Emotionally Disturbed: A Diagnosis Or Not?

Emotional disturbance is a term used to describe a range of mental disorders that affect mood and emotional reactions. It is often used as an umbrella term for several different mental disorders, including anxiety disorders, depressive disorders, bipolar disorder, and premenstrual dysphoric disorder (PMDD). Emotional disturbance can be characterised by an inability to build or maintain satisfactory interpersonal relationships, inappropriate behaviour or feelings in normal circumstances, and a pervasive mood of unhappiness or depression. While the exact causes of emotional disturbance are unknown, factors such as heredity, brain disorder, diet, stress, and family functioning have been suggested and researched. Treatment for emotional disturbance typically involves a combination of medication and psychosocial interventions, such as cognitive behavioural therapy and dialectical behaviour therapy.

Emotional disturbance criteria

Emotional disturbance is a broad term for several different mental disorders that affect a person's mood. Emotional disturbances can be diagnosed by mental health professionals, such as psychiatrists, nurse psychotherapists, or psychologists.

The criteria for emotional disturbance are outlined as follows:

• Inability to learn that cannot be explained by intellectual, sensory, or health factors.
• Inability to build or maintain satisfactory interpersonal relationships with peers, family, or teachers.
• Inappropriate types of behaviour or feelings under normal circumstances.
• A general pervasive mood of unhappiness or depression.
• A tendency to develop physical symptoms or fears associated with personal or school problems.

It is important to note that the presence of these criteria does not necessarily indicate an emotional disturbance, as other factors and contexts must be considered.

The term "emotional disturbance" is often associated with schizophrenia but does not include students or individuals who are "socially maladjusted". The law and psychiatric community have not clearly defined "social maladjustment", which has caused confusion.

Diagnosis methods

Emotional disturbance is a commonly used umbrella term for several different mental disorders. Diagnosis methods for emotional disturbance involve identifying the presence of certain characteristics over a long period and to a marked degree that adversely affects a person's educational performance or daily functioning.

The Individuals with Disabilities Education Act (IDEA) defines emotional disturbance as a condition exhibiting one or more of the following characteristics:

• An inability to learn that cannot be explained by intellectual, sensory, or health factors.
• An inability to build or maintain satisfactory interpersonal relationships with peers and teachers.
• Inappropriate types of behaviour or feelings under normal circumstances.
• A general pervasive mood of unhappiness or depression.
• A tendency to develop physical symptoms or fears associated with personal or school problems.

These characteristics often persist over long periods and significantly impact a person's life, indicating the presence of an emotional disturbance.

Mental health professionals use functional behavioural assessments to evaluate individuals and address emotional disorders. The specific diagnostic criteria for emotional disturbance include experiencing inappropriate actions or emotions, learning difficulties, and a general feeling of unhappiness or depression.

It is important to note that emotional disturbances can vary in severity and presentation, and a qualified professional should be consulted for an accurate diagnosis.

Treatment options

Emotional disturbance is a broad term for a variety of mental health disorders that affect a person's ability to learn, manage their emotions, and build healthy relationships. Treatment options for emotional disturbance vary depending on the individual, their age, and the severity of their symptoms. Here are some common treatment approaches:

Therapy

Therapy is a common treatment option for emotional disturbance. This can include cognitive-behavioural therapy (CBT), dialectical behaviour therapy (DBT), psychodynamic therapy, and social skills training. Therapy can help individuals identify and change unhealthy patterns in their thoughts, behaviours, and emotions. It provides a safe space to explore and process feelings constructively. Therapy can also help individuals develop social and interpersonal skills, improve emotional regulation, and address emotional triggers.

Medication

In some cases, medication may be prescribed to help manage emotional disturbance. This includes antidepressants, mood stabilizers, and antipsychotics. Medication can be used in combination with therapy to stabilize mood swings and improve symptoms of anxiety, depression, and bipolar disorder.

Alternative Treatments

For treatment-resistant cases or when conventional treatments are not effective, alternative treatments may be considered. These include electroconvulsive therapy (ECT), transcranial magnetic stimulation (TMS), and psychedelic-assisted therapy.

Educational Support

For school-aged children with emotional disturbance, educational support and accommodations can be crucial. Alternative schools or specialized programs within traditional schools can provide the necessary emotional and behavioural support, along with academic instruction tailored to their needs. These programs focus on both emotional development and academic growth, helping students build critical social-emotional skills alongside their academics.

Family Counselling

Family counselling is often recommended as part of the treatment plan for emotional disturbance. This involves treating the entire family to aid in the healing process and improve family dynamics that may contribute to or be affected by the individual's emotional disturbance.

Self-Help and Support Groups

In addition to professional treatment, individuals with emotional disturbance and their families can benefit from self-help resources and support groups. These groups provide connection, understanding, and advocacy for those living with emotional disturbance. They offer information, referrals, and a network of support to navigate the challenges associated with emotional disturbance.

Symptoms and characteristics

Emotional disturbance is an inability to build or maintain satisfactory interpersonal relationships with peers or family. It is often described as a general pervasive mood of unhappiness or depression. Individuals with emotional disorders exhibit inappropriate behaviour or feelings under normal circumstances. Emotional disturbance is a commonly used umbrella term for several different mental disorders, including anxiety, depression, bipolar disorder, and post-traumatic stress disorder (PTSD).

The symptoms of emotional disturbance vary depending on the individual and the specific disorder. However, some common indicators of emotional disturbance include:

• Hyperactivity, characterised by a short attention span and impulsiveness
• Aggression towards animals and humans, including self-injurious behaviour
• Difficulty in learning
• Temper tantrums and poor coping skills
• Withdrawal from social events due to excessive fear or anxiety
• Distorted thinking, which is often inaccurate and negatively biased
• Excessive anxiety, being overly sensitive to issues
• Abnormal mood swings, including serious shifts that threaten the individual's well-being

Individuals with emotional disturbances may also experience physical symptoms such as constant stomachaches, headaches, or other aches and pains without obvious causes.

In children, symptoms of emotional disturbance may include:

• Changes in school performance
• Excessive worry or anxiety, such as fighting to avoid bed or school
• Hyperactive behaviour
• Frequent disobedience or aggression
• Frequent temper tantrums

It is important to note that these symptoms can vary in intensity and duration, and not everyone with an emotional disturbance will exhibit the same behaviours.

Prevalence and common types

Emotional disturbance is an umbrella term for several different mental disorders. According to the Individuals with Disabilities Education Act (IDEA), emotional disturbance is:

> "...a condition exhibiting one or more of the following characteristics over a long period of time and to a marked degree that adversely affects a child's educational performance:

>

> (A) An inability to learn that cannot be explained by intellectual, sensory, or health factors.

>

> (B) An inability to build or maintain satisfactory interpersonal relationships with peers and teachers.

>

> (C) Inappropriate types of behavior or feelings under normal circumstances.

>

> (D) A general pervasive mood of unhappiness or depression.

>

> (E) A tendency to develop physical symptoms or fears associated with personal or school problems."

The prevalence of emotional disturbance varies depending on the age group and demographic surveyed. Overall, it is estimated that 1 in 10 (10%) or about six million people in the United States have experienced emotional disturbances at some point in their life. This figure includes school-aged children, where 1 in 10 children in the US experience emotional disturbance and require treatment and appropriate mental health services. In the 2018-19 school year, 5.4% of students with disabilities were identified with emotional disturbance, ranging from 1.6% to 17.36% across different states.

Among young adults aged 18-25, the prevalence of emotional disturbance was highest at 9.7%, compared to 6.9% for adults aged 26-46 and 3.4% for those aged 50 and older. Approximately 18% of adults aged 18-54 experience severe emotional disorders each year.

Some of the common types of emotional disturbances include:

• Anxiety disorders: This includes generalized anxiety disorder (GAD), obsessive-compulsive disorder (OCD), panic disorder, post-traumatic stress disorder (PTSD), social anxiety disorder, and specific phobias. Anxiety disorders are characterized by excessive, persistent, uncontrollable, and overwhelming fear and irrational fear of everyday situations.
• Bipolar disorder: Also known as manic-depressive illness, bipolar disorder is characterized by dramatic mood swings, ranging from overly "high" or irritable to sad and hopeless, often with periods of normal mood in between. These mood swings are accompanied by severe changes in energy and behavior.
• Conduct disorder: This disorder is characterized by a persistent pattern of behavioural and emotional problems, including aggression towards people and animals, destruction of property, deceitfulness, lying, stealing, and truancy. Individuals with conduct disorder have difficulty following rules and exhibiting socially acceptable behaviour.
• Eating disorders: This includes extremes in eating behaviour, such as eating too much or too little, or feelings of extreme distress or concern about body weight or shape. The two most common types are anorexia nervosa (self-starvation) and bulimia nervosa (binge eating followed by purging). Binge eating disorder is also characterised by excessive eating but without subsequent purging.
• Obsessive-Compulsive Disorder (OCD): OCD is sometimes classified as an anxiety disorder and is characterised by recurrent, unwanted thoughts (obsessions) and/or repetitive behaviours (compulsions). Individuals with OCD may engage in rituals such as counting, cleaning, or handwashing to temporarily alleviate anxiety.
• Psychotic disorders: This umbrella term includes severe mental disorders such as schizophrenia that cause abnormal thinking and perceptions, including delusions (false beliefs) and hallucinations (false perceptions).

Frequently asked questions