Dr. Megan Spencer is a clinical psychologist at Dakota Family Services. She is passionate about working with individuals and their families and highly values the therapeutic relationship. Dr. Spencer enjoys helping people better understand themselves and their psychological functioning. She looks forward to working with anyone who is looking to better understand and/or improve themselves or their children and families. Her practice includes diagnostic and psychological evaluations and individual cognitive behavioral therapy.
Featuring Dr. Megan Spencer, Clinical Psychologist, Dakota Family Services
Host Tim Unsinn (00:00):
Welcome to Mind Your Mind, a podcast presented by Dakota Family Services, an outpatient behavioral health clinic located in Minot, Bismarck, and Fargo, North Dakota. In this podcast, I will talk with our experts about understanding and nurturing our mental health and wellness. I'm your host, Tim Unsinn. Join me each episode as we explore the intricacies of our minds, decrease the stigma of mental illness, learn practical tips for managing our mental health and well-being, and recognize when it's time to ask for help. Join me now to mind your mind.
Welcome to this episode of Mind Your Mind. Our guest is Dr. Megan Spencer. Dr. Spencer is a clinical psychologist and provides diagnostic and psychological evaluations, and CBT. Dr. Spencer, it's great to have you on Mind Your Mind. Our topic is mood-related disorders in children and adolescents. However, before we get to the topic, let's talk about why you do what you do. Why is the work that you do important to you?
Dr. Megan Spencer (00:59):
Really it's about people. I love working with people and I truly do enjoy watching the journey of self-discovery and learning what's best for them.
I think the topic that we're going to hit today, parents are like yes, yes. Every child has got some kind of mood going on. So anyway, yeah, let's get right to it. Mood-related disorders in children and adolescents. What is a mood disorder versus normal changes in mood?
That's a great question. And to be honest, this is something that I do truly talk about on a pretty regular basis with people. And so the really cool thing about being humans is we get to experience emotion. We're supposed to experience sadness and happiness and joy and surprise and fear. Those are all normal. And so that's kind of the normal changes. But truly, the mood disorder is when those changes become more persistent and more intense. And so not necessarily, you know, fluctuating with changes in situations, but truly, being more enduring and more intense than what we would consider more normal fluctuations.
All right. So what are the mood-related disorders diagnosed in children and adolescents, knowing that there is a difference?
Absolutely. So, you know, there are definitely some disorders across the span that we hear about. But particularly with kiddos and adolescents, one we hear is Disruptive Mood Dysregulation Disorder. And so, kind of a defining characteristic is gonna be really severe and recurrent temper outbursts. And so severe meaning, very intense, right. Kiddos have temper tantrums. That's not unusual. But this is really gonna be out of proportion in intensity and really duration in terms of how long those outbursts last. They can be verbal or behavioral. So, kind of verbal rages or physical aggression, whether that be to people or property. And again, those outbursts not only are out of proportion, but also inconsistent with that developmental level, which we really have to think about in terms of the age of the kiddo and their developmental level. And this is gonna be an outburst quite significant and inconsistent with that developmental level.
I would think as a parent, you're able to distinguish between that brief mood change to mood disorder, to that very aggressive or very, you know, prolonged kind of thing.
Yes. It's the intensity of it that is really one big piece. And then that duration how long it lasts, past what you would think would be a trigger or a cause of that.
So what are some of the causes for that?
In terms of Disruptive Mood Dysregulation Disorder, causes can be a few different things. You know, in terms of day-to-day, it could be, you know, they're playing a game and the power goes out and so their game shuts down. And, you know, typically a kiddo might get upset. But this kiddo or adolescent kind of gets out of control. They might, you know, start throwing things. They might start yelling and screaming. And they can't necessarily calm in a fairly meaningful way or within a certain amount of time, if that makes sense.
Yeah. Not able to handle that short-term stress.
It's like not seeing the light end of the tunnel, but seeing that stress and it's like the end of the world.
Exactly. And they can't necessarily see that, okay, wait, like five minutes, the electricity will come back on, I'll get my game back. It's just that kind of immediate outburst, right. But the other piece to that is the mood between those outbursts, between those temper tantrums are truly more irritable. So it's not, you know, the kiddo is happy and easygoing and then they kind of are, you know, a stressor happens and they have an outburst. For this particular disorder, the mood is persistently irritable or angry between those temper outbursts. So one of the other disorders we hear a lot about with kiddos and adolescents is those Major Depressive Disorders. And so a lot of time we hear with depressive disorders that real depressed and down mood, which most certainly can be the case. But there's also in kiddos and adolescents, there is that piece where yes, their mood may be more depressed and down for that more intense and prolonged time, but it also could be an irritable mood. And so the difference here though, is with the depressive disorders, the depressed or irritable mood is truly every day, nearly most of the day, but for really, truly a two-week period and not persistent, like with the Disruptive Mood Dysregulation. So this is for about a two-week period, they experience the change in mood and then it eventually remits or goes away and they kind of experience more normal moods. And then the other part of that is, sometimes in kiddos, they might not be able to explain it, but it could be observable, right. They could be just more frustrated, easily. It could be more tearful, more crying.
The other part of that is they're, you know, things that they normally enjoy, we hear a lot about, that they just don't wanna do it, right. That motivation, that interest is gone. The energy is low. They just kind of seem more, you know, mopy, sitting around, not really active like they normally are. Sleep sometimes during that same two-week period might be disturbed in that, you know, when they typically sleep seven to nine hours, now they're wanting to sleep 10, 11, 12 hours, or even the opposite. They're waking up earlier in the morning, they're not sleeping like they normally do. We might also hear some adolescents talk about, you know, feeling kind of restless or being or opposite being really slowed down. Another thing is they might have difficulties with being able to concentrate and focus. So that can be another symptom of that kind of depressive disorders.
And lastly, the one I wanna make sure I also mention is called Premenstrual Dysphoric Disorder. And this specifically relates to females only. And the symptoms then kind of relate to some of those Major Depressive Disorder symptoms I just mentioned. But what this truly relates to is those symptoms occur the majority of the menstrual cycle. And so, for the majority of that female menstrual cycle, they experience those depressive episode symptoms. But then those symptoms start to improve within a few days after the onset of menses, but then become minimal or absent for the weeks post-menses, or once that period has resolved. And so some of those symptoms may also include mood swings. Again, not normal fluctuations, but more intense. And then suddenly feeling sad or tearful. They might experience anxiety or tension, or again, feeling kind of keyed up or on edge, as well as changes in appetite, feeling overwhelmed. There might be also accompanying physical symptoms like joint or muscle pain, sensations of feeling bloated. And so these are all kind of symptoms related to those disorders that we see in children and adolescents. But aren't certainly an exhaustive list, but the more common.
Now as a parent, I can imagine parents that are dealing with this, may be hearing this for the very first time. So what can you do if you suspect your child or adolescent, may be struggling with mood-related disorder?
First and foremost, I always say communication. Always talk, right? Doing things behind a kiddo or adolescent's back is only gonna make things worse, more times than not. And so if you suspect there is something going on, they're struggling more than maybe you would think is typical or normal, ask them about it, talk to them about it, say you're concerned, right? Because look, kids wanna know that we're there for them, and we're recognizing things are off, right. That shows that we care, that shows that we're there. And so if you suspect this particular, you know, a disruptive mood dysregulation, ask them and say, you're concerned and ask what's going on. And if they, you know, if they can't necessarily pinpoint it, or know why or what to do, get help, right. See if you, as a family can figure out a way to manage it. And if you can't, there's certainly, people out there that can help. Like psychologists, mental health professionals.
You're listening to Mind Your Mind. Our guest is Dr. Megan Spencer. We are talking about mood-related disorders in children and adolescents. And now we're just kind of wrapping up here talking about, you know, if you suspect your child or adolescent, may be struggling with this. So as a parent, having that conversation. Imagine that: communication, conversation with our kids. Unplugging everything and just have a conversation.
So what are some ways as a parent, just maybe one or two that a parent can address this? I know talking is one way, but how do we have that conversation that's not going to trigger, maybe, some of that emotion.
So, the important thing is kind of when and how. So in all reality, when your kiddo or adolescent is already upset, having that conversation probably isn't the best time. So having it when your kid or adolescent is more in a calmer or neutral state. And then the other part of it is really how you approach it. Tone of voice and being more calm in your demeanor and more calm in how you approach the conversation in your tone can truly make a difference because it's really about, you know, removing defensiveness and opening up that line of communication.
Great advice. That's kind of what I was looking for. As a parent, you don't want to hit the problem when it's hot, you want to get it when it's cold and easy to the conversation or easier, if you will.
All right. You've been listening to Mind Your Mind. Our guest has been Dr. Megan, Spencer. Dr. Spencer, before we wrap up, I do have a last question for you and you know, what's coming, you've prepared. What do you do personally, to mind your mind?
So for me, it's, with the weather getting better, again, it's always with my family, watching my kids grow and, the wonders of the world is awesome through their eyes, but also getting outside with the kiddos and the family.
Awesome. Thank you so much for your time. Always appreciate your time and talent. Thank you.
Thank you for joining us for Mind Your Mind, a podcast presented by Dakota Family Services. You can't have health without behavioral health. Remember to mind your mind. For more information, links to additional resources, contact information, and much more, go to dakotafamilyservices.org.
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