Emotional & behavioral disorders, 2

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By Rose Jessica Octaviano

A Sound Mind

Tuesday, July 8, 2014


TWO weeks ago, the Philippine Mental Health Association (PMHA) Bacolod-Negros Occidental Chapter turned 38 on June 25. We continue to grow with the support of our benefactors, members, volunteers, staff and friends. We are very grateful to all of you.

PMHA would like to thank L' Fisher Hotel, MediChem Pharmaceuticals, Metro Inn Hotel, Atty. John Orola, Councilor Caesar Distrito, Carl Balita Review Center and EFO Consultancy, Octaviano family, Shirley Maghari of Manulife Philippines, Councilor Jocelle Batapa-Sigue, Butchok's, Dr. Cecille Tolosa, USLS-Guidance and Evaluation Center, Carl, Gee and Therese Benares and Grace de Guzman.

Our main activity for the anniversary was organizing a lecture forum titled, "Sad, Mad, Glad: How Emotions Affect Children's Behavior." The resource speaker was Dr. Cornelio Banaag, Jr., PMHA national president and considered as the "father of child psychiatry in the Philippines."

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A thanksgiving Mass and agape lunch commemorated the 38th founding day attended by the PMHA board of directors (past and present), members, volunteers and staff. The Mass was celebrated by Fr. Ronald Quijano, PMHA auditor.

Last week, I shared about Dr. Banaag's talk. He discussed about the different emotional and behavioral disorders. He divided them into two - the externalizing disorders and the internalizing disorders.

The types of externalizing disorders are attention deficit hyperactivity disorder (ADHD), conduct disorder and oppositional defiant disorders.

The internalizing disorders are:

1. Anxiety Disorder
2. Depressive Disorder
3. Bipolar Disorder

The markers for internalizing disorders are:

Withdrawn, avoids social contacts
Daydreams a lot
Fearful of things without reason
Frequent bodily complaints
Depressed, sad
Serious impediments or block to normal development

The signs and symptoms of internalizing disorders are:

1. Anxiety disorder

Persistent, excessive worry and anxiety at home, in school, in community Excessive worry separating from home/caregiver
School refusal
Following traumatic event (abuse experience, disaster)
For older children: anxiety, panic
For infants: disorder sleep, excessive startle, cries on separation
Obsessive-compulsive behavior - hand-washing, checking doors
Extreme shyness - social phobia
Somatic symptoms with no organic reasons (headache, vomiting, recurrent abdominal pain (or RAP)
Interventions
Counseling, reassurance, psychoeducation for patients, parents
Early referral to specialist

2. Depressive disorder

Continuous feelings of sadness, hopelessness
Irritability, temper tantrums, crying outbursts
Somatic complaints: head/stomach aches
Losing interest in things previously enjoyed
Low self-esteem, low self-worth
Suicidal ideas
Declining grades in school
Withdraws socially

3. Bipolar disorder

Remarkably increasing in prevalence in past decade
Difficult to diagnose in pre-pubertal children
Mixed episodes
Adolescents more easy to diagnose
Labile mood: Swinging from depression to mania
Mania presentation
Euphoria: dancing at home after being expelled from school
Grandiosity: I will be president of the Philippines; telling principal to fire a teacher for incompetence
Intense anger/rage lasting for hours
Decreased need for sleep: I don't need sleep, so many things I have to do
Racing thoughts, ideas
Incessant talking

Dr. Banaag stressed that bipolar disorder is hard to diagnose in children. He said that sometimes the symptoms are sometimes similar to disruptive behavior disorder. This disorder may likely co-exists with other disorders like ADHD or oppositional defiant disorder or conduct disorder

Disruptive behavior disorder

Antisocial behavior
Sociopathic tenancies that cause serious harm to others
Often loses temper with others
Argues with adults
Actively defies or refuses to comply with requests or rules
Blames others for his or her mistakes
Deliberately annoys other people
Aggressive and cruel toward people and animals
Deliberately intimidates other people
Makes deliberate attempts to annoy others
Bullying
Revenge-seeking behavior
Lying, stealing, conniving
Willful destruction of property
Decreased problem-solving skills
Physically, emotionally, or sexually abusing others
Child frightens and alienates friends, family, and peers
Intensely rigid and touchy
Lack of remorse
Loneliness
Anger
Spitefulness
Vindictiveness
Resentfulness
Feeling as though they have nothing lose by engaging in illegal or dangerous behavior

Parents are encouraged to bring their children to a professional when these symptoms persist. There is nothing wrong if your child has these disorders. It is not your fault, it is nothing to be ashamed of.

Published in the Sun.Star Bacolod newspaper on July 08, 2014.

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