. Because being anxious or depressed makes it hard to learn, schools are beginning to teach social and emotional learning (SEL) skills to kids with LDs, to help them cope with difficult feelings. Learning support by itself is not enough to help kids succeed.

But while SEL skills are very helpful, kids showing signs of depression — like being tired all the time, seeming sad, or losing interest in things they usually enjoy — should see a medical professional for treatment.

We think of learning disabilities as affecting kids in school, but challenges in skills like reading, writing, math, and language affect all aspects of life, not just academic performance. We are using them all the time — reading street signs, counting change, playing games, and following conversations with friends.

Struggling with skills that appear to come easily to others, inside the classroom or out, can take an emotional toll starting at an early age. Research shows that children with learning disorders are at higher risk for developing depression. This risk increases as children enter their teenage years.

“Kids spend the majority of their waking hours in school,” says Laura Phillips, PhD, a neuropsychologist. “When you spend eight hours a day engaged in something that’s challenging for you it has a very significant impact on your self-concept — meaning your idea about who you are as a person — and your ability to feel successful.”

#James Donaldson notes:
Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.
Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.
Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.  #http://bit.ly/JamesMentalHealthArticle
Find out more about the work I do on my 501c3 non-profit foundation
website www.yourgiftoflife.org Order your copy of James Donaldson's latest book,
#CelebratingYourGiftofLife: From The Verge of Suicide to a Life of Purpose and Joy

Click Here For More Information About James Donaldson

Click here to follow James Donaldson's Blog

School and self-worth

Depression can manifest in different ways:

- Appearing sad or irritable
- Trouble sleeping
- Losing interest in things you once enjoyed 
- Being tired all the time
- Gaining or losing a lot of weight

But at its root are feelings of hopelessness and low self-worth. Studies show that for kids with learning disorders, the school environment can contribute to and breed these feelings.

A child with an undiagnosed learning disability is particularly at risk for depression because they don’t understand why they struggle with things that others don’t. Frustration and failure create a sense that something must be wrong with them. A diagnosis can be reassuring and offer them the support they need — but success will still be a struggle. When it comes to a child’s emotions, an LD diagnosis is not a magic bullet.

??“It doesn’t always feel better right away,” notes Helene Omansky, LCSW, a senior social worker at the Child Mind Institute. “It will get better, but newly diagnosed kids need time to adjust to their support system, and to develop confidence in skills that they may have lacked.”

If you think your child might be depressed, consult a medical professional for help — but know there are ways parents and teachers can offer support, too.

Academic challenges get tougher

The requirements of school change as you get older, and there’s one shift that can be particularly tough for kids, especially those with reading and language deficits. “From kindergarten through second grade, you’re learning how to read,” Dr. Phillips explains. “By third grade, the emphasis shifts to reading to learn.”

In other words, reading becomes incorporated into every class. Kids who struggled in language arts classes but prided themselves on their math skills are suddenly confronted with math word problems. “And then they lose that confidence in the thing that might’ve been maintaining their sense of self and self-esteem,” Dr. Phillips explains.

This change is the first of many. Kids will continue to wrestle with their challenges in unexpected ways, and this can be discouraging.

“The impact of alearning disorder becomes more widespread as you move through school,” Dr. Phillips says.

It’s important for parents to understand the depth of frustration a child may be feeling and acknowledge it, says Omansky. We’re naturally inclined to dispel negativity with encouragement — “You’re so smart!” — but this can make a child feel isolated and unheard. If a child is saying they feel dumb because they can’t figure out how to solve a word problem, Omansky says, “It’s okay to validate that by saying something like, ‘I can see how frustrating this is for you.’”

Comparisons with peers

Around 8 or 9 years old, kids become less self-focused and begin to understand themselves in the context of — and in comparison, to — their peers. Where before school was merely frustrating, now kids may wonder why certain things appear to come easily to others. They may feel like they’re working twice as hard as those around them, and understandably, they may think this is unfair.

Kids also become more self-conscious at this age and might feel like their deficits are on display. This can look like a kid who doesn’t want to raise their hand in class, but it can also look like a kid who plays by themselves at recess. When a child can’t solve a math problem or gets called out for not finishing an assignment, it’s easy for them to go from “I feel dumb” to “Nobody is going to like me,” Omansky notes.

Kids with learning challenges can also struggle with social skills, such as following the thread of a conversation or finding the right words to respond. They sometimes fumble social cues, and given enough negative feedback, might avoid socializing altogether.

Some kids draw attention away from their challenges by acting out. Being perceived as funny or rebellious might even bolster your self-esteem. But avoiding your challenges doesn’t make you feel any better about them, it just makes you more determined to hide them.

Hiding the signs

Rates of learning disorders are not significantly different among genders, but boys are more likely to be diagnosed because of their tendency to be disruptive in class — an obvious red flag. Girls, meanwhile, tend to withdraw, making identification harder.

“Girls are much more likely to quietly sit in the back of the class and try to sink into the ground,” Dr. Phillips says.

This translates to girls not receiving a learning disorder diagnosis or being diagnosed late. When LDs are overlooked, a child’s anxiety or depression can be the first recognized signs that they need help. “They might become highly anxious or more academically demoralized,” says Dr Phillips. “So, it might be the anxiety or depression that first brings them to clinical attention.”

It’s important for adults to empathize with this experience, too. “Well-intended parents and teachers don’t want to put a spotlight on a kid unnecessarily, but they may not be asking the right questions that would allow for further intervention or exploration,” says Omansky. When a child is anxious, unmotivated, or depressed, the adults in their lives should investigate if they might be struggling, she adds. “Kids don’t always have the skillset to know how to self-advocate and say, ‘I don’t understand.’”

A vicious cycle — how depression impacts learning

Depression can actually impact cognitive functions, making learning challenges more acute.

Research shows that depression can:

- Slow information processing
- Slow memory consolidation, or how your brain transforms the things you learn into long-term memories
- Make it harder to pay attention and concentrate
- Interfere with sleep, which can also be bad for your brain

It’s a vicious cycle — learning challenges contributing to depression, contributing to more challenges — but there are ways to interrupt it.

Classroom safety

How a child relates to their school environment can also affect how they learn and how they see themselves. This is a particularly important factor for Black children and other children of color, especially if they attend predominantly white schools. “If there’s a difference in skin color between kids and their teachers, they might enter the classroom with a different level of anxious arousal that they have to overcome in order to be fully engaged,” Dr. Phillips says.

If the school environment already makes you anxious, you’re more likely to shut down if learning is also a challenge. You might even develop a fear of going to school at all. Teachers should be aware that kids don’t experience school in a vacuum. They should understand the racial, cultural, demographic factors that impact kids, so kids feel safe enough to learn and ask for help if they need it.

Combining academic and emotional supports

Schools are beginning to embrace emotional supports for children with learning disorders. When kids feel defeated by their challenges, and resist learning because it makes them feel bad about themselves, academic support alone is not enough.

Increasingly, schools are using  social and emotional learning (SEL) techniques to help kids develop an awareness of the emotions that drive their behaviors — whether they are acting out, trying to disappear, or simply avoiding the tasks that are most difficult for them.

Kids can be taught strategies to manage big emotions around learning. Take kids with math learning disorders, who become anxious when asked to solve math problems. They tend to engage in negative self-talk — “I’m so bad at math. I’m going to fail this math test. I’m so stupid, I’m not going to get into college.”

The negative self-talk interferes with problem solving. “It taxes your working memory to the point where you can’t effectively problem solve,” explains Dr. Phillips. “So, you do poorly and then you see yourself as a bad math student.”

But kids can interrupt the cycle with a simple trick: saying the steps of the math problem as they do them. “If you’re verbally working through the steps, you can’t engage in negative self-talk and so you can’t tax the working memory system,” she adds.  “It’s very effective.”

The ability to embrace this kind of creative problem-solving is the secret weapon of having a learning disorder — but when a child shows signs of depression, it’s important to seek professional treatment. Understanding that emotional challenges and learning challenges are intertwined can help parents get kids the support they need.

https://standingabovethecrowd.com/james-donaldson-on-mental-health-learning-disabilities-and-depression-2/