Juvenile-HD

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SECTION 1 - AT RISK
Age & Probability Chart
At Risk For HD-What Next?
At-Risk Checklist
Best Interest of Child?
Crystal Ball?
Food For Thought
Parent Hasn't Tested?
Q&A On Risk of Inheriting JHD
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SECTION 2 - GENETIC TESTING
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Intro: Genetics/Genetic Testing
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Prenatal Testing-In General
o Genetic Testing Resources
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SECTION 3 - JHD
Coping With The Early Years
Age of HD Appearance
Age of Onset-Historical
Family-HD Underestimated
Children of Parents With HD
Child~Parent Ill
Clinical Description JHD
HD - What Kids Are Saying
HD & Me
JHD-Duration of Illness
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JHD Symptoms
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Talking With Children About HD
5 Stages of HD
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SECTION 4 - SYMPTOM RECOGNITION
Parent Resources
8 Fears of A Chronic Illness
Anxiety/Apathy/Irritability~HD
Anxiety, Fears & Phobias
Apathy-Physician's Guide
Ataxia
Attention-Perceptual/Unawareness Physician's Guide
Bed/Pressure Sores
Bed/Pressure Ulcer Guideline
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Bradykinesia
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Chorea
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Contractures~Joints Locking
Dehydration-Physician's Guide
Dehydration
Delirium
Denial of HD
Depression~Physician's Guide
Depression-Understanding It
Depression-How To Help
Depression - Treatment Resistant Patient
Depression-Other Resources
-Read If Your Child Is On Antidepressant
Disgust - Impaired Recognition in HD
Dissociative disorders
Driving - Physician's Guide
Dyslexia
Dyslexia Resources
Dystonia
Dystonia/Rigidity & Spasticity Physician's Guide
Dystonia-Predominant Adult-Onset HD
Epileptic Seizures and Epilepsy
Epilepsy-Seizures~PG
-Seizures ~Special Populations
Falling~Safety
Falling - Subdural Hematoma Risk
Fevers - Unexplained
Fevers, sweating & menstural cycles in HD
GERD (Stomach)
HD Principle Treatments
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Hand muscle reflexes in HD
Hypothalamus - A Personal Theory
Insomia ~Physician's Guide
Irritability~Temper Outburst Physician's Guide
Learning Disability
Mania/OCD~Physician's Guide
Mood Disorder Rate In HD
Myoclonus (Movements)
Nails-What To Look For
Night Terrors
Obsessive Compulsive OCD
Panic Disorder
Personality disorders
Pneumonia
Pneumonia-Advanced Stages
Pneumonia - Aspirated (Inhaled)
Prosody - Social Impairment
Sexuality~Physician's Guide
Skins Sensitivity
Sleep Disorders
Smoking-Physician's Guide
Spasticity
Stress
Tremors
Why Certain Symptoms Occur
Symptom & Treatment Resources
SECTION 5 - COMMUNICATION
Communication Resources
Communication Problems
Communication Strategies For HD~Jeff Searle
SECTION 6 - EATING/SWALLOWING/NUITRITION
Hints For Weight Loss in HD
HD & Diet~HSA Fact Sheet 7
Nutrients: Some Possible Deficiency Symptoms
Nutrition and HD~Anna Gaba (Recipes)
Nutrition Information In HD~Naomi Lundeen
Speech & Swallowing~Lynn Rhodes
Swallowing & Nutrition Physician's Guide To HD
Swallowing & Nuitrition Resources
Swallowing Warning Signs
5 Swallowing Problems
Taste changes in HD
Weight Gain
Resources-Drinks/Shakes
-Feeding Tubes~Advanced Stages of HD
-Feeding Tube~Jean Miller
-Feeding Tubes: One More Word ~Jean Miller
-Feeding Tubes & Baby Foods
-Feeding Tube~Dental Care
-Feeding Tube Instructions~Jean Miller
-Feeding Tube Resources
SECTION 7 - THERAPIES
Finding a Therapist - Behavoir
What Is A Physiotherapist?
Physical Therapy In HD
Speech-Language Therapy
Therapy Descriptions
Therapy Resources- Easter Seal
Therapy Resources
SECTION 8 - MEDICATIONS
HD Treatments
Medications-Movement Disorders
Medication/Emergency Info Forms
Cutting Prescriptions
Drugs-Look 'Em Up
-Adolescents Under 25
-Antidepressant Adverse Effects
-Anti-psychotic
-Anxiety-Antidepressant
A-Z Mental Health Drugs
-Creatine
-EPA~Fish Oil
-Haldol/Haloperidol - Clinical Sheet
-Haldol~Clinician Description
-Haldol & HD
-Haldol/HD Patient Experiences
-Haldol~ Patient Handout
-Mood Stabilizers: ASK 3 Questions
-Neuroleptic Malignant Synd WARNING
-Olanzipine-Risperidone/blood tests
-Celexa/Luvox/Paxil/Prozac/Zoloft
-Psychiatric Drugs & Children
Sertraline ~Zoloft
-Spasticity Meds/Treatments
-SSRI Medications
-Tardive Dyskinesia WARNING
-Weight Gain Medications
-Sites/Help the Medicine Go Down
-Vitamin & Mineral Deficiencies
SECTION 9 - SURGERIES
Surgery-Movement Disorders
o Surgery Resources
SECTION 10 - PROCEDURES
Clinic Visits-How To Prepare
CT Scans, MRI's etc.
Swallowing Tests
Tests Commonly Used
o Procedures Resources
SECTION 11- ALCOHOL/DRUGS
Alcohol-Parent's Guide
Alcohol-Talking To Your Child
Drugs-What To Do?
Drugs-Talking To Your Child
Disciplining-Ages 0-13 & Up
SECTION 12- SUICIDE
Straight Talk On Suicide
Teen Suicide-You Need To Know
o Suicide Resources
SECTION 13 - DIVORCE
Divorce & Child Stress
Tips For Divorcing Parents
SECTION 14 - DISABILITY ISSUES
Guides To Disability Issues
Caring-Child & Medical Technology
Caring for a Seriously Ill Child
Child Long Term Illness
Disability-Special Education Plan
IFSP Early Intervention Process
Disability Resources
Financial Planning
Wishes Can Come True-Children's Wish Foundations
Special Needs Resources
Special Needs Camp - About
Special Needs Camp - Finding One
SECTION 15 - ASSISTIVE TECHNOLOGY
Child Assistive Technology
Adaptive Equipment Resources
Products
SECTION 16 - EMOTIONAL ISSUES
Signs of Unhealthy Self-Esteem
Emotional Behavior Links
o Emotional Support Resources
SECTION 17 - GRIEF
Helping Child Deal With Death
o Grief Addtional Resources
SECTION 18 - ADD/ADHD
ADD & Teens
Conduct Disorders
FAQS & Related Info
Understanding AD/HD
What Is AD/HD?
Research Articles
Resources
SECTION 19 - HD SUPPORT GROUPS
HD Support Groups
National Youth Association
SECTION 20 - HD LINKS
HD Links
Related Resources
Tips For Friends
SECTION 21 - BENEFITS/INSURNACE
HD Disability
Benefits Check UP - See What You Can Get
Medical Insurance Bureau's Facts On You!
Medicare-Medicaid
Medicare Rights-Home Health & Hospice
Medicare Rights Center Resources
No Insurance? Try This!
Prescription Drug Cards Part I
Prescription Drug Cards Part II
Social Security-Children With Disabilities
SECTION 22 - ARTICLES/JHD
JHD and ADD
SECTION 23 - CAREGIVING
Articles-Resources
Caregiver Self-Assessment
Caregiver's Handbook
"First Shift With A Person With HD"
Getting Respite Care/Help At Home
Helpful Forms-Info
Home Emergency Preparations
Symptom Management
Ten Tips
Useful Tools
SECTION 24 - BIO
Our Personal Experience
Coping At The End
Kelly E. Miller
Song & Verse
Letter From My Heart
GUESTBOOK
Depression-Understanding It

INDEX Page

Your daughter spends more time in her room than usual, with the door closed and the shades drawn. She sleeps a lot, and even the family dog can't make her smile anymore. She has stopped hanging out with her friends, and when you ask what's going on, she just mumbles.

Normal teen behavior? Not really. There's more here than meets the eye, something that's telling you things are not right.

It's possible that your child is depressed. In the United States, depression is the most common mental health disorder, affecting 17 million people of all age groups, races, and economic backgrounds each year. As many as one in every 33 children may have depression; in adolescents, that number may be as high as one in eight. If you suspect that your child is depressed, you'll want to learn more about what depression is, what causes it, and what you can do if your child is depressed.

What Is Depression?
Depression isn't just bad moods and occasional melancholy. It's not just feeling down or sad, either. These feelings are normal in children, especially during adolescence. Even when major disappointments and setbacks make people feel sad and angry, the negative feelings usually lessen with time. But when a depressive state, or mood, lingers for a long time - weeks, months, or even longer - and it limits a child's ability to function normally, it can be diagnosed as depression.

Two types of depression, major depression and dysthymia, can affect children. Major depression is characterized by a persistent sad mood and the inability to feel pleasure or happiness. A child with major depression feels depressed for most of the day, almost every day.

If the sadness is not as severe but continues for a year or longer, the condition may be dysthymia.

Bipolar disorder is another type of mood disturbance and is characterized by episodes of low-energy depression (sadness and hopelessness) and high-energy mania (irritability and explosive temper).

What Causes Depression?
Depression usually isn't caused by one event or thing; it's the result of one or more factors, and its causes vary from child to child. Depression can be caused by lowered levels of neurotransmitters (chemicals that carry signals through the nervous system) in the brain, which limits a person's ability to feel good. Depression can run in families, so a child who has a close relative with depression may be more likely to experience it herself.

Significant life events such as the death of a loved one, a divorce, a move to a new area, and even a breakup with a girlfriend or boyfriend can bring on symptoms of depression. Stress also can be a factor, and because the adolescent years can be a time of emotional and social turmoil, things that are difficult for anyone to handle can be devastating to a teen.

Also, chronic illness can lead to depression, as can the side effects of certain medicines or infections.

Diagnosing Depression
Depressed children have described themselves as feeling hopeless about everything or feeling that nothing is worth the effort. They honestly believe that they are "no good" and that they're helpless to do anything about it.

But for an accurate diagnosis of major depression to be made, a more detailed clinical evaluation must be done. A medical or mental health professional (such as a psychologist or psychiatrist) must be sure that your child has had five or more of the following symptoms for more than 2 weeks:

  • a feeling of being down in the dumps or really sad for no reason
  • a lack of energy, feeling unable to do the simplest task
  • an inability to enjoy the things that used to bring pleasure
  • a lack of desire to be with friends or family members
  • feelings of irritability, anger, or anxiety
  • an inability to concentrate
  • a marked weight gain or loss (or failure to gain weight as expected), and little or too much interest in eating
  • a significant change in sleep habits, such as trouble falling asleep or getting up
  • feelings of guilt or worthlessness
  • aches and pains even though nothing is physically wrong
  • a lack of caring about what happens in the future
  • frequent thoughts about death or suicide

A child who has dysthymia must experience two or more of the following symptoms almost all the time for at least 1 year:

  • feelings of hopelessness
  • low self-esteem
  • sleeping too much or being unable to sleep
  • extreme fatigue
  • difficulty concentrating
  • lack of appetite or overeating

Depressed children and teens are more likely to use alcohol and drugs than those who aren't depressed. Because these substances can momentarily allow a child to forget about her depression, they seem like perfect "fixes." But they don't fix anything; in fact, they can make the depressed child feel even worse.

Recognizing Depression in Your Child
If you've discovered that more than a few of the symptoms of major depression or dysthymia apply to your child, you may have reason for concern.

Don't dismiss your concerns or think that the symptoms will go away by themselves - they probably won't, and they may get worse. And don't think that you're responsible for your child's depression - even if something you did (such as a divorce) triggered it, it's not your fault. It's nobody's fault.

Let your child know that you are there for her, whenever she needs you and wherever you may be. Remind your child of this over and over again - she may need to hear it a lot because she feels unworthy of love and attention. If your child shuts you out, don't walk away - remain there for her. Once your child begins to talk, let her talk about whatever she wants to talk about and don't criticize. The important thing is that she's talking and communicating her feelings. This will help your child begin to realize that her feelings and thoughts really do matter, that you truly care about her, and that you never stopped caring even when she became depressed.

If You Suspect a Problem
The good news is that there are professionals who can help your child. Depression can be successfully treated in more than 80% of the people who have it. But if it goes untreated, depression can be deadly. Depression is the number-one cause of suicide.

Depression is commonly treated with a combination of therapy and medicine. A psychiatrist can prescribe medicine, and although it may take a few tries to find the right one for your child, most children who follow the regimen eventually begin to feel better. Therapy focuses on the causes of the depression and works to help change negative thoughts and find ways to allow your child to feel better. Feeling is healing, and talking about feelings can be a powerful antidote for depression. A good therapist will communicate this to your child.

With proper treatment and your help, your child can lead a normal, happy, and fulfilling life.

Reviewed by: Paul Robins, PhD
Date reviewed: May 2001

 
Source:  KidsHealth www.KidsHealth.com is a project of The Nemours Foundation which is dedicated to improving the health and spirit of children. Today, as part of its continuing mission, the Foundation supports the operation of a number of renowned children's health facilities throughout the nation, including the Alfred I. duPont Hospital for Children in Wilmington, Delaware, and the Nemours Children's Clinics throughout Florida. Visit The Nemours Foundation to find out more about them and its health facilities for children http://www.nemours.org/no/ 
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Dysthymic Disorder

 
Background: The current consensus is that major depressive disorder, dysthymia, double depression (alternating dysthymia and depression), and some apparently transient dysphorias all are manifestations of the same disease process. Thus, all of these varieties of depression respond to similar psychological and physical treatments, and they share polysomnographic abnormalities.

Because transitions between dysthymia and major depression are common, dysthymia is highly predictive of a major depression. For this reason, considerable redundancy will occur between a discussion of major depression and a discussion of dysthymia. However, the goal of this chapter is to emphasize issues that apply particularly to dysthymia.

By definition, dysthymia is a chronic mood disorder, with a duration of at least 2 years in adults and 1 year in adolescents and children. It is manifested as depression for most of the day, occurring more days than not, and accompanied by some of the following symptoms:

  • poor appetite or overeating
  • insomnia or hypersomnia
  • low energy or fatigue
  • low self-esteem
  • poor concentration
  • difficulty making decisions, and
  • feelings of hopelessness.

For cases of dysthymia, manic episodes must not have occurred, and major depressive episodes must not have occurred in the first 2 years of the illness (1 year in children).

By contrast, major depression is diagnosed if 5 or more of the following symptoms have been present most of the day, every day, for the past 2 weeks and if depressed mood (the first symptom) or loss of interest or pleasure in usual activities (the second symptom), or both, is present.

  • Depressed mood

  • Loss of interest or pleasure in usual activities

  • Significant weight loss or gain

  • Insomnia or hypersomnia

  • Psychomotor agitation or retardation

  • Fatigue or loss of energy

  • Feelings of worthlessness or excessive or inappropriate guilt

  • Diminished ability to think or concentrate

  • Recurrent thoughts of death or suicide

Chronic depression can be separated into the following 3 subtypes:

  • Chronic major depression with a duration of more than 2 years

  • Milder dysthymia

  • Double depression, where episodes of major depression are superimposed on more enduring dysthymia

A potential point of confusion is the term dysphoria, which is defined as a mood of general dissatisfaction, restlessness, depression, and anxietya feeling of unpleasantness or discomfort. Thus, dysphoria refers to a transient state that fails to meet the criteria for dysthymia or major depressive disorder either in severity or in duration. The term dysphoria also may be used for more specific disorders such as gender-specific dysphoria, dysphoric mania, premenstrual (late luteal phase) dysphoria, and hysteroid dysphoria.

While dysthymia is by definition less severe than a major depression, the consequences of dysthymia without major depression are grave and include severely impaired functioning, increased morbidity from physical disease, and increased risk of suicide. 

See EMedicine's full article on this subject, including Authors, Description, Treatment, Medication, and Care: http://www.emedicine.com/med/topic3120.htm