Title: Kevin Leehey M.D. Child, Adolescent, and Adult Psychiatry Board Certified
1Kevin Leehey M.D.Child, Adolescent, and Adult
PsychiatryBoard Certified
2Community of Concern Workshop
- Depression and Self Destructive Behaviors
Kevin Leehey, M.D. 296-4280
3Overview
- 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
4Causes
- 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
5Types of Depression
- Major
- Dysthymic disorder
- Depression NOS
- Bipolar Depression
- Existential or adolescent angst
- Personal and Family History PH, FH
Kevin Leehey, M.D. 296-4280
6Major 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
Kevin Leehey, M.D. 296-4280
7Especially 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
Kevin Leehey, M.D. 296-4280
8Other Forms of Depression
- Dysthymia
- Depresson NOS
- Existential, angst
- Bipolar Depression
- PH and FH
Kevin Leehey, M.D. 296-4280
9Mania while not ones 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
Kevin Leehey, M.D. 296-4280
10Anxiety
- 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
11Stress
- 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
12Co- and Extra-curricular Activities
- studies show
- 10-20 hours a week is best for most teens
- Kids who do lt10 hours and kids who do gt20 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
13Self Destructive Behavior
- Any behavior that hurts you
- Substances
- Eating disorders
- Piercings ? Tattoos?
- The choking game
- Self harm, self mutilation
- Suicide
Kevin Leehey, M.D. 296-4280
14Self 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
Kevin Leehey, M.D. 296-4280
15Suicide
- 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
16Suicide - contd
- 1) Depressed, angry, substances
- 2) the last person youd 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
17How 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
Kevin Leehey, M.D. 296-4280
18How do I help? - contd
- 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
19Therapy 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
Kevin Leehey, M.D. 296-4280
20Medication
- 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
21Medication - contd
- 25 best with therapy alone, 25 best with
medicine alone, 50 best with combination for
Major Depression or severe Anxiety - SRIs, buproprion, SNRIs, etc.
- Bipolar disorder usually requires medicine
- Omega 3 (and 6) FAs, supplements, vitamins,
diet, exercise, other
Kevin Leehey, M.D. 296-4280
22Good night and good luck!
- Kevin Leehey M.D.
- 296-4280
- leeheymd.com
Kevin Leehey, M.D. 296-4280