Knowing mental health: Eating disorders

Posted on October 27, 2014November 13, 2014 by Aaron Garth

The final week of our mental health month brings us to eating disorders. As youth workers we have seen a marked increase in eating disorders over the past ten years with body image being consistently rated by young people in their top few issues. Approximately 15% of Australian women experience an eating disorder during their lifetime however it is not just an issue for females either. Many young males also deal daily with eating disorders. The mortality rate for people with eating disorders is the highest of all psychiatric illnesses, and over twelve times higher than that for people without eating disorders. Approximately one in twenty Australians has an eating disorder with the rate increasing in the Australian population.

There is a high level of co-morbidity of mental illnesses with eating disorders. Eating disorders are most commonly accompanied by depression and anxiety disorders; however, substance abuse and personality disorders are also highly prevalent in people with eating disorders. In fact, research suggests that approximately 60% of people with an eating disorder will also meet diagnosis for one of these other psychological disorders (Beyondblue, 2014).

Knowing eating disorders

According to the Diagnostic and statistical manual of mental disorders (fifth edition), “eating disorders are characterised by a persistent disturbance of eating or eating-related behaviour that results in the altered consumption or absorption of food and that significantly impairs physical health or psychosocial functioning“. The following diagnoses come under feeding and eating disorders:

Pica
Rumination disorder
Avoidant/restrictive food intake disorder
Anorexia nervosa
Bulimia nervosa; and
Binge eating

Each of these diagnoses, save for Pica, can only be assigned individually to a person in a single clinical episode. Meaning you cannot have a diagnosis of Anorexia nervosa and Bulimia nervosa in the same presentation. This is due to their substantially different clinical course, outcome options, and treatment needs. The diagnostic criteria for these disorders is relatively straight forward however the disorders themselves are quite misunderstood. As youth workers we must have a solid understanding of these disorders so we can break the stigma and provide the most appropriate treatment options and support to our clients.

Aaron Garth

Aaron Garth is the Executive Director of Ultimate Youth Worker. Aaron has worked as a youth worker in a number of settings including local church, street drug and alcohol outreach, family services, residential care, local government and youth homelessness since 2003. Aaron is a regular speaker at camps, retreats, & youth work training events and is a dedicated to seeing a more professional youth sector in Australia. Aaron is a graduate of RMIT University and an alumnus of their youth work program. He lives in Melbourne with his wife Jennifer & their daughters Hope, Zoe, Esther, Niamh and son Ezra.

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Knowing mental health: Depressive disorders

Posted on October 15, 2014May 26, 2020 by Aaron Garth

Depressive Disorders

While each one of us from time to time all feel sad, moody or low, some people experience these feelings intensely, for long periods of time (weeks, months or even years) and sometimes without any apparent reason. Depression is more than just a low mood, it is a disorder which has an impact on both physical and mental health. Adolescence is a critical time for mental health and it is estimated that 75 per cent of adult mental health conditions emerge before a person reaches the age of twenty-five. Around 550,000 young people in Australia aged between sixteen and twenty-five years live with depression or anxiety.

Depression, it can be beaten.

According to the DSM5 the following diagnoses come under depressive disorders:

Disruptive mood dysregulation disorder
Major depressive disorder
Persistent depressive disorder (dysthymia)
Premenstral dysphoric disorder
Substance/medication induced depressive disorder
Depressive disorder due to another medical condition
Unspecified depressive disorder

[Tweet “#UltimateMentalHealth In adolescents #depression is often observable as irritable mood over sad or low mood.”]

Of the above disorders the most common one for youth workers to encounter in their young people is the diagnosis of ‘major depressive disorder‘. It is characterised by discrete episodes of at least two weeks duration (although most episodes last considerably longer) involving clear cut changes in affect, cognition, and neurovegetative functions and inter-episode remissions. While these brain disorders can be diagnosed as one off episodes they are more often recurrent in a majority of cases. In adolescents depression is often observable as irritable mood over sad or low mood.

Major depressive disorder often finds itself in comorbid unity with anxiety in many of our young people. It is important for youth workers to have a good understanding of the diagnosis of depression as the consequence of leaving this disorder without treatment cans be fatal. The severity of the disorder and the persistence of psychotic features and remission status make up the criteria for diagnosis. If the disorder is severe it can lead to suicidality and in turn death.

Aaron Garth

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Knowing mental health: Depression

Posted on October 13, 2014November 13, 2014 by Aaron Garth

Depression can be kicked

Depression

We continue mental health month at Ultimate youth Worker with the most spoken about of brain disorders, Depression. Depression goes by many different names and it stalks people with the skill of a bloodhound. It chases you down in everyday situations and squashes your ability to reach your goals. The most disturbing quality of all is it slowly stops them of life. When we speak of depression as a disorder of the brain we are speaking of the everyday crippling sense that the world is going to squash us that some of us feel that stop us from living our life to the full.

The common feature of all depressive disorders is the presence of sad, empty, or irritable mood, accompanied by somatic (physical) and cognitive (mental) changes that significantly affect the individuals capacity to function. The black dog and its friends spend most of their time making our mood low which in turn makes us physically and mentally feel like we are walking in mud. Our ability to deal with the day to day stresses of life, work productively and fruitfully, and make a contribution to our community becomes limited and if it persists can become a chronic condition.

[Tweet “#UltimateMentalHealth Do you understand depressive disorders in young people? #youthwork”]

The major differences among the depressive disorders are issues of duration (how long the symptoms last for), timing (whats happening for you at the time), or presumed aetiology (the causes, or manner of causation of a condition). Symptoms of depressive disorders can last from two weeks to a number of years. The onset of the symptoms can be a certain time of the month through to a significant bereavement and anything in between.

Major Depressive Disorder

…represents the classic condition known to most of us in this group of disorders. It is characterised by discrete episodes of at least two weeks duration (although most episodes last considerably longer) involving clear cut changes in affect, cognition, and neurovegetative functions and inter-episode remissions. While these brain disorders can be diagnosed as one off episodes they are more often recurrent in a majority of cases.

As youth workers we will work with many young people with depressive disorders. We must have a strong understanding of the diagnostic criteria, treatment options and recovery planning for young people living with depression. We can then support them to make informed decisions about the treatment planning and recovery orientation. We owe it to them to be well informed.

Aaron Garth

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Knowing mental health: Anxiety disorders

Posted on October 7, 2014March 12, 2019 by Aaron Garth

Anxiety is a problem faced by around one in ten young Australians aged 18-25.

For young people aged 13-17, the figure is approximately one in twenty-five. Anxiety is a normal emotion experienced by everyone at some stage. It is an emotional anticipation of future threats. It is often associated with muscle tension and vigilance in preparation for future danger and cautious or avoidant behaviours. Anxiety disorders differ from developmentally normative fear or anxiety by being excessive or persisting. However, Anxiety disorders come when a persons level of anxiety is heightened over an extended period of time beyond developmentally appropriate periods. Anxiety disorders differ from one another in the types of objects or situations that induce fear, anxiety, or avoidance behaviour, and the associated cognitive ideation (American Psychiatric Association, 2013).

What do you know about anxiety?

When our young people gain a diagnosis and tell us that they have anxiety it could be one of a number of disorders which come under this umbrella. According to the DSM5 the following diagnoses come under anxiety disorders:

- Separation anxiety disorder

- Selective mutism

- Specific phobia

- Social anxiety disorder

- Panic disorder

- Agoraphobia

- Generalised anxiety disorder

- Substance/medication induced anxiety disorder

- Anxiety disorder due to another medical condition

- Other specified anxiety disorder
- Unspecified anxiety disorder

[Tweet “14% of females and 8% of males have experienced an anxiety disorder in the last twelve months”]

We aren’t going to go into detail about all of these here (Phew). What we want to give you is an overview. In time we will go into some detail on these disorders.

Approximately twice as many young women are diagnosed with anxiety disorders as males. 14% of females and 8% of males have experienced an anxiety disorder in the last twelve months this is equivalent to around 435,000 young people in Australia every year. This mean we are extremely likely to have clients with an anxiety disorder during our career. Anxiety is the number one mental health issue we will find ourselves working with.

Anxiety disorders often have comorbid disorders alongside them so it is important for us to understand the extent of the issues surrounding an anxiety diagnosis. Get to know the diagnostic criteria for these disorders. Know as much as you can about them. Your young people will thank you for it.

Aaron Garth

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Knowing mental health: Anxiety

Posted on October 4, 2014November 13, 2014 by Aaron Garth

Don’t empty today of its strength

We kick off mental health week with the most prevalent of disorders, Anxiety. Anxiety robs people of their ability to cope with the turmoil of everyday situations. It robs them of the ability to reach their potential. Most of all it robs them of life. When we speak of anxiety as a brain disorder we are not speaking of the everyday anxieties we feel when we have to do something like driving in heavy traffic or speaking in front of a group. We are speaking of the crippling anxieties that some of us feel that stop us from living life to the full.

When our thinking becomes so disordered by anxiety we cannot do even the most basic tasks. We cannot get out of bed, leave the house or even hold a conversation. Our ability to think clearly and rationally is basically gone. Your limbic system takes control and your primal fight or flight instincts kick in. your frontal lobe, the part of the brain that orders rational thought, has been overridden. All the fears and failures you can imagine are now in control of your thought and actions. You are now in a state of complete primal anxiety.

Add to all of this the fact that adolescence is already a time of storm and stress and we have a setting that is ready to ignite. Our young people are already experiencing changes in their brains which they are struggling to deal with and on top of that anxiety is nipping at their heals. Any strength that they had to face the daily challenges of being an adolescent is torn away to deal with their anxieties. Grades, relationships, groups, fears, all of these and more conspire against our young people. They set them up for worry and dread.

As youth workers we often provide a first point of contact for young people to address their anxieties. By developing a trusting relationship where young people can confide in us their fears we can support them to begin a journey of recovery. Understanding the triggers, diagnosis and treatment options available to our young people assists us to guide them through the maze of service provision to find the right support options for them. It gives them back the strength they need to beat their anxiety.

Aaron Garth

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youth workers need to stop mental health stigma

Posted on October 2, 2014November 13, 2014 by Aaron Garth

In my class on mental health I often ask if we are beating back the stigma of mental illness. Students often say no… but after some thought and discussion they often change their mind. “We are beating back the stigma of anxiety, depression and body image” they would say. It is then that I ask them, “What would you do if you were running a youth program and one of the participants had a psychotic break?” Most of the students with fear in their eyes speak about keeping all the other participants safe while seeking help for the one having the break. This leads me to ask what they would do if one of their young people was depressed. No fear here, they would just get alongside the young person. Stigma is still very much at the forefront of challenges for mental health.

I agree with my students, we have made leaps forward. But, we still have a long way to go. While we have made great steps forward in areas such as anxiety and depression; eating disorders, schizophrenia and personality disorders to name a few are still very stigmatised. Much of the stigma still comes from fear. We fear that which we don’t know. When was the last time you saw a schizophrenic portrayed as “normal” in the media. they are always touted as weird, scary or worse. What about people with personality disorders how are they portrayed on film?

As youth workers we believe that young people have enough issues without having to add stigma to the list. However we as much as any member of the general public stigmatise mental illness. We don’t mean to do it, but in our fear we allow our prejudices to come to the fore. Fear comes from our lack of knowledge. As the general public knows very little about mental health so it is with youth workers. Even though our clientele are likely to have mental health issues we do not really study it and unless we spend significant personal resources we will have minimal understanding of brain disorders at best.

We must have an understanding of brain disorders

To stop the stigma of mental illness we must have a solid understanding of the causes, diagnostic criteria, treatment options and recovery options. We need to be better than we are right now. Unfortunately this means going against the grain. I was speaking to an educator recently who believed that because youth workers don’t diagnose we don’t need to know how a diagnosis is formed. It is this antiquated idea of youth work and how we support young people that causes stigma. The same educator could not see why we need to have more than mental health first aid as it is psychologists who will do the work. I mentioned that it was youth workers who often hold the cases and that most psychologists will only give a dozen sessions.

We need to have a better understanding of mental health. It stops the stigma!

Aaron Garth

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