In an adult:
A person with one or more of the following symptoms should be evaluated by a psychiatrist or other physician as soon as possible:
- Marked personality change
- Inability to cope with problems and daily activities
- Strange or grandiose ideas.
- Excessive anxieties.
- Prolonged depression and apathy.
- Marked changes in eating or sleeping patterns.
- Extreme highs and lows.
- Abuse of alcohol or drugs.
- Excessive anger, hostility, or violent behavior.
A person who is thinking or talking about suicide or homicide should seek help immediately.
In a child:
Having only one or two of the problems listed below is not necessarily cause for alarm. They may simply indicate that a practical solution is called for, such as more consistent discipline or a visit with the child's teachers or guidance counselor to see whether there is anything out of the ordinary going on at school. A combination of symptoms, however, is a signal for professional intervention.
- The child seems overwhelmed and troubled by his or her feelings, unable to cope with them.
- The child cries a lot.
- The child frequently asks or hints for help.
- The child seems constantly preoccupied, worried, anxious, and intense. Some children develop a fear of a variety of things--rain, barking dogs, burglars, their parents' getting killed when out of sight, and so on--while other children simply wear their anxiety on their faces.
- The child has fears or phobias that are unreasonable or interfere with normal activities.
- The child can't seem to concentrate on schoolwork and other age-appropriate tasks.
- The child's school performance declines and doesn't pick up again.
- The child's teachers, school administrators, or other authority figures in the child's life ask the parent what might be troubling the child.
- The child is having difficulty mastering school work.
- Teachers suggest that the child may have a learning disability or other type of school-related problem.
- The child loses interest in playing.
- The child tries to stimulate himself or herself in various ways. Examples of this kind of behavior include excessive thumb sucking or hair pulling, rocking of the body, head banging to the point of hurting himself, and masturbating often or in public.
- The child has no friends and gets into fights with other youngsters. Teachers or others may report that "this is a very angry or disruptive kid."
- The child isolates himself or herself from other people.
- The child regularly talks about death and dying.
- The child appears to have low self-esteem and little self-confidence. Over and over the child may make such comments as: "I can't do anything right." "I'm so stupid." "I don't see why anyone would love me." "I know you [or someone else] hates me." "Nobody likes me." "I'm ugly. . . too big. . . too small. . . too fat. . . too skinny. . . too tall. . . too short, etc."
- Sleep difficulties don't appear to be resolving. They include refusing to be separated from one or both parents at bedtime, inability to sleep, sleeping too much, sleeping on the parent's or parents' bed, nightmares, and night terrors.
- The child begins to act in a provocatively sexual manner. This is more common in girls as they approach puberty and thereafter, but even much younger girls may flirt with men in sexually suggestive ways.
- The child sets fires.
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