Mental Health
Key Points
- Young males may express certain mental health disorders in ways that are very different from young females.
- Among these disorders are ADHD, psychotic disorders, bipolar and related disorders, depressive disorders, anxiety disorders, obsessive compulsive disorder and disruptive mood dysregulation disorder.
- Suicidal behavior is not a diagnosis but stems from other mental health disorders. Suicidal behavior includes suicide ideation, suicidal behavior and suicide attempts.
AYA males may suffer from a range of mental health disorders. Some of these are more prevalent among young males than among young females, and the rate of diagnosis may differ by gender. Young males may also express certain mental health disorders in ways that are very different from females.
Among the disorders that affect young males are depressive disorders, anxiety disorders, ADHD, psychotic disorders, bipolar and related disorders, obsessive compulsive disorder, and oppositional defiant disorder.1 Suicidal behavior includes suicide ideation, suicidal behavior and suicide attempts.2 Suicidal behaviors may be present with a variety of other mental health disorders. All of the descriptions of diagnoses which follow are based on the latest version of the Diagnostic and Statistical Manual of Mental Health Disorders.
There is a wide array of evidence-based interventions for all of these disorders. Early intervention for prodromal psychotic conditions is particularly important and has been shown to be efficacious. With all mental health disorders early intervention is crucial, and in order for this to take place there has to be screening and detection.
ADHD
Attention-Deficit/Hyperactivity Disorder (ADHD) can result in performance issues in social, educational, or work settings. Symptoms are divided into two categories: inattention and hyperactivity and include behaviors like inability to sustain attention, difficulty organizing tasks and activities, excessive activity or internal restlessness. There may be inappropriate risk-taking behaviors. Boys with hyperactivity are often labeled as behavior problems in school and are disciplined as such, which can interfere with their getting appropriate help and cause impairment of self-esteem and self-worth.
Psychotic Disorders
Psychotic disorders are severe mental disorders that cause abnormal thinking, feeling and perceptions. People with psychoses can lose touch with reality. Positive symptoms include delusions and hallucinations.3 Negative symptoms include social withdrawal and changes in cognition. Late adolescence and early adulthood is a time when psychotic illnesses are most likely to become manifest, so screening during this time is beneficial.
Bipolar Disorder
Bipolar disorder is a condition in which a person may alternate between periods of a euphoric or very irritable mood and incapacitating depression.
Types of bipolar disorder:
Type I: Have had at least one manic episode. Usually there are also episodes of depression.
Type II: Is defined by a pattern of depressive episodes shifting back and forth with hypomanic episodes, but no full-blown manic or mixed episodes.
Manic behavior can include not sleeping for several days at a time and not being bothered by not sleeping, increase in goal-directed activity, inflated self-esteem, distractibility, and being more talkative than usual.
Depressive Disorders
The main types of depressive disorders are major depressive disorder and persistent depressive disorder. Depression may also occur related to other medical, substance or mental health disorders. It is important to note the severity, acuity and duration of the depression
Depressive disorders can co-occur with many other disorders and males less often seek help for these conditions.
Anxiety Disorders
These are among the most prevalent mental health conditions affecting youth and males less often seek help for them. Anxiety disorders include generalized anxiety disorder, panic disorder, social phobia and specific phobia. Symptoms of many of these disorders begin in childhood or adolescence and can become chronic if untreated.
These disorders include obsessive-compulsive disorder, body dysmorphic disorder and trichotillomania (hair-pulling disorder), as well as hoarding disorder and excoriation (skin-picking) disorder. They have features in common such as an obsessive preoccupation and repetitive behaviors.
Disruptive, Impulse-Control, and Conduct Disorders These include oppositional defiant disorder, conduct disorder, disruptive behavior, impulse-control, disorders, intermittent explosive disorder, pyromania, and kleptomania. These disorders are known as externalizing disorders because they are shown in outward behavior and are directed towards others rather than the self. Examples include physical aggression,verbal bullying, defiance, theft and vandalism.
Suicidal Behavior
Suicidal behavior includes suicide ideation, suicidal behavior, suicide attempts, and death by suicide. It is crucial to screen all teens for suicidal thoughts, behaviors, intent and access to means. Boys present less often with depression and suicidal ideation but have a 4:1 ratio of death by suicide compared to females.
