Often times the controversy occurs as to what is normal in terms of adolescent mood and what may fall under the auspice of a mood disorder. This controversy is a very real debate because many adolescents can present as having extreme difficulty, bouts of anxiety or irritability, and/or severe mood swings. But isn’t that what being a teenager is all about? Hormones are raging, bodies are changing, and moods are altering. Sometimes from day to day moods can appear as night and day…and this could all be just a part of normal developmental growth as an adolescent…

Unfortunately, due to this belief, many struffling teens are discounted or not validated, therefore at mood disorder goes undiagnosed and hence untreated.

Research shows that up to 14% of children will have one bought of clinical depression prior to the age of 15. Up to 30% of bipolar patients report having their first episode prior to age 20. These statistics are alarming and certainly give credence to the fact that mood disorders are very real in children and adolescents. Out of 100,000 adolescents, two to three thousand will have mood disorders – out of which 8-10 will commit suicide…definitely a reason to take the subject very seriously.
So the question becomes a matter of differentiating between normal developmental symptoms and/or moods, and those that are out of the ordinary. If you know a teen that is struggling and there is a possibility or a potential for a mood disorder, it is better to take precaution. Always refer to a professional for a thorough assessment of the situation, the symptoms, and the impairments. Professionals that specialize with adolescents would be able to quickly determine whether the stuggles are within developmental limits or whether there is a possible mood disorder. Professionals with minimal experience in adolescent development may misdiagnose, so it is important to refer to a specialist.

Mood disorders can be a manifestation of life’s stressful events for an adolescent, such as a death, parental divorce, a move, loss of friendship, etc. More commonly adolescent mood disorders are retrieved either environmentally or biologically, i.e. one or both parents struggle with a mood disorder. The key is to take a genuine interest in the adolescents around you, whether you work with them in a professional manner, or as a family member. Observe, listen, and believe.

Written by:
Leslie Rae Johnsen, MA, LLP
Clinical Director & Director of Adolescent Services



Many of us working with the adolescent population have come across an individual who struggles to focus, has a hard time sitting still, is easily distracted, can be poorly organized, and seems to have difficulty concentrating on one topic at a time. Working with this type of adolescent can be frustrating and at times as professionals we can feel overwhelmed or exhausted. Therefore it is important that we learn effective strategies and interventions to utilize in order to minimize our frustrations and keep the individual as our focus.

Before we can know what interventions to use with an adolescent struggling with Attention Deficit Disorder we must first get to know the situation and what they are struggling with. What are their symptoms? What areas of life are being affected by their symptoms? What else is going on in the individual’s life? What is it that they need from us as professionals? It is important to learn the adolescent’s unique behaviors and get to know their strengths and weaknesses. As professionals we can build our interventions around the adolescent’s strengths to make fun, obtainable goals. We can then help them to understand what is expected of them and assist them in achieving their own success. Whether the enviornment is at school or at home, creating a positive, reinforcing environment is an essential piece in helping the adolescent work on accomplishing their goals.

An adolescent with Attention Deficit Disorder needs structure to assist them in completing tasks and assignments. As professionals we must take the role of coaching them along and teaching them ways to effectively perform and complete tasks. Evaluate your standard of success for the adolescent you are working with and acknowledge that any progress is good progress. Don’t expect perfection and set realistic goals for yourself as a professional. Be sure that the individual is aware of your expectations and guide them along their path to success.

Written by:  Perspectives of Troy


All of us have encountered the exceptional student: the child who may have a developmental delay, learning disability or medical issue. The child we want to help so much that is also the child that presents such a challenge to us. Think of that child right now… Picture him or her and feel the anxiety it evokes in you. We strive to be ever-nuturing professionals, but we are born to be human. This juxtaposition challenges us to be honest with our own limitations. Compassion fatigue is real and helpers working with exceptional people are especially vulnerable.

Without attending to this fatigue, the children we work with ultimately suffer. Exceptional kids tend to be highly sensitive, which means they are more likely to pick up on non-deliberate displays of discomfort. In other words, compassion fatigue can manifest as impatience or intolerance. Our own unresolved exhaustion could then contribute to the very hurts they are seeking help to alleviate. We must always be aware of any negativity we may harbor that could harm the children we assist, especially the ones labeled “different” in society.

On the contrary, we may sometimes find ourselves more likely to overextend for the exceptional child. We may even feel a sense of pity. These children need compassion but sometimes are crippled by pity, disempowered to potentially perpetuate their disabilities. Bear in mind, we must spend that energy empowering children, rather than reinforcing feelings of helplessness or debility.

Awareness is one of our most powerful tools to combat compassion fatigue, and therefore, properly assist the exceptional child. Being cognizant and honest of our own feelings leads us to a new opportunity for advancement. Education is another key that leads us to greater competency. With competency comes comfort and with comfort comes a more relaxed, effective treatment approach. Finally, be sure to cultivate a strong support network. All helpers need helpers. Evaluate your own needs, whether that means an exercise routine or a weekly dinner with a friend. Find positive supports so that you can continue to be an effective, empathic force in the lives of the people you choose to serve.

Written by: Perspectives of Troy



Eating disorders (ED’s) are on the rise. There are approximately 5-10 million females and 1 million males that presently suffer from eating disordered behavior. In addition, it is estimated that at least 80% of American women are dissatisfied with their size, and 1 in 2 women are on a weight loss regime.

Adolescents see images in the media of drastically this actresses and models and believe that to be the norm, and something to strive for. This is believed to be ‘beautiful’ and ‘good’.

While Anorexia is the eating disorder that tends to gain the most public hype, Binge Eating Disorder is actually the most common disorder of the three types. A typical clinical case that I see consists of a young girl that vacillates within all of the disorders: anorectic behavior (restricting), binging (consuming a vast amount of calories typically in one sitting), and at time bulimia (binge/purge cycle).

However it should be noted, that there really is no ‘typical’ case. ED’s can manifest in a multiplicity of different ways and are often found co-morbidly with other disorders; such as depression, anxiety and substance abuse. Gone are the days where it was assumed that the individual with the eating disorder is a pre-teen or teenaged female. Males that are exhibiting ED behavior is increasing. Adolescent males are presenting with ED’s or ED like behaviors and compulsivity more often. This tends to create what I call the ‘double shame’ factor. Males are more reluctant to engage in treatment, for fear of being judged given the predominant nature of female ED’s and also have the shame of suffering from the disorder.

What causes ED’s to develop?   There are a vast number of theories about what causes ED’s. I have come to the conclusion in my clinical work, that there truly is no easy answer. There is no one “cure”.

What does tend to be present the majority of the time in these cases (whether male or female) is the following:
– The adolescent lacks positive coping skills in their life to tackle stress, depression, and/or anxiety.
– The adolescent closes off their emotions and feelings, and uses (or restricts) food as a means to put a block on any feelings that arise.
– They may have come from a background with mixed messages about food (all or nothing phenomenon).
– They suffer from low self-esteem and there may be an abuse history of some kind.

In terms of treatment, ED’s require a team approach. There must be a primary therapist involved. The therapist aids the client in (as I like to say): ‘figuring out why they do what they do, and then doing something about it’. A dietician can help the individual relearn how to eat properly and to develop a solid meal plan. A primary care physician monitors any coinciding health related issues, and sometimes, even an exercise physiologist is incorporated into treatment to help the person learn what is healthy and balanced exercise and activity versus abusive.

**If you or anyone you know is suffering from an ED (or you even suspect they are), do not wait to get help. Statistics have shown that in about 85% of cases, recovery is possible. If left untreated, the behaviors will get worse, and can prove to be fatal.**

Written by:  Perspectives of Troy