MENTAL HEALTH CRISIS – PART IV – THE TWO ILLNESSES THAT HIT CAREGIVERS THE HARDEST

In this post, we’ll try to address the two areas which are probably the most emotionally disturbing to the victims as well as the caring community; suicides and children.

1.  CHILDHOOD MENTAL ILLNESS

Perhaps no other segment of the mental illness population creates more emotional distress for us than what seems to be a substantial increase in those issues affecting children; eating disorders, ADHD, autism, et al.

Almost 13% of teens in a recent study admitted to a suicide plan, up from 11% just five years ago.  Is childhood mental illness really on the rise or is it being over diagnosed?  The evidence seems to say yes and yes.

Consider the comments of Allen Frances, who chaired the task force for the “Diagnostic and Statistical Manual of Mental Disorders,” the standard for mental diagnostics, by the American Psychiatric Association.  He feels strongly that the increase is a fact explainable through overenthusiastic diagnoses and increased societal pressures.

The definitions have expanded and the pressures on our children have grown immensely; do well in school, go to college, be popular with peers and gain approval of parents.  The bottom line is there are more children dealing with mental health issues than ever before.

Before stimulant drugs such as Ritalin, Concerta andAdderall began their rise to popularity in the 1970s, treatment for attention-deficit hyperactivity disorder (ADHD) focused on behavioral therapy.  As concerns build over the mounting dosages and extended treatment periods that come with stimulant drugs, clinical researchers are revisiting behavioral therapy techniques.  Whereas stimulant medications may help young patients focus and behave in the classroom, research now suggest that behaviorally based changes make more of a difference in the long term.

Other research has examined the role of behavioral interventions not only for school-age children, but also for their parents.  Parents of children with ADHD tend to exhibit more parenting-related stress and difficulties than do those of non-afflicted offspring.  After training parents in stress management and giving them behavioral tools to help their children, psychologist Bill Pelham of Florida International University saw significant improvement in their children’s behavior, such as the frequency of classroom disturbances.

There is a high degree of correlation between ADHD and learning disabilities.  Some kids act out and do not give a full effort because the work is too difficult for them.  Almost 70% of people in jail have an undetected learning disability.

Where Does it Start?

The concept of ghosts in the nursery refers to the relationship between a parent’s early, usually conflicted experiences of the parenting they received during their childhood and their own parenting style.  Grounded in the psychoanalytic tradition, this concept suggests that parents may relate to their own children based on vague representations of the parenting they received during their own childhood.

In other words, a parent’s reaction to her child is often mediated by unresolved issues from her relationship with her own mother.

2.  SUICIDE—THE ULTIMATE MENTAL ILLNESS

More than 90 percent of people who commit suicide have a diagnosable mental disorder—most commonly a depressive disorder or a substance abuse disorder.

Four times as many men than women commit suicide.  However, women attempt suicide two to three times more often than men.

Writing in the N.Y. Times, David Brooks addressed this problem, saying:

“Between 1999 and 2010, the suicide rate among Americans between 35 and 64 rose by 28 percent.  More people die by suicide than by auto accidents.

When you get inside the numbers, all sorts of correlations pop out.  Whites are more likely to commit suicide than African-Americans or Hispanics.  Economically stressed and socially isolated people are more likely to commit suicide than those who are not.  People in the western American states are more likely to kill themselves than people in the eastern ones.

Some people commit suicide because their sense of their own identity has dissolved.  Some people do it because they hate themselves.  Some feel unable to ever participate in the world.

In her eloquent book “Stay:  A History of Suicide and the Philosophies Against It,” Jennifer Michael Hecht presents two big ideas that she hopes people contemplating potential suicides will keep in their heads.  Her first is, “Suicide is delayed homicide.”  Suicides happen in clusters, with one person’s suicide influencing others.  If a parent commits suicide, his or her children are three times more likely to do so at some point in their lives.  In the month after Marilyn Monroe’s overdose, there was a 12 percent increase in suicides across America.

Her second idea is that you owe it to your future self to live.  A 1978 study tracked down 515 people who were stopped from jumping off the Golden Gate Bridge.  Decades later, Hecht writes, “94 percent of those who had tried to commit suicide on the bridge were still alive or had died of natural causes.”

“The causes of suicide are complex, and are often a result of anguish driven by mental illness.  Suicide is a tragedy and one that the caring community is working to prevent by funding research on the brain, partnering to design effective interventions, and supporting those who have suffered a loss.”

Susan Bacon, who worked on skid row for many years, said, “I could not believe the number of elementary school kids who were suicidal.  Many felt they were a financial burden; and if they died, it would help the family cut expenses.  So sad”!

What are the most common warning signs?

A warning sign does not automatically mean a person is going to attempt suicide, but it should be taken seriously.  The warning signs that we pay particular attention to are:  a prior suicide attempt, talking about suicide and making a plan, giving away prized possessions, preoccupation with death, signs of depression, hopelessness and anxiety, increased drug and alcohol use.

If someone suspects that a friend or family member is considering suicide, what should they do?

There are three very important things to do if you notice the warning signs for suicide.  The first thing is to always show the person that you are concerned about them—listen without judgment, ask about their feelings and avoid trying to come up with a solution to their problem.  Next, ask directly about suicide—be direct without being confrontational; say, “are you feeling so bad that you are thinking about suicide?”  Finally, if the answer to your question is “yes” or you think it is yes, go get help—call a crisis line, visit the school counselor, tell a parent or refer the teen to someone with professional skills to provide help.  Never keep talk of suicide a secret!

In our next blog on mental illness in October, we’ll attempt to outline where we are today and what has happened to the mental illness care system.

ArtSchwartzSig

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