Some signs that a child has emotional problems include school problems, frequent fights, trouble sleeping, sad feelings, thoughts about suicide or running away, stealing, lying or mood swings. Others include setting fires, obsessive thoughts or compulsive behaviors, troubled or disturbing thoughts, use of drugs or alcohol, withdrawal or social isolation, hurting or killing animals, dangerous or self-destructive behaviors, trouble paying attention and anxiety or frequent worries. If you suspect that your child may have an emotional problem, you should seek an evaluation by a mental health professional specifically trained to work with children.

What services do you provide for my child?

The Department of Psychiatry and Behavioral Neurosciences at Cedars-Sinai Medical Center has services designed specifically to meet the behavioral health needs of children. After an evaluation to determine the clinical needs of your child, a referral would be made to meet those clinical needs. The child services that are provided through the department include:

Brief Early Intervention Group
Preschool and Parenting Services
Attention Deficit Hyperactivity Disorder Services
Family and child services - individual and family therapy
Specialty groups, such as the Social Skills Art Therapy Group (ages seven through nine)

If treatment is recommended, what can my child and I expect?

After a thorough evaluation, your clinician or doctor (or both) will decide the level of treatment your child needs, and they will discuss the options with you. Inpatient or outpatient treatment could entail individual therapy, family therapy, group therapy, medication management or any combination thereof. For services not offered within the department, we will give you a list of recommended treatment sites for you to explore. If a service is offered within the department and you agree to attend, an individualized treatment plan will be developed for you and your child.

How do I know if my adolescent needs help?

Some signs that an adolescent has emotional problems include school problems, frequent fights, trouble sleeping, sad feelings, thoughts about suicide or running away, stealing, lying or mood swings. Others include setting fires, obsessive thoughts or compulsive behaviors, troubled or disturbing thoughts, use of drugs or alcohol, withdrawal or social isolation, hurting or killing animals, dangerous or self-destructive behaviors, trouble paying attention and anxiety or frequent worries. If you suspect that your adolescent may have an emotional problem, you should seek an evaluation by a mental health professional specifically trained to work with children.

What services do you provide for my adolescent?

The Department of Psychiatry and Behavioral Neurosciences at Cedars-Sinai Medical Center has services designed specifically to meet the behavioral health needs of adolescents. Your adolescent would be evaluated to see what clinical needs he/she may have, and a referral would be made to meet those clinical needs. The adolescent services that are provided through the department include the Attention Deficit Hyperactivity Disorder Services, individual and family therapy for teens and the following specialty group therapies:

Early Adolescent Group (ages 10 to 12)
Late Adolescent Group (ages 16 to 18)
Family Interactions Program
Multi-Family Teen Group
Eating Disorders Group

If treatment is recommended, what can my adolescent and I expect?

After a thorough evaluation, your clinician or doctor (or both) will decide the level of treatment your adolescent needs, and they will discuss the options with you. Inpatient or outpatient treatment could entail individual therapy, family therapy, group therapy, medication management or any combination thereof. For services not offered within the department, we will give you a list of recommended treatment sites for you to explore. If a service is offered within the department and you agree to attend, an individualized treatment plan will be developed for you and your adolescent.

Who needs help?

Anyone who:

Has been suffering anxiety or depression symptoms for two weeks or more
Has been suffering from the loss of a loved one beyond normal grief
Behaves in such a way that it comes to the attention of friends or family, including over-spending, breaches of reality, drug usage or social isolation

If I want treatment, what should I expect?

An intake coordinator will assess your needs, and a therapist will perform an evaluation, which could involve one or more sessions. Afterwards, we will create a treatment plan with your special needs in mind.

I am concerned that my elderly parent may be an alcoholic. Is this common?

Alcohol abuse is a hidden epidemic among the elderly, leading to memory loss and behavior changes. In addition, many elderly patients overuse prescription medications. A full evaluation by a geriatric physician is necessary to identify and treat these problems.

I have noticed that my elderly friend seems to be more forgetful. Is this a sign of Alzheimer's disease?

Possibly, but not absolutely. A reduction in the ability to remember or think clearly as we age can be due to a variety of causes. Alzheimer's disease is only one of these. It is important for your friend to check with his or her doctor to determine the cause of these problems.

Does depression persist into old age? I have always thought it was an illness of the young.

Depression is, in fact, very common in the elderly. By some estimates, 40 to 60% of elderly patients who see a doctor have some sort of depressive illness. In most cases, depression is as treatable in the elderly as it is in the young.

How do I know if I need therapy?

People seek therapy for many reasons. Typically, someone will start therapy when he or she is feeling very sad, blue, anxious or when life seems too overwhelming. People may also seek therapy after a major life crisis, such as a divorce, death or a job loss. Others may want help with stress from their jobs, money problems, parenting issues, relationship difficulties or when day-to-day responsibilities seem unmanageable.

How do I find a therapist who is good for me?

There are many ways to find a therapist, such as a referral from your primary medical doctor, a friend or family member. Another way is to call a local hospital or mental health center. You can also call your insurance company, and they will give you someone in the network.

How long do I need to go for therapy?

This depends on what kinds of problems brought you to therapy. Some people just need brief care, while others benefit from long-term therapy. Types of therapy include individual, group, couples and family therapy. Discuss which type is best for you with your therapist.

How do I know if I need medication?

The medications used to treat mental illnesses are like any other your doctor might prescribe. You will undergo a professional evaluation to determine your specific needs, and your doctor will share the results with you. If your doctor suggests taking medication, make sure you understand its benefits and side effects. Remember that since each person is unique, do not take other people's medications, even if their problems appear to be like yours.

What kinds of medications are available to help with depression? Anxiety?

Science has made great advances in treating depression and anxiety. Research scientists have identified some brain abnormalities that help cause depression and anxiety. Up to 80% of people with some form of depression respond well to treatments that combine antidepressant medication and talking therapy. The same is true for some that suffer from anxiety disorders. The three classes of antidepressant medications are:

Heterocyclic antidepressants (formerly called tricyclics)
Monoamine oxidase inhibitors (MAOIs)
Serotonin-specific agents

Antidepressant medications change neurotransmitters and other brain systems. This eases emotional suffering, energy and appetite loss and sleeping difficulties. Patients with depression can also benefit from non-drug therapy. This helps them address issues that may have contributed to their depression.

The largest class of medications used to treat anxiety is the benzodiazepines. These can be very effective in treating anxiety, but patients must work closely with prescribing physicians and staff and take the medications as prescribed. Benzodiazepines can become habit-forming. If you have ever had an addiction problem, it is vital that you tell your doctor. Buspirone, another medication for anxiety, is not a benzodiazepine and is not addictive.

Who can prescribe antidepressant or anti-anxiety medications for me?

Psychiatrists and doctors from other specialties may prescribe such medicines. Psychiatrists specialize in treating these disorders. They often work with psychologists and other therapists who provide talking therapies.

Are antidepressants or anti-anxiety medications addictive?

Nearly all antidepressants and many anti-anxiety medications are non-addictive; however, benzodiazepine medications, which are in the same family as Valium, can be addictive. If you have anxiety and a history of alcohol or drug abuse, tell your physician about your addiction history.

What side effects are common with antidepressants and anti-anxiety medications?

Many medications have side effects. They are classified based on a number of factors, including whether they sedate (i.e., dull the senses), alter blood pressure, effect sexual function, are habit-forming, impact the digestive system, cause agitation or effect sleep. If your doctor recommends an antidepressant or anti-anxiety medicine, be sure to talk about its possible side effects.

When should I expect to feel better from my medication?

Generally, it takes two to four weeks to feel benefits from antidepressant medication; however, you will likely feel the drug in your body right away. Anti-anxiety medications begin to work almost right away.

How long would I need to stay on medication?

That depends on several factors, including:

Your age
How long you have had depression or anxiety
The seriousness of the depression or anxiety problem

How do I know if I have a problem with drugs or alcohol?

One method is to answer the C.A.G.E. questions:

Have you tried unsuccessfully to CUT DOWN on your drinking in the past?
Do you become ANGRY when others point out you are drinking excessively or may have a problem with alcohol?
Do you feel GUILTY about your alcohol or drug use?
Do you take a drug or alcohol EYE-OPENER first thing in the morning?

Yes to one or more of these questions indicates a problem. Another method asks:

Are you using more of a substance to experience the same effect (a sign of increased tolerance)?
Do you use drugs or alcohol to keep from experiencing physical discomfort (a sign of withdrawal)?
Do you continue to use drugs or alcohol despite knowing that it is harmful to your health?
Do drugs or alcohol harm your family life or keep you from family or work duties?

Yes to one or more of these questions also indicates a problem. The National Institute on Alcohol Abuse and Alcoholism defines moderate drinking as:

Two drinks per day for a man under 65
One drink per day for a woman under 65
One drink per day for a woman or man over 65

Using these guidelines, you may have an alcohol problem and should consider treatment if:

You are male and drink more than 14 drinks per week or more than four drinks per occasion
You are female and drink more than seven drinks per week or more than three drinks per occasion
You have a family history of alcoholism

What is an intervention?

An intervention is a congregation of one or more persons and an individual with a drug or alcohol problem for the purpose of helping that individual. Family and friends are often the most successful in persuading an abuser to enter a treatment program.

How do I find help?

You may find general help and specific treatment plans from many sources. Alcoholics Anonymous is listed in the phone book. City, county and state offices of alcohol and drugs have listings of programs. You may also call Cedars-Sinai's intake coordinator at (310) 423-3411.

What are 12-step programs?

They are the largest self-help programs for alcoholics and drug addicts. People who have problems with opiates (e.g., heroin), cocaine, methamphetamines or other drugs can choose from various divisions of the 12-step, anonymous programs, including:

Alcoholics Anonymous
Narcotics Anonymous
Cocaine Anonymous
Marijuana Anonymous
Other anonymous programs

Alanon, Narcanon and other programs support family members and friends of alcoholics and drug abusers. These programs uphold the belief that alcohol or drug abuse is a life-long problem that is bigger than the individual, and although they suggest participants turn their problems over to a higher power, the programs are not tied to a specific religion.

How do I know which 12-step meeting to attend?

Finding the best and most desirous meeting for your individual needs may take some time. The 12-step system has many different groups, including some that cater to those not spiritually inclined.

I notice that I have been more nervous lately. Do I have a panic disorder?

Doctors diagnose panic disorders based on symptoms that could be alleviated through counseling, medication or both. Your doctor can help you decide whether or not you have this disorder.

I have been feeling bluer in the last couple of weeks. Do I suffer from depression? Is it a chemical imbalance?

Doctors may diagnose depression when a blue mood lasts two or more weeks. They also look at other symptoms, such as weight change, sleep changes and concentration difficulties. Depression is a mental illness, not a character weakness, that often requires treatment through counseling, medication or both.

My friend is overusing alcohol. How do I know if he is an alcoholic?

Doctors diagnose alcoholism based more on social or job impairment than on how much one drinks. Sometimes these impairments are subtle, but more often, they are quite obvious to those close to the person. Sometimes one sees depression along with alcoholism. In that case, both require treatment. More information about alcoholism is in the "Questions about drugs and alcohol" section above.