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Treating an adolescent's severe psychological disorder often will require a combination of two things: medication and motivation, says Dr. Richard C. Ferre.

The family of a troubled youth may have sought help for some problem like a reading disorder. But it turns out that the boy actually is depressed, and his depression keeps him from concentrating long enough to master reading assignments.Actually, the youth turns out to be not as reading-disabled as believed. On low doses of an anti-depressant he will begin feeling much better within a short time, said Ferre, a psychiatrist who is chairman of the Department of Psychiatry at Primary Children's Medical Center, 100 N. Medical Drive.

Ferre and Marianne Maughan-Pritchett, a therapist at Wasatch Canyons Hospital, 5770 S. 1500 West, will discuss childhood behavior Saturday during the Deseret News/Intermountain Health Care Hospitals Health Hotline. The public may seek advice from them free of charge.

In the hypothetical story, with treatment the boy becomes more stable, and improved concentration allows him to progress in his reading.

With depression, some adolescents feel, "you can't think, you can't focus your attention, your energy level is low, you tend to be very impatient, you can't follow through with things."

In more severe cases, such as an obsessive-compulsive disorder, drugs also can help. This disorder causes repetitive behavior, such as repeatedly washing hands.

"The brain produces far too much anxiety, and the brain tends to compensate for that by creating rituals or obsessions that the person feels compelled to follow," he said.

A young person with this affliction may find himself washing hands and rechecking the locks on doors before going to bed. Maybe this troubled person will repeatedly make sure that his school books are stacked beside the bed and that the alarm clock is set.

"Some rituals like this can take half an hour before the kid goes to bed," Ferre said.

In an extreme case, the anxiety may be so high that the youth fears he may have murdered someone, or hurt someone at school inadvertently - even though he did not. He may fear going to school because of that.

A key to helping someone with this kind of problem is to explain that it is not him who is doing the compulsive things, but his brain. The psychologist may help him understand that the brain is a separate organ, which can have an illness, and that the correct medication can calm the brain.

Then the youth must also hear that it is his job to take a stand against unwanted thoughts, to "put them out of the mind and fight this thing," he said.

With that motivation, and the help of medicine, the youth can realize when he is starting to win the battle. He may literally feel that he is becoming more and more in control of his own brain.

He can take the medicine and deal with the intrusive thoughts and bad feeling.

According to Ferre, treatment is most effective if it is started when the patient is young. The young seem to respond more quickly. "The older you get, the harder it becomes" to overcome these disorders, he said.

Another area that has been controversial is the use of Ritalin, a drug that is intended to treat attention-deficit disorder. People with the disorder may act impulsively or may lack empathy for others. Acting before they think, they may get into trouble.

In addition, the lack of ability to concentrate may harm school work.

But some parents fear that Ritalin will be addictive or that it will harm their children, he said.

The fact is, Ferre added, Ritalin can be extremely beneficial.

"With the help of a good school and support of parents, these kids do extremely well. And many of them, without this medication, wind up in the juvenile justice system."



Free call-in service

Is your child's behavior inappropriate? How can you tell if she is depressed? What new medication can help with behavioral and psychological problems in adolescents?

Anyone with questions like these can find two child behavior specialists with plenty of answers Saturday during the monthly Deseret News/Intermountain Health Care Hospitals Health Hotline. The telephone call-in service will be available from 11 a.m. until 1 p.m. that day.

The experts are Marianne Maughan-Pritchett, who has a master's degree in her field and helps children at Wasatch Canyons Hospital, and Dr. Richard Ferre, a psychiatrist who is chairman of the Department of Psychiatry at Primary Children's Medical Center.

To reach them toll-free from anywhere in the region, dial 1-800-925-8177. Nobody needs to give a name to seek advise.

The hotline is a free community service provided on the second Saturday of every month by the Deseret News and IHC.