Leave a comment

James Donaldson on Mental Health – We Must Fight Mental Illness Stigma

James Donaldson notes:

Welcome to the “next chapter” of my life… being a voice and an advocate for mental health awareness and suicide prevention, especially pertaining to our younger generation of students and student-athletes.

Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.

Having gone through a recent bout of depression and suicidal thoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.  http://bit.ly/JamesMentalHealthArticle

 

 

Jennifer Lawrence, while accepting her Oscar award in 2013, said: “It’s so bizarre how, in this world, if you have asthma, you take asthma medicine. If you have diabetes, you take diabetes medicine.

“But, as soon as you have to take medication for your mind, there’s such a stigma behind it.”

This begs the question: What happens when we ignore or stigmatize mental health issues?

What happens when our attitude towards mental illness is so negative and access for treatment is so scarce it forces those suffering from mental illness to be isolated and too afraid to seek help? And ultimately, how does this affect the lives and upbringing of Idaho’s children and adolescents who struggle with mental illness?

The results of this stigma, including a lack of access to behavioral health care across the state, are disastrous. In Idaho, we have the 5th highest suicide rate in the nation, and suicide is the second cause of death for children and adolescent youth. Every year, we lose on average 26 children age 10 to 18 by suicide, and 90% of those who died by suicide had an underlying mental illness. As alarming as these statistics are, we still struggle as a community to effectively discuss mental illness.

Research from psychiatrists and psychologists points to the need to change our outlook on mental health. Just as we would sympathize with any Idahoan who has cancer or HIV/AIDS, we should also express the same empathy toward someone with a mental illness.

Like any other illness, with treatment and social supports, people with mental illness can live healthy and productive lives. Children with mental illness can reach their full potential, succeed in school, thrive in everyday social environments and become productive citizens. However, positive outcomes are harder to achieve if our youth feel hopeless or like they don’t belong because of their mental illness.

Changing the conversation involves more than switching our mindset. It also encompasses investing in our youth by increasing access to mental health care.

The implementation of Idaho’s Youth Empowerment Services was a crucial step in the process. YES offers start-to-finish resources for Idaho families, from helping find access to providers and then developing unique treatment plans for their mental health conditions. However, there is still more that needs to be done, particularly to increase access to mental health services for children in rural areas.

By creating conversation around mental health, it will double the compassion we are able to show individuals struggling with their own issues. We must change our society’s mindset, and we also must be willing to invest in mental health services for those in need.

Once we can talk about mental health in any form and in any place without shame – from our homes, to our schools, and to our workspaces – only then can we as a society truly begin to work towards a world where those struggling with mental health have a clear path ahead of them towards recovery.

Anselme Sadiki is the executive director of the Children’s Home Society of Idaho.

Good Health is Mental Health

Leave a comment

This was a great show that aired a coupl

This was a great show that aired a couple of days ago on on PBS Newshour.

Students talk about it and discuss… and then keep a watchful eye over each other.

http://ow.ly/vzOw30mDtU5

Leave a comment

This was a great show that aired a coupl

This was a great show that aired a couple of days ago on on PBS Newshour.

Students talk about it and discuss… and then keep a watchful eye over each other.

http://ow.ly/vzOw30mDtU5

Leave a comment

James Donaldson on Mental Health – There are Serious Problems in our Medical Industry With an Alarming Number of Doctors taking their Own Lives… THEY get Paid Bucketloads of Money – But a Dark Trend is Affecting This Profession, Leading to Record Numbers of Suicides.

James Donaldson notes:

 

Welcome to the “next chapter” of my life… being a voice and an advocate for mental health awareness and suicide prevention, especially pertaining to our younger generation of students and student-athletes.

Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.

Having gone through a recent bout of depression and suicidal thoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.  http://bit.ly/JamesMentalHealthArticle 

Doctors and Suicide

 

ON A seemingly ordinary Thursday morning last May, respected Brisbane gastroenterologist Andrew Bryant went to work but never came home.

Shortly after arriving at his practice, the 54-year-old ended his life. He didn’t write a note, leaving his wife Susan and their four children to wonder what had gone so horribly wrong.

But the reality is that Dr. Bryant’s story is tragically common in Australia, with staggering rates of suicide in a vocation that’s devoted to health and wellbeing.

“I’ve learned that the medical profession is one of the worst industries statistically in terms of mental health outcomes,” Dr. Bryant’s son John, 26, told news.com.au

“Considering it’s a caring profession, it seems that far too many don’t care for themselves, which is surprising and alarming.”

Dr Andrew Bryant took his life in May last year, part of a serious problem in the medical profession. Picture: Supplied

Dr. Andrew Bryant took his life in May last year, part of a serious problem in the medical profession. Picture: SuppliedSource: News Corp Australia

Data shows that medical professionals are more likely to die by suicide than the general population — female doctors 2.2 times more, male doctors 1.4 times.

Young doctors at significant risk, with 20 per cent of trainees experiencing suicidal thoughts.

A cluster of suicides among doctors over the past two years sent shockwaves through the profession and prompted an urgent response from the Australian Medical Association.

Reliable, recent figures are difficult to come by but the most indicative data shows that there were 369 suicides by health professionals between 2001 and 2012.

Today, a senior doctor who has lost three colleagues, published a powerful piece in the Medical Journal of Australia demanding widespread systemic change.

“In recent Australian surveys, one in five students reported suicidal ideation in the preceding 12 months, while 50 percent of junior doctors experienced moderate to high levels of distress,” Ann McCormack, an endocrinology specialist at St Vincent’s Hospital Sydney, wrote.

“What seems clear to me is that inherent traits in the individuals who choose a career in medicine, and often create excellent doctors, also set them up for high rates of distress.”

What’s happening to put our doctors in such precarious positions and what’s being done?

OUT OF THE BLUE

John’s beloved father, who exemplified the image of a community-minded family man, was the last person he expected to be at risk of suicide.

“My dad was a very energetic person and a lot of fun to be around,” the Brisbane paralegal recalled.

“He was quite generous with his time and involved in lots of different things, volunteering quite often. He was a good person. He was happy.

“As well as a gastroenterologist, he was an Air Force reservist. He loved to cycle on the weekends as a hobby and go sailing. He kept very busy.”

Throughout October and November, news.com.au has been highlighting the issue of men’s mental health with the campaign The Silent Killer: Let’s Make Some Noise in support of Gotcha4Life and Movember.

Gotcha4Life is dedicated to an in-school program helping educate young men about resilience and the importance of friendships and runs a scholarship program with Lifeline to train more males counselors.

John Bryant, pictured with his late father Andrew, said his dad was the last person to be at risk of suicide.

John Bryant, pictured with his late father Andrew, said his dad was the last person to be at risk of suicide. Source: Facebook

 

In the days following his death, Andrew’s grief-stricken wife Susan wrote a heartfelt email to her law firm colleagues to explain what had happened.

“I don’t want it to be a secret that Andrew committed suicide,” she said, encouraging recipients to share her words.

They did and the message quickly went viral on social media, adding to calls for more resources dedicated to reversing suicide rates among medical professionals.

“He hadn’t been sleeping well since late February, but he was never a great sleeper,” she said. “He was very busy with work, but he had always been busy. In retrospect, the signs were all there. But I didn’t see it coming.

“He was a doctor; he was surrounded by health professionals every day; both his parents were psychiatrists, two of his brothers are doctors, his sister is a psychiatric nurse — and none of them saw it coming either,”

John said his dad seemed a bit flat in the weeks before he died. Work was busy and he was more stressed than normal, but there was nothing significant to raise a red flag.

“In retrospect, there were signs that he was struggling but at the time it wasn’t enough to make us concerned. We thought he seemed a bit flat but not that he was at risk of suicide.”

Young trainee Sydney doctor Chloe Abbott took her life in January 2017, just months after cracks began to appear and her concerned family begged her to quit medicine.

Like so many others beginning their careers, she was juggling a 60-hour work week at a hospital with a 30-hour study load on top. It left no downtime to see her loved ones.

Chloe Abbott was lost in January 2017 to suicide due to the pressure of being a junior doctor.

Chloe Abbott was lost in January 2017 to suicide due to the pressure of being a junior doctor. Source: Supplied

That’s not an anomaly. Data shows doctors aged 30 and under work the longest hours of any age group and industry in Australia.

That cohort also scores highest on the three measures of burnout risk in medicine — emotional exhaustion, high cynicism, and low professional efficacy.

Her colleagues thought she “had it all”, her mother Leonie said, and Chloe’s death “rocked them to their core and it shattered their beliefs”.

“They would be thinking if Chloe couldn’t do it, how can I do it?” Leonie said. “If Chloe couldn’t manage this life as a doctor, how on earth can I do it? Then they would look at themselves as far less resilient and capable than Chloe.”

Leonie Eagles with daughters Jessica and Micaela Abbott, who have taken on advocacy for mental health in medicine since the death of Chloe. Picture: Tim Hunter.

Leonie Eagles with daughters Jessica and Micaela Abbott, who has taken on advocacy for mental health in medicine since the death of Chloe. Picture: Tim Hunter.Source: News Corp Australia

 

Her family has become lobbyists for a transformation of the “toxic” culture of medicine, which saw them receive a Pride of Australia medal for their work.

Dr. McCormack said she felt compelled to write about the still-taboo issue of doctors who suicide after a spate of personal experiences.

“Over a matter of months, two female junior doctors committed suicide at our hospital, and more recently, suicide entered my inner circle with the death of one my close male colleagues,” she said.

“Such stories are not unusual in our profession.”

OUR UNWELL DOCTORS

Dr. Bryant had never shown any signs of depression, anxiety or any other mental illnesses.

But around Easter last year, he seemed to be increasingly anxious about work. He was behind on administrative tasks, he began to doubt his abilities and his spirit appeared crushed.

“I did what I could to help where I could, but I was confused,” Susan said.

“He’d always been busy and the practice, as far as I could tell, was running just as it had for the last 20 years.”

A week later, he was on call for Brisbane’s public hospitals in what turned out to be “one of the worst on-call weeks he had ever had”, she said.

Dr Andrew Bryant with his daughter Charlotte and wife Susan.

Dr. Andrew Bryant with his daughter Charlotte and wife Susan.Source: News Corp Australia

 

John Bryant has turned his attention to fundraising and raising awareness of mental health

John Bryant has turned his attention to fundraising and raising awareness of mental healthSource: Facebook

By the end of it, he was exhausted but still unable to sleep. The following Tuesday, he was distraught after the death of a patient.

“Andrew was always upset when any of his patients died, but his level of distress, in this case, was unusual,” Susan said.

Almost two years on, she has come face-to-face with the enormous internal and external expectations faced by doctors, and the alarming consequences it can lead to.

Before she died, Chloe wrote about the pressures she and her colleagues were feeling and implored the industry to change from within.

“As competition for places has intensified, academic research experience has become an increasingly significant point of difference for trainees, but this is yet to be reflected in many pathways currently available in Australia,” she wrote.

“Instead, trainees are burdened with meeting their clinical training requirements while simultaneously attempting to pursue academic research, often leaving them in difficult financial circumstances — the remuneration of these endeavors is significantly less than a full-time medical trainee income.”

Doctors are more likely to die by suicide than the general population, with women and trainee doctors at most risk. Picture: iStock

Doctors are more likely to die by suicide than the general population, with women and trainee doctors at most risk. Picture: iStockSource: Supplied

 

Perfectionism is rife among doctors, Dr. McCormack wrote, which can contribute to success as well as a mental health downfall.

“Among the medical workforce, work-life balance is poorly practiced and modeled,” Dr. McCormack wrote.

“In fact, there is a subtle undertone rampant within the medical fraternity, in which late-night emails, missing a child’s school concert, publishing multiple articles a year, and not taking annual leave to become unvoiced indicators of a truly committed doctor.”

In addition to extraordinary pressure, numerous reviews and investigations have revealed a disturbing underbelly in medicine.

A 2016 survey in Victoria found 25 percent of health staff had experienced workplace bullying, while a similar probe in 2014 found 40 percent of nurses had been harassed in the previous 12 months.

In 2015, the Royal Australasian College of Surgeons found that 49 percent of respondents had been subjected to discrimination, bullying, harassment or sexual harassment.

And last year the Australasian College for Emergency Medicine released the results of a member survey that found 34 percent of respondents had experienced bullying, 21.7 percent discrimination, 16.1 percent harassment, and 6.2 percent sexual harassment.

Chloe Abbott’s mother Leonie Eagles has become an advocate for the issue of doctors who suicide. Picture: Justin Lloyd

Chloe Abbott’s mother Leonie Eagles has become an advocate for the issue of doctors who suicide. Picture: Justin LloydSource: Supplied

 

Johanna Westbrook from the Australian Institute of Health Innovation at Macquarie University said the alarming trends posed a risk to both doctor and patient safety.

A Senate Inquiry conducted in 2016 into the medical complaints process in Australia recommended that governments, hospitals, colleges, and universities commit to eliminating bullying and harassment.

But Professor Westbrook said it “provided little direction as to how this should occur”.

Adding to the problem is a finding by Beyond Blue that 58 percent of doctors feel embarrassed when seeking treatment for mental health issues.

 

Abbott family win Pride of Australia award for mental health campaigning

A serious stigma is prevalent in medicine, particularly when it comes to conditions like depression and anxiety. According to Beyond Blue, 47 percent of doctors admitted they were less likely to employ someone who has a history of mental illness.

And 44 percent of doctors felt depression or anxiety were signs of weakness.

“If doctors do not deal with the mental health issues they are experiencing, it can affect their ability to deliver the best care,” the organization’s boss Kate Carnell said.

TRAINEE DOCTOR CRISIS

Following the spate of deaths in recent years, Australian Medical Students Association president Robert Thomas said greater support is needed.

“Students put in a lot of effort and a lot of emotional baggage comes with medical studies, especially when you’re not making any money,” Dr. Thomas said.

“The struggle is hard these days, not only for an internship but getting on to a training pathway. I think that really adds to students’ stresses and workloads because everyone’s trying to get that Ph.D. or do that extra research project to stand out from the growing crowd.”

John Bryant has turned his efforts to fundraising for Beyond Blue after his father and respected gastroenterologist Dr Andrew Bryant took his own life. Picture: Tara Croser.

John Bryant has turned his efforts to fundraising for Beyond Blue after his father and respected gastroenterologist Dr. Andrew Bryant took his own life. Picture: Tara Croser.Source: News Corp Australia

The Beyond Blue research found 43 percent of medical students had a high likelihood of experiencing a minor psychiatric disorder. By comparison, the risk of high psychological distress in the general population is 2.6 percent.

Chloe’s relatives want to see safe working hours, breaks, more adequate compensation and a serious focus on cultural change.

“That work falls to other colleagues that are already under immense stress … you’re seen as that person who’s letting the team down,” her sister Micaela said.

WE NEED TO DO MORE

Since his father’s death, John has thrown himself into initiatives that raise funds for and awareness of mental health.

Last year, he and his brother Nick took part in the Noosa triathlon and together raised $28,000 for Beyond Blue.

John signed up again this year and has so far raised more than $8000 for the charity. He is also an ambassador for Bicycle Queensland, acting as a mental health ambassador.

“It has been completely devastating. This isn’t something we’ll ever really get over. You become better at dealing with it, I think, but it’s still very difficult. It doesn’t go away.

“I’m trying to make some positives out of a really bad experience. Hopefully, we can learn from what happened and help some other people.”

Doctors are unwilling to seek help if they’re struggling with mental health issues, research has found.

Doctors are unwilling to seek help if they’re struggling with mental health issues, research has found. Source: Supplied

 

In her piece, Dr. McCormack said a raft of system-wide changes were needed, including senior doctors investing in the improvement of their physical and mental health to set an example for juniors.

“Doctors need to learn how to be kinder to themselves and extend compassion towards the struggles of both junior and senior colleagues,” she said.

“Medical students should be selected not just on academic performance, but increasingly sophisticated aptitude testing should be used.”

A greater monitoring of the mental health of medical students should be prioritized, she said, and broader wellbeing programs for professionals at all levels should be mandatory.

“Helping doctors build resilience may be protective against burnout and suicide in times of personal hardship,” she said.

If you or someone you know needs help, please contact Lifeline on 13 11 14 or visitlifeline.org.au.

Find out more about the work of Gotcha4Life by visiting gotcha4life.org.

National Suicide Prevention Lifeline

Leave a comment

James Donaldson on Mental Health – What Are the Symptoms of Depression in Teenagers? Signs Your Child Might be More Than Moody

James Donaldson notes:

Welcome to the “next chapter” of my life… being a voice and an advocate for mental health awareness and suicide prevention, especially pertaining to our younger generation of students and student-athletes.

Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.

Having gone through a recent bout of depression and suicidal thoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.  http://bit.ly/JamesMentalHealthArticle 

Since adolescents are often moody, it can be difficult to recognize when your son or daughter has become depressed and might need help. The thing people tend to notice first is withdrawal, or when the teenager stops doing things she usually likes to do. There might be other changes in her mood, including sadness or irritability. Or in her behavior, including, appetite, energy level, sleep patterns, and academic performance. If several of these symptoms are present, be vigilant about the possibility of teen depression.

This is especially important because, by the time family members and other people around a teenager note her lack of interest in most things, or what we call anhedonia, she’s usually been depressed for some time. Depression is an internalizing disorder, i.e. one that disturbs a patient’s emotional life, rather than an externalizing one, which takes the form of disruptive or problematic behavior. As such, it takes a while not only for others to recognize it but often for the patient herself to realize that her thinking, and emotional responses, are disturbed.

Note that there are actually two kinds of depression. In major depressive disorder—the most familiar form of depression—the symptoms occur in what may be severe episodes that tend to last from seven to nine months. But there is also another form of depression called dysthymia, in which the symptoms are milder, but they last longer, even years. So while the experience of dysthymia may be less debilitating for the child at any given moment, the risk is that there is more accrued damage, more time in which the child is kept out of the healthy development process.

When a teenager is depressed, his suffering isn’t the only reason it’s important to get help. In addition to the disorder itself, there are add-on effects that may cause lifelong issues. With depression symptoms come to include low energy and poor concentration, two factors that are likely to have a significant impact on social and academic functioning.

It’s easy to see the effects of poor academic functioning: falling behind in school undermines a child’s confidence and self-image, and can impact his future if it’s prolonged. But social learning is just as critical as academic learning in adolescence. Deficits in social skills not only put depressed teens behind their peers but in themselves can compound their depression.

Related: Supporting the Emotional Needs of Kids With Learning Disabilities

Depression plus anxiety

It’s important to understand that a teenager who is depressed may also develop anxiety, and may need to be treated for two separate disorders. It may be that depression leads to anxiety—the negative state of mind of a depressed teenager lends itself to uncertainty. If you’re not feeling good about yourself, or confident, or secure, or safe, anxiety may find fertile ground. It may also be because the regions of the brain affected by anxiety and depression are close together, and mutually affected.

Two serious problems that are directly associated with teenage depression and anxiety are suicidal thinking (or behavior), and substance abuse. Suicide is the third leading cause of death among adolescents and young adults aged 15 to 24, and we know that most kids who commit suicide have been suffering from a psychiatric illness. Especially at risk are teenagers who hide their depression and anxiety from parents and friends. That’s why it’s important to be alert to signs of these disorders—withdrawal, changes in school performance, eating habits, sleeping patterns, things they enjoy doing—even when teenagers aren’t forthcoming about how they feel.

Similarly, the majority of teenagers who develop substance abuse problems also have a psychiatric disorder, including, most commonly, anxiety or depression, which is another important reason to get treatment in a timely way.

Related: What to Do if You’re Worried About Suicide

Treatments for depression

Fortunately, early involvement of health care professionals can shorten the period of illness and decrease the likelihood of missing important life lessons.

The most common treatment a mental health professional is apt to use is some form of cognitive behavioral therapy, and depending on how young the child is, it may involve teaching the parents as well. Cognitive behavioral therapy is based on the idea that a person suffering from a mood disorder is trapped in a negative pattern of thought. Depressed kids tend to evaluate themselves negatively, interpret the actions of others in a negative way, and assume the darkest possible outcome of events. In CBT, we teach sufferers to challenge those negative thoughts, to recognize the pattern and train themselves to think outside it. And in many cases, we see real improvement.

If the depression is moderate to severe, treatment may involve medications such as antidepressants. A combination of psychotherapy and medication usually works better than either alone.

National Suicide Prevention Lifeline

Leave a comment

James Donaldson on Mental Health – Mental Health Disorders and Teen Substance Use Why it’sEspecially Tempting — and risky — for Kids with Emotional or Behavioral Challenges

James Donaldson notes:

Welcome to the “next chapter” of my life… being a voice and an advocate for mental health awareness and suicide prevention, especially pertaining to our younger generation of students and student-athletes.

Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.

Having gone through a recent bout of depression and suicidal thoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.  http://bit.ly/JamesMentalHealthArticle  

School Shootings Suicide

by Caroline Miller

 

When teenagers are struggling with emotional problems, they often turn to alcohol or drug use to help them manage painful or difficult feelings. In this, they are not different from adults. But because adolescent brains are still developing, the results of teenage “self-medication” can be more immediately problematic.

In the short term, substance use can help alleviate unwanted mental health symptoms like hopelessness, anxiety, irritability, and negative thoughts. But in the longer term, it exacerbates them and often ends in abuse or dependence. Substance use escalates from experimentation to a serious disorder much faster in adolescents than it does in adults, and that progression is more likely to happen in kids with mental health disorders than in other kids.

“The rule of thumb is that almost half of the kids with mental health disorders if they’re not treated, will end up having a substance use disorder,” explains Sarper Taskiran, MD, a child, and adolescent psychiatrist at the Child Mind Institute.  A 2016 study of 10,000 adolescents found that two-thirds of those who developed alcohol or substance use disorders had experienced at least one mental health disorder.

Substance use also interferes with treatment for mental health disorders and worsens the long-term prognosis for a teenager struggling with one. How can we help these young people avoid the substance use trap when the deck seems to be stacked against them?

Why are kids with mental health disorders prone to substance use?

Kids who are anxious or depressed may feel more emotionally “even” if they drink or smoke marijuana. For socially anxious kids, it can quiet the anxiety enough to allow them to function in peer groups. And since their friends do it, it’s not stigmatized the way taking medication is.

“Pre-gaming is a lot about anxiety,” notes Jeannette Friedman, MSW, who works with families of adolescents with substance use problems. “The kids are saying ‘Let’s go have some fun before we go to the real party.’ But in fact, most of them feel like they need it to calm down enough so they can walk into a group where they’re going to feel exposed and criticized.”

A teen with anxiety might start by smoking marijuana to calm down before social events, and soon find himself smoking every morning just to get to school. “I’ve had very stressed-out kids say, ‘I get high before I go to school because I’m so anxious when I think about the start of the school day,’ says Ms. Friedman. “‘If I smoke a little weed, I don’t feel so anxious.’”

Kids who are depressed may use alcohol or marijuana to cheer themselves up, Dr. Taskiran notes, and blunt the irritability that is a symptom of adolescent depression. “They know there’s something wrong with them,” he says. “They’re not taking pleasure in things, they’re not feeling happy. So if their peers are offering a drug that makes you happy, that’s often the first thing they turn to.” Substance use can quiet negative thoughts that plague depressed kids.

It’s also common for children with mental health or learning disorders to develop self-esteem problems, a sense that there’s something wrong with them or that they’re flawed. When these children reach adolescence, with its focus on fitting in, notes Ms. Friedman, “they really want to be normal and they don’t feel normal. And that means they’re more vulnerable to somebody passing around a drug because they’re just trying to feel better.”

Why is alcohol use riskier for teenagers?

Alcohol affects teens differently from adults. While adults tend to get more subdued and slowed down by alcohol, in adolescents it’s the opposite. They tend to become more energetic, engage in more risky behavior and get more aggressive.

Dr. Taskiran uses the example of driving.  “When adults drink and drive you to worry about slowing of the reflexes and lapses in attention, like missing a stop sign,” he explains. “But with adolescents, we’re worried that they’re going to get more activated. It’s not that they won’t see the red light, but they might try to run it.”

This is especially dangerous for kids with ADHD, who are already impulsive. And substance use makes depressed teenagers more prone to impulsive suicidal behavior.  “The adolescent will still be depressed,” says Dr. Taskiran, “but the things that usually hold him back won’t be there while he’s intoxicated, like love for family or the belief that he’s going to get better.”

Why teenagers get addicted sooner

Adolescent alcohol or drug use accelerates very quickly when an untreated mental health disorder is present. ”Within months we can see problematic use,” says Dr. Taskiran.

Why are they different than adults? In the adolescent brain, pathways between regions are still developing. This is why teens learn new things quickly. This “plasticity” means the brain easily habituates to drugs and alcohol. “If you start drinking at 30, you don’t get addicted nearly as fast as if you start drinking at 15,” adds Ms. Friedman.

Alcohol and drugs also affect the same brain regions that are at play in behavior disorders like ADHD and ODD, says Dr. Taskiran. Teenagers who have those disorders get more satisfaction from the substance — and are more likely to become addicted. “Biologically they get more from the drug,” he adds, “so that’s why they get more hooked on it.”

It’s important to know that substance use can have disrupted a young person’s life even if he is not technically dependent on the drug. This is especially true for youth with mental health disorders. “You might not see withdrawal, you might not see the craving, which are the hallmark symptoms for dependence,” says Dr. Taskiran. “But the impact in his social life and academic life, or in terms of his mental wellbeing, might still be large.”

Why substance use makes depression and anxiety worse

“Self-medicating” with recreational drugs and alcohol works temporarily to alleviate symptoms of anxiety or depression because they affect the same brain regions that the disorders do. But the result is that teens feel even worse when not using.  That’s one reason substance use is a risk factor for suicide in kids with depression, Dr. Taskiran notes.

 Another negative effect of substance use is that it undermines treatment. First, it diminishes a teenager’s engagement in therapy, and hence its effectiveness. Second, if she is taking prescription medication, it may lower the effectiveness of that medication. “The drugs and the medications target the same areas of the brain,” explains Dr. Taskiran. When meds have to compete with drugs or alcohol, they are less effective. “Also, it’s not uncommon with kids who are using substances to be noncompliant with their meds.”

Psychosis and substance use

Michael Birnbaum, MD, is a psychiatrist who heads an early treatment program for young people who have had a first psychotic episode, usually signaling the onset of schizophrenia. Dr. Birnbaum estimates that at least 50 percent of his patients have at least some history of drug and alcohol use. Getting a handle on substance use is important for the recovery process, he says. “Folks who are still using are more likely to struggle with ongoing psychotic symptoms, and also are more likely to have a relapse.”

Most of the people who come to the early treatment program have just come from a hospitalization, he notes,  and they are eager to make sure that doesn’t happen again. “So part of the discussion is how do we prevent a relapse?” he continues. At Dr. Birnbaum’s program, clinicians work to understand what substance use was doing for the patient. “It may seem obvious to us,” he says. “’Okay, you need to stop using now.’ But there may be other reasons for continued use that, to the patient, outweigh the risks.”

Dr. Taskiran echoes that approach. “The last thing I’d say from the get-go to one of my patients is, ‘Marijuana is bad for you,’ because the kid has heard that from teachers, parents, TV, everywhere. So instead what I say is, ‘What is it doing for you? What are you getting out of it?’”

All behavior serves a purpose, even if it’s self-injurious or risky behavior. “If you’re trying to take something away from a teenager, you need to replace it with something,” says Dr. Taskiran. “So instead of just saying, ‘Don’t do that, it’s bad for you,’ we’re trying to replace the need for substance with a coping strategy, with tools for coping without the substances.”

Peer Support

Leave a comment

James Donaldson on Mental Health – Tips for Communicating With Your Teen Keeping the Parent-Child Relationship Strong During a Tricky Age

James Donaldson notes:

Welcome to the “next chapter” of my life… being a voice and an advocate for mental health awareness and suicide prevention, especially pertaining to our younger generation of students and student-athletes.

Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.

Having gone through a recent bout of depression and suicidal thoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.  http://bit.ly/JamesMentalHealthArticle 

Teen Photos

by Rachel Ehmke

 

The teenage years have a lot in common with the terrible twos. During both stages, our kids are doing exciting new things, but they’re also pushing boundaries (and buttons) and throwing tantrums. The major developmental task facing both age groups is also the same: kids must pull away from parents and begin to assert their own independence. No wonder they sometimes act as if they think they’re the center of the universe.

This makes for complicated parenting, especially because teens are beginning to make decisions about things that have real consequence, like school and friends and driving, not to speak of substance use and sex. But they aren’t good at regulating their emotions yet, so teens are prone to taking risks and making impulsive decisions.

This means that having a healthy and trusting parent-child relationship during the teenage years is more important than ever. Staying close isn’t easy, though. Teens often aren’t very gracious when they are rejecting what they perceive to be parental interference. While they’re an open book to their friends, who they talk to constantly via text messages and social media, they might become mute when asked by mom how their day went. A request that seemed reasonable to dad may be received as a grievous outrage.

If this sounds familiar, take a deep breath and remind yourself that your child is going through his terrible teens. It is a phase that will pass, and your job as a parent is still vitally important, only the role may have changed slightly. Here are some tips for navigating the new terrain:

1. Listen. If you are curious about what’s going on in your teen’s life, asking direct questions might not be as effective as simply sitting back and listening. Kids are more likely to be open with their parents if they don’t feel pressured to share information. Remember even an offhand comment about something that happened during the day is her way of reaching out, and you’re likely to hear more if you stay open and interested — but not prying.

2. Validate their feelings. It is often our tendency to try to solve problems for our kids or downplay their disappointments. But saying something like “She wasn’t right for you anyway” after a romantic disappointment can feel dismissive. Instead, show kids that you understand and empathize by reflecting the comment back: “Wow, that does sound difficult.”

3. Show trust. Teens want to be taken seriously, especially by their parents. Look for ways to show that you trust your teen. Asking him for a favor shows that you rely on him. Volunteering a privilege shows that you think he can handle it. Letting your kid know you have faith in him will boost his confidence and make him more likely to rise to the occasion.

4. Don’t be a dictator. You still get to set the rules, but be ready to explain them. While pushing the boundaries is natural for teenagers, hearing your thoughtful explanation about why parties on school nights aren’t allowed will make the rule seem more reasonable.

5. Give praise. Parents tend to praise children more when they are younger, but adolescents need the self-esteem boost just as much. Teenagers might act like they’re too cool to care about what their parents think, but the truth is they still want your approval. Also looking for opportunities to be positive and encouraging is good for the relationship, especially when it is feeling strained.

6. Control your emotions. It’s easy for your temper to flare when your teen is being rude, but don’t respond in kind. Remember that you’re the adult and he is less able to control his emotions or think logically when he’s upset. Count to ten or take some deep breaths before responding. If you’re both too upset to talk, hit pause until you’ve had a chance to calm down.

7. Do things together. Talking isn’t the only way to communicate, and during these years it’s great if you can spend time doing things you both enjoy, whether it’s cooking or hiking or going to the movies, without talking about anything personal. It’s important for kids to know that they can be in proximity to you, and share positive experiences, without having to worry that you will pop intrusive questions or call them on the carpet for something.

8. Share regular meals. Sitting down to eat a meal together as a family is another great way to stay close. Dinner conversations give every member of the family a chance to check in and talk casually about sports or television or politics. Kids who feel comfortable talking to parents about everyday things are likely to be more open when harder things come up, too. One rule: no phones allowed.

9. Be observant. It’s normal for kids to go through some changes as they mature, but pay attention if you notice changes to her mood, behavior, energy level, or appetite. Likewise, take note if he stops wanting to do things that used to make him happy, or if you notice him isolating himself. If you see a change in your teen’s daily ability to function, ask her about it and be supportive (without being judgmental). She may need your help and it could be a sign she needs to talk to a mental health professional.

Alarming Statistics on Mental Illness