1.  Sleep changes (insomnia to hypersomnia)  Appetite changes (loss of to over eating)  Arousal changes (lethargic to manic)

2.  Emotional Sensitivity (blunted to hyper)  Concentration/attention usually decreases  Academic performance usually decreases (anorexia is usually an exception)

3.  Because many disorders share similar symptoms, it is important to get a professional assessment.  Most conditions respond very well to psychotherapy/ counseling and many also respond well to medications.  A combination of medication and counseling is usually the best option.

4.  Disruption  Feelings  Behavior

5. Family Issues Death, separation, long-term unemployment, illness, abuse, frequent moving, alcohol/drug abuse

6. Peer Relationships Poor peer acceptance, being an outsider, lack of physical development, fear of relationship with opposite sex, bullying, sexual identity issues

7. School Issues  Pressure for good grades  Starting a new school  Failing at a sports team/club

8.  Low Self Esteem  Isolation  Trapped  Withdrawn  Lonely  Depressed  Apathy  Guilt  Fear ◦ Of abuse ◦ Of intolerable conditions

9.  Delinquency  Eating Disorders  Truancy  Drug/Alcohol Use  Running Away  Sexual Activity  Social Withdrawal  Suicide Attempt

10.  Many sources can create the same symptomatic behavior.  The same symptomatic behavior can be a part of multiple diagnoses. For example poor concentration can be caused by ◦ anxiety ◦ depression ◦ PTSD ◦ substance abuse ◦ insomnia

11.  Many behavior signals are typical of “normal adolescent behaviors.”  Diagnosis comes through professional referral.