Child Mental Health: 7 Common Myths

It is easy to empathize with suffering we can see: a child who lost hair in chemotherapy, for instance. The suffering of a child with psychiatric issues is far less obvious. Many children and teens with emotional problems keep their pain secret. Others express their feelings in risky or offensive ways. Due largely to stigma–fear, shame and misunderstanding about mental health disorders–the majority never receive clinical care.

Debunking myths about child mental health is critical to getting more children the help and understanding they deserve.

MYTH 1: A child with a psychiatric disorder is damaged for life.
A mental health condition is by no means an indication of a child’s potential for future happiness and fulfillment. The most important thing to remember here is that early intervention can be very effective at preventing chronic, debilitating conditions. If parents and teachers recognize the early signs of a psychiatric disorder — whether it’s ADHD or depression or anxiety — and get a child treatment, she has a much better chance of eliminating, or effectively managing, symptoms that would otherwise interfere with relationships and her ability to succeed at school and at work.

MYTH 2: Psychiatric problems result from personal weakness.
It can be difficult to separate the symptoms of a child’s psychiatric disorder — impulsive behavior, aggressiveness or extreme shyness, for example — from a child’s character. But a mental health disorder is an illness, just like diabetes or leukemia is not a personality type. By way of example, anorexic girls are often blamed for starving themselves, but the obsessive fears and distorted body image that drive their behavior have genetic and biological bases. We can’t expect children and teens to have the tools to overcome anorexia (or any other psychiatric disorder) on their own, but they can absolutely recover with the help of their parents, clinicians and a carefully individualized treatment plan.

MYTH 3: Psychiatric disorders result from bad parenting.
While a child’s home environment and relationships with his parents can exacerbate a psychiatric disorder, these things don’t cause a disorder. Anxiety, depression and learning disorders — indeed, the full range of mental health conditions — often have biological causes. Parenting isn’t to blame. But parents play a central role in a child’s recovery. They provide support and care that is crucial to their child’s treatment plan and future development.

MYTH 4: A child can manage a psychiatric disorder through willpower.
The key word here is disorder. A disorder is not mild anxiety or a dip in mood. It is severe distress and dysfunction that can affect all areas of a child’s life. A heartbreaking number of parents resist mental health services for their children because they fear the stigma attached to diagnoses or see psychiatrists as pill-pushers. This is incredibly sad because kids don’t have the skills and life experience to manage a condition as overwhelming as depression, anxiety or ADHD. They can benefit profoundly from the right treatment plan, which usually includes a type of behavioral therapy, and have their health and happiness restored.

MYTH 5: Therapy for kids is a waste of time.
Treatment for child mental health disorders isn’t old-fashioned talk therapy. Today’s best evidence-based treatment programs for children and teens use a cognitive-behavioral model: therapy that focuses on changing thoughts, feeling and behaviors that are causing them serious problems. This is solution-driven therapy, and it’s a key component of some of the most exciting and innovative new treatments plans for kids. Research has shown that there’s a “window of opportunity” — the first few years during which symptoms of mental health disorders appear — when treatment interventions are most successful. This means that early identification followed by therapeutic interventions can give kids the tools they need to decrease, or effectively manage, their symptoms before they experience the stigma and negative effects of a fully developed psychiatric disorder.

MYTH 6: Children are overmedicated.
Since so many public voices (many without authority or clinical experience) have questioned or decried the use of medications in the treatment of childhood psychiatric disorders, many people believe that psychiatrists simply prescribe medication to every child they see. The truth, however, is that good psychiatrists use enormous care when deciding whether and how to start a child on a treatment plan that includes medication — usually along with behavioral therapy. Medication is not the norm. Approximately 20 percent of children and teens in America have psychiatric issues at any one time; only five percent of them take medication. We never doubt whether a child with diabetes or a seizure disorder should get medication; we should take psychiatric illness just as seriously. The larger problem is that millions of children who suffer from serious psychiatric problems never receive any help.

MYTH 7: Children grow out of mental health problems.
Children are less likely to “grow out” of psychiatric disorders than they are to “grow into” more debilitating conditions. Most mental health problems left untreated in childhood become more difficult to treat in adulthood. Since we know that most psychiatric disorders emerge before a child’s 14th birthday, we should have huge incentive to screen young people for emotional and behavioral problems. We can then coordinate interventions while a child’s brain is most responsive to change, and treatment is more likely to be successful. Left untreated, disorders often lead to substance abuse, difficulties with relationships and work, and brushes with the law.

Harold S. Koplewicz, M.D.
President, The Child Mind Institute
Director, Nathan S. Kline Institute for Psychiatric Research

The opinions expressed herein are solely my own as a child and adolescent psychiatrist and public health advocate.

Touch And Reconnecting With Ourselves

We can be so focused on the perceived shortcomings of our bodies — too thin, too fat, too big, too small — that we fail to appreciate what an extraordinary means we have at our disposal to experience the world around us — our body’s sense of Touch.

It’s a strange irony, but in our society we are both too obsessed with our bodies and simultaneously not aware enough of them. We think too much about our bodies (‘Do I look fat in this?’, ‘Should I have a face-lift?’, ‘A nose-job?’, ‘Should I go to the gym more often to build up my muscles?’), but we don’t spend enough time feeling with our bodies — noticing and appreciating how our bodies feel, moment to moment, as we encounter the world and interact with it and the people around us. We don’t spend enough time truly inhabiting our bodies; instead, we spend a lot of time in our heads or our minds, thinking about things, people, anxieties or events outside ourselves.

Over the next few weeks, I’d like to devote some time and space to reflecting on our five senses and how we can learn to tune more deeply into the world around us, to feel more in touch with life and, internally, more in touch with our experience of the world through our sensory input. Today, appropriately enough, I’m going to start with Touch.

The skin is by far the largest of our organs; it protects us from infection and toxins, keeps our inner workings warm and dry, and provides us with an exquisitely sensitive way of experiencing the world around us. It begins in the womb, where we are fully enveloped in our mother’s amniotic fluid, the perfect protective environment for us as developing beings. Our skin is at one with its surroundings and so are we; there is no ‘other’. Birth is a traumatic emergence into a cold, strange world, where the air is so much thinner and less supportive than the warm liquid we are accustomed to. We are touched by other objects; where once we were touched all over and all at once by the amniotic fluid, now we are touched on individual parts of ourselves — a hand here, a cheek there, and so on.

As we grow, touch is our way of finding out about the world around us, a world that only gradually comes into focus as our eyesight and ability to interpret what we see improves. It’s only later that we become more reticent about touch; how often were you told as a child ‘Don’t touch that!’ either because it was potentially dangerous (such as a hot iron) or fragile (grandmother’s best china) or whatever? Touch becomes conditional: I’ll touch it if it’s safe, not going to hurt me, doesn’t belong to someone else, won’t break. And so we begin to cut ourselves off from touch.

Our society has taken this one stage further: it’s almost impossible now to feel comfortable about touching another person’s child to soothe them if they’re upset, for fear of being accused of suspicious motives. If you were in a crowded shopping centre and saw a child on their own, seemingly lost and tearful, how easy would it be for you to go over and touch them gently on the shoulder to let them know they are not alone?

It has been argued that many individuals in our society are effectively ‘touch-deprived’ and that this is the root cause of their mental or emotional distress — the absence of physical touch being a contributing factor to a sense of emotional loneliness and isolation. Research has shown that touch, or the lack of it, can seriously affect the emotional development of the individual; in his article ‘Touch and Human Sexuality‘, Robert Hatfield describes some of this fascinating research, which suggests that people who are deprived of affectionate touch as children are more prone to problems with close personal relationships as adults. The key phrase here is ‘affectionate touch’; for children who have experienced consistently neglectful, punitive or abusive touch from others, the sensation of being touched by another person may well feel threatening and stressful rather than soothing.

Adults also need to be touched — not necessarily in a sexual way. I used to savor the delicious warmth of a massage therapist’s hands on my aching shoulders after a hard day at work. I could really feel my muscles uncoiling, as if from tightly wound springs, and reconnecting with the rest of my body to make me feel more than just a dense mass of shoulder pain. Touch like this helps to reduce levels of the ‘stress hormone’, cortisol, and encourages general feelings of wellbeing.

I see it as no coincidence that we talk about being in or out of touch with things, whether that’s with other people or ourselves or the outside world. We are contained within our bodies, and our sense of touch is our quintessential means of reaching out from within our bodies and connecting with ‘outside’. There’s a handout that I use with some of my clients, particularly those who feel out of touch with themselves and who they are in relation to the world. It has 6 columns, one of which is headed ‘TOUCH’. I ask my clients to think about what things they like the ‘feel’ of and why. I tried it out on my stepson a moment ago and this is what he said: ‘I like the feel of my cat’s coat; it’s silky on my fingers but there are tickly bits as well. It’s thick and smooth and she tickles me with it when I’m asleep’. For me, I love the cool sensation of a crisp cotton pillow-slip on my cheek, the womb-like sensation of slipping into a deep hot bath, and the soft furriness of the leaves of the silver-grey plant we called ‘Lamb’s Lugs’.

Focusing on touch takes me out of my head and into my body and its contact with the outside world; it provides a pause for reflection and that, for me, is a welcome respite from the frantic pace of daily life.

I wonder who or what will you touch today?

This article was written by Libby Webber for Counselling Resource Online at:
http://counsellingresource.com/features/2010/09/13/touch-reconnecting-with-ourselves/

Aging Drug Users Are Increasing and Facing Chronic Physical and Mental Health Problems

Health and social services are facing a new challenge, as many illicit drug users get older and face chronic health problems and a reduced quality of life. That is one of the key findings of research published in the September issue of the Journal of Advanced Nursing.

UK researchers interviewed eleven people aged 49 to 61 in contact with voluntary sector drug treatment services.

“This exploratory study, together with our wider research, suggest that older people who continue to use problematic or illegal drugs are emerging as an important, but relatively under-researched, international population” says lead author Brenda Roe, Professor of Health Research at Edge Hill University, UK.

“They are a vulnerable group, as their continued drug use, addiction and life experiences result in impaired health, chronic conditions, particular health needs and poorer quality of life. Despite this, services for older drug addicts are not widely available or accessed in the UK.”

Figures from the USA suggest that the number of people over 50 seeking help for drug or alcohol problems will have risen from 1.7 million in 2000 to 4.4 million by 2020. And the European Monitoring Centre for Drugs and Drug Addiction estimates that the number of people aged 65 and over requiring treatment in Europe will double over the same period.

The nine men and two women who took part in the study had an average age of 57. All were currently single and their homes ranged from a caravan, hostel or care home to social housing.

Key findings from the study — by the Evidence-based Practice Research Centre at Edge Hill University and the Centre for Public Health at Liverpool John Moores University –included:

  • Most started taking drugs as adolescents or young adults, often citing recreational use, experimenting or being part of the hippy era. Child abuse and the death of a parent were also mentioned.
  • Some started taking drugs late in life due to stressful life events like divorce or death. Meeting a drug using partner was another trigger. One man started taking drugs later in life to shock his drug taking partner into stopping and ended up developing a drug habit himself.
  • First drug use varied from magic mushrooms, LSD, amphetamines and cannabis to heroin and methadone. Alcohol and smoking often featured alongside drug use.
  • Some increased their drug use over time, while others had periods when they tried to reduce or even abstain from drugs. All but two of the participants were taking methadone, either as maintenance or as part of a reduction strategy in order to give up drugs.
  • A number of the participants said they were trying to use drugs responsibly and it was felt that their age and the influence of drug treatment services were factors in this. They also appeared more aware of the need to maintain their personal safety, based on previous experiences.
  • Most recognized that their drug use was having detrimental and cumulative effects on their health, as they had developed a range of chronic and life-threatening conditions that required hospitalization and ongoing treatment.
  • Physical health conditions included: circulatory problems such as deep vein thrombosis, injection site ulcers, stroke, respiratory problems, pneumonia, diabetes, hepatitis and liver cirrhosis. Malnutrition, weight loss and obesity also featured, as did accidental injuries due to falls and drug overdoses.
  • Common mental health problems included memory loss, paranoia and changed mood states, with anxiety or anger also featuring.
  • All wished they hadn’t started taking drugs and would advise young people not to. A few were keen to give up, but others felt it was too hard. One man described his drug use as “disgusting and squalid” while another said that the older he got the worse his drug use got and that it was a “crazy” situation.
  • All were single or divorced and drug use was a common factor in relationship breakdowns. Most lived alone, with three relying on careers who were also drug users. Pets were often important for some, providing companionship as well as a sense of responsibility and structure to their day.
  • Drug use was often associated with chaotic lifestyles and relationships and some reported periods of imprisonment.
  • Participants were positive about the support they received from voluntary drug services, but had mixed experiences of primary and hospital care. Some felt stigmatized by healthcare professionals, while others received compassion and acknowledgement of their drug use.

“Our population is aging and the people who started using drugs in the sixties are now reaching retirement age,” says Professor Roe.

“It is clear that further research is needed to enable health and social care professionals to develop appropriate services for this increasingly vulnerable group. We also feel that older drug users could play a key role in educating younger people about the dangers of drug use.”

This story was originally published at ScienceDaily: http://www.sciencedaily.com/releases/2010/09/100909074009.htm

How the Mind Counteracts Offensive Ideas

People react to ideas they find offensive by reasserting familiar structures of meaning.

The human mind is always searching for meaning in the world. It’s one of the reasons we love stories so much: they give meaning to what might otherwise be random events.

From stories emerge characters, context, hopes and dreams, morals even. Using simple structures, stories can communicate complex ideas about the author’s view of the world and how it works, often without the reader’s knowledge.

And when stories embody values in which we don’t believe, we tend to reject them. But, according to a new study published in the journal Personality and Social Psychology Bulletin, it goes further than just rejection, psychologically we push back against the challenge, reasserting our own familiar structures of meaning.

In their research Proulx et al. (2010) used two stories that illustrate divergent views of the world to explore how people react to offensive ideas.

The Tortoise and the Hare

The first story was Aesop’s fable The Tortoise and the Hare. I’m sure you know it (if not, it’s here) so I’ll cut straight to one of its morals: if you keep plugging away at something, like the tortoise, you’ll eventually get there, even if you’re obviously outmatched by those around you.

Another interpretation is that the hare loses the race because he is overconfident. Either way, both the hare and tortoise get what they deserve based on how they behave. This is the way we like to think the world works: if you put in the effort, you’ll get the reward. If not, you won’t. The lazy, overconfident hare always loses, right?

An Imperial Message

Quite a different moral comes from the second piece the researchers used: a (very) short story by Franz Kafka called ‘An Imperial Message’. In this story a herald, sent out by the Emperor, is trying to deliver an important message to you. But although he is strong and determined, no matter how hard he tries, he will never deliver it (you can read the full story here).

Contrary to Aesop’s fable, Kafka is reminding us that effort, diligence and enthusiasm are often not rewarded. Sometimes it doesn’t matter if we do or say the right things, we won’t get what we want.

In many ways Kafka’s story is just as true as Aesop’s fable, but it is a much less palatable truth. Aesop’s fable seems to make sense to us while Kafka’s story doesn’t, it feels empty and absurd. Consequently we’d much rather hold on to Aesop’s fable than we would Kafka’s depressing tale.

Unconsciously threatening

These two stories were used by Proulx et al. to test how people reacted firstly to a safe, reassuring story and, secondly, to a story that contains a threat to most people’s view of the world. They thought that in response to Kafka’s story people would be unconsciously motivated to reaffirm the things in which they do believe. In their first experiment the researchers used measures of participant’s cultural identity to test this affirmation.

Twenty-six participants were given Aesop’s advert for hard work and another 26 were given Kafka’s more pessimistic tale. As predicted participants who read Kafka’s story perceived it as a threat to the way they viewed the world. They reacted to this threat by affirming their cultural identities more strongly than those who had read Aesop’s fable, which didn’t challenge their world-view.

In other words the participants in this study were pushing back against Kafka’s story by reaffirming their cultural identity.

Absurd comedy

In two more studies Proulx et al. addressed a couple of criticisms of their first study: that participants might have found Kafka’s story (1) too unfair and (2) too unfamiliar. So, in a second study they used a description of a Monty Python sketch which participants weren’t told was supposed to be a joke. In the third study they used Magritte’s famous absurdist painting of a bowler-hatted gentleman with a big green apple in front of his face.

The idea of using absurdist stimuli like Monty Python and the Magritte painting is that, like Kafka’s short story, they challenge our settled perceptions of the world.

The research backed up this idea. Both Python and Magritte produced the same counter-reaction in people, leading them to restate values in which they believed. Similar but non-absurd stimuli didn’t have the same effect.

Instead of using cultural identity, though, the researchers measured notions of justice and need for structure. Participants reacted to the meaning threat implicit in Python by handing out a larger notional punishment to a lawbreaker. Here the threat of the absurd caused participants to re-affirm their belief in justice.

In the third study participants reacted to the meaning threat of the Magritte painting by expressing a greater need for structure. They were suddenly craving meaning; something, anything that makes sense, instead of this bowler-hatted man with an apple in front of his face.

Absurd truth

What this research underlines is that we push back against threats to our world-views by reasserting structures of meaning with which we are comfortable.

The researchers measured cultural identities, ideas of justice and a generalized yearning for meaning, but they probably would have found the same results in many other areas, such as politics, religion or any other strongly held set of beliefs.

When there’s a challenge to our established world-view, whether from the absurd, the unexpected, the unpalatable, the confusing or the unknown, we experience a psychological force pushing back, trying to re-assert the things we feel are safe, comfortable and familiar. That’s a shame because stories like Kafka’s contain truths we’d do well to heed.

This article was originally published at: PsyBlog http://www.spring.org.uk/

LOW VITAMIN D LINKED TO SCHIZOPHRENIA

There may be a link between sunlight, vitamin D and children’s brain development.
Content provided by Timothy McDonald, ABC Science

THE GIST

  • Babies born with low vitamin D levels are shown to be twice as likely to develop schizophrenia.
  • The finding may mean there could be a way to prevent cases of the disease.
  • Scientists caution more research needs to be done to confirm the link.

Babies born with low vitamin D levels are twice as likely to develop schizophrenia later in life, researchers from the Queensland Brain Institute have found.

But the researchers say the good news from the study is that it suggests it may be possible to prevent schizophrenia.

John McGrath from the Queensland Brain Institute says there have been suggestions for some time that there may be a link between sunlight, vitamin D and brain development. He says it is increasingly clear children with low vitamin D levels are more likely to develop schizophrenia.

“For the babies who had very low vitamin D, their risk was about twice as high as those babies who had optimal vitamin D,” said McGrath.

“But the amazing thing was that the study that was based in Denmark, where low vitamin D is quite common, we found that if vitamin D is linked to schizophrenia our statistics suggest that it could explain about 40 percent of all schizophrenias. That’s a much bigger effect than we’re used to seeing in schizophrenia research.”

While the simplest way to get enough vitamin D is to spend more time in the sun, it remains unclear whether there are fewer cases of schizophrenia in a country like Australia which sees a lot more sunlight.

“We don’t have high-quality data on that, but some statistics suggest we do have slightly lower incidences and prevalence of schizophrenia,” said McGrath.

“Like many other diseases, like multiple sclerosis, schizophrenia tends to be more common in places further away from the equator. And if you’re born in winter and spring you tend to have a slightly increased risk of schizophrenia also, and that was one of the original pieces of the jigsaw puzzle that led us to wonder maybe vitamin D could be implicated.”

Ian Hickie from the Brain and Mind Research Institute in Sydney says he is not surprised by the results, however he says more research is needed.

“So the real acid test is going to be trying to lift vitamin D levels in pregnant women and newborns and see whether there’s an effect on later schizophrenia,” said Hickie. “Or even in fact, looking at providing higher levels of vitamin D by vitamin D supplementation in other ways later in life and particularly childhood and the teenage years, to see whether you might reduce the risk of onset of schizophrenia.”

Vitamin D supplements may prove an effective way to prevent schizophrenia. But McGrath agrees there is only a statistical link at the moment and that does not prove vitamin D deficiencies are to blame for schizophrenia.

“Because the treatment and the outcome can be separated by about 20, 30 years, we need to treat pregnant women and then wait for their offspring to develop schizophrenia,” he said. “It will be a very challenging study to do.”

It could be decades before scientists know for sure.

“But medical research tends to move at a steady pace. I think the other thing is that there are many other studies suggesting that vitamin D is good for baby’s bone health,” McGrath said.

“So it may well be that recommendations will be made to women to increase their vitamin D status for more obvious outcomes, like baby’s rickets for example. If that happened then it may well be that schizophrenia would start to fall in decades to come.”

But Hickie warns against spending too much time in the sun to get more vitamin D because that could increase the risk of skin cancer.

“Rates of melanoma and skin cancer are obviously very high in our country and directly related to sun exposure, particularly in childhood,” he said.

“So on the one hand we need to be careful about over exposure to sunlight, on the other hand it may well be that in some places, or in some individuals, low levels of vitamin D may constitute a risk factor, particularly in pregnancy and therefore affecting the rates of vitamin D in newborn children.”

“So this is one of the issues that we’re going to need to look at clearly. I don’t think it means that everyone should be rushing out into the sun and necessarily putting themselves at risk of other sun-related cancers.”

Even if vitamin D does make a difference, there are several other factors that may play a part.

A predisposition to the illness can run in families, chemical imbalances in the brain may be responsible and stressful events are often thought to play a role in the onset of the schizophrenia.

This article was originally posted at Discovery.com: http://news.discovery.com/human/vitamin-d-schizophrenia.html#mkcpgn=hknws1