Adolescent mental health awareness sesssion

Dr. S. SIVASAILAM
MBBS, DNB(Psych), MNAMS
Consultant Psychiatrist,
Rengasamy Nursing Home,
Tuticorin
ADOLESCENT and MENTAL HEALTH

BRIEF HISTORY OF
WORLD MENTAL HEALTH DAY
AND
WHY IT’S BEEN CELEBRATED?

1. World Mental Health Day - 10th
October 1992.
2. The man behind was Deputy
Secretary General Richard Hunter.
3. Initially there were no themes
HISTORY OF WORLD MENTAL HEALTH DAY

1. The man who first bought the theme -
Secretary General Eugene Brody.
2. A theme for the Day was used for the
first time.
3. Theme “Improving the Quality of
Mental Health Services throughout the
World.”
The First Theme

List of themes
•1996 Women and Mental Health
•1997 Children and Mental Health
•1998 Mental Health and Human Rights
•1999 Mental Health and Ageing
•2000-2001 Mental Health and Work
•2002 The Effects of Trauma and Violence on
Children & Adolescents
•2003 Emotional and Behavioural Disorders of Children &
Adolescents
•2004 The Relationship Between Physical &
Mental Health: co-occurring disorders

List of themes
•2005 Mental and Physical Health Across the Life Span
•2006 Building Awareness – Reducing Risk: Mental
Illness & Suicide
•2007 Mental Health in A Changing World: The Impact of Culture and Diversity
•2008 Making Mental Health a Global Priority: Scaling up Services through
Citizen Advocacy and Action
•2009 Mental Health in Primary Care: Enhancing
Treatment and Promoting Mental Health
•2010 Mental Health and Chronic Physical Illnesses
•2011 The Great Push: Investing in Mental Health

List of themes
•2012 Depression: A Global Crisis
•2013 Mental Health and Older Adults
•2014 Living with Schizophrenia
•2015 Dignity in Mental Health
•2016 Psychological and Mental Health
First Aid
•2017 Mental Health in the Workplace
•2018 Young People and Mental Health
in a Changing World

1. To help raise mental health
awareness.
2. To ensure that people with
mental health problems can live
better lives with dignity.
WHY MENTAL HEALTH DAY CELEBRATED?

1. Every year one adult in four, along
with one child in ten, will have a
mental health issue.
2. Its affecting millions of lives,
affecting their capability to live the
day, to sustain relationships, and to
maintain work.
CURRENT MENTAL HEALTH SCENARIO

1. Stigma the first and foremost factor affect to
offer help.
2. According to UK estimates, only about one-
fourth of those with mental health problems
undergo ongoing treatment.
3. If you see most persons, ranging from isolation
to uncertainty on where to get help or
information, to relying on the informal support of
family, friends or colleagues.
STIGMA & MENTAL ILLNESS

1. The best way to deal with this stigma is to
break it through facts and a better
understanding of mental health problems.
2. From identifying the causes, pinpointing
solutions, and ultimately recognizing that we
are really dealing with medical issues.
3. Ensure that it’s a disease of brain.
Raising Awareness

ADOLESCENT MENTAL HEALTH
1. Introduction
2. Bio-Psycho-Social changes
3. Normal Adolescence Psychology
4. Social Medias/Factors influence
5. Common Psychiatric disorders
6. Management

INTRODUCTION
1. Adolescence is a critical link between
childhood and adulthood, characterized
by significant physical, psychological,
and social transitions.
2. It’s the period in life when many
changes occur.
(e.g.) changing schools, leaving
home, and starting university
or a new job etc.

INTRODUCTION
3. They can also be times of stress and apprehension.
4. However, in some cases, if not recognized and
managed earlier, these can lead to mental illness.
5. Even though the online technologies, bring so
many benefits, at the same time it put additional
pressures, addicted to them getting connected to
virtual networks at any time of the day and night.

6. In addition more number of Young
people are spend most of their day on the
internet – experiencing cyber crimes, cyber
bullying, and playing violent video games.
7. 67% of adolescence having their own
mobiles and want to live in digital space.
8. Suicide and substance abuse numbers
have been steadily rising, but for young
adults only little will be known about
mental illness and psychological wellbeing.
INTRODUCTION

9. We want to bring attention to this
issues our youth and young adults are
facing in our world today
10. To begin the conversation around
what they need in order to grow up
healthy, happy and resilient.
INTRODUCTION

Developmental Process in Adolescence
- BioPsychoSocial Model
Changes happen in 3 Areas
Biological Aspect
Psychological Aspect
Social Aspect

Biological Aspect
1. Onset of Puberty  Maturation of Hypothalamic-pituitary-adrenal-
gonadal axes.
2. Age of Onset – Females – 11 years
Males – 13 years
3. But the onset of puberty has been steadily declined over the past 100
years.
Precocious or Delayed Puberty
15% have a deviation in either way
Sense of inferiority
Low self-esteem
Loss of Confidence

Biological Aspect
Changes in hormones
1. For Females - FSH & LH steadily increases throughout the
adolescence and peak at 17 - 18 years.
2. For Males – Testosterone steadily increases throughout the
adolescence and peak at 16 – 17 years.
3. Testosterone is responsible for Masculinization of boys &
Estradiol is responsible for feminization of girls.

Biological Aspect
Changes in hormones
1.Hormones directly influences the CNS functioning - Mood &
Behaviour.
2.High Testosterone levels- Aggression & Impulsivity in males
3.Low estrogen levels – Depressed mood in females
Testosterone levels are important for libido in both sexes.
Manifests sex drive and masturbation in both sexes

Biology Aspect – Brain Development
1. Synaptogenesis followed by Synaptic Pruning and Axonal
Myelination in prefrontal cortex and Medial Temporal lobe.
2. Development of executive functions, that is, cognitive skills that
enable the control and coordination of thoughts and behaviour.
3. Performance on tasks including inhibitory control, processing
speed, prospective memory, working memory, decision-making
and risk taking behaviour continue to develop during adolescence.

Cognitive & Personality Development
1.At the beginning of adolescence – Thinking usually become
Abstract
Conceptual
Future-Oriented
2.Remarkable development of creativity
Writing, Poetry, Arts, Music, Sports, Humanitarian issues,
moral, ethics & religion.
3.Development of Identity

Development of Identity – A sense of self.
1.Identity Diffusion – Failure to develop cohesive self or self –
awareness
2. Adolescent Identity Crisis- partly resolved by move from
dependency to independence.
Few may find out struggle in establishing their sex roles and gender
identification disorder.

1.Negativism
2.Peer Group influences
3.Risk taking behaviours
4.Generation Gap with Parents & Elders
5.Development of morality
6.Choice of occupation.
7.Substance use
8.Violence

Social Aspect
1.More self-conscious and concerned with other people's
opinions as they go through puberty and the period of
adolescence.
2.Relationships with peers, family and society go through
distinct changes during this time and more involvement with
peers.
3.They are more concerned in taking decisions and start to
disengage from parental control.

Social Aspect – Role of Parents
1. Some adolescents adopt the values and roles that their parents expect
for them. Other teens develop identities that are in opposition to their
parents but align with a peer group.
2. As adolescents work to form their identities, some of them pull away
from their parents, and been influenced by peer.
3. Warm and healthy parent-child relationships have been associated
with positive child outcomes, such as better grades and fewer school
behavior problems.

Social Aspect – Role of Peers
1. As children become adolescents, they usually begin spending more time with
their peers and less time with their families, and these peer interactions are
increasingly unsupervised by adults.
2. Deviant peer contagion – Peer Influence in which is the reinforce the
problem behavior by laughing or showing other signs of approval that then
increase the likelihood of future problem behavior.
3. Negative peer pressure can lead adolescents to make riskier decisions or
engage in more problematic behavior like drinking alcohol, use drugs, and
commit crimes.
4. Positive peer relationships are happier and better adjusted

3. NORMAL ADOLESCENCE PSYCHOLOGY

NORMAL ADOLESCENCE PSYCHOLOGY
Common people term - Maturity
1. Emergence of abstract thinking.
2. Growing ability of absorbing the perspectives or
viewpoints of others.
3. An increased ability of introspection.
4. Development of personal and sexual identity.

NORMAL ADOLESCENCE PSYCHOLOGY
5. Establishment of a system of values.
6. Increasing autonomy from family and more
personal independence.
7. Greater importance of peer relationships of
sometimes subcultural quality.
8.Emergence of skills and coping strategies to
overcome problems and crisis.

1. Adolescents continue to refine their sense
of self as they relate to others.
2. Erikson referred to the task of the
adolescent as one of identity versus role
confusion.
3. Thus, in Erikson’s view, an adolescent’s
main questions are “Who am I?” and
“Who do I want to be?”
ERIK ERIKSON

ERIK ERIKSON
Identity Vs Identity Diffusion or Role Confusion
1.Identity Crisis, occurs at the end of adolescence,
itself is a normal event.
2. Failure to negotiate this stage, leaves the
adolescents without a solid identity.
3. Usually suffer from not having a sense of self
and by confusion about their place in their world.

ERIK ERIKSON
Role Confusion
1.Abnormal behaviour.
2.Running Away.
3.Lack of confidence.
4.Criminality.
5.Overt Psychosis.
6.Gender identity problems
7.By joining Cults or by identifying with folk heroes

ERIK ERIKSON
- How a person’s psychology falls love – quite interesting
Form a Sense of Self-Identity
Project their Diffused Self
Image onto the partner
Making it Gradually assume a
more distinctive shape
Then overidentify themselves
with the love object

JEAN PIAGET - Abstract Thinking
1. Understands world through
hypothetical thinking and
scientific reasoning.
2. Logic, classification and
comparison in everything sees.
3. Ethics/Politics/Moral/Social
issues

4. SOCIAL MEDIAS and OTHER FACTORS
INFLUENCES

Digital Network in India
1. There has been extensive use of social networking in India by
youth and the number of users has been rising day by day.
2. Life cant be imagined without facebook, whatsapp, Instagram,
twitter, linked-in and youtube.
3. Its been significantly inducing a lot of cultural changes and
personal life changes.
4. Because of this a large number of youth are getting into social
network addiction.

HOW WE COPE UP OUR LIFE STRESS WITH DIGITAL SPACE
LIFE STRESS
FEELING OF BREAKDOWN
GETTING ABSORBED INTO FB
Temporary Relief- Away from
the reality (Life Stress)

Positive effects on social media
Role Confusion
1.Abnormal behaviour.
2.Running Away.
3.Lack of confidence.
4.Criminality.
5.Overt Psychosis.
6.Gender identity problems
7.By joining Cults or by identifying with folk heroes

What is Internet Addiction
1. Preoccupied with the internet
2. Spending more time
3. Avoiding or postponing important work.
4. Interfering in the routine schedule
5. Felt despair when not available.
6. Felt loss of control when it need to cut down.
7. Restless and tense in cutting down
8. Route for Escapism from the current problem

HOW FACEBOOK/WHATSPP ADDICTION DEVELOPS
Instant Gratification- Dopamine
reward activity (Pleasure)
Send a message, wait for reply.
Anticipate the other persons respond
If anticipation turned out to real.
Activated dopamine reward system
Started doing randomly. Doesn’t know
whom the person they’re texting
Send a message, wait for reply.
Anticipate the other persons respond
If anticipation not turned out to real.
Lose their control, Impulsive
Got Frustrated, Depressed mood.
Suicidal tendency.

What happen to the higher mental functions?
What happen to their studies
1.Reduce the attention span
2.Decrease the STM and LTM
3.Impairs the judgement skills
4.Poor decision making skills
5.Avoid/Escapism from problems

Negative effect of Excessive Facebook Users
Compulsion –
1. A compulsion to dissociate from your real world and
go live in the facebook world.
2. Escapism from the burden of life
3. Avoiding the on-going stress.

Fear of missing out or FoMO
1. Its a pervasive apprehension that others might be having
rewarding experiences from which one is absent.
2. This social anxiety is characterized by a desire to stay continually
connected with what others are doing.
3. Its a fear of regret which may lead to a compulsive concern that
one might miss an opportunity for social interaction.

Hidden personality of FB Users
1.Exhibitionism
2.Voyeuristic
3.Interaction – seeking Behavior
4.Dysthymic
5.Impulsive
6.Passive-Aggressive

1. The Hindu reported 2 days before, India’s National Institute of Mental
Health and Neurosciences (NIMHANS) has just received a case of
what it calls ‘Netflix addiction.’
2. The case is of an unemployed 24-year-old, who shut himself at home,
and was hooked on to Netflix for six months.
3. Such cases of addiction, like any other including gaming,
pornography, chatting, social media, smart devices and others ride on
factors driven by psychosocial and environmental conditions.
NETFLIX ADDICTION
- Our country’s 1st
case reported

SHUT – Service for Healthy Use of Technology
(NIMHANS, Bangalore)
1. Encourage real life friendship.
2. Postpone Immediate Gratification
3. Make proper Bedtime
4. Reward for off-screen.
5. Improve digital decision making
6. Teach good online behaviour

Hazard of video games
1. Insomnia
2. Feelings of restlessness
3. Irritability
4. Preoccupation with thoughts of previous online activity.
5. Neurasthenia
6. Migraines
7. Impulsive
8. Aggressive outbursts
9. Mood Swings

5. COMMON PSYCHIATRIC DISORDERS

Half of all mental illness begins
by the age of 14
1. Half of all mental illness begins by the age of 14, but most cases go
undetected and untreated.
2. In terms of the burden of the disease among adolescents, depression is
the third leading cause.
3. Suicide is the second leading cause of death among 15-29-year-olds.
4. Harmful use of alcohol and illicit drugs among adolescents is a major
issue in many countries and can lead to risky behaviours such as unsafe
sex or dangerous driving.

EMOTIONAL DISORDERS
1. ANXIETY DISORDERS
2. Phobia – Agarophobia
3. Panic disorder
4. Acute stress disorder
5. Hypochondriasis

MOOD DISORDERS
1. Bipolar Affective Disorder
2. Severe Depression
3. Persistent Mood disorder

SUBSTANCE ABUSE DISORDERS
1. Alcoholism
2. Nicotine
3. Tobacco
4. Cannabis
5. Volatile solvents
6. Sedatives

PSYCHOSIS
1. Schizophrenia
2. Acute Psychosis
3. Delusional disorder

SELF-MUTILATING BEHAVIORS
1. Deliberate self harm
2. Delinquent behaviour
3. Dysmorphophobia
4. Low self esteem
5. Adjustment disorder

SUICIDE
1. Adolescence are more chance of suicidal
attempt/completion because of cognitive immaturity
& impulsivity.
2. Boys- Completion
3. Girls – Attempt
4. School/College students are at more risk

Prevention begins with better understanding
1. Prevention begins with being aware of and understanding the
early warning signs and symptoms of mental illness.
2. Educate the parents can help build life skills of adolescents to
help them cope with everyday challenges.
3. District Mental Health Program provide training for health
workers to enable them to detect and manage mental health
disorders.

COPING STRATEGIES
- How a person deals with their emotion in facing challenges
Danger or Threat in life –
Acute/Chronic
Analysis of Available resources
Change situation itself/Change
ourselves to adopt reality
Failure – Learn from mistakes &
Correct

POSITIVE COPING
– They manage and rectify the problems by taking care of the health

Negative Coping
- unlikely to tackle the problems and there may be an ill effects on health

Psychological Therapies
1. Cognitive Behavioural Therapy
2. Insight Oriented Therapy
3. Mind fullness

COGNITIVE BEHAVIOURAL THERAPY
Thought, feelings, actions -
interconnected
It focus on current thoughts
rather than past
Negative thoughts & feelings
are charged
Replaced by realistic, positive
thoughts
Talking therapy – it change
the way we think & behave

INSIGHT ORIENTED THERAPY
Understand the basis of
thinking, emotions, behavior
It motivates you and make
aware of your weakness
Accept the reality
It guides you the best
possibilities
The better you know yourself
the better you function

PSYCHOLOGICAL THERAPIES
LIFE STRESS
FEELING OF BREAKDOWN
GETTING ABSORBED INTO FB
Temporary Relief- Away from
the reality (Life Stress)

Medical Management
1. Antipsychotics
2. Mood stabilizers
3. Anxiolytics
4. Antidepressants

Common Antipsychotics
1. Always the conventional first
1. Haloperidol 10 – 30mg/day
2. Trifluperazine 5-20 mg/day
3. Thioridazine 25-100 mg/day
4. Chlorpromazine 200-600 mg/days
2. Atypical comes the next
1. Risperidone 6-8 mg/day
2. Quetiapine 100-200 mg/day
3. Olanzapine 20-30 mg/day
4. Amisulphiride 300-800 mg/day

Mood stabilizers
1. Lithium – Always first line – Cost effective 400-900 mg/day
(Monitor Ser.Li levels)
2. Carbamazepine – 15 mg/kg/day
3. Sodium Valproate – 20 mg/kg/day
4. Oxcarbazapine – 300-600 mg/day
5. Topiramate – 50-100 mg/day
6. Lamotrigine – 100-200 mg/day

Anxiolytics
1. Diazepam 5- 10 mg/day
2. Alprazolam – 0.5 – 2mg/day, more dependence
3. Clonazepam – 0.5-2mg/day
4. Lorazepam - 1-4 mg/day
5. Chlordiazepoxide – 10- 150 mg/day (Contraindicated in Elevated Liver
enzymes)
6. Oxazepam – currently available will be helpful in increased SGOT,
SGPT

Antidepressants
1. Imipramine- 75-150mg/day
2. Amitriptyline – 75-150 mg/day
3. Fluoxetine – 20-60 mg/day
4. Sertraline – 50-200 mg/day
5. Escitalopram 10-30 mg/day
6. Fluvoxamine – 50-200 mg/day
7. Venlafaxine – 75- 150 mg/day
8. Desvenlafaxine – 50-100 mg/day
9. Bupropion – 150- 300 mg/day

How to improve mental resilience
- It’s the ability to cope the stress and
return back to precrisis state
1. Less screen time
2. Have real friend and not virtual
3. Daily do physical workouts
4. Healthy Breakfast
5. Yoga
6. Meditation

TAKE HOME MESSAGE
1. Social Media’s strongly influence the adolescence’s mental health.
2. Adolescents take these virtual medias & substance abuse as path of
escapism from reality.
3. Positive Coping skills should be taught appropriately to handle the
digital space.
4. Earlier the diagnosis and treatment there will be better recovery.
5. Last but not least consider the psychological issues as a physical
disorder, that minimize the stigma.

Adolescent mental health awareness sesssion

More Related Content

Similar to Adolescent mental health awareness sesssion

Recently uploaded

Adolescent mental health awareness sesssion