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Kevin Leehey M.D. Child, Adolescent, and Adult Psychiatry Board Certified 296-4280 leeheymd.com 296-4280 leeheymd.com.

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Presentation on theme: "Kevin Leehey M.D. Child, Adolescent, and Adult Psychiatry Board Certified 296-4280 leeheymd.com 296-4280 leeheymd.com."— Presentation transcript:

1 Kevin Leehey M.D. Child, Adolescent, and Adult Psychiatry Board Certified 296-4280 leeheymd.com 296-4280 leeheymd.com

2 Community of Concern Workshop  Depression and Self Destructive Behaviors Kevin Leehey, M.D. 296-4280

3 Overview  What causes depression, anxiety, and self harm?  What is Depression ?  What is Anxiety ?  What is stress?  What is self destructive behavior ?  How do I help my teen ?  What causes depression, anxiety, and self harm?  What is Depression ?  What is Anxiety ?  What is stress?  What is self destructive behavior ?  How do I help my teen ? Kevin Leehey, M.D. 296-4280

4 Causes  Genetics  Life events, losses, environment, disappointments  “Stress” - personal, family, peers, societal pressures  Alcohol and other drugs  Health problems  ADD, ADHD, Learning Disorders  “Nature vs Nurture” - genes or experiences  Genetics  Life events, losses, environment, disappointments  “Stress” - personal, family, peers, societal pressures  Alcohol and other drugs  Health problems  ADD, ADHD, Learning Disorders  “Nature vs Nurture” - genes or experiences Kevin Leehey, M.D. 296-4280

5 Types of Depression  Major  Dysthymic disorder  Depression NOS  Bipolar Depression  Existential or adolescent angst  Personal and Family History PH, FH  Major  Dysthymic disorder  Depression NOS  Bipolar Depression  Existential or adolescent angst  Personal and Family History PH, FH Kevin Leehey, M.D. 296-4280

6 Major Depression : for diagnosis 5 of below for at least 2 weeks  Sad, mad, down most of every day  Anhedonia - loss of interest, withdrawal  Fatigue, loss of energy  Sleep change - up or down  Appetite change - up or down  Feel worthless, hopeless, guilt, negative  Agitation or slowed movements and thoughts  Decreased concentration and ability to think, or decide  Recurrent thoughts of death or suicide  Sad, mad, down most of every day  Anhedonia - loss of interest, withdrawal  Fatigue, loss of energy  Sleep change - up or down  Appetite change - up or down  Feel worthless, hopeless, guilt, negative  Agitation or slowed movements and thoughts  Decreased concentration and ability to think, or decide  Recurrent thoughts of death or suicide Kevin Leehey, M.D. 296-4280

7 Especially common in depressed teens :  Irritable, cranky, negative  Withdrawal, isolation  Change or avoid friends  Drop in school performance  Quit or fail to follow through with activities, jobs, etc.  Substance abuse  Anxiety, worry about the future, hopeless, no longer trying, loss of motivation  Irritable, cranky, negative  Withdrawal, isolation  Change or avoid friends  Drop in school performance  Quit or fail to follow through with activities, jobs, etc.  Substance abuse  Anxiety, worry about the future, hopeless, no longer trying, loss of motivation Kevin Leehey, M.D. 296-4280

8 Other Forms of Depression  Dysthymia  Depresson NOS  Existential, “angst”  Bipolar Depression  PH and FH  Dysthymia  Depresson NOS  Existential, “angst”  Bipolar Depression  PH and FH Kevin Leehey, M.D. 296-4280

9 Mania: while not one’s usual self for at least a week, a marked change  Elevated, expansive, irritable, temper  Inflated self esteem, grandiosity  Markedly decreased need for eating or sleeping  Pressured speech  Racing thoughts  Flight of ideas  Loss of judgement, spend, sex, illegal, pleasure seek, substance abuse, gamble, unwise business ventures  Agitation  Distractible  Psychosis can occur  Elevated, expansive, irritable, temper  Inflated self esteem, grandiosity  Markedly decreased need for eating or sleeping  Pressured speech  Racing thoughts  Flight of ideas  Loss of judgement, spend, sex, illegal, pleasure seek, substance abuse, gamble, unwise business ventures  Agitation  Distractible  Psychosis can occur Kevin Leehey, M.D. 296-4280

10 Anxiety  Excessive worry, fear, nervous  Generalized Anxiety Disorder, GAD  Panic, “anxiety attack”  Separation anxiety, school anxiety  Social anxiety  Obsessive Compulsive Disorder, OCD  O/C style, perfectionism  Over-sensitive,over-reactive, control  PH and Family history  Excessive worry, fear, nervous  Generalized Anxiety Disorder, GAD  Panic, “anxiety attack”  Separation anxiety, school anxiety  Social anxiety  Obsessive Compulsive Disorder, OCD  O/C style, perfectionism  Over-sensitive,over-reactive, control  PH and Family history Kevin Leehey, M.D. 296-4280

11 Stress  Forces from the outside (or inside) that impinge, affect, or impact us.  Mild to moderate stress can promote growth. Severe, sudden, or chronic stress cause biologic damage resulting in physical and emotional damage, disease.  Trying to do too much too fast, pressure to grow up, achieve, excel  Positive coping  Negative coping  Forces from the outside (or inside) that impinge, affect, or impact us.  Mild to moderate stress can promote growth. Severe, sudden, or chronic stress cause biologic damage resulting in physical and emotional damage, disease.  Trying to do too much too fast, pressure to grow up, achieve, excel  Positive coping  Negative coping Kevin Leehey, M.D. 296-4280

12 Co- and Extra-curricular Activities  studies show :  10-20 hours a week is best for most teens  Kids who do 20 hours do less well in school  Sports, clubs, music, job, youth groups, 4H, horses, volunteer, martial arts, etc.  learn a skill, develop a hobby, make new friends, build self esteem, manage time, get experience, build a resume, find a mentor, have positive fun  studies show :  10-20 hours a week is best for most teens  Kids who do 20 hours do less well in school  Sports, clubs, music, job, youth groups, 4H, horses, volunteer, martial arts, etc.  learn a skill, develop a hobby, make new friends, build self esteem, manage time, get experience, build a resume, find a mentor, have positive fun Kevin Leehey, M.D. 296-4280

13 Self Destructive Behavior  Any behavior that hurts you  Substances  Eating disorders  Piercings ? Tattoos?  The “choking game”  Self harm, self mutilation  Suicide  Any behavior that hurts you  Substances  Eating disorders  Piercings ? Tattoos?  The “choking game”  Self harm, self mutilation  Suicide Kevin Leehey, M.D. 296-4280

14 Self Harm  Cut, scratch, burn, mutilate  Trendy, myspace, “community”, “emo”  Arms and more  Mild to severe  To release feelings physically; to convert emotional pain into physical  Usually not suicide intent  Cut, scratch, burn, mutilate  Trendy, myspace, “community”, “emo”  Arms and more  Mild to severe  To release feelings physically; to convert emotional pain into physical  Usually not suicide intent Kevin Leehey, M.D. 296-4280

15 Suicide  “accidental”, uncertain intent, ambivalent, passive, nihilism  Ideation, plan, intent, act  #2 to 3 cause of death age 15-24  Firearms 80% in boys; 50% girls  Overdoses, hanging, “accidents”  Arizona in worst 5  “survivors”, the suffering of those left  “accidental”, uncertain intent, ambivalent, passive, nihilism  Ideation, plan, intent, act  #2 to 3 cause of death age 15-24  Firearms 80% in boys; 50% girls  Overdoses, hanging, “accidents”  Arizona in worst 5  “survivors”, the suffering of those left Kevin Leehey, M.D. 296-4280

16 Suicide - cont’d  1) Depressed, angry, substances  2) “the last person you’d ever expect”  3) Eating Disorders especially Bulimia  4) Psychosis or severe mental illness  Disciplinary Crisis  Connectedness, support system  Lethality of method and intent  Rate dropped 25 % in last decade  Prevention, treatment  1) Depressed, angry, substances  2) “the last person you’d ever expect”  3) Eating Disorders especially Bulimia  4) Psychosis or severe mental illness  Disciplinary Crisis  Connectedness, support system  Lethality of method and intent  Rate dropped 25 % in last decade  Prevention, treatment Kevin Leehey, M.D. 296-4280

17 How do I help my Teen?  Model healthy living and coping  Reasonable expectations  Be present, involved, and caring  Avoid over-control and intrusion  Focus on developing the life skills your teen will need for happy independence  Encourage but limit electronics  Use the Community of Concern  Model healthy living and coping  Reasonable expectations  Be present, involved, and caring  Avoid over-control and intrusion  Focus on developing the life skills your teen will need for happy independence  Encourage but limit electronics  Use the Community of Concern Kevin Leehey, M.D. 296-4280

18 How do I help? - cont’d  Teach or provide “teacher” of healthy coping skills, stress mgmt, values, spirituality, self esteem, goals  The “relaxation response”  Motor vehicles, firearms, substances  Parenting books  Therapy and counseling  Medication  Teach or provide “teacher” of healthy coping skills, stress mgmt, values, spirituality, self esteem, goals  The “relaxation response”  Motor vehicles, firearms, substances  Parenting books  Therapy and counseling  Medication Kevin Leehey, M.D. 296-4280

19 Therapy and Counseling  Individual therapy- Cognitive Behavioral (CBT), Behavior Management, Interpersonal, Psychodynamic, Psycho-education  Family therapy- Family system, Structural, Parenting, Psycho-education  Intensive Outpatient Programs  Residential Treatment  Inpatient Hospitalization  Individual therapy- Cognitive Behavioral (CBT), Behavior Management, Interpersonal, Psychodynamic, Psycho-education  Family therapy- Family system, Structural, Parenting, Psycho-education  Intensive Outpatient Programs  Residential Treatment  Inpatient Hospitalization Kevin Leehey, M.D. 296-4280

20 Medication  Safety - carefully prescribed and monitored the safety record is excellent  The more “biologic” signs that are present the more likely medicine will help and is needed  The more severe the anxiety or depression  The stronger the family and personal history  If therapy is not enough, not effective, refused, or if medication is preferred  Safety - carefully prescribed and monitored the safety record is excellent  The more “biologic” signs that are present the more likely medicine will help and is needed  The more severe the anxiety or depression  The stronger the family and personal history  If therapy is not enough, not effective, refused, or if medication is preferred Kevin Leehey, M.D. 296-4280

21 Medication - cont’d  25% best with therapy alone, 25% best with medicine alone, 50% best with combination for Major Depression or severe Anxiety  SRI’s, buproprion, SNRI’s, etc.  Bipolar disorder usually requires medicine  Omega 3 (and 6) FA’s, supplements, vitamins, diet, exercise, other  25% best with therapy alone, 25% best with medicine alone, 50% best with combination for Major Depression or severe Anxiety  SRI’s, buproprion, SNRI’s, etc.  Bipolar disorder usually requires medicine  Omega 3 (and 6) FA’s, supplements, vitamins, diet, exercise, other Kevin Leehey, M.D. 296-4280

22 Good night and good luck!  Kevin Leehey M.D.  296-4280  leeheymd.com  Kevin Leehey M.D.  296-4280  leeheymd.com Kevin Leehey, M.D. 296-4280


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