Kollam Adolescence

Slide 1: 

12/3/2010 1 dr krishnan sivasubramoney

Slide 2: 

Dr. Krishnan Sivasubramoney, MBBS, MD, DPM, DIP.NB, MNAMS Assistant Professor of Psychiatry MO in Charge – Holistic and Stress Research Clinic Department of Psychiatry Medical College, Thiruvananthapuram Understanding Adolescence

Slide 3: 

12/3/2010 dr krishnan sivasubramoney 3

Adolescents !!! : 

Adolescents !!! 12/3/2010 4 dr krishnan sivasubramoney

Slide 5: 

12/3/2010 dr krishnan sivasubramoney 5

Slide 6: 

12/3/2010 6 dr krishnan sivasubramoney

Adolescence : 

Adolescence 12/3/2010 7 dr krishnan sivasubramoney

Slide 8: 

Adolescents too are brainy… 12/3/2010 8 dr krishnan sivasubramoney

Medicines are not the only solutions… : 

Medicines are not the only solutions… 12/3/2010 dr krishnan sivasubramoney 9

Slide 10: 

12/3/2010 10 dr krishnan sivasubramoney

Slide 11: 

Blastocyst 12/3/2010 11 dr krishnan sivasubramoney

Slide 12: 

12/3/2010 12 dr krishnan sivasubramoney

Slide 13: 

12/3/2010 dr krishnan sivasubramoney 13

Slide 14: 

12/3/2010 dr krishnan sivasubramoney 14

Slide 15: 

12/3/2010 dr krishnan sivasubramoney 15

Why ? : 

Why ? Every normal human being has normal yet disquieting problems to face. During adolescents so many things happen to body, mind and emotions. Useful information and skills can be taught so that adolescents can be prepared to make healthy decisions. 12/3/2010 16 dr krishnan sivasubramoney

He is… : 

He is… 12/3/2010 17 dr krishnan sivasubramoney

Slide 18: 

12/3/2010 dr krishnan sivasubramoney 18

Slide 19: 

“Son…I think it is time we had a talk about sex”. “Sure, Dad. What do you want to know?” 12/3/2010 19 dr krishnan sivasubramoney

Before this presentation : 

Before this presentation A period of learning and teaching Growth and development A period of revolution A period of values A period of spiritual enlightenment 12/3/2010 20 dr krishnan sivasubramoney

This presentation aims not to teach you…But aims to help you to remember… : 

12/3/2010 dr krishnan sivasubramoney 21 This presentation aims not to teach you…But aims to help you to remember…

Slide 22: 

12/3/2010 dr krishnan sivasubramoney 22

Slide 23: 

“U don’t understand” – Nobody understands – Professionals have few good answers to the problems teens and their parents face Adolescence is a transition zone where we treat adults as children 12/3/2010 dr krishnan sivasubramoney 23

A period of rapid change and difficult challenges : 

A period of rapid change and difficult challenges Physical changes Psychosocial demands Becoming independent from parents Developing skills in interacting well with peers Developing a set of ethical principles Becoming intellectually competent and confident Acquiring a sense of social and personal responsibility 12/3/2010 24 dr krishnan sivasubramoney

Coping with Sexuality… : 

Coping with Sexuality… Learning how to deal with changing sexual feelings Deciding whether to participate in various types of sexual activity Discovering how to recognize and reciprocate love Learning how to prevent untoward effects – pregnancy, STI 12/3/2010 25 dr krishnan sivasubramoney

Link between pubertal development, body image and self image : 

Link between pubertal development, body image and self image Teenagers are especially concerned with personal attractiveness – pimples, scars, height, weight, color etc Influenced by movies, television, advertisements Their own concern about physical appearance is usually of more importance to them than it is to other people 12/3/2010 26 dr krishnan sivasubramoney

Task of learning about one’s body and its sensual and sexual responses and needs : 

Task of learning about one’s body and its sensual and sexual responses and needs Concerned about body changes brought about by puberty – normal discharges Start physical inspection  enjoys the exploration Leads to deliberate attempts at producing sexual arousal (rehearsals for later experience) Reading ‘small books’, watching films Starts enjoying being touched 12/3/2010 27 dr krishnan sivasubramoney

Slide 28: 

By god’s grace everybody need not learn English 12/3/2010 28 dr krishnan sivasubramoney

Forming an identity : 

Forming an identity Starts developing a rigid gender role Males Athletic body Emotional control Willing to take physical risks Females Remaining attractive Supportive 12/3/2010 29 dr krishnan sivasubramoney

Developing a personal sexual value system : 

Developing a personal sexual value system Influenced by Family values Religious values Values of the closest friends 12/3/2010 30 dr krishnan sivasubramoney

Independence : 

Independence Adolescents look to peers for support and guidance Try to correct mistakes of older generation Peer group pressure  peer’s expectation of sexual experience Sex is a way of proving their ability to make independent decisions and of challenging the values of older generations 12/3/2010 31 dr krishnan sivasubramoney

Societal reactions : 

Societal reactions Society puts adolescents in double bind No status of child / adult Bans Sex education (don’t put ideas into head) Limits information (keep them afraid of pregnancy) Censor information (pure minds think pure thoughts) 12/3/2010 32 dr krishnan sivasubramoney

Sexual maturation – girls : 

Sexual maturation – girls Beginning of breast development (8-13 years) Appearance of pubic hair Lengthening of vagina Enlargement of uterus Menarche (12 +/- 1 year) (age on the decline) Influenced by SE factors, climate, heredity, family size and nutrition Increased vaginal secretion - sexual excitement, daydreaming, reading, sexual activity 12/3/2010 33 dr krishnan sivasubramoney

Sexual maturation in boys : 

Sexual maturation in boys Growth of testis Growth of penis and accessory sex organs (prostate, seminal vesicles, epididymis) Nocturnal emissions – surprised, puzzled, frightened Growth of pubic hair Appearance of facial and axillary hair Deepening of voice (testosterone stimulation of larynx) Estrogen fat accumulation Testosterone – muscle growth 12/3/2010 34 dr krishnan sivasubramoney

Physical changes during puberty : 

Physical changes during puberty 12/3/2010 35 dr krishnan sivasubramoney

Patterns of sexual behavior : 

Patterns of sexual behavior Sexual revolution is not still over More males report having had intercourse Gap in rates of coital experience between the sexes has decreased 12/3/2010 36 dr krishnan sivasubramoney

Slide 37: 

Am I doing the right thing? Am I doing the thing right? 12/3/2010 37 dr krishnan sivasubramoney

Different motivations in girls and boys : 

Different motivations in girls and boys Boys Badge of manhood Symbol of achieving maturity and social status Girls A marker of personal and social maturity A way of obtaining or solidifying love and commitment 12/3/2010 38 dr krishnan sivasubramoney

Varying motives : 

If you love me you will permit I permit because I love you Varying motives 12/3/2010 39 dr krishnan sivasubramoney

Views about sex & sexuality : 

Views about sex & sexuality 12/3/2010 dr krishnan sivasubramoney 40

Gay & Lesbian adolescents : 

Gay & Lesbian adolescents The homophobic society Realization of having a different sexual orientation Rejection and hostility – parents, relatives, friends, religious institutions 12/3/2010 41 dr krishnan sivasubramoney

Sexual behavior during adolescence : 

Sexual behavior during adolescence Masturbation – BOTH MALES AND FEMALES increase in frequency & numbers By the end of adolescence, almost all males, and ~3/4 of females have masturbated Safe sexual release Learn about self Noncoital sexual expression Noncoital sex: physical contact excluding coitus (i.e. kissing, touching, and manual or oral-genital stimulation) Oral-genital activity has increased How far to go often an issue Learning about sexual intimacy Technically can “stay a virgin” 12/3/2010 42 dr krishnan sivasubramoney

Problems of the 20th – 21st century : 

Problems of the 20th – 21st century Sex addiction Mobile mania Internet addiction Paraphilias – fetishism, voyeurism, frotteurism 12/3/2010 43 dr krishnan sivasubramoney

Factors that predispose teenagers to: : 

Factors that predispose teenagers to: Early intercourse Low SES/poverty Family conflict/marital disruption/single-parent or reconstituted family Low parent education and supervision Substance abuse Low self-esteem, hopelessness Poor academic performance Exposure to TV w/high sexual content Previous sexual abuse Later intercourse Higher SES Religious beliefs Spiritual interconnectedness w/friends Good relationship with parents, and perception of parental disapproval of teen intercourse good school performance Late onset of puberty 12/3/2010 44 dr krishnan sivasubramoney

Problems faced by adolescent : 

Problems faced by adolescent 12/3/2010 drkssmoney 45

Last but not the least… : 

Last but not the least… Spirituality Guidance for a Career 12/3/2010 dr krishnan sivasubramoney 46

Studies & EXAMS : 

Studies & EXAMS 12/3/2010 dr krishnan sivasubramoney 47

Sexual abuse : 

Sexual abuse 12/3/2010 dr krishnan sivasubramoney 48

Other mental health Problems : 

Other mental health Problems Depression Anxiety ADHD Conduct disorder Antisocial personality disorder Impulse control disorders Substance use disorders – pan masala, smoking, alcohol, hard drugs Atypical presentations – Somatic symptoms 12/3/2010 dr krishnan sivasubramoney 49

Slide 50: 

Counseling Schedule: Late Adolescence

Early Adolescence Counseling for Youth : 

Early Adolescence Counseling for Youth Whom do you go to for help if you’re having trouble in your relationship? What do you do to stay safe? What do you and your friends like to do? What after-school activities are you involved with? Whom do you turn to for advice and encouragement? With independence comes the responsibility for staying safe. 12/3/2010 52 dr krishnan sivasubramoney

The Possible solutions : 

The Possible solutions Treat them as much like adults as possible Do things with them Don’t say: ‘THIS WILL NEVER WORK’. 12/3/2010 dr krishnan sivasubramoney 53

The Possible solutions : 

The Possible solutions Why are we always fighting, thinking of correcting and teaching them Can we learn from them? 12/3/2010 dr krishnan sivasubramoney 54

The Possible solutions : 

The Possible solutions 12/3/2010 dr krishnan sivasubramoney 55

The Possible solutions : 

The Possible solutions 12/3/2010 dr krishnan sivasubramoney 56

Characteristics of Healthy adolescents : 

Characteristics of Healthy adolescents Appreciates and values own body and mind. Takes responsibility for own behaviors. Is knowledgeable about various issues. Communicates effectively with family about many issues, including sexuality. Seeks and understands information about parent’s values and considers them when forming own values. Interacts with both genders in appropriate and respectful ways. Expresses love and intimacy in developmentally appropriate ways. Able to evaluate personal readiness for mature relationships. 12/3/2010 57 dr krishnan sivasubramoney

Sex education for adolescents : 

Sex education for adolescents Great deal of controversies Several opinions At home – in the context of family values At religion sponsored meetings – within the proper moral framework AIDS education getting more attention 12/3/2010 58 dr krishnan sivasubramoney

Best accepted views : 

Best accepted views Encourage adolescents to make healthy decisions for themselves Support / encourage abstinence Teach safe sex practices Strengthen communication between parents and children A comprehensive sexuality education which involves parents and community leaders Offer quality counseling to those who call for help. 12/3/2010 59 dr krishnan sivasubramoney

Sex education for adolescents : 

Sex education for adolescents Cannot be successful if it focuses only on biological facts and negative consequences Topics to be covered Intimacy IP relationships Sexual decision making Different sexual orientations Coercive sex 12/3/2010 60 dr krishnan sivasubramoney

Should be honest / Provide scientific Message : 

Should be honest / Provide scientific Message 12/3/2010 61 dr krishnan sivasubramoney

In Conclusion…. : 

In Conclusion…. In order to effectively assist adolescents with their own life adults must first: Identify their views and values. Support adolescents autonomy when possible. Show empathy and be good listeners. Familiarize themselves with available programs and resources for teens. Know when, how, and where to make referrals for adolescents who are having problems 12/3/2010 62 dr krishnan sivasubramoney

In Conclusion…. : 

In Conclusion…. Opinions might differ We can and must work together because we do have a common goal: To assist all adolescents to avoid unintended events and consequences in life and to help them to become good individuals of tomorrow. 12/3/2010 63 dr krishnan sivasubramoney

Slide 64: 

12/3/2010 64 dr krishnan sivasubramoney Dr. S. Krishnan, MBBS, MD, DPM, DIP.NB, MNAMS Assistant Professor of Psychiatry MO in Charge – Holistic and Stress Research Clinic Medical College, Thiruvananthapuram Email: manaskrishnan2003@gmail.com Ph: 9447 123 789