Emotionally Naked. Anne Moss Rogers

Youth with conduct disorder violate these social norms at home, at school, and with peers. These are the kids who often start fights, bully others, skip school, have frequent suspensions on their record, drop out of school, run away, ignore curfews, end up as discipline problems, and at juvenile detention centers. Children with conduct disorders are more apt to become injured and often have trouble with family and peer relationships. Conduct disorders frequently co-occur with depression, but the depression is rarely diagnosed in these cases because the conduct issues are more prominent.

      Bipolar Disorder

To be diagnosed with bipolar disorder, the individual must have met criteria for a depressive episode and have had at least one episode of mania, which is defined as a distinct period of abnormally and persistently elevated, expansive, or irritable mood.²¹ It can last a week or more and include grandiose feelings of self-esteem, marked by sleeplessness, talking fast, bursts of creativity and ideas, and increased risk taking. Hormonal changes also make it difficult to discern between normal teen emotional behavior versus manic symptoms. In addition, bipolar disorder in teens is often misdiagnosed as ADHD and vice versa, and can be overlooked initially because the teen might have already been diagnosed with depression or anxiety instead of bipolar disorder because mania isn't always the first symptom to express itself. Those experiencing mania can have elevated mood, feel extremely agitated, behave brashly or lavishly, assume superiority or grandiosity, or dress and act flamboyantly. They might post obsessively on social media or start telling dirty jokes at inopportune times and in front of inappropriate audiences. Some with bipolar disorder (and depression) have psychosis and hear voices that can sometimes tell them to suicide.

      Substance Use Disorder

^{Substance use disorders are patterns of symptoms resulting from continued use of a substance, despite harmful consequences. Addiction is the most severe form of substance use disorders, a chronic relapse disease caused by repeated misuse of one or more substances.22 Substance misuse can lead to substance use disorder but whether it does or not depends on age, family, and health history, as well as environment, which can include mental illness and/or exposure to traumatic events. Developing teen brains are more susceptible to substance use disorders than adult brains and there are many substances to which someone can become addicted. The most common substance is alcohol, followed by marijuana, prescription medications, over-the-counter medications such as cough syrup with dextromethorphan (e.g. Robitussin®), air dusters, and aerosol whipped cream (e.g. Reddi-Wip®). The misuse of easily accessible substances can lead to the eventual dependence on street drugs. The development of physical withdrawal symptoms, which can be relieved by taking more of the substance, is what separates addiction from substance misuse. Teens often start using to fit in, experience highs, “numb” feelings related to an adverse event, or normalize or regulate their moods pertaining to grief or a mental illness. Substance use disorders can co-occur with other mental illnesses and disorders. Drinking alcohol at an early age, binge or heavy drinking, and drinking behaviors that meet criteria for mild, moderate, or severe alcohol use disorder can all lead to increased risk of suicidal ideation and attempts. Persons with heavy alcohol use are five times more likely to die by suicide than social drinkers23 and toxicology reports on suicide decedents indicate that 75% of suicides involve one or more substances.24}

      Eating Disorder

An eating disorder is a severe disturbance in people's eating behaviors and their related thoughts and emotions. Preoccupation with food, body weight, and shape are other symptoms of eating disorders. Common eating disorders include anorexia nervosa, bulimia nervosa, and binge-eating disorder. A substantial number of individuals affected by an eating disorder may also be suffering with a mood disorder, especially major depressive disorder.²⁵ Eating disorders are often accompanied by thoughts of suicide or suicide attempts, as this is the most common cause of death among individuals with eating disorders. Eating disorders have the highest mortality rate of all psychiatric disorders.²⁶ Studies have shown that within the eating disorder population, people with anorexia have the highest rate of suicide death and those with bulimia have the greatest number of attempts. Furthermore, one study also found that half of the people struggling with binge eating disorder have attempted suicide. Suicide attempts by individuals with anorexia tend to be planned, while attempts by individuals with bulimia tend to be more impulsive.²⁷

      Schizophrenia

Schizophrenia is a serious mental illness that affects how a person thinks, feels, and behaves. People with schizophrenia experience symptoms of psychosis, which can consist of delusions (false beliefs) and hallucinations (seeing or hearing things that others do not see or hear). Experiencing psychotic symptoms is a significant risk factor for suicide, and the early stages of psychotic disorders like schizophrenia represent a particularly critical period of risk. Other symptoms of schizophrenia include incoherent or nonsense speech, and behavior that is inappropriate for the situation. People with schizophrenia may also experience depression, anxiety, sleep problems, social withdrawal, lack of motivation, and difficulty functioning overall. They may seem like they have lost touch with reality, which causes significant distress for the individual, their family members, and friends. Onset of schizophrenia is typically in young adulthood, but the initial and less severe phase of psychotic symptoms may begin in childhood or adolescence. If left untreated, the symptoms of schizophrenia can be persistent and disabling. However, effective treatments are available. When delivered in a timely, coordinated, and sustained manner, treatment can help affected individuals to engage in school or work, achieve independence, and enjoy personal relationships.²⁸

      Generalized Anxiety Disorder

Anxiety is the most common emotional problem in children. Youth can develop crippling worries about many things, from germs to vomiting to their parents dying. Some anxious kids are painfully shy, and avoid things that other kids enjoy. Some have tantrums and meltdowns, and others can develop elaborate rituals, like compulsive handwashing, aimed at diminishing the fear.²⁹ Generalized anxiety disorder is a mental health disorder characterized by feelings of worry about multiple things that are strong enough to interfere with one's daily activities. Examples of other anxiety disorders include panic disorder, social anxiety disorder, and specific phobias. The ongoing worry and tension of anxiety may be accompanied by physical symptoms, such as restlessness, feeling on edge or easily fatigued, difficulty concentrating, muscle tension, or problems sleeping. In addition to genetics, brain chemistry, personality, and life events, teens can experience feelings of anxiety that are fueled by high expectations and pressure to succeed, a world that feels less safe than it used to, and digital media sites where teens tend to compare their life and social situations to what others are posting. According to the National Institutes of Health, nearly 1 in 3 adolescents ages 13 to 18 will experience an anxiety disorder. Between 2007 and 2012, anxiety disorders in children and teens went up 20%.³⁰ Some teens like the pressure and need it to meet deadlines. Others shut down or avoid situations that would otherwise help them learn to manage events that challenge them and build resilience.

      Post-Traumatic Stress Disorder (PTSD)

To develop PTSD, an individual must have been exposed to actual or threatened death, serious