Section 1. Focus On ISSUES

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1 Section 1 Mental Disorders Objectives Before class begins, write the objectives on the board. Have students copy the objectives into their notebooks at the start of class. 1. Focus Warm-Up Quick Quiz Use the clickers to survey student responses. Give students several minutes to read the choices and select their responses. Then ask students to prepare their written explanations for each answer. Call on volunteers to share their responses with the class. Teaching Transparency W12 Section 1 Objectives Explain how mental disorders are recognized. Identify four causes of mental disorders. Describe five types of anxiety disorders and four other types of mental disorders. Vocabulary mental disorder anxiety anxiety disorder phobia obsession compulsion mood disorder depression schizophrenia personality disorder 82 Chapter 4 Mental Disorders Quick Quiz Which of the following statements are always true? Which are sometimes true? Which are always false? It is easy to identify a person with a mental disorder. Mental disorders are caused by emotional problems. Mental disorders affect a person s ability to function. People who have a mental disorder are dangerous. For each of your responses, explain why you gave the answer you did. What Are Mental Disorders? A mental disorder is an illness that affects the mind and reduces a person s ability to function, to adjust to change, or to get along with others. For example, a mental disorder could affect a person s ability to study, keep a job, or make friends. Recognizing Mental Disorders Some behaviors fall outside the broad range of normal behaviors. For example, it is normal to wash your hands before eating. But it isn t normal to keep washing your hands when they are already clean. If behaviors, feelings, or thoughts are highly unusual and not appropriate to a situation, they are considered abnormal. Mental health experts see abnormal thoughts, feelings, or behaviors as signs, or symptoms, of a mental disorder. The distress that people who have mental disorders experience affects their ability to function. Figure 1 lists symptoms of attention-deficit/hyperactivity disorder or ADHD. ADHD usually appears in childhood. A person with ADHD often has difficulty in school, at home, and in social settings. When ADHD is treated with medication, the results may be immediate and dramatic. Remember, just because someone has trouble sitting still or paying attention from time to time, it doesn t mean that person has ADHD. The symptoms must be frequent and affect the person s ability to function. Sensitive Issues It is likely that some of your students are being treated for mental disorders. Avoid using labels such as schizophrenic. Use a person with schizophrenia or a person who has schizophrenia instead. Focus On ISSUES L3 Overdiagnosis of ADHD Mental health professionals disagree on the reason for the rapid increase in ADHD diagnoses. Some think the diagnosis is overused, especially for boys, who make up percent of ADHD cases. They argue that many of these children are just normal, active children. Others argue that the rapid growth in diagnosed cases is due to increased recognition of the disorder by parents, educators, and psychologists. Still others argue that ADHD is an underdiagnosed disorder. 82 Chapter 4

2 Signs of Attention Deficit Doesn t pay attention to details Makes careless mistakes Does not seem to listen Is disorganized Forgets to do daily activities Is easily distracted Has difficulty following instructions Causes of Mental Disorders Researchers have made progress on figuring out what causes mental disorders, but there is still much to learn. Sometimes a mental disorder has a single cause. But more often a combination of factors are involved. Physical factors, heredity, early experiences, and recent experiences can cause mental disorders. Physical Factors Damage to the brain may cause a mental disorder. The damage could be caused by a growth, or tumor, in the brain; an injury to the brain; or an infection that destroys brain cells. Exposure to a poison such as lead, or prolonged use of alcohol or other drugs can also damage the brain. Heredity A person may inherit a tendency toward a mental disorder. This doesn t mean the person will necessarily have the disorder. It only means that the person is at greater risk if events in his or her life act as a trigger for the disorder. Early Experiences Extremely negative experiences that occur early in life can lead to mental illness. For example, a child who is neglected or a child who is abused may develop a mental disorder. Recent Experiences Some mental health experts think that recent experiences are more likely than early experiences to trigger a mental disorder. An example would be the death of a loved one. Connect to YOUR LIFE How would having ADHD affect someone s ability to study? Signs of Hyperactivity Fidgets or squirms while seated Has trouble staying in seat Frequently runs about or climbs Has trouble working quietly Talks excessively Has trouble waiting or taking turns Interrupts others FIGURE 1 Some people with ADHD display the entire range of symptoms. Others mainly show signs of attention deficit or hyperactivity. Mental Disorders and Suicide Teach L3 L2 EL Reading/Note Taking 4-1 Adapted Reading/Note Taking 4-1 What Are Mental Disorders? L2 Visual Learning: Figure 1 As a class, make a list on the board of expectations teachers have for student behavior in a classroom. Explain that those expectations could be considered a norm, or standard, against which any given student s behavior is measured. Then, ask students to look at the signs for hyperactivity in Figure 1. Discuss how these behaviors would make it difficult for a student to function in most classrooms and how they might affect a student s ability to get along with others. L3 Addressing Misconceptions Causes of Mental Disorders Students may think that having a mental disorder is a sign of weakness or bad character. Review the causes of mental disorders listed in the text. Then ask students how much control they think a person has over those causes. Explain that, given the causes, one could argue that people have less control over the development of most mental disorders than they have over the development of most physical disorders, for which there are often risk factors related to behavior. L2 Cooperative Learning Have students work with a partner to make a concept map that organizes the information about the four listed causes of mental disorders. Make sure students understand that mental disorders can be caused by a combination of factors. L4 Gifted and Talented Researchers continue to explore the effect of neurotransmitters the molecules that transmit messages between neurons on mental disorders. Some examples include serotonin, GABA, and dopamine. Because neurotransmitters have multiple functions in the body, it is difficult to pinpoint their role in mental disorders. Many drugs used to treat mental disorders act by decreasing or increasing the level of neurotransmitters, or inhibiting their effect on specific neurons. Have students collect and annotate articles from newspapers or online news sites about the latest research on neurotransmitters and mental disorders. Display the annotated articles in class. Connect to Sample answer: ADHD would YOUR LIFE make it difficult for a person to focus on studying, especially for long periods of time. Mental Disorders and Suicide 83

3 Chapter 4, Section 1 FIGURE 2 About 12 percent of Americans are affected by Anxiety Disorders phobias at some point in their lives. Predicting Which of L3 these phobias might interfere with normal, everyday activities? Arachnophobia fear of spiders Aviophobia fear of flying Class Discussion Remind students that fear is a helpful emotion when it encourages people to practice healthful behaviors such as wearing a seat belt. Fear is a harmful emotion when it is an overreaction to a threat, whether real or imagined. L1 Visual Learning: Figure 2 Pronounce the name of each phobia in Figure 2. Explain that the suffix phobia means fear of. Make sure students understand the difference between a dislike and a phobia. (Phobias affect a person s ability to function.) Call on students to answer the caption question. Caption Answer: Sample answer: The phobias most likely to interfere with everyday activities are agoraphobia and claustrophobia. EL Building Vocabulary If students are having trouble with the term panic attack, you might want to discuss the term panic button. People say Don t push the panic button when they think someone might overreact to a situation and do something foolish. Connect to Allow students to answer YOUR LIFE this question in their private journals. 84 Chapter 4 Acrophobia Agoraphobia Claustrophobia Ophidiophobia Common Phobias Phobias fear of high places fear of open or public places fear of small, closed-in places fear of snakes Anxiety Disorders Have you ever been extremely afraid in a situation even though you knew the actual threat did not justify such an intense response? Have you ever been fearful without knowing why? If so, you have experienced anxiety. Anxiety (ang ZY ih tee) is fear caused by a source you cannot identify or a source that doesn t pose as much threat as you think. Everyone experiences anxiety now and then. For example, you may feel anxious before a final exam, a school dance, or tryouts for the wrestling team. These feelings are normal and usually short-lived. When the anxiety persists for a long time and interferes with daily living, this is a sign of an anxiety disorder. About 13 percent of children and teens age 9 to 17 will have an anxiety disorder. Examples of these disorders are generalized anxiety disorder, phobias, panic attacks, obsessivecompulsive disorders, and post-traumatic stress disorder. Generalized Anxiety Disorder A person with this disorder displays intense worry, fears, or anxiety most days for at least six months. These thoughts and emotions do not have a single specific source. They occur in many different situations. Many of the warning signs of stress can also be signs of this disorder, including irritability, muscle tension, trouble falling asleep, and trouble concentrating. Phobias Martin was on his way to visit his grandparents. As he walked toward the elevator in their building, he began to feel dizzy and nauseous. His heart began to pound, and he had trouble catching his breath. He knew he could not face getting into the elevator, so he climbed three flights of stairs instead. Martin has a fear of small, closed-in places, such as an elevator. Anxiety that is related to a specific situation or object is called a phobia (FOH bee uh). Martin s phobia is called claustrophobia. Figure 2 lists some common phobias. Connect to YOUR LIFE Do you have a phobia that you are aware of? If so, how do you deal with your phobia? 84 Chapter 4 TEENS Are Asking... Q: I worry about getting into college, making the team, and having time to work at my job. Do I have an anxiety disorder? A: Typical teens have a lot to worry about. In fact, a bit of worry or anxiety can help you to get motivated to perform tasks such as studying. Short-term anxiety brought on by a particular situation is perfectly normal. However, anxiety that interferes with daily life and lasts for a long time period is a sign of an anxiety disorder. If you are concerned, you should discuss your anxiety with a parent, guardian, or other trusted adult. The school counselor or nurse can also help you to deal with your anxiety.

4 Panic Attacks Brianna was standing in line at the movies. Suddenly, for no apparent reason, she felt intense fear and a strong desire to leave the theater. Brianna was having a panic attack. During a panic attack, a person will experience some of the following symptoms. fast heart rate choking sensation rapid breathing chest discomfort or pain fear of suffocation nausea or stomach distress believes he or she is dying dizziness or lightheadedness sweating fear of losing control trembling or shaking an out of body sensation People who have repeated panic attacks tend to worry about having another. To avoid another attack, they may change their behavior. If, for example, they have attacks in restaurants, they may stop going out to eat. Obsessive-Compulsive Disorder An unwanted thought or image that takes control of the mind is an obsession (ub SESH un). An obsession may lead to a compulsion (kum PUHL shun), an unreasonable need to behave in a certain way to prevent a feared outcome. Repeatedly checking that the stove isn t on or that a door is locked is a compulsion. A person who thinks and acts in such ways has an obsessive-compulsive disorder (OCD). Post-Traumatic Stress Disorder People who survive a lifethreatening event may develop post-traumatic stress disorder. They may have flashbacks or nightmares that produce intense fear or horror. They may be unable to sleep or to concentrate. Because situations that remind them of the event can produce intense anxiety, they begin to avoid those situations. They may feel guilty because they survived and others did not. FIGURE 3 People who witness traumatic events as part of their jobs are at risk for post-traumatic stress disorder. This firefighter witnessed the September 11th attacks in New York City. L2 Active Learning Instruct students to work individually to make a table of information that compares the various types of anxiety disorders. Have students use the following column heads: Disorder, Symptoms, and Effect on Daily Life. Challenge students to make clear distinctions between the disorders. L3 Building Health Skills Analyzing Influences Students may not realize that anyone who experiences or witnesses traumatic events, including children, can develop post-traumatic stress disorder. The event may be a natural disaster, or it may be a violent episode in the home or in the neighborhood. Ask students to think about how such events are covered in the media, especially on television. Have them consider both the initial coverage and the coverage that occurs on the anniversaries of events. Ask students to write a paragraph about how media coverage could effect survivors or witnesses. 85 EL English Language Learners Create a word wall by using a bulletin board or large sheet of poster board. At the beginning of each section, have English language learners help you record the section vocabulary terms on the word wall. As they encounter each term within the text, have a volunteer record its definition on the word wall. At the end of the chapter, use the word wall to review all vocabulary terms. Mental Disorders and Suicide 85

5 Chapter 4, Section 1 Other Mental Disorders L3 Online Activity PHSchool.com Use the Web Code to access an online activity about bipolar disorder. Have students complete the Web activity. L2 Class Discussion After students have read the description of manic-depressive disorder, ask them to distinguish between normal mood shifts and mood shifts that would signify a disorder. (Normal mood shifts occur based on events or situations in a person s life. The shifts experienced by a person with manic-depressive disorder occur for no apparent reason.) Explain that teens often experience rapid, extreme mood shifts. Remind students that this is a normal part of adolescence. L3 Addressing Misconceptions Schizophrenia Students may think that schizophrenia results in split, or multiple, personalities. This is a misconception that is reinforced by the frequent misuse of the term schizophrenia in books and movies. Point out that, although the term schizophrenia does mean split mind, this refers to a split from reality, not a split personality. L4 Building Media Literacy Challenge students to find examples of works of literature or movies that focus on characters with mental disorders. Have students analyze the type of disorder depicted as well as any stereotypes about individuals with mental disorders that are present in the book or movie. Ask students to share their findings with the class. For: More on bipolar disorder Visit: PHSchool.com Web Code: ctd-2041 FIGURE 4 The English artist Louis Wain had schizophrenia. His cat drawings alternated between those that were more realistic and those that were less realistic, or abstract. Other Mental Disorders Young people can have mental disorders other than anxiety disorders. Some teens and young adults have mood disorders or schizophrenia. Others have impulse-control disorders or personality disorders. Mood Disorders People who have a mood disorder experience extreme emotions that make it difficult to function well in their daily lives. Bipolar disorder is an example of a mood disorder. Normally, people have moods that shift from happy to sad, based on what is happening in their lives. People who suffer from bipolar disorder shift from one emotional extreme to another for no apparent reason. Bipolar disorder is also called manic-depressive disorder. During a manic episode, people are usually overly excited and restless. They may talk so rapidly that it is impossible to follow what they are trying to say. They may have difficulty concentrating for long on any one thing. They often show poor judgment. Manic episodes alternate with periods of deep depression. Depression is an emotional state in which a person feels extremely sad and hopeless. In between manic episodes and periods of depression, a person with bipolar disorder may behave normally. Schizophrenia One of the most serious mental disorders is called schizophrenia (skit suh FREE nee uh). It can be identified by severe disturbances in thinking, mood, awareness, and behavior. Schizophrenia means split mind. People with this disorder have minds that are split off or separated from reality. People who have schizophrenia are rarely harmful to others. At times they may even appear normal. At other times, they may talk to themselves, display inappropriate emotional responses, dress and act strangely, and withdraw from others. Sometimes they develop fears that are not supported by reality. They may believe that someone or something controls their thoughts or wants to harm them. 86 Chapter 4 FYI! Development of Schizophrenia There is an explanation for why the onset of schizophrenia occurs in late adolescence or early adulthood. Researchers have identified abnormalities in the brain structure of people who develop schizophrenia. Not everyone who has these abnormalities will develop schizophrenia. Brain damage that occurs during fetal development or at birth increases the risk. The final trigger occurs during adolescence when there is a natural pruning of synapses in the brain to make the brain more efficient. In the brains of people who will develop schizophrenia, too many synapses are pruned. 86 Chapter 4

6 L2 Building Health Skills Communicating Ask students to assume they have a friend who has a problem with gambling on the Internet. Have students form small groups to discuss strategies they could use to communicate their concern. Have each group write a role-play that demonstrates one strategy. Ask groups to perform their role-plays for the class. L3 Building Health Skills Accessing Information Have students research various support groups and other resources available for those with impulse-control disorders. Then, as a class, discuss which resources seem most helpful. Impulse-Control Disorders People with an impulse-control disorder cannot resist the impulse, or drive, to act in a way that is harmful to themselves or to others. You may have heard of people who cannot resist the impulse to take items that they don t need or want. These people have an impulse-control disorder called kleptomania. About 75 million people in the United States cannot control the urge to gamble. Their need to gamble is so great that they will go into debt or even steal in order to continue to gamble. This impulse-control disorder is most common among males. Being able to place a bet on the Internet has contributed to the problem. Plus, poker tournaments on television have made poker more popular among younger people. Uncontrolled gambling among male teens is on the rise. One teen became so addicted to playing poker online that he lost $5000 of his parents money. He then stole another $3500 from a friend s house. Mental health experts may add uncontrolled shopping to the list of impulse-control disorders. For shopping to be classified as uncontrolled, the shoppers must buy many things that they do not need and must know that they don t need these things. The shopping must also interfere with work, school, or family obligations, or cause financial problems. About 85 percent of uncontrolled shoppers are female. Connect to YOUR LIFE Do you know someone with an impulse-control disorder? How does this affect his or her life? FIGURE 5 Some teens spend hours playing poker online or with their friends. A person who cannot resist the urge to gamble has an impulse-control disorder. Connect to Allow students to answer YOUR LIFE this question in their private journals. Mental Disorders and Suicide 87 L1 Special Needs Allow students with special needs to focus on a general definition of the term mental disorder rather than the definitions of specific disorders. Emphasize the effect of mental disorders on a person s ability to function. Ask students to fold a stack of three pieces of notebook paper in half to form a small booklet. Have the students work alone or with a partner to record facts about mental disorders in their booklets. Mental Disorders and Suicide 87

7 Chapter 4, Section 1 3. Assess Evaluate These assignments can help you assess students mastery of the section content. Section 1 Review Answers appear below. Teaching Resources Practice 4-1 Section 4-1 Quiz L2 Reteach Have students use the heads and subheads to review the information about mental disorders presented in this section. Call on students to verbally summarize the characteristics of each disorder. L4 Enrich Teaching Resources Enrich 4-1 Health at School Dealing With ADHD Introduce the activity by having students review the symptoms of ADHD that are listed in this section. If you have students in your class with ADHD, consider how they might respond to this assignment. Some may prefer to avoid the topic. Some may want to act as expert witnesses. FIGURE 6 Just looking at a crowd of people usually won t tell you who has a personality disorder. Section 1 Review Key Ideas and Vocabulary 1. What is a mental disorder? How are mental disorders recognized? 2. List four possible causes of mental disorders. 3. What is an anxiety disorder? What is the key difference between a phobia and generalized anxiety disorder? 4. What is a compulsion? How does a compulsion differ from an obsession? 5. What are some symptoms of a mood disorder? Critical Thinking 6. Relating Cause and Effect Explain how someone who has frequent unexpected panic attacks might develop a phobia. Personality Disorders Recall that your personality determines how you tend to relate to other people. Most people can get along with a variety of people in different situations. Other people are not as flexible. People who have a personality disorder display rigid patterns of behavior that make it difficult for them to get along with others. The many different types of personality disorders fall into three broad groups. Group A: People with personality disorders in this group tend to be cold and distant. They cannot form close relationships. Some may be so absorbed in their own thoughts that they withdraw from reality. Paranoid personality disorder is a Group A disorder. The term paranoid is used to describe someone who is overly suspicious of other people. Group B: People with personality disorders in this group are often overly emotional or unstable. They can be selfish and demanding. They may place a high value on themselves and no value on others. Antisocial personality disorder is a Group B disorder. A person with this disorder may commit violent acts without any sense of guilt. Group C: People with personality disorders in this group often cannot make decisions. They may have a strong need for the approval of others. They may avoid people for fear of rejection. Dependent personality disorder is a Group C disorder. People with this disorder often need help from others to properly care for themselves. Health at School Dealing With ADHD Interview a teacher or guidance counselor at your school. Ask what strategies can help a student with ADHD to succeed in school. How can students help a classmate with ADHD? Write a paragraph summarizing your findings. 7. Classifying Eric spends about six hours a day playing video games. He resents being called away from the computer for supper. He has lost interest in most other activities and his grades are dropping. What type of mental disorder might Eric have? Explain. 88 Chapter 4 88 Chapter 4 Section 1 Review 1. an illness that affects the mind and reduces a person s ability to function; abnormal thoughts, feelings, or behaviors 2. physical factors, heredity, early experiences, recent experiences 3. anxiety that persists and interferes with daily living; a phobia is related to a specific object or situation, generalized anxiety disorder has no specific source 4. an unreasonable need to behave in a certain way; a compulsion involves an action, while an obsession is a thought or image 5. extreme emotions that make it difficult to function 6. They fear situations that trigger attacks. 7. Eric may have an impulse-control disorder; he cannot resist the impulse to play.