Antisocial Personality Disorder
Recognizing the Signs and Finding Help
Teens with antisocial personality disorder, or APD, often had conduct disorders when they were younger. According to Mental Health America, about 6 to 16 percent of males have this mental illness, and their behaviors are hard for parents to ignore.
It’s a fact that parents fight with their adolescent children. It’s also a fact that most teens take risks, break the rules, and do things their parents find strange and baffling. Sometimes, the strange things teens do pass away with time as part of a phase. In some cases, however, teens become dangerous during adolescence, and they put their safety and the safety of others at risk. These teens might have antisocial personality disorders, and while these conditions can be difficult to treat, parents must make the effort to help their teens in order to keep the community safe.
The information contained in this article might be frightening for parents to read, as they might not want to consider that their children could take the actions outlined here. At Muir Wood, we encourage parents to call and talk with us if they think their children have antisocial personality disorder. Reading about the disorder can be helpful, but talking about the specifics that impact a family, with a professional who is trained to help, might be the best way to handle this very serious condition.
A Lack of Empathy
Teens with antisocial personality disorder, or APD, often had conduct disorders when they were younger. According to Mental Health America, about 6 to 16 percent of males have this mental illness, and their behaviors are hard for parents to ignore. Children with this disorder tend to be disruptive, breaking rules and refusing to take responsibility for the damage they cause. These children might also lie, steal, damage property or otherwise disrespect other people. Parents of a child like this might be very accustomed to calls from the principal’s office, and they might be adept at explaining the actions their children take. It’s difficult to live with, to be sure, but as adolescence approaches, this disorder can deepen and darken, and APD can begin to take hold.
People with APD may continue to commit crimes and hurt others, but they might also be adept at manipulating others. They might be able to:
- Use flattery to escape punishment
- Employ wit and charm to deceive others
- Display arrogance when confronted
- Manipulate others through lies and deceit
These people have learned how to cover their tracks, and while they might continue to show no remorse for the pain they inflict, they may have learned how to make their behaviors seem more palatable to the public.
In other words, they put a new face on old behaviors, and they hope that this will help them to escape notice.
The National Institute of Mental Health reports that about 1 percent of the adult population in the United States has an antisocial personality disorder, and about 46.1 percent of these people are receiving some kind of treatment. Unfortunately, it’s possible that many of these people are receiving their treatment through the criminal justice system. The actions that people take due to APD are often hard for law enforcement officials to overlook, and the prison sentences can be very strict and long.
Obtaining a Diagnosis
The Mayo Clinic reports that a person must be at least 18 years old in order to obtain an official diagnosis of APD. Experts want to ensure that they’re not giving a diagnosis of a personality disorder to teens who are still undergoing personality changes, so they hold off on providing this label until a child is a little older. This doesn’t mean that teens can’t have APD, of course, but it does mean that their doctors might use a slightly different term when describing what they have, until their 18th birthday rolls around.
There are no blood tests or brain scans that can be used to diagnose APD, and people who have the condition may not have the ability to be open, honest and truthful with those who want to help them. As a result, providing a proper diagnosis sometimes means reviewing the person’s criminal and academic record, and then interviewing people who have interacted with the person on a day-to-day basis.
Experts look for evidence of:
- Antisocial acts, including stealing, bullying or harming animals
- Theft, vandalism or other acts that break the law
- Aggression or irritability, including physical or verbal assaults on others
- Repeated lies or deceit
- Lack of remorse
Participating in an interview like this can be difficult, as parents might be accustomed to “covering up” for their teens and protecting them from the consequences of their actions. Being honest, however, is the best way to ensure that a teen has access to the right kind of help. Parents might be able to provide the piece of the puzzle experts need in order to provide an accurate diagnosis.
As mentioned, some people with APD are too dangerous for parents to approach on their own. They don’t see their behaviors as unusual, and they might respond with anger or defiance when the people they love suggest that they should change their ways or do something different. Just talking to them about the issue is unlikely to change their minds. It’s only likely to make them strike out with anger or manipulation. An expert really is needed in order to help the family make a plan to help the person. Some families simply find a treatment program that might help, and they hire an expert to escort the person to care. Other families hold a structured conversation in which they outline the treatment options for the disorder, and ask the person to enter care or submit to a series of harsh consequences. Either method can be painful, but both might help the person to enter treatment before something terrible happens.
If you need this help for your adolescent boy, please see our admissions page to find out how the process works. We can also help you find a professional to transport your child to our care, and we can answer any treatment questions you might have.
Bipolar Disorder and Addiction
The Ups and Downs of Co-Occurring Illnesses
Bipolar disorder is treatable, but without help, those who have this disease are at a greater risk of developing substance abuse and addiction issues.
Adolescents can be moody and changeable, and predicting how they might feel or react in any given moment can be difficult, if not impossible. Racing hormones, a growing body and changing circumstances can all conspire to make a teen’s life hard, and they may bow to the pressure and express their distress through their personalities. Parents of teens might learn to go with the flow, riding out the waves of emotions coming from their teens without overtly reacting or attempting to change the tide. It makes life easier, and the home less stressful, to be sure. There are times, however, when shifts in personality are due to a sinister cause, and ignoring those causes could lead to trouble down the line.
Bipolar disorder is a mental illness characterized by major shifts in personality, and according to the National Institute of Mental Health (NIMH), at least half of all cases of this disorder begin before the person reaches age 25. It’s a treatable disorder, but without help, those who have bipolar disorder are at a greater risk of developing substance abuse and addiction issues. This article will help parents to understand how the disorder works, and how they can identify the problem in the behaviors their teens display.
Shifts in Mood
A classic case of bipolar disorder involves shifts between two very different emotional states: one active and busy (mania) and the other low and slow (depression). The feelings that take hold during an episode are strong and intense, and they can cause the teen to behave in ways that seem bizarre or uncharacteristic. In a classic presentation, the episodes last for a week or two, and the symptoms persist every day for most of the day. Teens seem to be “stuck” in one particular mode, until the cycle shifts and another extreme mood takes over.
During a manic episode, a teen might:
- Seem silly, happy or goofy
- Talk quickly, jumping from topic to topic
- Develop insomnia
- Become angry or irritable
- Take risks
During a depressed episode, a teen might:
- Seem low and sad
- Develop physical illnesses, including stomach and head pain
- Sleep long hours
- Ask to stay home from school in order to sleep
- Seem uninterested in activities the teen once enjoyed
- Talk about death or suicide
Teens can also develop mixed episodes in which they have some parts of both types of mental health issues. They might seem sad yet high in energy, for example, or they might be uninterested in activities yet discuss all topics at a rapid pace. According to NIMH, children with bipolar disorder have more mixed episodes like this than adults with the illness do.
Bipolar disorder can come in many different forms, and teens might not have symptoms that fit the “classic”‘ presentation of the disease. In order to help accurately diagnose those with the illness and provide them with the proper type of care, experts tend to split bipolar disorder into four categories or levels, as follows:
- Bipolar I disorder, in which manic episodes last for seven days or more, followed by depression that lasts at least two weeks. The symptoms are so severe here that the person often needs care in a hospital.
- Bipolar II disorder, in which depression changes places with mania on a regular basis, but there are no full-blown mania episodes.
- Bipolar disorder not otherwise specified, in which people have symptoms of the illness, but the symptoms might not be strong enough or last long enough to merit a full diagnosis of the disorder.
- Cyclothymic disorder, in which people have symptoms of mania shifting with mild depression.
The Link to Substance Abuse and Addiction
Living with bipolar disorder can be incredibly difficult, and the Depression and Bipolar Support Alliance suggests that most people spend 10 years with the illness before they’re provided with the proper diagnosis. This means that people may spend years looking for their own solutions to the problems they face, and for some, this means leaning on substance abuse and addiction.
Drugs of abuse can seem like a reasonable solution to a bipolar issue, as they can calm the hyperactivity that comes during a manic episode. Sedating drugs can make the mind work at a slower pace, and this might be just what a person needs when mania seems to take hold. During a manic episode, however, teens have very little impulse control, and they’re more likely to take risks with their health and well-being. A teen like this might very well overindulge in drugs and alcohol, causing damage in the brain that could lead to addiction down the line. The Mayo Clinic reports that about half of all people who have bipolar disorder also abuse alcohol, and many more abuse drugs. It’s clear that this is a link that’s much too strong to be ignored.
Substance abuse can bump a teen from one cycle to the next, making shifts more dramatic and more damaging. Addiction can also deepen and worsen feelings of depression, making teens feel yet more hopeless and lost. As addiction takes hold, the brain becomes less and less capable of making the chemicals used to signal pleasure, so teens who abuse drugs may be physically unable to experience joy.
Spotting addiction in teens can be somewhat difficult, as teens can be secretive when they know their actions are likely to cause alarm. There are some signs, however, that could indicate that a teen has a substance abuse or addiction issue, including:
- Frequent requests for money, or stealing money
- Missing liquor or prescription medications from the home
- Sudden interest in air fresheners or incense
- Reduced attention to grooming or hygiene
- Increased demands for privacy
- Getting Better
Medication is often part of the treatment protocol for teens with bipolar disorder. Medications can help to soothe the cycling that’s typical in bipolar disorder, and the chemical imbalances caused by bipolar disorder can often be amended with the proper type of drugs given at the appropriate dosage level. It might take a process of trial and error, however, in order to find the right medication program. Some medications might not work in the teen, while others might cause side effects that teens dislike.
Therapy can help teens learn how to spot the symptoms of a manic or depressed episode, while providing them with skills they can use to manage the shifts without leaning on addictive drugs. Therapy might also help teens learn how to explain their disorder to other people, and get along with the people they love even when they’re not feeling well. It’s a method used to build awareness and bring a teen a sense of control, and it can be quite helpful in the fight against bipolar disorder.
Teens might also be encouraged to develop healthy habits that could stem a recurrence of bipolar disorder. Good options include eating well, developing an appropriate sleep-wake cycle and taking medications every day. Teens might even learn to journal about their thoughts and symptoms, so they can communicate clearly with their doctors about the effectiveness of the treatments they’re receiving.
Bipolar disorder can’t be cured, so teens who have the disorder will need to learn how to manage the disease and stay on top of it for the rest of their lives. Through therapy, teens can develop these skills, and this might help them to keep an addiction issue well under control for good.
According to the American Psychiatric Association, 80 to 90 percent of those with bipolar disorder have a relative with either depression or bipolar disorder. As this statistic makes clear, it’s quite possible that parents are able to spot symptoms of bipolar disorder because they either have the illness, or they know someone else who does. As a result, they’re in an excellent position to help their teens get the help they’ll need in order to get better.
Some teens with bipolar disorder respond with happiness or relief when they’re approached by their parents.
When they understand that their symptoms are due to a disorder that can be effectively treated, they might feel a sense of hope that’s been missing in the days and weeks prior. There are some teens, however, who become angry when they’re approached. They might not feel as though they have a disorder at all, for example, or they might not want to admit that they have a problem that needs treatment, not time, in order to resolve.
If a quick one-on-one talk about the nature of bipolar disorder isn’t helpful, teens might need a formal intervention. Here, the family holds a talk with the help of a licensed professional, and the group works together to help the teen see the behavioral changes that have taken place. Talks like this are just slightly more formal than a typical parent/child chat, and they might be able to help parents really reach in and make a difference.
At Muir Wood, we know that even thinking about bipolar disorder or addiction in your teenage son can be distressing, but we’d like to give you hope. Our program can help your son learn how to manage his condition, and we can help you to learn how to provide him with an environment that can foster his continuing growth and education. We can even provide your family with intensive aftercare programs, ensuring that you have the support you’ll need when formal treatment ends. Please call us to find out more.
Schizophrenia and Addiction
Spotting The Symptoms and Finding Help
As the brain moves through adolescence, adjusting, growing and amending, drugs can be a toxic addiction that could cause a seed of schizophrenia to grow and blossom.
About one in 100 people around the world has schizophrenia, according to the National Alliance on Mental Illness, and most of these people developed their disorders when they were just leaving adolescence behind. It’s not precisely clear why schizophrenia and adolescence seem to blend and meld in this way, but it’s quite possible that drug abuse and addiction play some sort of role.
As the brain moves through adolescence, adjusting, growing and amending, drugs can be a toxic addiction that could cause a seed of schizophrenia to grow and blossom. Learning more about what the disease might look like, and why drug abuse might be so dangerous for people who are at risk for schizophrenia, could help parents to protect their children from this mental illness later in life.
Adults who have schizophrenia often have symptoms that are significant and difficult to ignore. They may have positive symptoms, including hallucinations, false beliefs or thought disorders. They may also have negative symptoms, including a flat tone of voice, an inability to feel pleasure or an unwillingness to speak. Some people with schizophrenia are unable to think clearly, make good decisions or remember important details. People with these symptoms may seem profoundly ill at ease in the world, and they may need a significant amount of help from their family members and friends on a daily basis.
With medication and therapy, they might be able to live on their own at home. But it’s not uncommon for adults with schizophrenia to live with others. They need time to focus on getting better, and this could get in the way of an independent life.
Teens with schizophrenia, on the other hand, may have symptoms that are much more subtle, including:
- Hallucinations that they may not discuss with others
- Unusual speech patterns
- Inability to make friends or maintain friendships
- Poor grooming
The American Academy of Child and Adolescent Psychiatry reports that children with schizophrenia may change slowly over time, moving from vibrancy into moodiness and despair. It might be easy enough for parents to misinterpret the symptoms of schizophrenia as changes that are common with adolescence, and they might hope that their children will “grow out of it.” Slow changes like this are just easy to find another explanation for, and they’re easy to disregard.
At times, parents are in the right to overlook the changes they see in their children. According to an article in the journal Clinical Psychology Review, about 50 percent of children who do not have schizophrenia will present with symptoms that could be interpreted as harbingers of the disorder.
These teens might seem lazy, grandiose or convinced of their powers. Adolescence can be a strange time for the mind, and only a qualified therapist can truly separate thinking that’s part of a disorder from thinking that’s normal in adolescence.
A Changing Mind
During adolescence, the brain is adding myelin to insulate the electrical connections in the brain and ensure that a message can move swiftly from one brain cell to another. In addition, cells in the prefrontal cortex are being rewired, and sometimes, they’re taken offline altogether while the growth process moves forward. According to research profiled in Nature, experts believe that this growth process can sometimes go astray during adolescence, making poor connections or fewer connections altogether. It’s unclear why these errors take place, but it is clear that people with schizophrenia seem to have brain cells that are radically different from brain cells seen in people who don’t have schizophrenia.
This same growth and wiring process could make an adolescent more likely to develop an addiction after dabbling in drug abuse. When parts of the brain aren’t working properly, compulsive behavior can take hold. It’s hard for teens to think clearly and make good decisions about the future, so the pleasure drugs bring in the moment might seem all the more attractive. Additionally, a rewiring mind might be more responsive to the pleasure boost of drugs, and an addiction could quickly follow as a result.
It’s clear that adolescence is a dangerous time both for addiction and for schizophrenia, but the two conditions are intertwined in an even more profound way, as some drugs seem to bring schizophrenia to the surface.
Marijuana, in particular, has been found to bring about symptoms of schizophrenia in people who have a predisposition to the disease. In one study of the link, published in the journal Schizophrenia Research, the lifetime risk of a psychiatric disorder was estimated among the relatives of someone who had both schizophrenia and marijuana abuse issues. Among those relatives, 7 percent were at risk for schizophrenia, compared to 0.7 percent of the people who didn’t have these factors in their family history. The researchers suggest that psychosis among people who abuse marijuana is directly tied to a genetic disposition to schizophrenia, and they suggest the drug is dangerous for people with this family history.
Unfortunately, marijuana, tobacco and alcohol abuse all seem to be popular among people who have schizophrenia, and their risk of addiction is higher than the risk seen in the general population.
For example, an article in the American Journal of Psychiatry suggests that about half of people who have schizophrenia also have some kind of substance abuse disorder. It’s possible that the impulsivity that comes with schizophrenia could tempt people to use drugs, even when those drugs aren’t good for them, but it’s also possible that addiction seems to calm the symptoms of schizophrenia, bringing a type of relief. People might feel calmer, soothed and capable while under the influence, and this might be attractive to people who have schizophrenia.
When to Step In
As mentioned, symptoms of schizophrenia can be mild in teens, and it’s common for those symptoms to go by unnoticed. According to an article in Advances in Psychiatric Treatment, about 65 percent of teens had a slow onset of symptoms lasting more than six months. It’s never a bad idea, however, to take a teen in for a psychiatric evaluation if symptoms seem unusual, strange or new.
Parents might make an appointment for an evaluation if they see:
- Declines in grades or sports performance
- Flattened emotions
- Strange movements
- Symptoms of paranoia or delusional thinking, even if they can be explained in another way
Teens who are abusing substances should also go through a formal mental health screening, just to ensure that schizophrenia isn’t lying at the root of abuse or addiction. Teens often turn to drugs when their mental health declines, so it’s a link that can’t be ignored.
Medications can be quite helpful for people who have schizophrenia, correcting the imbalances in the mind and allowing the person to feel calmer and much more in control. Medication management can be tricky, however, as the dosing can vary dramatically from person to person and some medications cause side effects that people find distasteful. At the beginning of the treatment process, doctors might use different types of medications at differing dosages, experimenting until the person feels no symptoms of schizophrenia and doesn’t feel hampered by side effects. Once the medication has taken hold and the person feels well enough to participate, therapy can begin.
Psychosocial treatment can help people learn how to manage their illness, making informed decisions about how they handle their symptoms and move forward with their lives. Teens might learn how to spot the signs of a relapse to disordered thinking, for example, allowing them to ask for additional help when times get tough. Teens might also learn how to build up a healthy life through diet, exercise and regular sleep patterns, and this might allow them to avoid a relapse to schizophrenia symptoms in the future. The condition can’t be cured, but it can be kept under control if teens learn how to spot the signs and participate fully in their care.
Substance abuse therapies take place at the same time, providing the teen with a full complement of therapies to help him/her deal with all of the issues taking place. Drug abuse counseling might help the teen to understand how substances make schizophrenia worse, and counselors might help teens to identify the situations in which they’re more likely to revert to drug abuse. When teens can name their weak spots, they can learn how to avoid them or deal with them. This can be an important therapy for people with co-existing substance abuse along with schizophrenia.
Schizophrenia is often treated on an inpatient basis, meaning that the person lives in a dedicated facility for care until he/she is well enough to return home once more. Parents might participate in therapy right alongside their children, learning about schizophrenia and addiction, and how they might help their children to succeed in the world when therapy is complete. This intensive family therapy can help the group work together to keep the teen safe in the future.
At Muir Wood, we help adolescent boys who have addiction issues, and we provide robust mental health screenings to ensure that we’re aware of all the disorders that might be hidden by that substance abuse. We’re adept at working with clients who have schizophrenia, and our counselors use proven methods to help boys learn how to control this chronic condition and move forward with their lives. We even provide life skills training, providing our clients with emotional tools they can use to relate meaningfully to other people. If this program sounds right for your son, please download our admissions packet to find out more.
Borderline Personality Disorder
Some teens develop BPD, and those who do not are at high risk for substance abuse and/or addiction, along with serious complications.