MODULE 7: Mental Health and Well-being in Middle and Late Adolescence

Inclusive Dates: May 12- 19, 2021

Psychological well-being
 Refers to an individual’s state or condition that is free from mental or emotional disorders.
 Free from distressing thoughts and emotions and can flexibly adapt to changing situations.

“Adolescents who are psychologically well can find ways to solve their problems in a more realistic manner, can make
better choices in life, and demonstrate resilience. Mental and emotional health may boost physical health thus you may be
free from frequent body pains and even sickness. Being mentally and emotionally healthy may result in acceptance,
optimism, happiness, and proactive responses.” GOOD NEWS 

“Abnormality and mental illness occurs when certain maladaptive behaviors and extremely deviant conduct are
exhibited.” BAD NEWS 

Different Types of Mental Disorders According to Diagnostic and Statistical Manual of Mental Disorders (DSM)

1. Eating Disorders
* Persistent disturbance of eating that result in altered consumption of absorption of food and significantly impair
physical health or psychosocial functioning.
* Common among teenagers and are associated with dissatisfaction with one’s body due to distorted body image.
Negative body image is associated with low self-esteem, Lack of social support, weight related-teasing, and pressure to
lose weight were linked to the negative body of image. ( Ata, Luden, and Lally, 2007)
Types of Eating Disorder
1.1. Anorexia Nervosa – intense fear of gaining weight, disturbed body image, refusal to maintain normal body
weight, and dangerous measures to lose weight.

1.2. Bulimia Nervosa – overeating followed by efforts to induce vomiting, fasting, and excessive exercise.

1.3. Binge- eating – overindulgence

of food but not followed by efforts to induce vomiting, fasting, excessive exercise. (Weiten et al., 2009)
2. Anxiety Disorder
* Characteristics: excessive fear, anxiety, behavioural disturbance
* Physical symptoms: fainting, sweating, palpitations, chest pain, and dizziness, fear of “going crazy”
* Factors that contribute to the development of this disorder: biological, cognitive, and environmental(bullying)
Types of Anxiety Disorder
2.1. Phobic anxiety – accompanied by trembling and palpitations. Adolescents are said to be experiencing this
phobia when their fears seriously obstruct everyday activities.
2.2. Panic attacks – characterized by an abrupt surge of intense fear or discomfort.
2.3. Obsessive-Compulsive disorder (OCD) – persistent, uncontrollable intrusions of unwanted
thoughts(obsessions) and urges to engage in senseless rituals (compulsions)

3. Major Depressive Disorder

* Characterized by: hopelessness, lack of energy in usual activity, crying for unexplained reasons, low self-
esteem, loss of interest in usual activities, can not make decisions, tend to blame others and hurt themselves.
* Diagnostic criteria present during two-week period according to the Diagnostic and Statistical Manual of
Mental Disorders IV (2013):
1. Depresses most of the day
2. Diminished interest in all or almost all of the activities of the day
3. Significant weight loss
4. Insomnia or hypersomnia
5. Psychomotor agitation or retardation
6. Fatigue or loss of energy nearly every day
7. Feelings of worthlessness or excessive or inappropriate guilt
8. Diminished ability to think or concentrate
9. Recurrent thoughts of death, suicide ideation, or suicide attempt
* Causes of this disorder: heredity, environmental factors, stressors

4. Bipolar Disorder
* Used to be called manic-depressive disorder. Both suffers from depression and manic periods. (Weiten, 2009)
* Symptoms: with very high levels of energy, exaggerated plans, and very optimistic views
Hyperactive and may even work without sleeping for days
Tend to talk very fast and have overflowing ideas in mind
Feel challenged in doing plans and obsessed about certain projects
Impulsive and sexually reckless, may have impaired judgment
*Factors to the development of this disorder: biological and psychological (Kalindini and McGuffin,2003)

5. Conduct Disorder
* Characterized by: repeated pattern of behaviour in which the basic rights of others are violated, policies, rules,
and regulations.
* Teenagers who have this disorder are labelled as delinquents
* Juvenile delinquency – any illegal act by a minor and it emphasizes the criminal act and the legal aspects of the
behavior (Dacey and Kenny, 1997) Delinquency(negative identity) is an attempt to establish one’s identity.

6. Personality Disorders
* an enduring pattern of inner experience and behaviour that deviates markedly from the expectations of the
individual’s culture, is pervasive and inflexible, starts in adolescence or early adulthood, becomes stable over time, and
leads to distress or impairment
* it manifests during a person’s interaction and it continues for several years.
* display deviant behaviours, oversensitivity or insensitivity, rigidness, self-centeredness, or extravagant illusions.
 Categories of Personality Disorders
6.1. Paranoid Personality Disorder – One who suffers from this has trust issues and suspicious on the
motives of the people around them. They usually think that others are thinking of hurting them and these thoughts cause
fears.
6.2. Antisocial Personality Disorder – this is manifested by the individual’s disregard or violation of the
rights of others. They do not care if their behaviors may harm others, but they will do and get whatever they want even at
the expense of others.
6.3. Histrionic Personality Disorder - this disorder is manifested by individuals who show excessive
emotionality and attention-seeking behaviours. At times, they will cry for no apparent reason just to express their feelings.
Also, they will talk or act like a baby just to be able to get attention from others.
6.4. Narcissistic Personality Disorder – this disorder exhibits pattern of grandiosity. They are self-
centered or think of themselves only, and their need for admiration is very strong. They lack empathy or the ability to put
themselves into the situation of others. Thus, it is difficult for them to understand the needs of others.
6.5. Avoidant Personality Disorder – this disorder is evident when individuals show a pattern of social
inhibition, feelings of inadequacy, and hypersensitivity to negative evaluation. So they prefer to be alone and try to avoid
social activities because of their fear of being judged or negatively evaluated by others.
6.6. Dependent Personality Disorder – this is manifested when individuals demonstrate a pattern of
submissive and clinging behaviour related to an excessive need to be taken care of. Thus, adolescents who suffer from this
personality disorder usually can’t work alone, feel helpless when unattended by someone, and may demand someone to be
always at their side.
6.7. Obsessive-Compulsive Personality Disorder – is manifested by a pattern of preoccupation with
orderliness, perfectionism, and control. So, adolescents who experience this disorder may be overly sensitive to the
cleanliness of their room. To illustrate, even a single strand of hair would cause irritation. They may not be able to study
in their room when things are disorganized.

7. Schizophrenia and Other Psychotic Disorders

* schizophrenia means “split mind” (Comer, 2013)
* It is a psychotic disorder usually characterized by the deterioration in personal, social, and occupational
functioning due to bizarre emotions and abnormal perceptions.
* They experience one of more of the following: delusions, hallucinations, disorganized thinking (speech) and
abnormal motor behaviour.
* They manifest odd thoughts, unusual interpretation of experiences, disturbed emotions, and motor
abnormalities. Adolescents who have this type of disorder loss contact with reality or psychosis.
* Example: They may see a police officer in the street controlling the traffic situation bu they may claim that the
police officer will approach them and bring them to jail.

8. Substance-related Disorders
* Drug – substance like alcohol, caffeine, marijuana, and tobacco whose chemical action alters the biological and
psychological functioning of the person.
* Drug dependency (addiction) – is manifested when an individual can no longer control his or her drug
substance intake.
* Drug abuse – is evident when an individual relies on drugs excessively which affects his or her relationship
with the family, efficiency at work, or even capacity to decide realistically.
* Tolerance – a concept commonly associated with substance abuse. It is the individual’s capacity to use the
substance repeatedly by small doses and later larger doses to produce the desired effects. (Sevilla, 2000)

9. Computer Addiction
* characterized by an excessive use of the computer or the Internet.
 * It is referred to as pathological because individuals have an uncontrollable use of the Internet.
* in a study conducted, it was found out that the pathological use of the Internet is correlated with depression,
anxiety, attention deficit and hyperactivity disorder (ADHD) symptoms, obsessive-compulsive symptoms, and aggression.

Threats to Psychological Well-Being

1. Family Situations
* Parents who often fight in front of kids may have lasting effects even as they reach adolescence.
* According to recent studies parents raised their children according to how they were raised. For example when
a teenager asked for permission to go to a party the automatic response is “no” because they were also not allowed by
their parents.
* The same study shows that adolescents who drink heavily often come from unhappy homes where tensions are
strongly felt.
* Parent’s inability to deal with their own stressors is normally felt by the children, affecting their psychological
well-being. So at times they would refer to friends and look for someone who can understand their situation.
* One social phenomenon today: temporary separation of a family member, usually a parent, due to overseas
employment. Overseas employment has economically benefited families by enabling them to have money for a better
quality of life in terms of home ownership, increased amenities, and improved education of the children. However, the
psychological costs have strongly affected children especially teenagers. Some teenagers whose both parents work abroad
find it difficult to adjust with hone-and school-related concerns. They find it difficult to manage financial matters, instill
discipline to younger siblings, and make decisions that require matured dispositions at home.
* Marital breakup has been associated with a higher incidence of antisocial behaviour among boys in the
classroom.
* Teenagers from non intact families are more likely to smoke, use drugs, and consume alcohol, even when
controlling for important factors such as age, sex, race, and parent education.
* Children growing up in without their own married parents are prone to higher rates of stress, depression,
anxiety, and low self-esteem during the teenage years.
* Research consistently shows that parental separation has lasting negative emotional effects throughout
childhood, adolescence, and adulthood.

2. Socioeconomic Factors
* Poverty is associated with mental health and psychological well-being.
* In a study conducted by World Health Organization (WHO) common mental disorders are about twice as
frequent among the poor as among the rich.
* Both rich and poor may experience mental health concerns. For the poor they don’t have money to buy food and
medicine so it contributes to poor mental conditions. Whereas for the rich, they have the money to buy what they want but
it may result to unregulated behaviours such as computer and Internet addiction.
*Scenarios in the Philippines that show poverty: Street children begging for food or money, children entering
public transport to clean your shoes then ask for money after, children selling sampaguita garlands, children cleaning car
windows and then ask for money after, a number of teenagers who cannot attend school because of their economic
condition.

3. School-related Factors
3.1. Bullying – refers to any severe or repeated use by one or more students of a written, verbal, or electronic
expression, or a physical act or gesture, or any combination directed at another student that has the effect of actually
causing or placing the latter in reasonable fear of physical or emotional harm or damage to his property; creating a hostile
environment at school for the other student; infringing on the rights of the other student at school; or materially and
substantially disrupting the education process or the orderly operation of a school. – Republic Act 10627 (Anti-bullying
Act of 2013)
 Indication of bullying : (1) when it is deliberately done to hurt someone (2) when bullies target single individuals
for bad treatment (3) when the act of teasing is done repeatedly (4) when the bullies know the persons being bullied
cannot defend themselves.
Forms of bullying : (1)Physical: biting someone, hitting, kicking, pulling one’s hair (2) Verbal: name calling or
labelling, writing insulting words and posting them in public areas, spreading false or malicious rumor, and sending
abusive text messages or making threatening telephone calls (3) nonverbal: making rude gestures and mean faces,
damaging one’s property like books, or stealing or hiding one’s personal belongings like bags, shoes, and notebooks (4)
psychological: intentionally ignoring someone in group projects, intimidate the victims, or leave them out of things (5)
Cyber bullying: sending threatening or malicious messages through social media, creating Web sites for hate messages, or
posting secrets through the Internet.
Target victims: new students in campus, those with few friends, unassertive students
Profile of a bully: bullied in their own household, came from hostile or unsupportive families, permissive
parents, and unloving families, victims of social rejection
3.2. Peer Pressure

Prevention of Mental Health Problems

1. Enhancing Self-esteem
* self –esteem means self-worth, it is your assessment of your importance as a person
* Characteristics of an adolescent with high self-esteem: confident, optimistic, feel good about themselves,
find ways to improve themselves, expresses opinions confidently, initiate conversation with others, work cooperatively
with a group, maintain eye contact. (Savin-Williams and Demont,1983)
* Characteristics of an adolescent with low self-esteem: feels negatively, feels inadequate and incompetent,
blames themselves. Too much of these feelings cause depression and mental disorder.
* Unrealistic high self-esteem may cause: arrogance and false sense of superiority
* How to enhance Self-esteem
1.1. Identify (self-assessment)the real causes of having low or unrealistic high self-esteem.
1.2. Seek social and emotional support.
1.3. Invest on your talents.
1.4. Use positive coping strategies when you experience problem

2. Enhancing Resilience
* Resilience means your capacity to recover from unpleasant experience. It is the ability to bounce back to
original condition after a life-changing experience like illness, death or a loved one, or an accident.
* How to enhance resilience
2.1. Establish connections .
2.2. Accept the reality that nothing is permanent in this world.
2.3. Love and take care of yourself.
2.4. Be more optimistic.
2.5. Strengthen your problem-solving abilities
How? : set realistic goals, identify and list all possible solutions to your problems, explore the
consequences of suggested solutions, prioritize the solutions, and implement the solutions.

3. Developing Self-regulation
* it is your capacity to control and monitor your own behaviour.
* it involves setting goals and standards and delaying gratification of needs.
* self-efficacy is an important components in self-regulation and it represents your beliefs about your capacity to
perform or do your plans. It is concerned not with your competencies but with your confidence to do your skills.

4. Enhancing Social Skills

 * it is the ability to relate more effectively with others.
* Ways to promote positive relationship with others according to Harrington:
4.1. Promote good feelings through positive reciprocity.
4.2. Show empathy.
4.3. Clarify boundaries and set people limitations.
4.4. Learn to negotiate.
4.5. Express gratitude.
4.6. Practice forgiveness.
4.7. Learn to help others.
4.8. Accept help from others.

5. Psychotherapies
* refers to the professional relationship between the counsellor/therapist and counselee/client, which aims to
promote psychological wellness through various interventions.
* Types of Psychotherapies
5.1. Psychoanalysis – aims to help the client uncover conflicts and repressed emotions that prevent
him/her to develop through free association, dream analysis, resistance, and transference.
5.2. Behaviour therapy – aims to help individuals change or modify behaviour by identifying
maladaptive responses to stressors.
5.3. Client-centered therapy – aims to promote psychological changes through a supportive emotional
environment.