Week 9: Substance Use

Issue of Teen Nicotine Use

One of the drugs that are most likely to induce chemical dependence in teens is also one of the most accessible: nicotine. Nicotine use is also often a prelude to the abuse of harder drugs, like alcohol or cocaine.

The National Institute on Alcohol Abuse and Alcoholism (NIAAA) notes that a high percentage of teenage smokers also abuse alcohol. In fact, the NIAAA reports that in one study, 80 percent of teens that smoked while they were going through alcohol treatment were still using nicotine four years after they completed rehab.

Among recovering alcoholics, nicotine abuse is seen as a lesser threat, a relatively harmless habit in comparison to alcohol addiction. In reality, tobacco-related illnesses are a leading cause of death among alcoholics going through treatment.

What Makes Nicotine So Dangerous?

One of the greatest dangers of nicotine is its addictive power. In the 1990s, scientists discovered similarities in the way rats’ brains responded to nicotine and cocaine. A study that appeared in Science in 1997 showed that both drugs activate many of the same regions of the brain, inducing the same compulsive behaviors in lab animals.

For teenagers, experimentation can quickly lead to dependence when it comes to nicotine. The British Medical Journal notes that children and teens become tolerant to the effects of nicotine more quickly than adults and that they don’t need to smoke every day in order to become addicted.

Although daily smokers are more likely to experience withdrawal symptoms when they try to give up tobacco, occasional smokers can also experience withdrawal symptoms such as:

•    Severe cravings

•    Anxiety

•    Irritability

•    Headaches

•    Depression

•    Changes in appetite 

Difficulty Concentrating

Prevalence of the Problem

The American Cancer Society (ACS) states that almost 4,000 young people under the age of 18 try smoking for the first time each day.

About one-third of children and teens who smoke will die before their time of cancer, emphysema or another condition related to smoking.

Fortunately, public education and negative social attitudes toward smoking have had a positive effect on young people. The popularity of smoking has declined since the 1990s, and fewer adolescents than ever are picking up cigarettes.

Marijuana is the most common illicit drug used in the United States by teens as well as adults. The growing belief by young people that marijuana is a safe drug may be the result of recent public discussions about medical marijuana and the public debate over the drug’s legal status

·      Some teens believe marijuana cannot be harmful because it is “natural.” But not all natural plants are good for you—take tobacco, for example.

These functions are the ones most affected by marijuana:

·      Learning and memory

·      Coordination

·      Judgment

Effects on health:

•       Increased heart rate

•       Respiratory (lung and breathing) problems

•       Increased risk for mental health problems

•       Increased risk of problems for an unborn baby

Week 8: Bipolar Disorder

Bipolar disorder, formerly called manic depression, causes extreme mood swings that include emotional highs (mania or hypomania) and lows (depression).

There are several types of bipolar and related disorders. For each type, the exact symptoms of bipolar disorder can vary from person to person.

Bipolar I disorder. You've had at least one manic episode. The manic episode may be preceded by or followed by hypomanic or major depressive episodes. Mania symptoms cause significant impairment in your life and may require hospitalization or trigger a break from reality.

Bipolar II disorder. You've had at least one major depressive episode lasting at least two weeks and at least one hypomanic episode lasting at least four days, but you've never had a manic episode. Major depressive episodes or the unpredictable changes in mood and behavior can cause distress or difficulty in areas of your life.

The Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association, lists criteria for diagnosing bipolar and related disorders.

Criteria for a manic or hypomanic episode

•       A manic episode is a distinct period of abnormally and persistently elevated, expansive or irritable mood that lasts at least one week (or less than a week if hospitalization is necessary). The episode includes persistently increased goal-directed activity or energy.

• •      A hypomanic episode is a distinct period of abnormally and persistently elevated, expansive or irritable mood that lasts at least four consecutive days.

Signs and symptoms include:

•   Inflated self-esteem or grandiosity

•   Decreased need for sleep (for example, you feel rested after only three hours of sleep)

•   Unusual talkativeness

•   Racing thoughts

•   Distractibility

•   Increased goal-directed activity (either socially, at work or school, or sexually) or agitation

Doing things that are unusual and that have a high potential for painful consequences — for example, unrestrained buying sprees, sexual indiscretions or foolish business investments

Symptoms in children and teens

The same DSM-5 criteria used to diagnose bipolar disorder in adults are used to diagnose children and teenagers. Children and teens may have distinct major depressive, manic or hypomanic episodes, between which they return to their usual behavior, but that's not always the case. And moods can rapidly shift during acute episodes.

Symptoms of bipolar disorder can be difficult to identify in children and teens. It's often hard to tell whether these are normal ups and downs, the results of stress or trauma, or signs of a mental health problem other than bipolar disorder. And children who have bipolar disorder are frequently also diagnosed with other mental health conditions.

    The most prominent signs of bipolar disorder in children and teenagers may include severe mood swings that are different from their usual mood swings.

The exact cause of bipolar disorder is unknown, but several factors may be involved, such as:

•   Biological differences. People with bipolar disorder appear to have physical changes in their brains. The significance of these changes is still uncertain but may eventually help pinpoint causes.

•   Neurotransmitters. An imbalance in naturally occurring brain chemicals called neurotransmitters seems to play a significant role in bipolar disorder and other mood disorders. 
 Inherited traits. Bipolar disorder is more common in people who have a first-degree relative, such as a sibling or parent, with the condition. Researchers are trying to find genes that may be involved in causing bipolar disorder.

Factors that may increase the risk of developing bipolar disorder or act as a trigger for the first episode include:

•   Having a first-degree relative, such as a parent or sibling, with bipolar disorder

•   Periods of high stress

•   Drug or alcohol abuse

•   Major life changes, such as the death of a loved one or other traumatic experiences

Week 7: OCD

Obsessive-compulsive disorder (OCD) is characterized by unreasonable thoughts and fears (obsessions) that lead you to do repetitive behaviors (compulsions). It's also possible to have only obsessions or only compulsions and still have OCD.

·      OCD usually begins in adolescence or young adulthood and is seen in as many as 1 in 200 children and adolescents.

·      OCD often centers around themes, such as a fear of getting contaminated by germs.

o   Ex: To ease your contamination fears, you may compulsively wash your hands until they're sore and chapped.

Obsessive-compulsive disorder symptoms usually include both obsessions and compulsions. But it's also possible to have only obsession symptoms or only compulsion symptoms (mayoclinic.org).

Obsessions often have themes to them, such as:

•   Fear of contamination or dirt

•   Having things orderly and symmetrical

•   Aggressive or horrific thoughts about harming yourself or others

Examples of obsession signs and symptoms include:

•   Fear of being contaminated by shaking hands etc.

•   Doubts that you've locked the door or turned off the stove

•   Intense stress when objects aren't orderly or facing a certain way

•   Images of hurting yourself or someone else

•   Thoughts about shouting obscenities or acting inappropriately

•   Avoidance of situations that can trigger obsessions, such as shaking hands

•   Distress about unpleasant sexual images repeating in your mind

OCD compulsions are repetitive behaviors that you feel driven to perform. These repetitive behaviors are meant to prevent or reduce anxiety related to your obsessions or prevent something bad from happening.

Examples of compulsion signs and symptoms include:

•   Hand-washing until your skin becomes raw

•   Checking doors repeatedly to make sure they're locked

•   Checking the stove repeatedly to make sure it's off

•   Counting in certain patterns

•   Silently repeating a prayer, word or phrase

Causes

The cause of obsessive-compulsive disorder isn't fully understood. Main theories include:

·         Biology. OCD may be a result of changes in your body's own natural chemistry or brain functions. OCD may also have a genetic component, but specific genes have yet to be identified.

·         Environment. Some environmental factors such as infections are suggested as a trigger for OCD, but more research is needed to be sure.

Factors that may increase the risk of developing or triggering obsessive-compulsive disorder include:

·        Family history. Having parents or other family members with the disorder can increase your risk of developing OCD.

Stressful life events. If you've experienced traumatic or stressful events or you tend to react strongly to stress, your risk may increase. This reaction may, for some reason, trigger the intrusive thoughts, rituals and emotional distress characteristic of OCD.